October 19th, 2012

Posture has long been considered a predisposing factor in causing musculoskeletal injuries and a source of chronic pain.  It is your physical therapist responsibility to come to the aid of you, the patient, and offer possible solutions.  Normal postural alignment allows for ease of movement, quick reactions in poor environmental conditions, full range of motion of joints and the ability for muscles to maximally contract and expand. With no abnormal forces on the musculoskeletal system, there will be less compensatory changes and substitution patterns and less stress on the joints. The penalties for poor posture include; increased joint wear and tear, decreased efficiency, disuse atrophy of muscles, fewer muscles recruited and abnormal muscle patterns resulting in substitution. Jacqueline Perry, MD describes normal posture in the following way, “the organism recognizes a forthcoming threat from the environment, and reacts to it quickly enough with efficient use of muscle work to prevent injury.”
Prevention of injuries begins with good vertical alignment resulting in normal load bearing throughout the joints. Every movement, especially in sports, begins from a posture and ends in a posture. In normal alignment, postural changes and adjustments can be rapid and automatic. The body cannot operate in malalignment efficiently. The result is poor performance, musculoskeletal injuries and pain. Changing postural relationships requires focusing on alignment, a thorough evaluation and an effective treatment plan and program. Frequent reevaluations are required to analyze the changes in alignment and adjust the treatment program accordingly.
In order for your physical therapist to be complete and maximally effective in treating your injuries, they must evaluate and realign your posture.  There is static and dynamic posture. Static posture is the skeletal system and the positions of the various joints and body segments using tonic muscle control. Dynamic posture refers to active muscle contraction, muscle coordination and control over the body. With the body in malalignment, dynamic muscle groups become weaker and static postural muscle groups become shorter. Following the evaluation, a specific sequencing of exercises is dictated to change the postural faults.
After a muscle has been caused to shorten, there is no appreciable spontaneous lengthening of the muscle during relaxation. Muscles are caused to lengthen by the pull of the antagonistic muscle, and by the action of gravity. In this program, the lengthening of a shortened muscle is a passive, not an active process. Which is different than contract relax or functional lengthening programs.
Postural realignment is accomplished through a progression of exercises that target the intrinsic postural muscle groups and retrains the neuromuscular system.  All of these exercises can be preformed as a home exercise program.  As a patient, it is your responsibility to do the exercise progam given to you in order to experience the ultimate outcome.  To learn more about receiving an individualized posture program that address your specific needs, contact us at Evolve Physical Therapy, San Diego, CA  92122, 858-457-3545.  We can help!

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