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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

February 2000

Back Pain - Part 3: Devastating Effects of Long-Term Poor Posture

By Rick Allen, DC

"Better health leads to better dancing."

Just after I completed my previous article on improving poor posture I received a chiropractic newsletter with an excellent article on the effects of poor posture. In fact, Dynamic Chiropractic considered this subject to be so important that they have started a new column devoted to reviewing posture written by two respected chiropractic authors, Steve Troyanovich and David Seaman, DC, MS, DABCN, FACC.

As I mentioned last month, because spinal health and dancing are intertwined (a healthy back is necessary for good dancing and dancing is one exercise that helps keep your back healthy), I'm going to take an extra two months to review their findings and add additional information from a post-graduate spinal rehabilitation course I completed last week.

Poor and Good Posture Defined

According to Kendall, in 1947 the American Academy of Orthopaedic Surgeons defined poor posture as "a faulty relationship of the various parts of the body which produces increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support." In 1949 they defined good posture as "that state of muscular and skeletal balance which protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude (erect, lying, squatting, stooping) in which these structures are working or resting. Under such conditions the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs."

Ideal and poor postures are illustrated below in figures from Kendall.

Poor posture example Good posture example

The Weight of the World? Almost!

World-renowned physiatrist Rene Cailliet, MD has demonstrated that if the head is translated forward, the weight exerted by the head is effectively increased by a factor of 10 with each additional inch of forward translation. That is to say, if the abnormal posture presented demonstrates two inches of forward head posture, the effective weight of the head to the supporting tissues is not 10 pounds, but 20 pounds; three inches of forward head posture results in an effective weight of 30 pounds, and so on. What do you think the effective weight is in the person pictured in Figure 3?

According to Cailliet, "to maintain direct vision, the head must be extended upon the cervical spine and thus increases the cervical lordosis. By virtue of the increased lordosis, the intervertebral foramina are compressed and the posterior articulations become more weight bearing. The erector spinae (cervical) muscles contract to support the cantilevered head and thus are in a constant state of isometric shortened contractions and contribute to pain and disability. Thus, the foraminal closures and the increase weight bearing of the facets cause local pain and radiating pain."

The Consequences of Long-Term Poor Posture

Forward posture example

Did some of the consequences of poor posture that I listed last month apply to you or to someone you know? They are all too common. They can be devastating long-term. Kendall, et al. noted in their classic work, Muscles: Testing and Function, "Postural faults that persist can give rise to discomfort, pain, or disability. The range of effect from discomfort to incapacitating disability [emphasis added] is related to the severity and persistence of the faults." Even though this is not new news, it does not diminish the importance of addressing poor posture.

Research has demonstrated that bad posture will lead to alteration in bone and soft tissues: bone spurs, intervertebral disc damage and fibrotic scar tissue. Evidence exists that some postural positions can compromise neural tissue by changing blood flow to the spinal cord itself. Connective tissues undergo plastic changes that can become permanent. This is probably why many individuals who exhibit the postural abnormalities of the person in Figure 3, right, cannot be placed into proper postural alignment with short-term methods.

What Should We Do about Poor Posture?

According to Troyanovich and Seaman, for the most part, doctors do what grandmothers do, i.e., tell patients to "stand up straight." Sound familiar? I, too, said that last month. There are more effective methods of spinal correction. They take time (typically 3 to 12 months), special training (for instance, the chiropractic biophysics and rehabilitation techniques that I use in my practice) and special equipment (such as the $3000+ I invested for a chiropractic drop table and traction devices). I'll go into more depth about these techniques next month.

References:

1. Steven Troyanovich and David Seaman. "The Chasm between Posture and Chiropractic Eduction and Treatment", Dynamic Chiropractic 1/1/2000.

2. Rene Cailliet. Soft Tissue Pain and Disability. Philadelphia: FA Davis Co., 1977.

3. Florence P Kendall, Elizabeth Kendall McCreary, and PR Provance. Muscles: Testing and Function. 4th ed. Baltimore: Williams & Wilkins, 1993.

Other articles directly about posture are:

You are invited to watch a half-hour video of good and bad posture on the beach in Fort Lauderdale, Florida by Paul St. John, LMT. It is a real eye-opener. Please call if you would like to watch it at my clinic.

Next article: Effective treatment for poor posture.

Dr. Rick Allen is a chiropractor, massage therapist and dance student who is located in Trout Lake Washington. Dr. Rick welcomes your questions and suggestions for future articles. However, he cannot make specific diagnoses or treatment recommendations unless you visit him in person. He can be reached by phone at 509-395-0024 in Trout Lake, or toll free at 1-888-247-3248, email or on the World Wide Web: www.CascadeWellnessClinic.com

DISCLAIMER: The information included in this website is meant to encourage thinking concerning choices of care for and insight pertaining to possible causes of various problems. It is not a prescription for or diagnosis of any disease or condition. Suggestions are based on the assumption by the writer that a thorough examination was done previously and the reader is under care by a healthcare professional. This information is not a substitute for a live doctor.

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