Instinctive Postural Correction?

[Guest guest]

Here is some further discussion on other lists relating to Barrett Dorko's

recent letter on postural correction. My own comments appear at the end of

this letter Any comments from other members on this topic?

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Respondent A wrote:

Hello everyone. Barrett, I am just curious and need clarification regarding

a point you made concerning postural reeducation.

" To my knowledge strength and posture are unrelated, and I don't personally

have any faith in instruction's enduring effect " and " the path toward the

desired position cannot be achieved efficiently or effectively with the

methods traditionally used by our profession " .

In postural dysfunction, is it not a combination of gravity pulling us into

an undesirable position with a sequelae of muscle imbalance (e.g., in rounded

shoulders, shortened pectoralis minor and lengthened rhomboids)?

Physiologically a lengthened or a shortened muscle that is restored to normal

length are weakened muscles. So wouldn't we would want to lengthen the

shortened mm. and strengthen the long weak mm? I know this is the crux of

Kendall's and Sahrmann's work.

I was at a private practice before I graduated that was heavily influenced by

Sahrmann. I saw the improvement of posture in most of the patients. Another

thought, when we instruct the patient to sit/stand more upright ad nauseum,

they become more aware of their posture which carries over during their day.

Many tell me that they realize that they are slouching when sitting at work,

and make adjustments based on the repetition when they are at therapy. It is

behavior modification for a postural behavior. How long that behavior of

self correction lasts following D/C, I don't know. Maybe an idea for a study?

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Barrett Dorko replied:

I appreciate the interest in this topic, and I'm very familiar with

Sahrmann's and Kendall's ideas. Kendall's book, you may note, is completely

unreferenced and her basic tenants of strength and postural correlation have

been questioned (read dismissed) quite effectively in our literature (see " A

Big Mistake " and " The Fatal Heuristic " on my web site for references and

further explanation).

It appears that Sahrmann has softened her approach from what I heard a few

years ago, now referring to " movement dysfunction " rather than weakness. This

sounds more like Feldenkrais to me, and I have a high regard for his

thinking.

I'm sure you saw postural improvement in the clinic, but the path toward this

and its enduring nature is something I question having seen the same

response myself. I don't think it lasts and I don't think many patients

continue to discipline their activity in this fashion. It isn't instinctive

in any way, and instinct is my interest here.

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Mel Siff:

A few things always concern me about the whole " postural correction " or

" realignment " concept:

1. Structural or observed symmetry all too often is regarded as the optimal

and safest end state for all

humans. The body very typically is an asymmetric system which displays a

level of plasticity and adaptability that is not always as homeostatically

" perfect " as seems to be implied by many posture police.

2. Posture often is regarded as something that is invariant and should not

vary to any noticeable degree from some hypothetical ideal or universal

model, despite the fact that any given motor problem may have more than one

unique solution.

3. Assessment of posture is far too often based upon static measurements;

very rarely is the topic of " situational " or " contextual " posture raised, nor

is dynamic posture ever measured under a wide range of conditions. Just as

some people display rather unaesthetic speaking voices, they may sing

exquisitely. Similarly, someone may display unaesthetic static posture, but

exceptional grace while in motion.

4. Sometimes individual posture is regarded as pathological, yet it has

never been established exactly which is the optimal postural reference model

for all static and dynamic situations.

5. It is too frequently proclaimed that the human body left to its own

devices will simply perpetuate " imbalances " or " imperfections " -- only

special therapeutic interventions will ever restore the body to its

hypothetical ideal state. Yet, it is not uncommon for the body to

spontaneously rectify so-called imbalances.

6. The concept of long lasting static posture runs contrary to how the body

functions. Speeded up video studies have shown that our bodies are always

indulging in subtle or gross movements to ensure that one precise posture is

NOT held for prolonged periods, thereby ensuring that stresses are not

imposed upon the same physical structures in exactly the same way. Even in

sporting and other complex movement situations, the same external movement

pattern may be produced by different musculoskeletal and neuromuscular

strategies, so that the idea of an invariant, highly stable single posture is

misleading.

7. It can be very misleading to assess the validity of postural correction

on the basis of changes in perception of pain, because absence of pain does

not necessarily imply the absence of pathology and vice versa.

8. A given postural intervention may not be the direct effector of change;

it might simply serve as the " last straw " in a long sequence of automatic and

therapeutically mediated changes, especially since many processes in

biological systems appear to be nonlinear in nature.

Dr Mel C Siff

Denver, USA

Supertraining/