A few things about me: I have one foot that points out a bit. I walk like half a duck. Nothing big, I’m probably the only one who notices this, but it’s there. If you stood me up for a postural examination, I would be in pretty much the same place as 99% of the therapists who take my Foundations Seminars; I’m crooked! But, so are about 99% of the people out there in the world. Some look like ducks, some like pigeons, some like Quasimodo, others like who-knows-what! Look around you, how many people look like that chart hanging on the wall at school, showing “perfect posture? It will be a small number that fits this “norm” of perfect posture. Do a bit of man/woman-on-the-street interviewing. Are those people who have imperfect posture suffering from pain? A certain percentage will have pain, but most will not. So why do we apply different standards to those who walk into our clinic/practice?
Physical Therapy 101 taught me to look at posture as a means of determining asymmetry. Asymmetry leads to pain. MFR 101 taught the same thing. Both are quite incorrect. I have said many times in this blog that, in the past, I treated with the mindset of returning the body to a more perfect postural alignment will bring about diminished pain, but now I realize that much more is happening than just a change in alignment. If the imperfect posture as a cause of pain logic was true, everyone with less than perfect posture would have pain. We all know that this is not true.
The lesson? Stop looking for ducks. Posture is a very small part of a much deeper assessment that therapists must perform. Think of all of the things we are accomplishing every time we touch and interact with someone. It is a rich, deep body that we impact when we treat. Postural correction, if that is a patient’s true goal, is fine. But, please consider letting posture play a more minor role. Quack.
For Now,
Walt Fritz, PT
Foundations in Myofascial Release Seminars and The Pain Relief Center, in Rochester, NY
The duck dose not have pain because its walk is functional.
As you previously described if we can put our hand on the skin and it engages with the clients pain then we can help them find the function that does not cause pain. For example in the hold in your illustration that you explained previously, I ask the client to move the legs as if they were walking. This often leads to their discovery that they are moving the shoulder in a way that aggravates the pain when walking.