Practical Science on Movement and Pain
Practical Science on Movement and Pain
In a previous post I wrote about several common misconceptions about posture. In this post I’ll try to explain some essential functional elements of good posture that are often overlooked, and give some creative ways to work toward them.
Good posture should meet several conditions.
First, it should be efficient, i.e. let you rest pain free in a particular position with a minimum of energy expenditure. Second, the posture should not inhibit any ongoing activities. Third, the posture must allow a quick and easy transition into the next relevant movement.
These requirements tend to be mutually supportive but sometimes compete with each other such that one consideration takes greater priority in certain situations. Lying on your back is the most efficient posture but it is not very good for performing any ongoing work. Sitting in a chair allows various ongoing activities, but doesn’t make you well prepared for running. An athletic crouch position makes you well prepared to move quickly without hesitation in a variety of directions, but it is relatively inefficient – i.e. it takes energy to maintain. Thus, you would not use the crouch to wait in line at a movie or talk to friends at a wedding. So, the optimal posture depends on a variety of considerations. Let’s review each in a little more detail.
I think efficiency is a key element of good body use. Efficient body use means the physical work you are doing is done with a minimum of effort or strain. In the case of posture, the work we are talking about is basically counteracting the force of gravity to hold yourself upright.
Many people have accurately described the biomechanics related to optimal standing or sitting. The main idea is that the various heavy bony segments of the body such as the feet, knees, pelvis, chest and head need to be stacked one over the other. This will tend to minimize the work of the muscles because part of the work of remaining vertical will be accomplished by the compressive forces of the well aligned skeleton.
But even a stacked skeleton requires muscular activity to stay upright. The big question is how to develop a pattern of muscular activation that maintains verticality with the least effort. Various experts have attempted to divide the muscles into “postural” and “prime mover” categories as a way to decide what muscles need to be developed or activated to have better posture. This approach has considerable truth to it, but it goes wrong when it leads people to place excessive attention on strengthening or activating one or two postural muscles like the multifidus or transversus abdominis, while neglecting the rest of the body.
Any movement, posture included, is an infinitely complex symphony of harmonious cooperation from each and every muscle in the body. Almost all of the more than five hundred muscles in the body can exert a direct or indirect mechanical force on the spine. This force must be balanced and countered by appropriate contractions from each and every other muscle in the body. Given the complexity of the body, we should be very skeptical of the ability of any therapist to change posture by focusing on one or two magical muscles. That’s like trying to change the country by electing a new president. It’s the system that needs to change, not one player in the multitudes.
So how do we change the posture system? One interesting approach that I like involves visualization. As I have discussed in previous posts, visualizing a certain movement activates the same neurons responsible for performance of the movement, and is a surprisingly effective way to improve movement skill. In the case of posture, such a visualization might involve one or more of the following images: the spine lengthens as the space between each vertebrae grows larger; the spine is like a curtain rod and lengthens out of itself; there is a string pulling the crown of the head upwards; the head is a balloon and is floating upwards; there is a weight on the tailbone pulling it downwards. The more vivd and real you can make these images the better.
If you engage in this imagery for a few minutes, even without making any conscious effort to adjust the spine, you will notice some immediate changes in your posture – hopefully that you feel taller and require less energy to stay upright. (To feel an even more obvious change in posture as a result of pure visualization, try standing and imagining the skin on the front of the body flowing upwards and the skin on the back flowing down. If you are like me, you will soon feel yourself leaning backwards to the point of almost falling over.) I will discuss these ideas in more detail in a future post on Ideokinesis, which is an excellent movement therapy used primarily by dancers, and is based purely on using imagery.
As I discussed in the previous post, posture does not mean holding still. Instead, posture must fully allow any ongoing activities such as breathing, watching the horizon, typing, reaching, or enjoying a delicious beverage. Usually this means that the head must be free to move, the ribs must be free to breathe and the arms must be free to reach. If you are sitting in such a way that inhibits any of these activities, there will be conflict, strain and wasted energy when it’s time to move (which is almost all the time.)
In fact, sitting in a way that inhibits free motion of the head, hands and ribs will create problems even before the need to move arises. Because of the importance and frequency of head, arm and breathing movements, we can infer that the muscles that control them were not intended to be occupied by postural duties. To make sure these muscles are not doing postural duty, you can make exaggerated use of them while sitting tall as a postural exercise. You might try visualizing maintenance of a long spine while moving your arms through some full range of motion and gentle circles, breathing air into every corner of your ribs, and turning your head to look at as many objects you can see near and far, above, behind and below.
Another criterium for good posture (that is usually overlooked) is that it must allow an easy and quick transition into the next potential movement. Of course, the next movement might be very different depending on the needs of the moment. Your need to be prepared while waiting for the ball on a soccer field is different from your needs sitting at a computer, which is different from your needs while standing in the middle of an African savannah with predators lurking in the distance. Because our bodies were designed by evolution to ensure survival in a setting more like the savannah, where a physical attack might be on the way from any angle at any time, let’s explore readiness for action from this perspective.
Here’s a bizarre experiment. Imagine that you are sitting at your computer in an environment where quick and powerful action might be required at any minute. Perhaps there are predators on the horizon and you need to scan near and far to see if one is approaching. Prepare to exit your chair and sprint out of the room if necessary. Or imagine that the moment your co-worker returns from the bathroom, you need to grab the printer and throw it as his head. Perhaps you need to do this anyway. Now examine your posture. You are probably sitting nearer to the edge of your seat and not using the back support. Your feet are probably arranged with a solid connection to the floor. Your pelvis is actively engaged with its base of support on the chair. Your spine is well balanced over the pelvis and ready to move in any direction. Your head and arms are free to move. So maybe there have been some improvements to your posture -more athletic, ready, stable. Or maybe you are now hiding under the desk.
The main point here, perhaps poorly made, is that there is more synergy between powerful athletic movements and everyday simple movements than we usually imagine. Our bodies are the result of a long process of natural selection – we should therefore expect that postures that are necessary to ensure survival are comfortable and healthy. Put another way, if you are aware of your environment and tuned into your base of support in a way that will allow easy and powerful motion in any direction with a minimum of preparation, then you will have probably have good posture.
Posture is not about holding a position and sitting up straight. It’s an athletic event filled with movement and preparation for the next movement. The better you move, the better you can just stay still and relax.