Correcting Faulty Posture

Posture is essentially 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 rest. Correct posture involves the positioning of the joints to provide minimum stress on the joints of the body. 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 can occur over time. As well, damage and changes to the surrounding tissues can happen, too.

Posture involves 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.

The effects of posture can be far reaching, involving respiratory, digestive, and circulatory systems as well as the musculoskeletal system.

How is poor or faulty posture developed?

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 reason, 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, or contracture
• respiratory conditions
• general weakness
• excess weight
• loss of proprioception–the ability to perceive the position of your body

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 effected 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 continuously mediated by the myotactic 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 nervous system. Therefore, posture to some extent can be relearned (corrected) just as it was learned in the first place.

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 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 cannot be over-emphasized. Also, much of the specific therapy in posture correction relies directly 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: heat; massage; stretching; strengthening exercises; and supportive measures to treat ligaments, bones, and nerves.

Shortened agonist muscles must be stretched before the antagonist muscles can be optimally exercised to increase their strength, or vice versa. Depending on the condition, manipulation may also be required to release an accompanying fixation. Therefore, manipulation should be added to the list of posture correction therapies.

(Thanks to Advance Chiropratic for the information above.)