working while sitting

how to sit with less or no low back pain

Long before doctors, scientists and other experts even started to think about human sitting, people already knew by themselves ‘how to sit’: the squat position.

Still today a great part of the world population is sitting this way, goes to the (squat) toilet and gives birth this way. Even now you can find those special squat toilets in France and other places. This natural way of sitting however is not possible behind an office desk, at school and university. Travelling this way is not an option. Why then this example?


Look at the picture. When you are flexible enough, try to sit this way. The feet flat on the floor and you may lean against the wall. Notice that your lower back is then convex and your pelvis tilts forward. Now, sit on a sturdy (kitchen)chair but do not correct: the lower back then tends to convexity. In the beginning this might feel relaxed but then it becomes fatiguing. Also breathing  becomes more difficult. Automatically you will try then to sit more upright. Unfortunately, also this  is tiring after some time.

Conclusion: we are not ‘built’ to sit this way … there must be an alternative … and there is!!

I called it ‘in between’  

Slide forward (translation) on a sturdy office chair until you feel a kind of ‘locking‘. You then sit on your ‘sitting’ bones,  halfway the chair and without backrest. Your pelvis is stabilized, you feel some more pressure under these bones. Once you got the right position: relax shoulders and muscles of the back. The feet rest flat on the floor. If you do this the right way you can sit upright without the need of back rest and an overload of muscle energy. This way of sitting is called:

Active sitting.

(be sure that the chair can not roll away and that you do not sit too much in front of it!!). Sitting this way relaxes the abdominal and dorsal muscles and allows us to breathe properly. Look in whatever office how people sit ……

In 2012 I visited a known factory of quality office furniture in Germany. Sitting is their philosophy. Although they found my ideas interesting, they preferred to continue their own. I suggested  a short tour to their offices. Almost all employees used their own quality chairs… on which almost

all were sitting in the active way without using the backrest!

Peter W.B. Oomens (Research on Posturology)

N B   binnen mijn praktijk podoposturale therapie bleef ik zoeken naar ‘logische’  oplossingen voor mijn patiënten met rug- en houdingsklachten. Zitten bleef lang een probleem, zeker wanneer je van de huidige inzichten uitgaat.

Zelfs met een professionele stoel (wat is dat?) is het zitten een kwestie van spieractiviteit. Spieren bekken/heupen, buikspieren en lage rugspieren moeten de ‘ergonomie’ van de stoelen ondersteunen. En dan nog …

Mijn conclusie was even eenvoudig als effectief: ‘halfway locked’ gezeten kán het bekken  niet voor- en achterover kantelen en is relatief minimale spierspanning vereist. 

Lange tijd heb ik een zitkussen via mijn praktijk geleverd. Zo op het oog lijkt het op het bekende wigvormige kussen. Lijkt, want schijn bedriegt…

Tot slot: op dit kussen heeft patent gerust, wat inmiddels is verlopen. Het mag dus gekopieerd worden.

let eens op hoe vaak mensen naar voren schuiven om rechtop te kunnen zitten met zo min mogelijk spierspanning, op een bureaustoel maar ook een zitkamerbank…



neuro-posturology, a multidisciplinary vision


More than twenty years I practised podopostural therapy, a neurophysiologic, postural treatment. The essence of this therapy is a pair of thin insoles, handcrafted and individually made, glued with 1 à 2 mm thin slices of cork. These minimal elements influence the skin of the foot sole while walking and standing. The insoles do not support the foot arches but activate the intrinsic foot muscles.


Posturology is the knowledge of the human posture, its interacting regulation systems and, based on feedback the integral implementation.

Posturology is the ‘knowledge’ of the human body, based on the ideas of the French Doctor René Jacques Bourdiol, suggesting that the human posture can be influenced by prescribing very thin, individual made insoles in shoes. The glabrous skin of our foot sole has a huge amount of pressure sensitive receptors (mechanoreceptors) which have a direct effect on the postural system. Posture related disorders and pain can be reduced by wearing the neuroreflectoire insoles. These podopostural insoles are basic within posturology, but can also be combined with other, manual treatments. the latter includes more. Below I  briefly summarize the already established relationships: 

  • Pain 
  • Sight
  • Manual therapy (especially craniomandibular/osteopathy) 
  • Matrix (most probably the interstitium BBRS)


In 1990 I wrote in the (Dutch) Journal of Integrative Medicine (1) the article ‘podo-orthesiology: a theoretical approach to pain’ (NTIG, 1990, 6 (39). With this article I introduced the concept neuromodulation (non-pharmacological). 

‘Pain stimuli pass through so-called nociceptive fibers to the central nervous system (CNS). Partly by A-delta (myelinated: primary pain) and C fibers (non-myelinated: secondary pain). These stimuli can be suppressed ( inhibited) by thick, non nociceptive A-alpha and A-beta fibres. Based on the foregoing it is therefore conceivable that segmental stimulation of the foot sole, for example by massage on the so-called baroreceptors, may have an inhibitory effect on the pain stimuli through thick A-beta fibres (Vater, Pacini and Merkel). 


In the early nineties I have been consulted by a 13-year-old girl together with her mother. She was severe suffering from low back pain and headache. Her knees were overstretched at standing and she had a deep lordosis. 

Moreover she was highly myopic, – / – 6 both eyes. In my daily practice I had already noticed that patients with neck pain and headache often had glasses. For this reason I asked my patients to take their glasses off during my corrections. Standing in opposite of a so-called optical test card she suddenly and unexpectedly called “I can read more!” After the first surprise I repeated the test and, indeed, she could see better and further. She also stood less overstretched. A phenomenon that I have seen countless times afterwards. In my opinion there is a relaxation my idea The postural optimisation found that the four straight and two oblique eye motor muscles of both eyes respond immediately this postural change. Apparently, a very sensitive control system.      

(The sight; a different vision on seeing; Peter W.B.Oomens, (Dutch) Magazine for Integrative Medicine, TIG 1994, 10 (2): 66-71). 

Temporomandibular joint

As a manual therapist (MTM) I am familiar with the fact that local mobilization influences the entire skeleton chain and that a fixation elsewhere within this chain reduces the effect. I was regularly consulted by patients who complained about the (often audible) occlusion of their temporomandibular joints. Podopostural optimization often proved effective (complementary).

At that time I had published a booklet “regulation therapy from the feet” (Tijdstroom 1991, ISBN

90-352-1365-3). I described the human posture in spatial perspective, under the name  Quadrant Theory. This theory and MTM connect seamlessly, according to my colleague physiotherapists, represented by Jaap Wijnand.

Matrix (ground regulation system)

This concept has its origins in ‘Das System der Grund Regulation’ pioneering research of Prof. Alfred Pischinger (Vienna). Scientists from the University of Utrecht called this later basisbioregulatiesysteem.

Rudolf Virchow (1821-1902) pathologist, had great influence on our medical thinking. Virchow suggested that disease is caused by disruption of the cell metabolism and cell structure. Cell research since then has an important place in the mainstream medical research. Obviously man is more than the sum of his cells.

This ‘more’ need to be found, according to Pischinger, in the environment surrounding the cells and organs, in which the very-finest endings of the autonomic nervous system and blood vessels are present:

the ‘ground regulation system’. The end of the vegetative nervous system terminates freely in this extracellular fluid. This is actually found anywhere in the body: bones, mucous membranes, organs, glands and so on. Disease is a disorder according to Pischinger at the base of the autonomic nervous system in this environment. The groundsystemof mesenchymal origin consists of soft connective tissue and intracellular fluid, approximately 60% of the human tissue comprising. In the Netherlands, cell biologist Dr. R. van Wijk et al of the University of Utrecht has done very extensive research. Also Harry Lamers, physician and the central person behind the neural therapy has given a significant contribution to this research.

If we look at this connective tissue also called matrix (van Wijk) in further detail, we see there capillaries, tiny blood vessels that supply nutrients and oxygen to the cells and remove waste products. Furthermore, we find small lymph vessels which end freely in this matrix. This also applies to the networks found here of free nerve endings. Specific cells involved in the construction and functions of the matrix itself, are also found. Besides the exchange of many substances, also hormonal interactions take place.


Wer Heilt hat Recht‘ (who heals is right; August Bier). 

A famous quote that I would like to expand: who helps another person to heal himself is right. Posturology is a vision that includes multiple techniques and approaches. As indicated above, the techniques described are reasonably mapped. It is expected that also hearing influences the postural balance. And so many links will still be made.

Peter W.B.Oomens

Research on Posturology

Wijk bij Duurstede Netherlands September, 2014


Electrodermaal en matrix onderzoek, R.van Wijk, F.A.C.Wiegant, J.E.M.Souren. In kader van toekenning Alfred Vogelprijs aan Dr.Roel van Wijk, Universiteit van Utrecht, november 1990 Neuraaltherapie en het basisbioregulatiesysteem, H.Lamers, Ankh-Hermes Deventer, 1988, ISBN90-202-1829-8


Leg length discrepancy: not always implicate a shorter leg!

Leg length discrepancy: not always means a shorter leg!

Numerous articles and comments have been written on leg length discrepancy (LLD).  How to measure it, how to test it, how to treat it.

I have often been consulted by patients who, according to their physician or therapist, should have a leg length discrepancy. Which was not seen before or even ignored. The majority had no medical history of broken legs or complicated fractures. Testing them  both laying and standing I measured indeed this LLD.

Seeing  back  many of them the before measured length  not only seemed to be changed, but also the leg itself!  At that time we made so-called radiographics on which you could see the pressure of the feet. Today this registration is all ict.

These length changes  were so frequent that there must be a pattern. As manual therapist and posturologist I am used to think 3 D (three dimensional).


In many cases I then noticed a pelvis rotation around the longitudinal body axis. I asked the laying patient to bend both knees, resting the feet, leaving the knees free to move. Almost always one or both knees moved to one side.   A lumbar support under the loins towards the pelvis was rotating, made, nine out of ten times, makes the LLD disappear. In my experience this was not a ‘real’ LLD but a ‘physiological’. Many professionals, for instance hairdressers, stand their whole working life most on one leg. The muscles of the foot/leg/hip at that side contract and a ‘created LLD’ is born! Do not start to treat this as a shorter leg by means of heel orthotics because the pelvis will rotate even more!! the pelvis has to be corrected by a contra-rotation.

June, 2019.

PRONATION  really understood?


  • you walk barefoot on, for example, sand
  • you leave visible footprints of the heelstrike and caput metatarsalia behind
  • you expect a (pronation) impression at the medial length arch 
  • you see the opposite, the lateral impression is deeper
  • the medial arch is most of the time not even visible at pronation 
  • pronation is a natural and therefore normal phenomenon and no illnes
  • that the anti-pronation does not make sense and may even be a contra-indication