Are you blaming BAD POSTURE for PAIN?
Well let me burst the bubble first, there is NOTHING CALLED AS GOOD OR BAD POSTURE . If I had a $ for everybody who is blaming BAD POSTURE for pain….. well lets just say I would be a pretty rich girl in that case.
POSTURE has literally become engrained in peoples thoughts when talking about back, shoulder or neck pain even though we have ton of scientific studies that compare the postures of pain free people with those suffering from pain and find no real differences, BUT this information gets regularly IGNORED.
This is super important. HOW can we blame something that we see in people WITHOUT pain as a cause of pain for those that do?
I will just let that sink in!!!!
So why does this matter?
Well simply put, which posture are you ACTUALLY measuring with your postural assessment. One may show an increase in lordosis, another less so.
I have some questions related to how we interpret postural assessments for the discussion:
Which of these postures is related to the problem?
How many times do you measure?
What are you comparing against to determine if the curve is too much or not enough?
The authors world-wide highlight a good point that the lack of consistency in standing posture may actually lead to the “wrong diagnosis and possibly unnecessary treatment”.
If you focus on something that is not an issue you do not focus on something else that might be or be blinded to the fact that it is not working or only works transiently (potentially why so much back pain is persistent).
What people actually use in their everyday lives might also be different to what is measured in the clinical setup. A clinician measures could be described as a SNAPSHOT.
So the SNAPSHOT postural assessment would not really inform us very well about how much lordosis was REALLY being used OR we could overestimate the extent of the imaginary problem : )
Another important question for those that assess posture is……are you MORE inclined to see an ‘ABNORMAL POSTURE’ whenever wherever there is PAIN?
IF DON’T YOU THINK YOU ARE BIASED?
WHAT POSTURE HEALTHY PEOPLE SIT?
Another question is how do people without back pain actually behave? They must be having great daily posture right? Well actually NO.
A study shows that asymptomatic folk , 50 of them, when seating actually SLUMP. In 10-min sitting, spinal angles flexed 24 deg at lumbar and 12 deg at thoracolumbar regions relative to standing posture. But this slumping does not seem to cause them problems.
So changes in our spinal curves seem to be fairly unrelated to pain.
SO IF POSTURE DOES NOT REALLY CORRELATE WITH PAIN, WHAT DOES IT CORRELATE WITH?
Well a scientific study shows that cervical spine alignment changes actually correlate with age. This study separated participants into 4 groups determined by age. They found that the measures of the angles of the neck all correlated with the increasing age range of the 4 groups.
Key point to remember here is that all the participants, 120 of them, had no pain. In fact the exclusion criteria here was pretty hard and the authors actually excluded 64 people, so 1/3 of the original sample, for having current or previous pain.
So simply put, as we get older our posture becomes ‘worse’ or perhaps better put our posture increases….BUT and a this a big BUT, this does not seem to cause MORE pain.
To sum up it does not seem as simple as ‘BAD POSTURE = PAIN' whatever you read or are told in a bar, gym or clinic room.
| Tags: | ##posture #pain #posturecorrection #physiotherapy |
