Posture has been a hot topic in health care for many years. Still, recently there seems to be greater interest in assessing posture and working to maintain and improve posture as we gain new knowledge about its importance in longevity and the possible connection to cognitive brain function, perhaps dementia.
As researchers continue to investigate those connections in the lab, health care professionals in the clinical setting are seeing the effects of inefficient posture as it relates to pain, degenerative changes, and functional movement.
Posture can be described as the position our body maintains in space to maintain balance while static or in motion. It is regulated automatically by our subconscious nervous system and can be influenced by neurophysiological, biomechanical, and emotional factors.
Ideal static posture is a position of the greatest biomechanical efficiency requiring the least amount of energy to maintain that also recognizes that the lateral curves of the cervical, thoracic, and lumbar spine exist in optimal angulations, the spine is aligned vertically, and the mastoid processes, shoulders, hips, and knees align on the horizontal plane.1
Why Do We Have Poor Posture?
Poor posture can be the result of numerous factors, including genetic predisposition, trauma, and lifestyle factors that include excessive amounts of sedentary activity.
Posture is usually associated with repetitive activities that we engage in daily, with the most common being sitting with our heads in flexion, looking at a computer screen, or using a personal electronic device. The data collected about posture associated with electronic devices is definitive; the positions we practice the most become part of our postural pattern.
Common Approaches to Poor Posture
Many devices have been created to improve posture, and most offer little, if any, long-term solutions. Braces, harnesses, straps to pull the shoulders back, and electronic devices to remind you to sit up straight when you slouch all fall short of providing long-lasting changes to postural change.
Our mothers' “gentle” reminders to “Sit up straight” had nearly the same effectiveness because posture is a subconscious process. Postural exercises can be vital to postural improvement, but muscle strength alone does not promise efficient posture. The postural muscles must be neurologically engaged, and that function begins with the feet.
Why Look at the Feet?
The feet are our interface with the earth, and they are richly supplied with mechanoreceptors that feed complex sensory information to the brain. The motor response is relayed back to the postural muscles to provide stability, balance, and movement coordination.
This process runs automatically, requiring no conscious thought on our part, and it works at varying degrees of efficiency depending on several factors, including our level of fitness, current injury, healed trauma, and anatomical asymmetry, to name a few.
The factors associated with trauma and anatomical asymmetry elicit an amazing muscular response in the nervous system that we call recruitment or compensation. The brain will recruit muscles not generally required for balance or movement to assist the muscles injured or neurologically inhibited by the nociceptive reflex patterns associated with injury, pain, and the subluxation complex. When we function repeatedly in this compensatory pattern, we develop neural networks that repeat that pattern until it becomes an inefficient hardwired pattern.
The feet are a consistent source of anatomical asymmetry. The measurement of navicular drop has shown that nearly 80% of the population have an asymmetrical foundation that elicits the inhibition of postural tone requiring muscular recruitment. We see this in gait pattern irregularity, functional movement distortions, and postural imbalances. The body will retain these inefficient patterns indefinitely because when it comes to neuromuscular activity, the neural networks that are wired together fire together.
Changing posture and functional movement requires changing the activation patterns of muscles. Evaluation of the feet with current laser-based scanning technology allows us to accurately assess the integrity of the plantar surface of the foot to determine if there is an existing structural inefficiency.
Custom orthotics in chiropractic practice have been successful in creating improvements in the activation patterns of the muscles of the lower extremity by creating muscular co-contraction reflexes from stimulation of the proprioceptive mechanoreceptors in the muscles of the feet. This is the basis of efficient posture and gait and is required to apply specific postural exercises effectively.
Without this neurological foundation, our body must use inefficient recruitment strategies that lead to the gradual process of degeneration. Exercise in this inhibited state is less effective and can actually contribute to further stress on compromised joints.
As we continue to learn more about posture and its influence on health, the chiropractor will have an opportunity to be at the forefront of health care in helping patients create long-lasting, neurologically based improvements in static and dynamic posture.
Reference
- Carini F, Mazzola M, Fici C, et al. Posture and posturology, anatomical and physiological profiles: overview and current state of art. Acta Biomed, 2017;88(1):11-16.
