Posture therapy
The posture and the way in which the posture is built up is the basis of many complaints of the musculoskeletal system such as back pain, neck pain, but also shoulder complaints, hip complaints and so on. Posture therapy is one of the most important therapies in the package of musculoskeletal medicine. It is also one of the most difficult executable for long-term effect.
Observation posture
Go sit on a terrace on a nice summer day (Northern Hemisphere) and watch people sit and walk. It is striking how many people have a sagging position, with a rounded middle back, and protruding neck and head. The shoulders often 'fall' forward. When walking, the feet are not lifted sufficiently. Compare this with the posture of a 3-year-old child who, sitting on the floor, can be upright for hours trying to discover the world. Now focus your attention on your own body, and take the different postures. Feel what happens with tension build-up and decay when changing postures, or for keeping a long time the postures. Also feel what happens to the mood and how it responds to the changes. You may experience little. In some people this can be a sign of limited body awareness.
Body awareness
The feeling for a good natural posture can be lost by using a lot of bad sitting furniture, bad condition, little exercise, overweight, fatigue due to long working days, going into computer games, and so on. The often and frequent ignoring of signals from the body leads to lessening of these signals or that an anesthetic for the signals occurs. In certain situations, the signals can return more severely in the form of complaints: back pain, neck pain, headache and other complaints. It is then difficult to see the connection with the long-standing non-optimal posture.
Overload
The origin of the complaints usually has to do with some form of overload. On the one hand, the physical condition is often no longer optimal, so that relatively small loads can cause complaints. On the other hand, an additional postural load is already present, which means that the fatigue limit is reached more quickly during activities. The result is often that the posture drops even further (gives relief from the symptoms), which puts the person in a vicious circle.
Distortion of the body
The consequence of such a posture is that the musculoskeletal system, for example the back, is biomechanically loaded and exhausted in the same way for a long time. Because in the course of time the body adjusts to the loads that are offered, it deforms, making the road back increasingly difficult. The risk of returning and maintaining complaints increases. Because the mass deformities also adversely affect the mobility of parts of the body, apart from complaints on the back, neck or head, complaints can also arise elsewhere. For example, when the shoulders go forward, shoulder complaints can occur more quickly. One of the characteristics of these complaints is that pain occurs during lifting of the arms, about halfway through the total movement trajectory.
Problem: change of posture
In general, the posture can still be corrected (technically) until puberty. After that, the possibilities decrease and more and more within the limitations of the individual must be sought for an optimal posture. This is easier said than done. Posture is behavior, and it is difficult to change behavior. It will first have to come from the person himself. That is why the full commitment of the person is required.
Posture therapy
The first step towards improvement is awareness of your own posture. Then begins the search for the optimal posture for this person. Finally, instructions will be given on how this posture is easiest to build and maintain. The practice musculoskeletal medicine works with a set of simple exercises and instructions, which are discussed step by step. Only by practicing a lot and often it is possible to break the old behavior. Under optimal circumstances, this process can be followed in 4 sessions over the course of a few months.
Supporting therapies
Posture therapy alone appears to be sufficient for a very limited group of people to get rid of the complaints. Often there are disturbing factors such as: the stiffening of certain parts of the back, the inability to move well of hips and knees, an overloaded painful intervertebral disc, and so on. In those cases extra support is needed with other elements from the musculoskeletal medicine.
References
Fast J. Body language. Pan Books, 1971.
Bashir W, et al. The way you sit will never be the same! Alterations of lumbosacral curvature and intervertebral disc morphology in normal subjects in variable sitting positions using whole-body positional MRI. Presented at: Radiological Society of North America 2006 Meeting; November 27, 2006; Chicago, Illinois. Abstract SSC20-07.
Lewis J, et al. Subacromial impingement syndrome: the effect of changing posture on shoulder range of movement. J Orthop Sports Phys Ther 2005; 35(2):72-87.
Gangopadhyay S, et al. Effect of working posture on occurrence of musculoskeletal disorders among the sand core making workers of West Bengal. Cent Eur J Public Health. 2010 Mar;18(1):38-42.
Roffey DM, et al. Causal assessment of awkward occupational postures and low back pain: results of a systematic review. Spine J. 2010 Jan;10(1):89-99.