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Together against back pain

Find guidance for a life with better back health:
With the expertise of professional associations and
ergonomic knowledge from 25 years of association work.

The AGR seal of approval- A guide you can rely on

More than just a label:
Decision-making support when shopping for back-friendly products.
Make sure your investment is good for your back.

What characteristics does a product have

  • to fulfil to provide the spinal column and the locomotor system with optimum support,
  • providing relief and not acting as a burden for the user?

As this is not immediately apparent in most products and as industry and the retail sector also talk lots of rubbish in his respect, the Aktion Gesunder Rücken (AGR) e.V. has developed a decision-making aid for consumers: the AGR seal of approval.

It is awarded only to products whose back-friendly design has been verified by an independent testing committee made up of experts from various medical disciplines. The special and at present probably unique feature of the seal is the medical, multidisciplinary approach to deciding which products receive the AGR seal of approval, without being influenced by industry which is frequently led by its own pure sales interests.

 This approach also convinced the magazine ÖKO-TEST, which awarded it a "very good" rating, as well as the portal "Label-online" of the federal association "Die Verbraucherinitiative e. V.", which rated the seal of quality as "particularly recommendable".

Commodities with a back-friendly design are essential and important aids in both preventing backache and in treating diseases of the locomotor system. But it is not always easy to decide which product is the right one. The seal of approval developed by the AGR together with Germany's two largest back school associations therefore provides valuable assistance for consumers when purchasing ergonomic everyday commodities such as office furniture, car seats, beds, bikes, upholstered furniture, shoes, satchels, furniture for children and youngsters, home workstations etc.

The strict testing criteria and the composition of the committee with designated medical experts means that the AGR seal of approval is well accepted in the medical world. This has been verified also by the results of a major survey on backache conducted among around 1,000 orthopaedic specialists in Germany. 90% of those interviewed said that patient willingness to use back-friendly everyday commodities constitutes a crucial success factor, also with regard to therapy. 71% even said that they preferred to recommend their patients aids that bear the AGR seal of approval. For consumers too, the seal has become established as a clear decision-making aid, signalising: "this is a back-friendly product!"

You will find a comprehensive list of all product segments and complete, helpful information about what to watch for in our back products ABC.

Comments on the seal of approval

Facts about awarding the AGR seal of approval


If a manufacturer wants to use the quality seal for a product, he must prove the back-friendly benefit in a test.

This test is not carried out by Aktion Gesunder Rücken, but by two medical associations (Forum Gesunder Rücken besser leben e.V. and Bundesverband deutscher Rückenschulen e. V.), which form an independent committee of doctors and therapists.

Only if this committee recognizes that a product can really help to avoid back pain, the seal of approval may be used. The manufacturer must present the mode of action of the product and submit evidence (e.g. in the form of studies).


In order to pass the quality seal test, a manufacturer must first apply to Aktion Gesunder Rücken.

It is needed an informal letter and a completed questionnaire. The Healthy Back Campaign then discusses all further steps with the manufacturer and leads the product to testing.


In order to be able to use the quality seal, a user contract between the manufacturer and Aktion Gesunder Rücken is necessary.

The most important points are:

  • The manufacturer's obligation to notify the Healthy Back Campaign and the assessment body of any changes to the product that might affect ergonomics. The panel will then decide whether the modified product requires a review.
  • Linking the quality label to scientific findings. If previous medical findings that led to the award of the seal change, the manufacturer must improve the product accordingly or may no longer use the seal.

AGR supporting members

Doctors and therapists promote and support
the independent work of the AGR (Campaign for Healthier Backs)

Did you know…

that AGR supporting members play large part in our independent work?

that AGR supporting members make a significant contribution which allows people with back pain to get help from the AGR?

that the AGR, thanks to the supporting members, advises thousands of people each year on life with improved back health? or

that AGR supporting members can also enjoy personal benefits?

Being an AGR supporting member is more than just a membership in an association. AGR supporting members are part of a community, sharing an interest in their fellow human beings. Helping people with back pain is important to them.

They support the expansion of our extensive activities – including the further development of the “Alliance Against Backache”. This results in competent, quality advice that ultimately serves their work and offers considerable added value for their patients.

People don’t just have to accept back pain. We want to make a contribution by showing how to do things differently. What people can do for a life with better back health. In keeping with the motto: Together against back pain.

Being a supporting member has special benefits. By utilising just one or two of the AGR benefits, your personal financial gain quickly exceeds your financial outlay. That is intentional and guaranteed!

Find supporting members

A list of our supporting members with contact details and further information is available here.

We support special projects with the help of our supporting members:

Better back health for the youngest!

AGR with the help of its supporting members and VS supports the “Moorkinners” in Bremervörde

In cooperation with our supporting members and VS, we were able to tackle a project of special importance to us this year. In the course of our “Campaign for Healthier Backs in Children”, we were able to make a greatly appreciated donation to the “Moorkinners”, a day-care centre in Bremervörde focusing on movement. After all, back problems are not a question of age so that back-friendly furnishings are important even for the youngest.

The day-care centre strives to impart an understanding of the importance of movement in a playful manner. Motor development is promoted and thereby supports integrated learning. We wholeheartedly agree with that since plenty of movement is elementary for the development of the body, soul and psyche and therefore also the back. The AGR supports this thinking.

After we presented the 12 Hokki to Elisabeth Knörr, the facility’s manager, Alice and Luca immediately claimed them.

They promptly took the mobile active chairs to the group rooms, beaming with joy. This immediately confirmed that we had definitely made the right choice.

The Hokkis are special seating furniture to encourage even more movement in the daily routine at the day-care centre. They are ideal for small suites where children can play games together at a table. Thanks to its special shape, a Hokki can move in all directions and is sure to offer numerous other potential uses in the future.

Alice and Luca’s exploratory urge (“Hey, you can rock with this!”) was clearly apparent during our visit. By the way, the Hokki is also ideal for a child’s room and naturally bears the AGR seal of approval.

“We, the Moorkinners team, are very happy about the donation of the Hokki stools for our day-care centre. It’s an enrichment to know that we can provide our children with secure support in their natural urge to move with these stools, thereby actively promoting their body and spirit,” Elisabeth Knörr says.

Thank you to VS, a leading manufacturer of furnishings for educational institutions, office furniture and equipment, and especially to our supporting members who made this donation possible in the first place. Even if you were not able to be there in person, looking into the bright eyes of the children and seeing their joy as they experimented was well worth it and we wanted to share that with you.

Thank you, supporting members, for your commitment!

The AGR Team

Alice and Luca with Katrin Schlichting and “Moorkinners” manager Elisabeth Knörr are pleased with the Hokkis,
presented by Malte Kammann and Jens Löhn of the AGR Team

Clever training with the right equipment

When it's a case of doing something beneficial for spinal health, preventing pain or dealing effectively with existing problems, experts tend to focus in particular on two structures: the autochthonous muscles and the proprioceptors. But what do these words mean and why are they so important?

The autochthonous muscles are small, deep muscles running along the spinal column. They keep us upright and stabilise the trunk. Proprioceptors are special depth sensors in muscles, tendons and joints. They keep the brain constantly informed about the position, tension and movement of the individual body parts. They are so important for spinal health because they permit find adjustments of the autochthonous muscles and are responsible for fundamental stability.

Special items of equipment make training particularly effective for these important structures.

 The following pages tell you more and show how to make your training particularly back-friendly.

What different types of bicycles are available and what is important for the selection?

Three steps to a back-friendly bike

  • 1st step: choosing the right type of bike and frame size

    The retailer must offer a sufficiently broad fleet of bikes for test-riding, including city bikes, trekking bikes, mountain bikes, racing bikes, recumbent bikes or even folding bikes. The range on offer should include at least different city and trekking bikes. There are many different types and names of bikes on the market. There are also various mixed forms so that boundaries often become fuzzy.
    • The most important types of bicycle are explained below.
      • City bikes are relatively heavy and are equipped with or without gears. They permit comfortable cycling in town in an upright position. The upright position tends to prevent the bikes from being used for long journeys. City bikes can carry relatively high loads and only rarely have derailleur gears. Dutch bikes are a special type of city bike and are designed among others with a closed chain case.
      • Trekking bikes, also called cross bikes or ATB (all terrain bikes) can be simply described as a combination of racing bike and mountain bike and come fully equipped with all features needed for cycling on the road (luggage rack, lights, mudguards and stand). These bikes are intended for general mobility in town and on tours. The tyres are broader and with a deeper profile than racing bikes, but much narrower than mountain bikes. Trekking bikes are usually equipped with luggage racks – but are not as stable under full load as touring bikes.
      • Touring bikes are specially made for cycling tours. In appearance they look like a mixture of racing and trekking bike. They are equipped with sturdy, durable parts and designed to carry heavy loads. They are designed for more moderate cycling behaviour.
      • Mountain bikes (MTB) offer a compact and robust design for sporty cycling on unsurfaced paths and open terrain. Many different subcategories of mountain bike have emerged in recent years, with varying wheel sizes, tyre widths and suspension types.
      • Racing bikes are used for road racing and for covering long distances at high speed.
    • The frame geometry
      • Frame and seat height
        The frame height (stated in centimetres or inches) is measured between the middle of the pedal crank bearing and the upper edge of the seat tube. The correct seat height indicates the distance from the upper edge of the saddle to the lowest position of the pedal that can still just be reached with the heel. Correct adjustment of the seat height is a basic prerequisite for fatigue-free cycling. Cycling with the seat height too low will sap energy and can cause knee problems.
      • Frame and seat length
        The effective length of the frame is the horizontal distance between the middle of the seat tube upper edge and the middle of the head tube that takes the steer tube. This length dictates the seat length, i.e. the distance between saddle and handlebars. The correct seat length permits the cyclist to stretch the spinal column in its natural double-S shape when sitting leaning forward slightly (max. 30 degrees). This is the only way for the back muscles to hold the upper part of the body and reduce the pressure on hands and arms. If the frame is too long or too short, the required sitting position won't be possible, not even with stems of different lengths or by adjusting the saddle. In addition to ergonomic aspects, the frame length also influences performance dynamics.
      • Stack and reach: new parameters for selecting frame size
        According to the bicycle experts, frame height is now obsolete as a reference size. Today it is stack and reach that tell you whether a frame has the right size. Stack and reach refer to the distance between the middle of the pedal crank bearing and the upper edge of the seat tube. Stack is the vertical distance, i.e. the height. Reach is the horizontal distance, i.e. the length. Bikes with more stack and less reach are higher and shorter. The cyclist sits in a more upright position, while less stack and more reach results in the cyclist bending forwards in a more stretched position.
  • 2nd step: "bike fitting" – individual adjustment of the selected bicycle type

    Selection of bicycle type and frame size is followed by "bike fitting", i.e. individual fine tuning of the components.
    • Handlebars
      The sitting position and handlebar shape need to be adjusted to each other. The handlebar should be ergonomically curbed so that the lower arms and wrists can be held in a straight line. The flatter and more stretched the cyclist's sitting position, the straighter the handlebars may be. Straight handlebars make sense for sporty bikes. They support direct steering but put a higher load on the muscles in the arms and shoulders. Make sure that the wrists are not bent when grasping the handlebars as this could cause incorrect loads. Handlebars with differing grip positions are therefore recommended for long journeys. For sporting cycling, the handlebar is lower than the saddle, but above the saddle when cycling for pleasure. The width of the handlebars should be the same as the width of the shoulders and be adapted to the cycling purpose. Basically, the handlebars are only correctly positioned when there is a certain pretension in the back muscles. This pretension stabilises the spinal column and protects it from excess loads. An extremely upright "Dutch bike" position with the handlebars and grips close to the body tends to put more strain on the back.
    • Handlebar stem
      The handlebar stem is the element connecting steer tube and handlebars. Adjusting the stem angle changes both the distance between the cyclists body and the handlebars and also the handlebar height.
    • Grips
      Grip tips: for detailed information about bicycle grips, visit our site about Grips
      • Anatomically shaped grips with damping characteristics help reduce impacts and pressure on the nerve roots. (The ulnar nerve is close below the surface of the skin in the area of the hypothenar muscles. It is very sensitive to pressure loads in this location.)
      • A large supporting surface is ideal in order to minimise the pressure and possible numbness in the ring finger and little finger.
      • Specially shaped, multi-position handlebars and grips with bar ends enable various hand and grip positions, counteracting rapid fatigue of the arms and wrists as well as tense muscles in the shoulder and neck area.
    • Saddle
      Saddle tips: for detailed information, visit our site about saddles
      • The retailer should offer saddles and seat posts in a range of varieties.
      • The seat should have a relief zone in the area of the perineum and genitals in order to facilitate a back-friendly pelvis position on the seat (maintaining the lordosis in the area of the lumbar spine).
      • The saddle must be selected individually (shape, size, hardness) and the position adjusted correctly (height, tilt, length position).
      • It is also advisable to measure the sitting bones when selecting the right saddle.
  • 3rd step: individual suspension/shock absorption

    The suspension reduces shocks and jolts caused by uneven road surfaces. The German Sport University in Cologne has investigated the impact of suspension systems on the spinal column and came to the conclusion that jolts are reduced by 35% in bicycles with full suspension. This protects the spinal column from critical shock loads. Full suspension also protects the cyclist's entire locomotor system, as well as improving safety aspects.

    The retailer should offer solutions that permit individual suspension/shock absorption.

    There are various suspension systems:
    • Suspension fork adjusted to bodyweight
    • Suspension in the seat post or direct with full-surface dampers in the seat
    • Rear wheel suspension adjusted to bodyweight
    • Full suspension (suspension fork and rear wheel suspension)

      Requirements for the suspension/shock absorption of a bicycle:
    • The spring kinematics must warrant low reciprocal effects between drive and suspension.
    • Any luggage must also be suspended and therefore fastened to the frame. The load carried on the bike may not impair the suspension functionality and safety aspects (weight distribution).
    • Attention should also be paid to selecting special tyres with adjustable tyre pressure to take account of performance dynamics.

It has been known for a while now that when fasciae stick together, this can cause constrained posture, tension and backache. Fasciae are a kind of connective tissue that form a network covering the muscles, bones and organs. They react to stress, one-sided loads, inadequate exercise and constrained posture.

When fasciae stick together, people suffering from backache have to work against a resistance with every single movement. Eventually the whole body is thrown out of kilter.

As well as dealing with the actual cause, massages can help, or there are also means for people to help themselves. Corresponding information and the necessary equipment can be found on the following pages: