Correcting Faulty Posture
Posture is essential to the position of the body in space. Optimal posture is the state of muscular and skeletal balance that protects the supporting structures of the body against injury or progressive deformity, whether at work or at rest. Correct posture involves the positioning of the joints to provide minimum stress on the joints of the body. Conversely, faulty posture increases stress on the joints. This increased stress can be compensated for by strong muscles, but if they are weak or the joints lack mobility or are too mobile, joint wear and modification can occur. As well, damage and changes to the surrounding tissues can occur. Posture can also involve the chain link concept of body mechanics in which problems anywhere along the body chain can lead to problems above or below that point.
For example, knee pain can arise from pelvic joint disorders. Without good posture, your overall health and total efficiency may be compromised. Because the long term effects of poor posture can affect bodily systems (such as digestion, elimination, breathing, muscles, joints, and ligaments), a person who has poor posture may often be tired or unable to work efficiently or move properly. Even for younger people, how you carry yourself when working, relaxing or playing can have big effects.
Did you know that just fifteen minutes reading or typing when using inappropriate biomechanics will exhaust the muscles in your neck, shoulders, and upper back?
Causes of Poor Posture
The causes of poor posture can be divided into two categories: positional and structural. Structural causes are basically permanent anatomical deformities not amenable to correction by conservative treatments.
Positional causes of poor posture include:
• Poor postural habit for whatever reasons the individual does not maintain a correct posture
• Psychological factors, especially self esteem
• Normal developmental and degenerative processes
• Pain leading to muscle guarding and avoidance postures
• Muscle imbalance, spasm, and contracture
• Respiratory conditions
• General weakness
• Excess weight
• Loss of proprioception – the inability to perceive the position of your body in space
Physiology of Posture
Posture control involves static and phasic reflexes. Static reflexes involve sustained contraction of the musculature while dynamic, short term phasic reflexes involve transient movements. Both types of reflex are integrated at various levels in the central nervous system (CNS) from the spinal cord to the cerebral cortex and are largely affected through extrapyramidal motor pathways. Postural reflex patterns from reflexes, such as the stretch and withdrawal reflexes, result in a coordination of many joint movements and combinations of muscle actions. These include contraction of prime movers, synergists, and stabilizers, along with the necessary relaxation of antagonists. These muscles are regulated for contraction intensity, speed, duration, and sequential changes in activity. The integrative pattern of posture is predominantly automatic and unconscious, resulting from the incessant shifting of weight (postural sway.) Postural corrections are continually mediated by the myotatic stretch reflex. Posture is further mediated by the visual, labyrinthine, neck righting reflexes, and by the interplay of joint reflexes. While the control of posture is primarily controlled by various reflex mechanisms, there is also extensive input from the higher centers of the central nervous. Therefore, posture to some extent can be relearned (corrected) just as it was learned in the first place. What does perfect posture look like?
Perfect standing posture is when the following are properly aligned:
• The points between your eyes, chin, collarbone, and midpoint between your ankles
• From the side, you can easily see the three natural curves in your back
• From the front, your shoulders, hips, and knees are of equal height
• Your head is held straight, not tilted or turned to one side
• From the back, the spinous processes of your spine should be in straight line down the center of your back
Obviously, no one spends all day in this position. But, if you naturally assume a relaxed standing posture, you will carry yourself in a more balanced position and with less stress in your other activities.
When you have poor posture, the body’s vertical position is out of alignment and the back’s natural curves become distorted. Head forward or slouched posture:
• Rounded shoulders
• Head forward, rounded upper back
• Arched low back
• Protruding buttocks
• Chest flattens
• Abdominal organs sag, crowding and making more work for your heart and lungs
• Seen often in women who have osteoporosis in later years
• Head pulled back
• Shoulder blades tightly pulled back
• Arched lower back
• Knees locked (hyperextended)
• Minimizes the spinal column’s ability to be a shock absorber for the body
Slumped sitting posture:
• Upper back humped or too rounded
• Head forward
• Rounded lower back
Tests for Postural Faults
The Wall Test- Stand with the back of your hand touching the wall and your heels six inches from the baseboard. With your buttocks touching the wall, check the distance with your hand between your lower back and the wall, and your neck and the wall. If you can get within an inch or two at the low back and two inches at the neck, you are close to having excellent posture. If not, your posture may need professional attention to restore the normal curves of your spine.
The Mirror Test- (Anterior View) Stand facing as full length mirror and check to see if:
1. your shoulders are level
2. your head is straight; no chin deviation; ears are level
3. the spaces between your arms and sides are equally spaced
4. your iliac crests and hips are level
5. kneecaps face straight ahead
6. a 5° foot flare is shown
7. arches are not flat
8. there is no Achilles deviation, and
9. no evidence of scrunching of the toes
Check for the following:
1. head is erect, not slumping forward or backwards; no anterior head carriage
2. chin is parallel to the floor; no hyperlordosis
3. shoulders are in line with the ears, not drooping forward or pulled back,
4. stomach is flat; neutral spine
5. knees are straight, and
6. pelvis is neutral (slight anterior tilt)
Correcting Postural Faults
A patient’s postural faults must be accurately diagnosed before they can be effectively corrected. Examination and diagnosis should include the following:
• observation of the patient as they sit and move about
• measurement or estimation of the deviation from the ideally erect postures using plumb lines, inclinometry, and posture guides
• three dimensional analysis
• spinal segmental alignment
• flexibility tests
• muscle length and strength tests
The importance of muscle testing to postural analysis can not be over-emphasized. Also, much of the specific therapy in posture correction relies on muscle tightness and weakness found during the examination.
Conventional Corrective Therapies
Five main modalities are employed in the conventional treatment of faulty body mechanics and hence postural faults: chiropractic treatments; hydrotherapy; soft tissue work (MRT); and stretching and strengthening exercises. Shortened agonist muscles must be stretched before the antagonist muscle can be optimally exercised to increase their strength, or vice versa. Depending on the condition, manipulation may also be required to release and accompanying fixation.
Often postural faults are the result of a leg length discrepancy; either functional or structural (anatomical.) Correction of functional shortness involves a number of factors. First, correction of any structural faults has to be made to allow for the normal weight distribution and normal functioning of the joints and muscles involved. This is done by correcting any muscular imbalances (right vs. left and front vs. back) that become apparent. Adjustments allow all joints to function under a proportionate weight distribution which is essential as they are the holding elements for muscles. Lastly, orthotics are prescribed to maintain any structural discrepancy remaining.
Article submitted by Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic
(original article provided by Dr. Weatherall at http://www.advancechiro.on.ca.)