In this blog, we will explore what sacral sitting is, why it occurs, the associated health conditions, and how to correct it through better seating solutions and postural management.
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What is Sacral Sitting?
Sacral sitting, also known as sacrum sitting, is a postural presentation where an individual sits with their pelvis tilted backwards, causing the base of the spine, known as the sacrum, to bear most of the body’s weight against the chair. This posture is particularly common in individuals who have limited mobility, muscle weakness, or poor posture. Over time, sacral sitting can lead to discomfort, pain, and further posture-related complications.
The sacrum is a triangular-shaped bone at the base of the spine, connecting it to the pelvis. Below the sacrum is the coccyx, also known as the tailbone. Ideally, when sitting, the pelvis should be positioned in a neutral state with the weight distributed evenly across the sitting bones. However, in sacral sitting, the pelvis tilts backward, forcing the sacrum and lower spine to absorb most of the pressure, leading to strain and discomfort.
Seat Sizing and its Role in Sacral Sitting
One of the most critical factors influencing sacral sitting is seat sizing. An improperly sized seat can encourage poor posture and exacerbate sacral sitting. The two key elements of seat sizing are:
Seat Depth
A seat that is too deep can cause a person to slide forward into a posterior pelvic tilt, leading to sacral sitting. Having the right seat depth allows the user to sit back fully against the backrest while maintaining an upright posture.
Seat Height
If a seat is too high, individuals may not be able to place their feet flat on the ground. Since around 19% of body weight is typically distributed through the feet, people often compensate by sliding forward into a sacral sitting position to ensure foot contact with the floor. Conversely, a seat that is too low can also encourage slouching.
Ensuring proper seat height and depth is essential for maintaining a neutral pelvic position and preventing sacral sitting. Read our guide on how to measure for the correct seat size to learn more.
Sacral and Coccyx Pain When Sitting
Individuals experiencing pain when sitting often have inflammation or pressure in the lower spine, particularly in the sacrum and coccyx (tailbone). This can result from:
Sacral Pain
Sacral pain is often caused by issues in the sacroiliac joints, which connect the sacrum to the pelvis. This condition, known as sacroiliitis, can lead to pain radiating to the hips, buttocks, and lower back.
Common causes include:
Inflammation
Conditions like arthritis can cause inflammation in the sacroiliac joints, leading to sacral pain.
Overuse
Activities such as sports, heavy lifting, or prolonged sitting can stress the sacrum.
Poor posture
Sitting in a sacral position for prolonged periods strains the sacrum, resulting in discomfort.
Trauma
Falls, accidents, or direct injury to the sacrum can also lead to inflammation and pain.
Coccyx Pain
Pain in the coccyx, also known as coccydynia, is a common issue for individuals who sit in a poor posture for extended periods. Causes of coccyx pain include:
Excessive pressure on the tailbone
Sacral sitting shifts more weight onto the coccyx, leading to discomfort and pain.
Prolonged sitting
Sitting for extended periods, especially on hard surfaces, can put pressure on the coccyx.
Injury or trauma
A fall or direct impact can bruise or fracture the coccyx.
Inadequate seating support
Chairs without proper cushioning or ergonomic design fail to distribute pressure evenly, leading to coccyx pain.
How to Relieve Coccyx Pain
To alleviate coccyx pain, consider the following:
Use a coccyx cushion
A specially designed cushion with a cut-out at the back helps relieve pressure on the coccyx.
Adjust seat positioning
Ensure proper seat height and depth to prevent excessive pressure on the tailbone.
Take breaks
Standing and moving periodically can reduce prolonged pressure on the coccyx.
Consult a professional
If pain persists, seeking advice from a medical professional or physiotherapist is recommended.
Postural Conditions Associated with Sacral Sitting
Sacral sitting is often linked to posterior pelvic tilt, a condition where the pelvis rotates backward, flattening the natural curve of the lower spine and forcing the sacrum to bear excessive pressure. Posterior tilt can develop due to prolonged poor posture, muscle weakness, or improper seating. If not corrected, this condition can lead to chronic lower back pain, hip discomfort, and reduced mobility.
Posterior Pelvic Tilt
Addressing Posterior Pelvic Tilt
Specialist seating solutions can help alleviate the issues caused by posterior pelvic tilt. Proper seating can support the pelvis in a neutral position, redistributing pressure more evenly across the sitting surface. This reduces stress on the sacrum and helps in maintaining good posture.
How to Correct Sacral Sitting
Correcting sacral sitting involves addressing the position of the pelvis and promoting a more natural, upright posture. Here are some effective methods:
Tilt-in-Space Chairs
Tilt-in-space chairs allow the seat and backrest to tilt backward simultaneously, redistributing body weight and reducing pressure on the sacrum. This type of seating promotes a more neutral pelvic position, supporting the lower spine and sacrum.
Tilt-in-space functionality
Postural Support Cushions
Adding a contoured cushion to a regular chair can help prevent posterior tilt by promoting a more upright sitting position. These cushions are designed to support the natural curve of the spine.
Seating with Lumbar Support
Chairs that incorporate built-in lumbar support help maintain the natural curve of the lower spine. This encourages the pelvis to stay in a neutral position, reducing pressure on the sacrum.
Our HiBack bedside chair has inbuilt lumbar support in the lower backrest, helping maintain a healthy spinal position for hospital patients using bedside chairs.
Specialist Seating Assessments
Consulting an occupational therapist or seating specialist for a professional seating assessment can provide tailored solutions based on individual needs. This may include custom seating, tilt-in-space chairs, or postural support aids.
Free & No Obligation Assessment
Positioning Belts or Harnesses
In cases where individuals have significant mobility issues, positioning belts or harnesses can be used to maintain pelvic alignment and prevent sacral sitting.
Conclusion
Sacral sitting can lead to significant discomfort and long-term posture issues if not addressed. Understanding the causes and associated conditions can help individuals take proactive steps to correct their sitting posture. Utilising specialist seating solutions like tilt-in-space chairs, postural support cushions, and professional seating assessments can significantly reduce sacral and coccyx pain while promoting a healthier sitting posture.
FAQs
Q: What is sacral sitting?
A: Sacral sitting refers to a seated posture where the pelvis tilts backward, causing the sacrum (the base of the spine) to bear most of the body’s weight. This posture can result in discomfort, pain, and long-term postural issues.
Q: Can sacral sitting cause long-term damage?
A: Yes, prolonged sacral sitting can lead to chronic lower back pain, hip discomfort, and potential spinal issues if not corrected.
Q: What is the best chair for sacral sitting?
A: Tilt-in-space chairs are highly recommended as they allow for proper weight distribution and reduce pressure on the sacrum.
Q: Can physical therapy help correct sacral sitting?
A: Yes, physical therapy can help strengthen core muscles, improve posture, and reduce the tendency to sit in a sacral position.
Q: How do I know if I am sacral sitting?
A: Signs of sacral sitting include slumped posture, pressure on the lower back or tailbone, and difficulty maintaining an upright seated position.
Q: How does seat height affect sacral sitting?
A: If a seat is too high, individuals may slide into sacral sitting to ensure their feet touch the floor, as around 19% of body weight is supported through the feet when seated properly.
Ralph has many years' experience in the healthcare sector. In a previous life he worked in finance, and his spreadsheet skills come in handy for all the analysis and research he does as he investigates topics and solutions for some of the world's most complex healthcare conditions and challenges. Aside from writing in-depth articles and organising webinars and interviews with top healthcare professionals, Ralph also administrates Vivid's "Healthcare Pioneers Board", a large group of healthcare specialists with multiple disciplines, who are working together to improve care for years to come.
