Are You Positioned For Success?
Health professionals are trained to objectively analyse presenting signs and symptoms, in order to offer possible solutions to all manner of ‘conditions’. Today I have been exploring Posture, and the role it generally plays in our daily functional activities, and specifically, in chronic pain presentations.
Why is this interesting?
Because we need to be Positioned For Success!
The way we habitually hold ourselves influences all our movements and ultimately affects how we go about accomplishing our everyday activities – whether we are working, playing sport or a musical instrument, relaxing or sleeping.
I did a bit of research around the topic of being positioned for success by being Cognitively/Mindfully and Behaviourally aware of our posture, and the influences we could pay more attention to.
It has been observed that poor posture is widespread in the general population. It appears to be an adaptive, self- perpetuating trait that most people lack the cognitive ability or desire to correct by themselves. (2)
Studies have shown that people in occupations that include prolonged periods of sitting may experience a high incidence of Low Back Pain. (1)
Commonly adopted relaxed postures are often passive in nature with a predisposition to “sway” standing and slumped sitting which can exacerbate pain. (4)
Increased pain does not leave us positioned for success.
Recent studies conclude that
- Forward head posture is the most common form of poor posture related to a multitude of myofascial pain disorders and cervical dysfunction. (2) This posture requires the person to flex the lower part of the neck forward and bend the upper portion of the neck backwards.
- Adopting passive postures such as sway standing and slump sitting can exacerbate pain in individuals with low back pain. Lumbopelvic stabilising musculature is active in maintaining optimally aligned erect postures, and are less active during adoption of passive postures. The muscles of the lumbopelvic region become deactivated and deconditioned, which increases the load on the lumbar discs and ligaments which in turn could leave the lumbopelvic region vulnerable to strain, instability or injury. (4)
- Back pain intensity and referred leg pain could be significantly reduced after sitting with a lordotic posture, demonstrating that a change in posture could have a positive effect on pain location. Centralisation (a change in distribution of referred symptoms from distal to a more central location) was brought about by certain lumbar movements and positioning. (1)
- Erect postural alignment in weight bearing positively facilitated the stabilising muscles of the lumbopelvic region. (4) Immediately we are better positioned for success in performing our daily activities.
Postural Training (being Positioned for Success) works on the assumption that an optimally aligned skeletal system reduces stress in its structures. It is recommended as one of the Interdisciplinary treatment components of Cognitive Behavioural Therapy (CBT) for chronic pain.
- It usually involves exercises performed repetitively to stretch structures that poor posture tends to shorten
- Strengthens structures that poor posture tends to weaken
- Creates awareness of desirable posture (2)
Cognitive Behavioural treatment methods have been applied to the most common chronic pain conditions. Posture correction in daily life, by its very nature, is considered Behavioural Therapy as the individual is required to continually monitor his / her improved conditioned posture for success. (2, 3)
These CBT Programmes usually involve multiple components, including
- Information to increase knowledge and awareness of the factors influencing the nature and typical course of chronic pain conditions
- Basics of pain physiology with the emphasis on chronic pain
- Biomedical and bio-behavioural management of the condition
- How to self-monitor the signs and symptoms of the condition
- Cognitive and behavioural therapies aimed at increasing physical and functional activities and adaptive responses to pain
- Skill training such as the use of relaxation, biofeedback, hypnosis and other self-control strategies to modify the perception of pain and related body sensations
- Information on the relationship between muscle fatigue, muscle tension and the psycho-physiologic aspect of stress
- Introduction to cognitive and behavioural pain and stress-coping strategies (3)
Instructions for Posture Correction to be positioned for success may include
- Don’t slouch when sitting on a chair
- Don’t sit with legs crossed
- Don’t rest chin on hand
- If sitting on the floor, sit upright by sitting on folded legs
My sitting posture may prevent me from being Positioned For Success
- Rest weight on both feet evenly
- Don’t lean against a wall
- Sleep on a firm mattress
- Sleep on your back
- Keep your neck straight by supporting on a low pillow or flattened towel
- Bring food to mouth without tilting head forward
- Chew looking straight ahead, not downward
- Walk with long even strides while swinging your arms
- Don’t carry a heavy package with one hand
- Don’t thrust head forward
With this information in mind, we could be more mindful to ensure we are better Positioned For Success, without compromising our Postural efficiency.
1. A comparison of the effects of two sitting postures on back and referred pain M M Williams, J A Hawley, R A McKenzie, P M van Wijmen Spine Vol 16, No 10, Oct 1991; 1185-1191
2. Usefulness of posture training for patients with temporomandibular disorders E F Wright, M A Domenech, J R Fischer Jr J Am Dent Assoc 2000; 131; 202-210
3. Posture correction as part of behavioural therapy in treatment of myofascial pain with limited opening O Komiyana, M Kawara, M Arai, T Asano, K Kobayashi J Oral Rehab May 1999; Vol 26; No 5;428-435
4. The effect of different standing and sitting postures on trunk muscle activity in a pain-free population P B O’Sullivan, K M Grahamslaw, M Kendell, S C Lapenskie, N E Moller, K V Richards Spine 2002; Vol 27; No 11; 1238-1244
Which strategies do you employ to ensure you are Positioned For Success?
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