Friday, April 17, 2015

Confessions of a Recovering Posture King

The Culture

I always enjoy a good parade.  The floats are often amazing and there is always a great display of talent.  I like to see the various people as they pass by.  What tends to strike me is the way the people in each of the groups all try to look the same.  The Military people stand erect with stomachs in and shoulders back and they stare straight ahead.  The dance school groups come by and have a very characteristic posture that just can’t be missed.  The people watching are often just as entertaining as the actual members of the parade!

We often see people or even look in the mirror and comment on how good or bad someone’s posture appears to us.  We seem to have an innate understanding of how each other is supposed to look - in our culture!  We often work hard to hold ourselves in uncomfortable positions just so people won’t look at our bearing and criticize.  We know they will because we do it ourselves.

I have to admit that as a therapist I was rather horrible at postural evaluation when I first started.  My wife worked as my receptionist and would often come beck and tell me what she saw in a person’s posture and movement.  This was invaluable to me because I just did not see it.

Then I Learned About Posture

Then I attended a workshop where a local DO taught us how to evaluate posture.  He mentioned during his demonstration that we could use this new tool to see if our clients were making progress.  I light went off in my mind – perhaps I could evaluate the posture and then create a treatment that would intentionally alter it!

I eagerly applied my knowledge of muscles and their areas of attachment and developed a plausible theory of what to treat and what order to do it in.  I made it all up as I went along.  The results were amazing.  I was helping people that I had not been able to help previously.  It was an exciting time.

I even wrote an article about how to do it and got it published in a medical journal.  I had people come up to me at professional meetings and thank me for my work in this area.  I was even asked to demonstrate it for my national association as a major contribution to our discipline.

Another doctor – this time a DC added a substantial missing piece to my puzzle.  I was especially thankful for his input and developed his material to suit my own needs.  I eventually taught this in the school where I worked for 18 years and in seminars to therapists all over the country and even internationally.

This section has contained a good deal of what I call “Blowing and Glowing.” There is a reason for the overrated build up.  I think that most of what I did is wrong.  This is my public retraction.  To set the record straight – I was a Posture King.  I was wrong.


I helped a lot of people utilizing the approach that I developed.  I now believe that those successes resulted from other factors that were not directly related to my postural understanding.  I see a number of problems with my previous approach. 

A lot of people with poor posture don’t hurt.  This is readily apparent.  Just look at the people who you know with less than stellar posture and ask them if they hurt.  Many of them do not.  If posture is directly a cause of pain we should find that everyone with poor posture also has a pain complaint associated with that particular postural fault.  It simply is not the case.

We are not simple machines – in fact scripture teaches that we are “fearfully and wonderfully made.”  If we were a simple machine it would make sense that a lift under a short leg would balance everything and our pain would just disappear.  I have put lifts in shoes and under heels for years and can confidently state that many people remained in pain.  They did so because we are a flesh and blood creation and have our very own nervous systems.  A machine would have been fixed.

Fixing the posture rarely works long term.  I could often make a posture look rather stellar but it was often a short lived thing.  I saw those who were helped long term but unless they followed through on a number of other things I had them doing - those were a minority. 

Anatomical variation is hugely apparent in people – often in the same people from side to side!  In a recent study the pelvis was compared for symmetry from side to side in the same person.  The sides were clearly different.  There is great variability in studies when therapist attempt to describe what they see posturally in the same person.  This is in the literature and I have seen it numerous times myself in settings where I have tried to teach postural assessment.

Freeze, Fight or Flight is something we have all heard of.  Simply stated – When we have a sense of threat we tend to curl up in a ball to protect our “tender vittles.” In our homes and work places we tend to live in this constant curled up little ball.  No amount of bodywork is going to correct our posture if we live under a constant state of threat and stay curled up in a tight little ball.

Why Did It Work?

To hear me tell the story above about how I learned of the importance of posture and how to treat it successfully you are probably wondering why I have come to believe my approach was wrong.  I did give those reasons in the last section but of course the question remains – Why did it work in the first place? You can bet I asked that question myself.  It’s the stuff insomnia is made of.  I have a few thoughts on that subject.

I not only started dealing with posture – I also began doing a number of other things at about the same time.  One of the biggest things was that I really lightened the amount of pressure I was using.  I really thought that in order to be effective that I had to cause a good deal of pain during the treatment session.  Once I lightened my pressure it really helped the process.

I also began to look into the ergonomics of my clients at home and at work.  I showed them how to vary their routine and encouraged them to move frequently.  This had the effect of allowing the blood to be supplied to the nerves and to lower the threat level experienced by the brain.  More blood to the nerves is generally a good idea.

I also started talking more with my clients about things that tend to perpetuate pain.  I recommended books and began to give a good deal of movement for them to do between sessions.  Those who did these things  seemed to improve more quickly.  I believe these are a few of the things that made people feel better and I credit them rather than my attempts to correct posture – with helping their posture!

Another Way

I now have an entirely different focus when I treat people.  I generally look for signs that a person is in sympathetic mode (that’s a fancy way of saying Freeze, Fight, or Flight).  There are a few indicators that are especially helpful.  
  • ·       Upper Chest Breathing
  • ·       Feet that point to the ceiling
  • ·       Cold hands and feet

I see these as indicators that their nervous system is on overload and I work to calm them down using a variety of massage techniques.  These are often performed on the neck.  It is very common to see a pelvis untwist and the shoulder drop after a few minutes of this.  I am trying to calm down the nervous system and as the person begins to relax they begin to uncurl from that tight little ball and the posture does actually change.  The difference – and this is a BIG DIFFERENCE – is that I am not forcing my will on the person and trying the change their posture. Instead, I am supplying novel input to their nervous system and it is adapting itself to the new information gleaned by its receptors in the skin that I am touching. 

There are a number of other ways of getting our nervous system out of this condition of sustained irritation.  Believers can be seen doing these things all throughout the scriptures.  Here a few of them.

Theologians in the Presbyterian tradition often speak of what they call the “Means of Grace.” These are enumerated as:
  • ·       The Word of God
  • ·       The Sacraments
  • ·       Prayer
Let’s look at these and see how they apply to our subject.

The Word of God is identified as the Scriptures contained in the Old and New Testament.  When we hear it preached, taught, or when we read it the Holy Spirit often uses it in our lives.  We deepen in our love for our Triune God as we see his plan of redemption, Christ’s death and resurrection for our sin, and as the Holy Spirit applies it to our lives.  This happens in many ways.  We begin to think about him and the focus and meditation of our heart is on him and his person and work.  We rise above this world and adore him.  It is not uncommon for our cares to roll away.  I have seen shoulders drop and people rise changed.  It’s hard to be in Fight or Flight when adoration of our God is occurring.

The sacraments of the church are identified as Baptism and the Lord’s Supper.  These are done in community.  People in pain often tend to live in isolation that increases stress.  In worship we not only adore God but we pray for each other and try to meet each other’s needs.  This often gets the focus off of us and our problems and can be incredibly effective in lightening our cares.

There is nothing quite like prayer to get out thoughts off of us and onto God.  We pray to him as Christ taught us.  We pray acknowledging who he is and what he has done.  We bring our requests to him and we trust him with our needs.  Talk about stress relief.  The Creator of the universe loves us and asks us to ask him.  Burdens are lifted.

There are other things that can also help in dealing the stresses that curl us into little balls.  Learning certain breathing techniques is a great way to bring us into a calmer state.  The way I like to have people train their breath is to have them breath in to a count of 4.  Hold for a count of 1. Exhale to a count of 6.  The longer exhale puts us into a more relaxed or parasympathetic state.  It should be done for about 3 minutes.

Nutrition is a big thing also.  Studies seem to indicate that stress uses up our B vitamins and that supplementing with a good B complex can keep our nervous system from being as irritated.

Regular massage therapy is also an ideal way to keep our nervous system happy.  As a massage therapist I recommend it highly.  Exercise is another great way to help your nervous system.  These are a number of ways to keep out of that tiny stressed out little ball – and maybe even improve your posture as a side effect!

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