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Changing posture and skeletal alignment – it’s not as easy as you think…

April 24, 2012

Can we change our posture?  Can we improve ‘skeletal alignment’?  To answer the first question…yes, but it takes a lot longer, and a lot more work than you (and many other’s think).  Regarding the second…I really dislike the term ‘skeletal alignment.’  Your skeleton is aligned in the precise position(s) governed by genetic predisposition and millions of years of natural selection.  When things come “out of alignment”….proceed to the nearest hospital as you have likely dislocated a joint!  Lets just drop that phrase here.

In the video below, Dr. Spina discusses concepts regarding postural rehabilitation and training.  Most important to note is the fact that exercise alone will NOT cause permanent changes to a persons posture.  The idea that stretching “lengthens” muscles, and strengthening “shortens” muscles is an archaic concept best left in the 1960’s.  Current literature clearly demonstrates that muscle length remains highly unaltered unless said alterations are governed by nervous system input.  This is otherwise known as neural drive.

Take home points:

1.  Posture is not determined by the mechanical state of the tissues…but rather by the dynamic control of said tissues.

2.  Good posture is a ‘learned’ phenomenon.  Conscious effort must be translated into unconscious patterns.

3.  Stretching and strengthening while important, only constituted a small portion of what is necessary to improve posture.

4.  Most important concept = POSTURAL CUEING – frequent cueing, increasing the number of times a particular neural signal is sent down a line of synapses will hone that particular signal such that it is automatically generated (think neural plasticity).

5.  Postural breaks are necessary and unavoidable.  It provides rest to posture governing tissues.


2 Comments leave one →
  1. ben permalink
    April 27, 2012 10:28 am

    Great insight again Dr Spina. I have seen on youtube a video whare an occupational therapist just periodically pokes the scapula or lumbar area and the client ‘automatically’ sits properly, etc. But how abt weight training clients who have chronic (eg, 10 years) of shoulder problems? With the altered rhythm, firing pattern, AC/GH/ST mechanics – apart from visual cues, what would be the best way to enable the client to reset to neutral scapula, GH, etc?

  2. April 27, 2012 7:21 pm

    Thanks for the question Ben…Without having had time to examine the patient, I can generally say this…I believe it important to always normalize tissue and joint mechanics BEFORE engaging a patient in any type of rehabilitation program. To do otherwise is to reinforce improper neural patterns created by the tissue/joint dysfunction. Thus for your patient, I would, to the best of my/your ability ‘normalize’ the AC/GH/ST mechanics using treatment – F.R. release, mobilization, etc – as well as P.A.I.L.’s (Progressive angular isometric loading) to begin to teach the motor units proper activation patterns. Then I would work to teach their system neutral scapula positions….followed by ‘challenging’ neutral scapula posture during peripheral movements.

    I hope this helps….the main point I think is normalize tissue 1st…then rehab on a properly functioning ‘platform’

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