Tuesday, 23 August 2016

Textbook Posture - It's A Myth

Does this sound familiar?

 "I went to get my spine x-rayed. Apparently my C5 is out by 14 degrees, my T1 by 30 degrees, and T3 by 10 degrees. I've been told that I need 3 months of treatments or else I'll be in pain for the rest of my life."


In the therapy field, I hear this a lot. Someone sees a practitioner for pain, they go get x-rays, CT scans, MRI's, and the works, and then they receive their alarming prognosis. It's hard to argue with a photo. You're taking a real-time picture of what's happening inside the body. If the imaging shows that your spine is out, then your spine is definitely out and you need to do something about it.

Well, maybe.

Textbook Perfection

Every medical professional that you've ever seen learned their stuff from textbooks. When it comes to anatomy and physiology, there are rules to how things are supposed to look. You're overall posture, for instance, should allow you to draw a straight line from your jaw joint through the shoulder, the middle of the hip, to a point just in front of your knee, and then finally to the ball of the ankle. There you go, all in black and white.



Except! The body is not black and white. Everything to do with health is a gray area, and every single body varies. Very rarely do we ever see a person with textbook perfect posture or spine that's free of degeneration. Often, it's the shape of the joints which throw things off. Other times, it's just the functional way your body holds itself due to your lifestyle. Maybe you ARE supposed to have a better posture than you do, but your tight or weak in certain areas. There are textbooks, but there are no handbooks to this. If you deviate from what your Anatomy 101 class says you should look like a little bit, it's no reason to rush to your chiropractor.

Postural Faults and Pain

That being said, if you do have a clear fault in your posture, such as rounded shoulders or an over-arched back, then could definitely be room to correct things. However, whether you're the therapist or the client, it's important that we remember to not stigmatize these imperfections.

I was reading one insightful article about disc bulges, one of the most feared and debilitating injuries that we can speak of when it comes to back pain. As it turns out, however, the images may show that you have a bulged disc, but you might not necessarily have any symptoms at all. Many faults and imperfections are natural, whether from birth or from the regular aging process. If you're asymptomatic, then there's a solid chance that you're going to remain that way, provided that your general health stays in check. I've heard many clients talk about the malaligned ways that their x-rays revealed their back likes to stay in, but guess what; chances are that my own x-rays would show many of the exact same things.

What If I Do Have Pain?

If pain is present, then there is obviously something going on that needs fixing. However, in these cases, let's still remember to pause and take a breath before dropping $900 on 5 months of prepaid traction and manipulations.

Again, malalignments and imperfections are often going to be present whether or not there's pain. Sure, you do want to focus on those areas by mobilizing joints and tractioning to reduce pain and pressure, but even then, those aren't necessarily cures.

Remember, it's more than probable that most of us have a postural imperfection without symptoms. So, if we do have symptoms, doesn't it stand to reason that those faults aren't necessarily the problem? They may not be helping, but more than often, I'm willing to bet there there is a strength imbalance, acute injury, or a habitual, repetitive task that would be much more beneficial to target. The most likely fact is that you're going to rehabilitate to the point that your pain is gone and function has returned before you see significant changes in your posture.

So Does Posture Not Matter?

I wouldn't go as far to say that you shouldn't care about posture or things picked up on your MRI. I'm just saying that visuals and images are essentially one test for your health when, in reality, there's a bigger picture to be painted. Is a person able to function and bend the way they need to? Are they in pain? How old are they and could this just be natural?

The important thing to remember is that posture charts to us and to many health professionals are like Barbie dolls to young girls. They're all fine and good but don't go thinking there's something wrong with you for not looking like that.

Her posture leaves me wondering anyway.

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