5 Physio tips for getting it sorted [PLUS FREE E-BOOK]

Up to 80% of adults will experience lower back pain at some point in their lives and it is the greatest contributor to disability globally (increasing by 18% between 2005-2015). It’s a big deal.

Although back pain can seem scary, there is comfort in knowing it is very well understood these days. Almost all back pain is easily diagnosed, treated and there are easy ways to prevent yourself from hurting your back in the future.

Kia ora, hello, my name is Bart de Vries and I am the Physiotherapist and founder behind Limber. At Limber we are on a mission to halve global disability from back pain by 2050 through connecting health sciences with good design and it was my back pain (from age 12) that inspired me to both become a Physiotherapist and found Limber.

Since the onset of COVID, Limber has been inundated with questions on how to set up the home office and trouble-shoot back pain. So let’s learn how to tweak your office setup so you don’t tweak your back.

This blog gives a basic outline of 5 physio steps to setup your office so you don’t get back pain. Step 5 being the “one stretch” that has been shown to dramatically reduce your chances of getting back pain, and reduce the likelihood to 0 in some cases you will need to see a doctor or take time off work for your next back pain episode.

So, what are the 5 steps? 

#1 Understand why you’re getting back pain

We have evolved in the direction of least effort. “If resting and inactivity reduce effort (metabolic energy cost), often considered a key target of natural selection, why is inactivity so bad for us?” asked a researcher at Yale. The current answer, it is the way we rest, rather than the amount we rest, that is the problem.

A mini-demonstration: Giving back pain the finger

Stretch your pointer finger back as far as it will go, then let it go. You’ll notice it can go quite a way and at the end of the stretch it is tight and starts to get sore. But as soon as you let go and it comes back to the relaxed middle point the discomfort goes away pretty quickly. 

Give back pain the finger

Now, bend your finger back as far as you can and keep it there for two minutes. Keep the pressure on. Notice how the side of your finger that is stretching (the underside) becomes whiter as the blood flow disappears because all the tissues are being stretched and squeezing the blood flow out. Notice as you keep it there the discomfort turns to pain and it becomes more painful the longer you keep it there. Then finally, notice when you let go how the pain lingers for some time afterwards.

This is because, like your back, your fingers can move quite a long way, and they should. But they are not made to stay in the end ranges for long periods of time. When we stay there our nerve endings that sense danger start to fire and signals to our brain that there is something to potentially be concerned about here. Our brain then produces the pain as a response to protect us, saying, “Hey, I don’t think this is a great idea. Can you please stop this - it could cause us some problems.” 

Naturally in the case of the finger, we stop, bend our finger in the opposite direction a few times and it starts to return to normal quickly. With our back, we never really get to stop. Everything in our current society points us to being seated and we don’t get to bend our back in the other direction to help us recover. So, our tissues start to get overloaded, our muscles and ligaments adapt to this seated position, and over time we lose flexibility, strength and stability of our lower back. 

This is when “all of a sudden” your back “goes” from doing something simple like tying your shoelace, making the bed, bending over to pick up a piece of paper. The activity you were doing that you feel triggered your back pain was in fact “the straw that broke the camel's back” in the majority of cases. Most of the damage had already been done well before you noticed your first episode of back pain. Tying your shoelace was just the last straw that pushed your tissues too far. Extended time spent sitting in a traditional chair sets your body up for failure. 

Our backs love movement and have the capacity to absorb huge amounts of load when in a neutral position. When we sit, our backs are forced into a weak and loaded flexion position which is okay for short periods of time. But, in today's world we don’t sit for short periods of time. We sit a lot. Over time, this sets our lower back up to become tight, weak and unstable. 

And it has been researched, people who get back pain spend more time in bent forward/flexed postures than people who don’t get back pain.

#2 Set yourself up to move, a lot.

The low hack.

The low hack.

The best posture is the next posture. Setting yourself up to move is setting yourself up for success.

The easiest way to set your work environment up so you move a lot more throughout the day is all about ‘getting high and going low’ - have a high working position and a low working position. What does this mean? 

Well, a high working position is a standing position, where you work standing up. A low position is where you work from a variation of postures based on the floor, the most movement-rich environment we have. This is the one time in life where we need to take both the high road and the low road, but avoid the middle road.

This is the low setup on a Limber Desk, supported by the Limber Stool to make floor positions more comfortable.

This is the low setup on a Limber Desk, supported by the Limber Stool to make floor positions more comfortable.

*We go into “active resting postures” and show you how the high and low positions can look, and how to go about creating them in more detail in the free ebook which you can download below.

#3 Avoid chairs

If you haven’t picked it up already, as a physiotherapist, I am not a fan of chairs. 

Unless absolutely required, the traditional office chair should be avoided at all costs, no matter how many ergonomic features it claims to have! It is a false friend, like alcohol when you’ve been dumped or chocolate when you’re sad. It will stab you in the back. 

The traditional seating position is the most likely contributor to your back pain, and it is the #1 aggravator of back pain. OK for short periods, but over an extended time this position focusses unnatural forces to the base of your lower back, squashes the tissues of your butt and legs (which are not weight bearing structures) and contributes to a cascade of metabolic, neck, gut, breathing and shoulder problems. 

Chair sitting is a very low muscle activity position, weakening the stabilising muscles of your spine, stiffening the hip joints and sending your nervous system and metabolism to sleep. For all intents and purposes it is a non-weight bearing position (excluding your lower back and butt) that limits the amount of movement you have to the level of swinging your feet or leaning on your arms. 

Sitting requires near zero strength, flexibility and power. Before you know it, you’ve spent 20 years favouring this position and you become stiff, weak and wobbly. 

If you don’t use it, you lose it (rule #1 of the body). If you’re serious about not getting back pain and improving your performance at work, remove the chair from your life. You’ll immediately move more without giving it any thought, guaranteed. 


More movement means less pain, more energy and more focus going into your work. 

#4 Get your screens right

Kneeling example.

Kneeling example.

Where your eyes go, your body follows.

Your gaze determines your body set up, so it is important that the screen is at the right height for you. If your screen is low and you need to look down, this bends your neck forward and the rest of your spine will follow. It is incredibly difficult to maintain a neutral spine when you are looking down. 

To set up right, adjust your screen or screens so your eyes are ⅔ the way up the screen. The idea here is that the screen is high enough to act as a moment by moment prompt to stand up tall, which keeps your spine upright. 

This is a rough science. Everyone has a bias to where they land their eyes on the screen, some work higher on the screen and some work lower. Find what gets you standing or floor sitting up tall. 

#5 The “One Stretch”

There has been a lot of research into back pain and there is one stretch that has become a go to for preventing back pain, and in ~66% of cases treating it too. Plus it has been shown to reduce the intensity of a back pain episode and speed up your recovery. 

This stretch has been tested in army recruits through to care workers in hospitals. In the army study (where they did a lighter version of the stretch) only 9% of those who did the stretch needed to see a doctor for back pain over the course of a year, versus 25% of those who didn't do the stretch. 

In the care worker study (where they did the stretch we will do) none of those who did this stretch needed to see a doctor for back pain or take any days off work due to back pain (compared to 9% and 7% respectively who didn’t do the stretch) over the course of a year.

What is this stretch? This stretch, plus a lot more facts, how to’s and stories are in the free e-book available for FREE download here.

Download free e-book

Downloadable ebook

The free ebook, that you can download by clicking here gives you all 5 steps in full detail, with the how to’s, the stories and the science to help you get a better understanding of how to set-up at work to stop back pain.