posture is a tricky thing - personally, I have some serious misgivings about the whole approach taken by most PT’s - I think that there r a lot of incorrec assumptions about how to characterize it, how to asess it, and how to address it
first thing, I tell most patients that there is no such thing as “correct” or “good” posture and no such thing as “bad” or “poor” posture;
instead, what I like to talk about is context dependent usage; I also talk about input / output;
my main reason for this is to remove the self-judgemental, value-based perspective that most people carry around all their lives: the know that they have “poor” posture and it becomes a guilt-based issue; this is not good, because it intereferes with one’s ability to take an objective look at how one is living in space, and because it forces people to ive up to an abstract, external ideal that may not be what they “need”;
for example, everyone is familiar with the old plumb line through the ear, shoulder, hip, ankle as an example of “correct” posture;
well, my first question i ask is this: if one is aligned that way, then at what point outside of that alignment is one’s posture no longer “correct”? I mean, we don’t stand still all day long, we move constantly - so the artifact of “correct” vertical alignment really doesn’t apply; so how far outside of this ideal alignment can one go before the posture is not correct? 1 mm? 1 cm? etc. - really, there’s no way to measure that, and as such, I don’t find it useful;
the other thing is this - if someone has a “hunched” posture, there’s a reason for it - usually, it’s because something in the anterior chest is shortened / tight; so what the body is doing by adopting this posture is putting those tight structures on slack, in order to decrease the perceived tension in the system; now, if I make you stand up straight, I have now increased adverse tension and in this case, the aligned posture creates discomfort (and no, those shortened structures are not just going to magically lengthen out now that you are adopting a more vertical alignment
see, my question is this: if vertical alignment in posture is “correct”, why doesn’t the body assume it naturally? why does everyone have to “work” at proper posture? if it were so natural, the body would naturally adopt that position; but here’s the problem: I believe that the truly “proper” posture is quadrupedal - which is what our spine was originally designed to work out of most if not all of the time - as soon as the spine goes vertical, it adopts a biomechanically inherently untenable context - and the best we can do is try to minimize the load by aligning it - but since we are not standing still all day, we really can’t maintain that - and so we are using the spine in a way inconsistent with it’s original “programming” (same with the guts, which are designed to hand verticaly and function on a horizontal plane - which is why you get so much congestion in the abdomen and pelvis over time, because the guts overly each other and the venous return is restricted - but anyway);
so, the first thing to consider is this: does one have symptoms / discomfort / decreased mobility? if so, then one has to consider the system as a whole, and assess what is the cause(s) of the dysfunction; if a pt has a markedly hunched posture, then that is one aspect of the assessment - but it’s not necessarilly somthing that I want to go and try to change initially or even at all - instead, we want to look at muscle balance - for example, are pecs tight / facilitated and are lower traps inhibited / weak? usually, we find this; so we treat that, if indicated - either by passively releasing the anterior structures or actively thrusting the spinal segments that are anteriorized (usually T5/6, which cause inhibition of lower traps), or something else; then after adressing the areas of dysfunction, we can look at active movements (actually, you can have the patient activey move to self-treat as well, that’s another option) and at vertical alignment;
when looking at vertical alignment, my goal is to help peope create a sense of spaciousness, of freedom in their movements - MA training is necesarily the opposite - a “binding” sort of movement quality, which makes sense if one is going to fight; so to balance out that habitus, there are various strategies to give someone a sense of more space in their tissues; doing this, one can then work with things like breathing (usually what I do first w/people, lying on their backs, allowing the breath to spontaneously manifest without conscious control but with non-judgemental awareness of the rhythmic changes), or respiratory / postural “noticing”; meaning that training people to notice when they hold their breath, when they fix into a certain position; then teaching them how to respond to that awareness (gently, not jerking out of it into a “correct” position) and how to maintain it dynamically throughout the day (this can take a while);
so, in the case of someone who is hunched over in their MA practice, the first step would be to identify ualitatively what that was like, and then to try to expand their awareness of alternate sort of body awareness that they could use to engender a more spaceous sort of usage when not in MA mode;
again, oine can do al this in a very general sense or one can give specific exercise (qigong, Alexander, Feldenkries, yoga, etc.) to help achieve this; but again, the goal is not to make someone adhere to an external ideal, but to find within themselves the solutions and then alow them to make the choice as they like; for example, I ask people, at the end of the day, when u come home and sit on ur couch to unwind, do you sit up straight or schlump? of course u sclump, if u didn’t that would be bizzare; OTOH, when sitting at a computer at work, adoipting a schlump wud not be conducive to optimal physiological function - but also sitting up straight rigidly without deviating doesn’t make much sense either; so it’s a question of the dynamic interplay between various extremes and how one functions in the field of awareness such that one is able to dynamically adapt to the demands of a given context;
this way, there’s no guilt, there is only open-ended exploration / discovery, which is ongoing and evolving constantly as one ages and also as one becomes more in tune
anyway, that’s my take on it (and SJ - we can play w/some of this stuff perhaps when we come up in Sept… :D)
