Posture is very much a sub-conscious activity. We automatically do what is needed without putting thought into it. However, it becomes imperative to bring it to the conscious level in order to make adjustments and corrections deliberately, as in the case of correction required for postural deviations. If allowed to go unnoticed for long, such deviations can cause muscle imbalances and eventually alter joint alignment and biomechanics.
When you go to a physical therapist, they look at your static standing posture, dynamic standing posture or posture in motion, (for example, gait assessment, heel walking, and toe walking) as well as challenge the base of support to assess balance/stability (single leg stance, tandem standing, etc.). A functional movement assessment looks at both static postures and dynamic movement patterns. A good posture in various positions is the basis of all functional movement. Hence in physical therapy sessions, posture is the first consideration towards fitness, not speed or number of repetitions of movement, as is popularly thought. A good static posture is the foundation on which you superimpose all other movement patterns. While looking at a good dynamic posture, there are certain basic movement patterns that we employ for all activities. These activities are variations of these basic movement patterns or building up of more complex movements over the basic patterns. The basic patterns consider biomechanics with good joint alignment and muscle function.
Progression for training of any activity or movement is necessarily from good static posture to basic or fundamental movement patterns followed by training of specialized or complex patterns needed for particular sport or dance. Repetitions and speed for fitness come only after these basic postural requirements are achieved. It is much like acquiring the motor skills in infancy. The young child puts the entire being into learning the new skill, be it rolling, coming up on arms in prone position, learning to shift weight and sit up, moving from sitting to standing, and so the list goes on. The baby will rock the weight till balance is achieved, then repeatedly practice that posture to build strength and agility and eventually master it with sufficient speed, till it is a sub-conscious activity.
There are some common traits we share in terms of basic posture like an upright spine and normal curves in the spine (lordosis in cervical and lumbar spine, and kyphosis in thoracic and sacral spine). Though “normal” here includes a range of joint mobility (about 10°-15°) when measured using an inclinometer. From observation, it is evident that each of us is comfortable in a particular posture and the muscles around the spine are in equilibrium at a different point in the range for each individual. Therefore, posture is an individual consideration. Basic factors such as spinal curves are common to all, however tuning should be done on an individual basis after detailed evaluation and should be adjusted as needed on an ongoing basis.
There are certain key muscles which are predominantly active to maintain upright position. Spinal stabilizers (erector spinae, multifidus, transversus abdominus, obliques), scapular stabilizers (rhomboids, serratus anterior, levator scapulae, trapezeii), and postural leg muscles (gastrocnemius-soleus, tibialis anterior, gluteus medius) play a vital role in static postures as well as in movements. Co-contraction of trunk muscle groups offer proximal stabilization and the leg muscles enable fine tuning to maintain a steady stance. Posture is more or less dynamic. Subtle body movements and weight shifts are happening all the time (one cannot stop breathing!) which cause the muscles to be in constant flux to balance the moment of force around a given joint.
To consciously make changes to posture, it is essential to improve muscle flexibility / joint mobility to allow greater range of motion than existing in case of soft tissue tightness / joint stiffness, or, to stabilize a hypermobile joint by co-contraction of muscles around the joint and challenging static holds. Manual therapy offered during physical therapy sessions can target specific deficits and impact those effectively as per individual needs. Once change is made consciously and repeated, this movement pattern is learned and recorded in the brain. Repetition and speed help strengthen the nervous pathway and permit ease of signal transmission to make this change “sub-conscious” or “automatic.” Soon this no longer requires conscious attention and a good movement pattern becomes the norm.
Thus, this five-part series on posture comes to conclusion after discussing basics of posture, basic postural positions and how to make changes to posture. The decision to make that change, and for the change to be effective, should come from you. Once committed, it is only matter of “when” and not “if” the change happens. And as always, the emphasis is on the journey made to change a habitual posture. In yoga, it is said “The study of asana, is not about mastering the posture. It is about using the posture to understand and transform yourself.”
Ami Gandhi is a licensed physical therapist in the state of California. She is the owner of StableMovement Physical Therapy, a small boutique practice in San Jose that offers patient centered, one-on-one, hands-on physical therapy.