Desk Setup and Posture for your Home Office

Many of us are working from home these days, and our normal "ergonomic" desk set up that we had at work may not be an option for you at home. Dr. Paula Sauer has created this video to go over tips & tricks to set up your workstation better at home. Posture awareness in seated and standing are also give, as well as guidelines for when to change your position.

Ergonomics at Home Video on YouTube

Additional free content found here --> Align Physical Therapy YouTube Channel


In general:

  • Use yoga blocks, books or small boxes to change either the surface height of your table or chair
  • Sit upright with you head, shoulders, and rib cage over your hips. Use tone of your belly to support yourself in this position
  • Use the back rest of your chair, but use a pillow or semi-flared small ball at your mid back to give you a better upright position
  • Monitor level should be at the height or your eyes, or tilted in a way where you can glance down without hunching forward to see the screen
  • Wrists and elbows should  be relatively parallel at elbow height.
  • Change your body position - get up, move around, stretch, and reset your posture before you start working again.
  • Set a timer and change your position or do a posture check every 45-60 minutes.
  • Use both seated and standing options to work.

Normal Curves of Your Spine vs Scoliosis

We are suppose to have some curve to our spine. These curves are best viewed when looking at someone from the side. Thoracic and sacral curves are kyphotic, meaning the curve comes out on the back of your body (posteriorly convexed) to allow space for organs inside your torso. Cervical and lumbar curves are lordotic, meaning the curve goes towards the front of your body (concaved posteriorly).

The word scoliosis means curvature from Greek. Scoliosis is an abnormal curvature of the spine which can take several different shapes and forms. It most commonly involves the thoracic spine, however other regions of the spine can be involved. The abnormal curve of scoliosis appears as a side curvature of the spine that is visible in the frontal plane. These curves are seen best when looking at the front or back side of a body. The side-bending involved with scoliosis is typically combined with a rotation of the vertebrae, and often a reduced kyphosis in thoracic curves.

Most cases (about 85%) of scoliosis occur during adolescence and are idiopathic. Idiopathic means there is no known cause. Scoliosis is defined as a curve measuring at least 10 degrees on x-ray, and is usually observed when the curve is about 20 degrees.  Scoliosis is described by location, direction and number of frontal plane curves. These are commonly described as C or S curves. The primary curve is labeled by the side of its convexity, and not the direction of the side-bend. A rib hump is typically on the convexed side due to coupled motion of side-bending with rotation. Scoliosis is the most common spinal disorder in children and adolescents. Scoliosis is a life-long condition. Management of scoliosis includes exercises, bracing, physical therapy, and in some cases surgery.

Scoliosis - Curve Types: Thoracic Curve: One of the most common patterns in idiopathic scoliosis, 90% occur on the right side. Thoracolumbar Curve: Also a common pattern in idiopathic scoliosis, 80% occur on the right side. Lumbar Curve: Less visible on physical examination, 70% occur on the left side. Double Major Curve: Most common is a right thoracic with left lumbar curves creating an S curve.

To be diagnosed with scoliosis, you will be examined by a physician with x-rays measuring the amount of their scoliotic curve(s). The angle measurement is called a Cobb angle. X-rays are taken of the whole spine and in full weight-bearing. Curves are then measured to assess the Cobb angle.

Idiopathic scoliosis means the cause is unknown. It most common form of scoliosis. It rarely causes pain in children, and in most cases the curve is minor enough to be considered an asymmetry. 80-90% of structural scoliosis is idiopathic, 10-20% is from congenital abnormalities, neuromuscular or musculoskeletal conditions. There is no clear cause for adolescent idiopathic scoliosis and is generally believed to be multifactorial. Recently studies point to a genetic role in addition to other cause. 

Functional Scoliosis, also called degenerative scoliosis or adult onset scoliosis, has a prevalence of more than 8 % in adults over the age of 25 and rises up 68 % in the age of over 60 years due to degenerative changes in the aging spine. Functional scoliosis can be corrected by shift in posture, while structural is fixed deformity cannot be fully corrected.

Scoliosis has not been found in chimpanzees or gorillas. It has been hypothesized that scoliosis may be related to differences in humans vs apes. Apes have a shorter and less mobile lower spine than humans, and they have highly developed erector spinae muscles. Humans have a more mobile lower spine and pelvis, with less developed erector spinae. And, humans are bipedal. It is thought that these characteristics may differentiate the lack of scoliosis in primate.

According to the fossil record, earlier hominins, such as Australopithecus and H. erectus, may have exhibited an even greater prevalence of scoliosis as bipedal ability was first emerging. Fossil records indicate there may have been selection over time for a slight reduction in lumbar length compared to what we see today. This suggests that selection has favored a spine that can efficiently support walking with a lower risk of spinal disorders. The links between human spinal morphology, bipedality, and scoliosis suggest a link between these features and a potential evolutionary basis for the condition. And, this may explain why some people have an extra lumbar vertebra.

Epidemiology: Although scoliosis can occur earlier or later in development and even into adulthood, one study states the primary age of onset for scoliosisis 10-15 years old making up to 85% of those diagnosed.The risk of curvature progression increases during puberty when the growth rate of the body is the fastest. Scoliosis with significant curvature of the spine is much more prevalent in girls than in boys, and girls are eight times more likely to need treatment for scoliosis because they tend to have curves that have a greater probability of progression. The majority of all cases of scoliosis are mild.

Scoliosis affects 2–3% of the United States population, which is equivalent to about 5 to 9 million cases. Some studies say up to 5% depending on the population studied.

Incidence of idiopathic scoliosis (IS) stops after puberty when skeletal maturity is reached, however, further curvature may proceed during late adulthood due to vertebral osteoporosis and weakened musculature.

Want us to help you reduce symptoms and build strength due to your spinal asymmetry or scoliosis? Schedule an appointment with us today.

What is your core? by Dr. Paula Sauer

There are plenty of articles and discussions around using your “core’’, but do you really know what is your core is? The answer might surprise you.

Technically your core essentially is  your abdominal muscles on the front, your paraspinals and gluteal complex on the back,  your diaphragm on the top, and the pelvic floor and hip girdle musculature on the bottom.

Within this anatomical box are 29 pairs of muscles that help to stabilize the spine, pelvis, and kinetic chain during functional movements. When the system works efficiently, the result is the appropriate distribution of forces, optimal control and efficiency movement, adequate absorption of ground-reaction forces, and an absence of excessive compressive, translation, or shearing forces on the joints within the kinetic chain.

The core assists in appropriate distribution of forces, optimal control and efficiency of movement.  For everything to work appropriately, our core requires cooperation and integration of active (muscular), passive (bones, ligaments), and neural-motor systems (nerve, CNS).  This concept can easily become very complex. It isn’t as simple as “tighten your belly.”

The core and movement theories behind how and why it all works allows for good postural alignment, ideal movement patterns, and decreased potential joint dysfunction.  Dysfunction in one joint anywhere in the body can lead to compromise elsewhere in the kinetic chain, as we see in some commonly in the clinic.

To develop a stable core is to develop the abdominal muscles. There are mainly two different types of muscles fibers that make up your abdominal muscles: slow-twitch and fast-twitch.

Slow-twitch fibers make up the deep core stabilizers, also referred to as “local stabilizers”. These are the deepest layer of abdominal muscles you have and are closer to the center of rotation of your spinal segments.

It is this ability to stabilize your lumbar spine in its many positions that enables you to overcome back problems and reduce your chances of a injuring your back or suffering a reoccurrence of injury.

They are ideal for controlling intersegmental motion because of their location and length, maintaining mechanical stiffness of the spine. They are ideal for responding to changes in posture and extrinsic loads. The key muscles of this system include: transverses abdominus, multifidi, pelvic floor muscles, and your diaphragm.

This ‘‘corset’’ around the abdomen consists of the abdominal fascia anteriorly, the lumbodorsal fascia posteriorly, and the transverse abdominis and internal obliques muscles laterally.

How does stabilization work? Intra-abdominal pressure increases due to muscle activation. This creates tension with surrounding structures including the abdominals and thoraco-lumbar fascia. The tension change in the intra-abdominal pressure stabilizing the torso, effectively creating an internal corset that provides stability to the spine.

The transverse abdominus is the innermost of the four abdominal muscles, and it has fibers that run horizontally. The transverse abdominus and the multifidi are considered ‘‘stabilizing muscles’’ and are fine-tuned continually by the central nervous system.

Research has shown that it is not simply the deep-layer abdominal muscles you recruit during stabilization of the spine, instead it is how they are recruited that is important. Co-contractionof the deeper-layer transverse abdominus and multifidi muscle groups occurs before any movement of the limbs.

In other research, it was found that those who sustained a low back injury had difficulty recruiting their transverse abdominus and multifidi muscles early enoughto stabilize the spine before movement.

Fast-twitch fibers make up the superficial, or outer-layer muscles, or the “global muscle system.” Because of their size and positioning these muscles are capable of producing a large amount of torque. They produce speed, power, control acceleration and deceleration, and give us the ability to make larger movements.

The transverse abdominus and the multifidi are considered ‘‘stabilizing muscles’’ that are modulated continually by the central nervous system and provide feedback about joint position, whereas the global and larger torque- producing muscles control acceleration and deceleration.  Some of these global muscles include the erector spinae, eternal obliques, and rectus abdomens muscles.

Want help finding your core? Book a session with one of our therapists or trainers today. Call our office or email us at