This is an excerpt from Postural Correction.
Who Might Benefit From Postural Correction?
The 30 postures described in Postural Correction are not specific to any one population, and many clients are likely to benefit from advice on avoiding or correcting postures that are likely to cause unwanted symptoms. The following list is not exhaustive but provides examples of the kinds of clients who may be susceptible to malalignment and for whom postural correction may be beneficial:
- Elderly people are more likely to present with genu valgum or genu varum when they are in the advanced stages of osteoarthritis. These postures can also be seen in people who have suffered knee injury or where injury or pathology affects the hips or ankles.
- The elderly are frequently observed to have kyphotic thoracic spines. So too are people who sit for prolonged periods or whose occupations involve repeated stooping.
- Many manual workers have asymmetric postures. For example, in the days when refuse bins were carried and emptied manually, refuse collectors portrayed lateral flexion of the spine as they repeatedly contracted muscles on one side in order to pick up and transport a dustbin. Whether such a working posture develops into true postural change is unknown but provides a good example of an activity that could lead to postural imbalance. Lateral flexion of the spine can also be observed in anyone who repeatedly carries a heavy bag on one side of the body. Vehicle-based camera crews filming sporting events have to look upwards to television screens for long periods, and at rest they may be observed to have hyperextension of the cervical spine. This is also common in linesmen employed to maintain overhead electrical cables, a job that necessitates climbing telegraph poles or using mobile elevated platforms whilst looking upwards. People with certain medical conditions are predisposed to malalignment. For example, hypermobile people lack stability in their joints and are likely to suffer increased cervical lordosis due to spondylolisthesis. Scoliosis is seen in 30% to 50% of people with Ehlers-Danlos syndrome hypermobility type; 23.7% have thoracic kyphosis and 43% to 55% have acquired flatfoot, and genu valgum often results from this foot posture (Tinkle 2008). In a study of 30 female teenagers with Down's syndrome, Dehghani and colleagues (2012) report the following percentages relating to specific postures: flatfoot (96%), genu valgum (83%), increased lumbar lordosis (63%), torticollis (lateral neck flexion) (60%), genu recurvatum (43%), kyphosis (10%), scoliosis (6%) and genu varum (3%).
- People who sustain injury to a joint may undergo a change in the posture of that joint, something that may be exacerbated through weight bearing. People who sustain injury during childhood sometimes develop marked asymmetrical postures in the lower limb and spine as they avoided bearing weight on the injured side. In some cases they never develop weight bearing equally through both lower limbs and show an unconscious preference for the uninjured side, despite having recovered many years previously from the initial injury.
- Non-symmetrical cervical postures may be observed in some people after whiplash injury.
- Pregnant women often appear to have increased lordotic lumbar spines, in which the spine is pulled forward due to the additional weight carried anteriorly.
- In addition to the postures described by Bloomfield and colleagues, in table 1.2 you can observe specific postures in sportspeople:
- The upper fibres of the trapezius muscles in tennis players tend to hypertrophy on the dominant side due to repeated elevation of the batting arm above shoulder height. The scapula on the dominant side of asymptomatic tennis players has been found to be more protracted than the scapula on the non-dominant side, and this asymmetry may be normal for this group of sportspeople (Oyama et al. 2008).
- Golfers may develop postures associated with rotation not just in the back and hips but at the knees and feet also.
- Boxers may have elbows that are flexed at rest due to hypertrophy and shortening of the elbow flexor muscles.
- Practitioners of wing chun kung fu frequently demonstrate internal rotation of both the hips and shoulders. This is because of the stance adopted for practicing many of the chi saus, the repetitive arm movements inherent to this form of martial art.
- Postural problems also develop in association with immobility:
- People who work at desks often display internal rotation of the shoulders and thoracic kyphosis due to prolonged sitting postures.
- People who use wheelchairs or who spend many hours sitting or driving as part of their occupation may develop postures associated with hip and knee flexion.
Learn more about Postural Correction.