Michael O'Neill Soft Tissue Therapy

04/03/2026

This graphic sums up something that many people in musculoskeletal care have been saying for years: the idea of a single “correct posture” simply isn’t supported by good evidence. Despite decades of advice telling people to sit perfectly straight, keep their back rigid, or avoid certain positions, research has not shown that one specific posture prevents back pain.

Human bodies are not designed to hold one position all day. Spinal curves vary widely between individuals and these differences are completely normal. Two people can have very different spinal shapes and both be perfectly healthy. Pain cannot reliably be predicted by the way someone sits, stands, or bends. What tends to matter more is sensitivity to load, overall activity levels, stress, sleep, and general health rather than the exact angle of the spine.

Posture also reflects behaviour, mood, and comfort. People naturally shift positions throughout the day depending on what they are doing and how they feel. Trying to force one rigid “ideal” position often makes people tense and hyper-aware of their body. Ironically, this can increase discomfort rather than reduce it.

The spine itself is an extremely strong and adaptable structure. It is built to move, bend, twist, and tolerate load. Sitting, bending forward, or lifting objects are normal human activities. These movements are not inherently dangerous. What usually helps more than obsessing about posture is simply changing positions regularly, staying physically active, and gradually exposing the body to normal movement again if someone has been avoiding it.

Another important point is that one approach never works for everyone. People differ in anatomy, tolerance to load, and daily demands. A position that feels comfortable for one person might not suit another, and that’s perfectly normal. The goal is not to chase a perfect posture but to maintain variety in movement and allow the body to adapt.

For clinicians, the key message is to avoid pathologising normal human variation. When we frame the spine as fragile or easily “damaged” by everyday positions, we often create unnecessary fear. A much more helpful message for patients is that their spine is robust, adaptable, and capable of handling normal life.

References
Slater D, Korakakis V, O’Sullivan P, Nolan D, O’Sullivan K. “Sit Up Straight”: Time to Re-evaluate. Journal of Orthopaedic & Sports Physical Therapy. 2019.
O’Sullivan PB et al. Cognitive functional therapy for chronic low back pain: a review of behavioural and movement approaches.
Saraceni N et al. To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? Scandinavian Journal of Pain. 2020.
Nolan D, O’Sullivan K. The relationship between posture and back pain: a systematic review.

09/02/2026

I talk about this a lot in clinic, this is a great post by Ben from Cor-Kinetic.

05/02/2026

Scar tissue is not a separate “bad” tissue that needs to be removed.

27/01/2026

Working with someone to help you navigate through chronic pain can often make a big difference.

"I can't recommend Michael enough, I have a complex chronic pain history (15 years) and have never had someone work with me and my body the way Michael has done. From the very first session I noticed immediate small changes and by putting in the work at home and in session for the first time in years I've got real and realistic hope of making impactful changes to my quality of life with treatment plans and exercises specific to my limitations and needs."

26/01/2026

My new coaster, now you may think why is he posting this, well it made me happy.

23/01/2026

Discs Don’t “Slip”

Discs Don’t “Slip”

The phrase “slipped disc” is anatomically incorrect. Intervertebral discs are firmly bound to the vertebral bodies above and below via cartilaginous endplates and reinforced by the annulus fibrosus. They cannot move, slide, or slip out of position.

What actually occurs is a disc herniation. This describes a situation where disc material, usually the nucleus pulposus, displaces through a defect or tear in the annulus fibrosus. The disc remains in its normal anatomical location; only internal material migrates beyond its usual boundaries.

An intervertebral disc is composed of a central nucleus pulposus, a surrounding annulus fibrosus made of concentric collagen lamellae, and cartilaginous endplates that anchor the disc to the vertebral bodies. These structures develop together and are mechanically integrated, which is why the idea of a disc “slipping” between bones is not biologically plausible.

Disc herniation is a process influenced by age-related changes, mechanical loading, and biochemical factors within the disc. Over time, the annulus fibrosus can develop fissures. When internal pressure rises, nucleus material may protrude or extrude through these fissures. Symptoms arise not because the disc has moved out of place, but because displaced disc material can irritate or compress nearby neural structures and provoke an inflammatory response.

Pain associated with disc herniation is driven by two main mechanisms. One is mechanical compression of nerve roots or the spinal cord. The other is chemical irritation, as nucleus pulposus material is biologically active and can sensitise adjacent neural tissue even without significant compression.

In clinical practice, accurate terminology matters. Saying “slipped disc” reinforces the idea that something is out of place and needs to be put back, which is misleading and often increases fear. Terms such as disc herniation, herniated disc, pr*****ed disc, or herniated nucleus pulposus accurately describe the pathology and align with modern anatomical and clinical understanding.

19/01/2026

An old post but worth posting again.

Rehabilitation plays a crucial role in the recovery process from injuries. It helps individuals regain strength, flexibility, and functionality while also reducing the risk of re-injury. It's important to understand that pain doesn't always indicate more harm—sometimes discomfort is a natural part of the healing process. Through proper rehabilitation, individuals can safely and effectively work towards restoring their physical well-being and overall quality of life. Remember, seeking guidance is key to successfully navigating the rehabilitation journey.

In clinic, hands on therapy is only a part of what I do, it is important to come up with a rehabilitation plan to help you actively recover.

09/01/2026

Last available appointment of the week
Saturday the 10th 10.30am

31/12/2025

Wishing you all a happy and healthy new year.

25/12/2025

Wishing you all a happy Christmas and new year.

17/12/2025

One of the biggest things I see in clinic is people believing their pain is caused by posture. They’ve been told it’s upper crossed syndrome, lower crossed syndrome, rounded shoulders, anterior pelvic tilt, or some “twisted pelvis” nonsense — and that this is the root of their pain. It isn’t.

Pain is far more complex than posture. Posture might play a small part at times, sure — but it’s much more about your habits, what you do all day, how you move, how you feel, and how you recover.

No one thinks about their posture when they’re not in pain. But the moment pain shows up, it’s the first thing people blame. That’s not coincidence — that’s conditioning.

The “posture industry” thrives on scaremongering. Practitioners love saying they can fix your posture and magically fix your pain. Some patients love hearing it too, because it gives them a simple answer.

But posture isn’t the villain. And trying to perfect it won’t save you.

Worry less about posture.
Focus more on how you’re living.