In early 2020, before the coronavirus shut down the world, I raised money to expand the North American footprint of Myodetox. As part of that process, I spent a lot of time meeting with investors and dealmakers. This was high-level networking of the sort that suits my outgoing personality. I love meeting people and exchanging ideas and opportunities. I feed off that energy and creativity. It makes me feel as if I’ve plugged into some mysterious energy source.

Though I’ve been a physical therapist since 2007, I never thought my work would lead to me being introduced to a powerful tech-industry lawyer—someone used to executing mergers and acquisitions involving billions of dollars. This lawyer was a promising enough connection that, after he and I spoke by phone, my Myodetox team and I flew to San Francisco for the sole purpose of meeting with him. As part of the visit, we scheduled a Myodetox session to take place in his office, the goal being to further his understanding of exactly what it is I do.

First, we talked about business. He wanted to know more about what Myodetox does and what—beyond our more contemporary vibe—differentiates us from our competitors. 

Eventually the conversation turned to the lawyer’s own body. Suddenly he transformed from a brilliant, self-assured tech titan to a person speaking about his body with about as much understanding as a five-year-old playing Operation. “My back has really been bothering me lately,” he said. “It’s this part right here. Do you know what that is?”

It was the lumbar spine, a pretty basic part of the human anatomy. “Can you sit up straight?” I asked. When patients come to me with back issues, this is always one of the first things I ask. How your spine looks when sitting tall is often a tell to what’s causing the pain.

After I spent a few minutes talking with the lawyer about the importance of  maintaining a strong posture—especially crucial for someone like him, who sat for most of the day—as well as other techniques like engaging the core muscles and doing some light treatment, I blurted out something that was probably less than diplomatic.

“You’re one of the smartest people I’ve ever met,” I said, “yet you have to ask a random bearded Asian guy from Toronto how your back works?”

I explained that I wasn’t trying to make him feel bad, but that the issue he was facing was exactly what I was trying to solve with my company: how to increase the baseline knowledge people have of their own bodies. I firmly believe that people should have at least a rudimentary understanding of the only thing they truly own.

I want to get them out of pain, futureproofing their bodies so they can maximize their full potential and live longer. Part of building a business like mine is meeting with numerous investors and VIPs. Most are type A, and many are brilliant. I’ve noticed a commonality, though, in meeting with them individually, as I did with that tech-industry lawyer. Many have made enormous sacrifices to fulfill their business dreams, but what they’ve sacrificed above all else is their health. They worked hard, relentlessly attending to every business detail, yet paid little heed to their own body. Until one day, surrounded by success and wealth, they woke up and realized that their body had betrayed them. Or, rather, they’d betrayed their body. Because they ignored it.

The idea that a person must choose between the two—either health or success— was always a false choice, anyway. Taking better care of your body can make you even more successful in life.  


One question lingers: Can I get back to where I was? Or is it all downhill from here? I’m here to answer yes to the first question, and no to the second. I’ve seen it myself with literally hundreds of patients I’ve treated over the years,  I’ve encountered hundreds of people crippled by debilitating pain, unclear about what caused it and about how it can be fixed. Many of these patients have seen numerous physical therapists, pain management specialists, and doctors before arriving at my clinic. What I encounter time and again is chronic pain caused by poor posture and a sedentary lifestyle that robs people of their mobility and flexibility and saps their strength. All of these elements feed on and amplify one another. But poor posture lies at the heart of it all. When we address postural issues, pain can resolve and people can move with greater ease and comfort. A vicious cycle becomes a virtuous cycle.

While pain may not be the root cause of your problem, often it’s the most pressing manifestation. It may well be the reason you sought out this book. In many respects, we’re still in the early stages of understanding the science underlying pain: how it happens, how it’s managed, and hopefully, how it can be stopped. Why does an injury to one part of the body result in pain in another, seemingly unrelated part of the body, as described above? Why is some pain fleeting and some continuous? Unlike bones and organs, the central nervous system can be remodeled by chemical and physical changes. But the science is an abstraction when you’re in chronic pain. The pain is all that matters for you in that moment. It has a claustrophobic effect, shrinking the world around you. It’s probably making your life a misery, and you want to know how the hell to get rid of it.

Chronic pain isn’t the temporary sensation that comes from a stubbed toe or a headache. It’s enduring, the continuation of pain long after the original transmitter of that pain is gone. It can become overwhelming, and it can make someone desperate. According to the journal Progress in Neuro-Psychopharmacology & Biological Psychiatry, “Individuals with chronic pain are at least twice as likely to report suicidal behaviors or to complete suicide.” People on the verge of such a tragic act often live like prisoners in their homes, spending their days on the couch watching TV and popping pain meds, silently mourning lost careers and dead relationships. The prescription medications they rely on can become a health problem in their own right, causing severe side effects and leading to addiction. In the United States alone, thirty-eight people a day, on average, die from an opioid overdose. Many of those tragedies began with prescription pain medicines.

Opioid abuse and addiction have become epidemics because so many people end up hurting, and it’s cheaper and easier to get a drug prescription than it is to receive good therapy. Patients shuffle in and out of clinics, looking for relief from their back pain, torn ligaments, pelvic pain, aching shoulders, and other ailments. Back pain is now a billion-dollar industry, with 70 percent of U.S. adults experiencing it at some point during their life. That’s why I’m so passionate about these issues, and why I intend to help solve them. I envision a world where back pain isn’t a leading growth industry. Physical therapy, like much of Western medicine, tends to be reactive. The medical system, including physical therapy, focuses on fixing problems rather than preventing them from happening in the first place. Most of the people who land in my office do so in pain. Rather than helping them maximize their full potential, I spend the initial sessions “course-correcting” and simply restoring them to their baseline, which should have been their starting point. Sometimes you have to take one step back to take two steps forward.

I believe optimal alignment and movement patterns will slow down the potential wear and tear from aging. My full-body-treatment approach restores balance by decreasing tension, reducing pain, aligning posture, increasing range of motion, and building strength. I have no doubt that the easier it is for you to line up with gravity, the better you’ll breathe, digest, stand, sit, and move.

One of my idols is Bruce Lee, the martial arts icon and movie star. I loved Bruce’s disdain for convention, his disregard of boundaries. Unlike his peers, he dabbled in bodybuilding-style workouts and read muscle magazines in search of new workout ideas. I’m similarly curious, open-minded, and unorthodox when it comes to physical therapy. I don’t adhere to one school of thought. I pick and choose from among different approaches, combining techniques I like into what works best for my patients while discarding what doesn’t.

Traditional physical therapists take a local approach to whatever ails a patient: “Your foot hurts. Let me look at your foot” or “Your knee hurts. Let me look at your knee.” My physical therapy approach is holistic, incorporating various strategies, many of which might seem unrelated at first. When patients tell me what’s wrong with them, I don’t view their complaint, whatever it might be, in isolation. I don’t even consider it solely in the context of their whole body. I view it in the context of their life. The wisdom of that approach seems self-evident, but it’s surprisingly rare in my field.

Low back pain, neck stiffness, serial headaches—they’re all the result of using the body in a way that it wasn’t designed for. The modern lifestyle of long work hours, a constant tethering to electronic devices and gadgets, and lack of exercise certainly doesn’t help. This lifestyle was ubiquitous before 2020, but for many people, the coronavirus pandemic sent it into overdrive. Suddenly, long work hours became endless work hours as the office and the home became one and the same. There was no need to walk down the office hallway to attend a meeting; now you simply had to log into a video conference call.

“Tech neck” and “iHunch” are the sound-bite terms coined to describe forward head posture, where the head tracks forward, out in front of the shoulders, while the eyes remain glued to a device. Fixing these problems entails more than just sitting up straight, but that distills the essence into one essential and straight- forward act. Sitting up straight can save people from a lifetime of pain, not to mention surgery and even disability. An ideal posture maintains the natural curves of the neck, middle back, and lower back. In contrast, a slouching posture places great stress on the muscles of the back and neck, as well as on the spine itself. It also contributes to depression, chronic fatigue, and chronic pain. When you slouch every day, your spine is like a door that doesn’t fit properly in a doorjamb. Open an ill-fitting door over many years, and the wear and tear will be far greater than if the door swung the way it should.

When someone slouches for hours at a time, pressure increases on certain areas of their spine. This can work for a while. But there’s a limit to how much the spine can handle in such a compromised position, and once damaged, the spine will never be quite the same. It’s so intricate and multifaceted in how it’s constructed that it’s hard, if not impossible, to repair perfectly.

Don’t get me wrong, sitting is not inherently bad. To suggest otherwise would be ridiculous. When sitting happens in short bouts, with the body in a biomechanically sound position, it’s fine from a musculoskeletal standpoint. The problem is the pro- tracted lengths of time people spend sitting and their tendency to sit in one position without switching it up, as well as the forces these habits, working in tandem, place on the spine. The answer isn’t standing all day, either; standing for too long also causes problems. Still, I believe changing your life begins with something as easy as sitting well 80 percent of the time you’re sitting. I’m convinced it’s the crucial first step for physical and mental well-being.

How you sit and stand today is a product of the life choices you’ve made along the way. Maybe you hunch as an adult because you were shy when you were younger and wanted to blend in rather than stand out. There are a million potential reasons why you might be slouching today. 

Rather than discouraging me, this realization gives me hope, and it should give you hope, too. Once you become aware of which forces shaped your current posture, you can take action. And that’s what’s fascinating about posture. In many ways, even if we don’t realize it, our posture is the best reflection of our life experiences to date. So if you want to improve your life, start by changing your posture.  

Excerpted from SIT UP STRAIGHT: Futureproof Your Body Against Chronic Pain with 12 Simple Movements, by By Vinh Pham and Jeff O’Connell. Scribner (May 10, 2022)