I’ve always had an issue with posture (not mine).
When I begin an evaluation, I always start with a standing assessment. That is usually the time they “admit” to me that they have bad posture and they know they need to work in it. There is very often a sense of shame attached to their admission. I often will ask them what it is that they need to do to fix their poor posture. Invariably they say something like “I need to strengthen” (you know what is coming from me here) or that they need to be more mindful of their posture. Many will report previous visits with physical therapists where the PT used lack of strength as a reason for poor posture.
Now before you quote me studies that show improvements in posture with exercise, save your fingers. I am sure someone has done a study that showed positive results, but what does improving strength really do for posture?
Forward shoulders are a typical type of postural deficit in many people. The exercise model will see this as weakness in the musculature in the upper back and shoulders. Strengthen the back and back of shoulders and the shoulders will be held in a more normal positions. Does this sound familiar? And, does this make sense?
Unless we are talking about smooth involuntary musculature, and we are not, muscles only respond when they are actively contracting. When you relax or take your mind away from the action, relaxation occurs and the shoulders will pop forward once again. But if you would simply move around the front of your patient and evaluate the tightness in the front of the shoulders and chest, you will see what can create real change in posture.
Using the “lack of strength model” to address poor posture is setting your patient up for failure. Think length, not strength.
Walt Fritz, PT
Coming to the health care world as a body worker first, I want to thank you for raising the issue of shortened myo-fascia as an important component of postural imbalances. I often see patients frustrated after receiving strengthening exercises without improvement. May I add, as a functional movement therapist that by releasing long held patterns in the myo-fascia, it then makes it much easier to retrain the muscles for the necessary stability and functional strength.
I also commend you for insightfully pointing out the emotional component of posture and movement. Your consciousness undoubtedly contributes to your success as a therapist.
Jaya,
Thanks for your kind words. Functional retraining is essential for any change in body posture to remain. I often see the retraining as automatic once the fascial tightness is taken away. Input and training from us adds further value. I know that I can be somewhat myopic in viewing the effects of releasing long held patterns. Other therapies can be of great value as well.
I love Posture! Thank you for the great topic. You are right to name both myofascial and the emotional state of the client as part and parcel of the whole picture. There is however the misconception (that you did not address) that posture as a static model or holding of a certain perfect place or position. Judith Aston has taught me about how posture is a range of motion (and emotion) which we can use to convey our experience to the world as well as how we receive from it. As bodywork practitioners we reveal the possibility of better posture. With some movement education, that person can choose where they want to be, depending on how or what they are feeling. This is truly our gift to our clients to broaden their possibilities in the world. Time and time again I have seen how clients “come out of their shell” and live their lives more fully present in it. Check out my “Sitting Comfortably” blog post on http://www.michellewald.com to see how I teach clients to find their best neutral, for now.
Michelle,
I agree fully that posture is a dynamic, not static state. It changes with the demands of life and we can impact this to a large degree.