Among the overwhelming quantity of information new parents must digest is the instruction to ensure their child gets adequate “tummy time” each day.
As the name suggests, it refers to periods of lying on one’s belly, which in babies serves to improve neck strength and prevent them developing misshapen heads.
Not content with letting infants have all the fun, adults have now co-opted the practice as a means of postural correction. Online, “adult tummy time” has gained traction in recent months, with videos filmed by prone TikTokers gaining millions of views.
What is adult tummy time?
There are variations in practice, but adult tummy time usually involves lying, baby-like, on one’s belly, passively propped up on elbows (the sphinx pose in yoga) or on one’s hands (cobra pose). Other videos show static holds without arm support, in an arched Superman position.
Various claims have been made about adult tummy time on social media, including that it can help “fix” one’s posture, alleviate neck and back pain, and undo “tech neck”, the hunched, head-forward position many of us inadvertently adopt while desk bound.
Posture and pain
Think of “good posture”, and the image of a soldier-like ramrod back might come to mind. “There are very strong cultural beliefs about what good posture is,” says Prof Leon Straker, of Curtin University.
But despite strongly held assumptions that a slumped posture increases your risk of neck and back pain, researchers say there is little convincing evidence this is actually the case.
One study in teenagers, co-authored by Straker, found no association between sitting posture and neck pain, while a second – which tracked young adults over five years – found that, surprisingly, “people with the really direct upright posture – which we normally think of as good – actually had slightly increased risk of pain”.
“The conclusion there is that posture is really important for function, but it doesn’t link strongly to your risk of pain,” Straker says.
“We do have some evidence [in adults] that people that have neck pain do tend to lean forward as they’re sitting at, say, a computer,” the head of physiotherapy at the University of Newcastle, Prof Suzanne Snodgrass, says. But association is not causation – it’s unclear whether that forward head position causes the neck pain, or whether people maintain that posture because they have neck pain.
Snodgrass says that when people are seated, “there’s certainly an ideal posture that we tend to talk about: upright, head sitting above your shoulders and not forward, shoulders above your hips, and not leaning forward”.
But people shouldn’t get too hung up on “trying to stay stiffly in a perfect posture all the time, because that can be just as bad,” she says. “It’s quite important to move and to feel comfortable moving in and out of different postures.”
“Many people can have what would be called poor posture and have no pain at all,” the head of physiotherapy at the University of Technology Sydney, Associate Prof Bruno Saragiotto, says. He points out that back pain is more strongly associated with low physical activity, stress, emotions and sleep than mechanical factors.
Can tummy time ‘fix’ tech neck?
Extended hours in front of screens, gimmicky dolls made by office equipment companies would have us believe, will eventually turn us all into slouched Quasimodos.
“If you sit hunched for a long time, does your posture end up being stuck that way? I think there’s some merit to that,” Snodgrass says. “For a lot of the years of your life, you can reverse things by doing exercise and movement.”
The rationale for adult tummy time “is that if your spine is in the opposite position, rounded for a lot of the day, if you put it in that [extension] position, you’re kind of balancing it out,” she says. “Tummy time probably helps your lumbar spine [the lower back] more than it helps your neck.”
But as for “fixing” posture, “it’s not going to change how you sit – it’s only going to move your spine in another way, to give it a bit more mobility when you’re doing other things.”
Saragiotto finds the idea of “fixing” posture problematic, because it “suggests that posture is a mechanical flaw, which often leads to over-medicalisation, anxiety and fear around normal posture variations”.
“A better idea is to build postural tolerance through exercise,” he says. “Posture is dynamic and adaptable, and not something to ‘correct’”.
For those inclined to spend more time belly down, Snodgrass advises trying to keep the neck neutral. “There’ll be some people that can’t get up on their elbows because their back is too stiff, and just lying on the tummy with their head on the ground is a stretch for them … As you get a bit more flexible, then you can come up on to elbows.”
Straker says that from a biomechanics perspective, “it makes good sense for people to be doing a trunk, head [and] neck extension activity to counter the flexed activity that we spend a lot of our time in”. Though the evidence doesn’t suggest adult tummy time will change posture or risk of neck pain in the long term, back extension positions may help to maintain range of movement, he says.
He emphasises the “need to start gently and progress it sensibly, so that you’re not actually … creating pain by doing something that you’re body’s not used to”.
Other movements to try
“There is no single ideal posture linked to pain prevention,” Saragiotto says. Although tummy time positions are low risk and easy to do, “there are better interventions supported by evidence, such as … pilates, having a healthy lifestyle, and even walking.”
In an office environment, “having breaks and moving during the day is usually what will help more than having a perfect ergonomic posture,” he says.
Snodgrass recommends several simple movements during the day. “I would start with standing back against a wall, and really just working on pulling your shoulder blades back first. Also lifting through the lower abdominal muscles, so pulling them up and in shoulders back … And then just lifting your head nice and long, and standing tall.”
“At home, you can lie on your back, knees bent, and have your arms out to the side, like drawing angels in the snow … so that you’re stretching your arms. That will stretch out that upper back as well, and while you’re doing that, tucking the chin down to lengthen the back of the neck.”
For strength, Straker also suggests exercises that involve lifting the head and neck against gravity, such as swimming.
Any ongoing pain, the experts say, should be assessed by a health professional.
Donna Lu is an assistant news editor at Guardian Australia
Antiviral is a fortnightly column that interrogates the evidence behind the health headlines and factchecks popular wellness claims
