The Three Pillars of Posture Motivation | Posture Doctor

The way we hold ourselves is a reflection of how we feel about ourselves. Not only do we look more attractive with upright posture, but science is beginning to show us that our brains are more capable of positivity when the body is in an upright stance.

What motivates you?

Are you driven by reward or punishment – carrot or stick?

The Carrot and Stick theory of motivation was given to us by philosopher Jeremy Bentham, and is derived from the old story of a donkey. The story goes that the best way to move a donkey is to put a carrot out in front and jab it with a stick from behind. It’s not really a very nice story. The carrot is the reward for action (moving forward for our stubborn donkey) while the stick is the punishment for inaction or not moving.

I’m definitely a carrot kinda gal. I spent last weekend training for my CSIA Level 1 certification. The CSIA or Canadian Ski Instructor’s Alliance, enables me to teach downhill skiing (which I delight in) to beginners and intermediates.

The stick was clear – the grueling impact on my body skiing hard for 16 hours over three days. On average, I was 25-30 years older than the majority of students on the course. Although it feels good to look back and think wow that was torture and I did it, that wasn’t my main motivation.

I would never run a marathon, or participate in a Tough Mudder competition. That just doesn’t do it for me. I’m a carrot kinda gal as I said. I don’t get up each morning to Posturecise, to avoid a stiff body, although I love that benefit; I Posturecise daily because I like what I see when I look in the mirror. Carrot, carrot, carrot!

Further Resources: Posturecise Crash Course

Does that sound awful? It’s not that I’m entirely vain – although I am a Leo! It’s that looking (and feeling) youthful signifies to me, that I get to do what I want to do, well into my senior years. I want to ski when I’m 70 and hike the Pyrenees Mountains when I’m 80. Nature is everything to me. That is my motivation. I love a good carrot!

Why do we want to correct our posture?

Over the years, many of you have become committed posture students. You enroll and actively participate in courses at Posture School, you email to ask questions about your posture and health and some of you work 1-2-1 with me over many months. Underlying each of these decisions was some kind of motivation.

Three pillars of posture motivation

It occurred to me fairly recently that the factors driving our motivation to correct our posture, can be summarized into three main categories or pillars of motivation.

Three Pillars of Posture Motivation


Pain is a wonderful motivator. It creates immediate need for action. At some point in our lives, most of us have been motivated by this stick. The problem for most of us who use this to drive our ongoing motivation, is that when the pain is gone, so is our motivation to take action.

Lack of pain does not equate lack of problem.

We can learn to thank our pain, because pain is a part of life and getting rid of the pain shouldn’t be the main goal. If we place our hand near a hot stove, pain very quickly makes us move our hand away. Without pain, we’d leave our hand in the hot flame and get badly burned.

I like to think of pain, as one of the body’s great communication tools. We can learn not to be fearful of pain but instead, become fascinated by our wonderfully working bodies. What is that headache telling us – are we dehydrated, are our muscles tense, do we need to eat?


You’d be surprised how often I hear from you about posture and appearance.

  • I have been struggling with neck hump since my early 20s.
  • How do I stand up straight without flaring my rib cage?
  • I sort of slump forward and this does not look good.
  • When I pose for photos, my upper body always leans far backward.
  • I thought I was standing straight but in reality my upper body always leaned far backward.

There is nothing wrong with wanting to look attractive. In fact there has been a lot of research into body posture and attractiveness.  The science suggests that our posture not only reflects our feelings, but also influences them.

One particular factor of attractiveness that has been extensively researched (including this study) is that of symmetry. You can think of symmetry as good posture and asymmetry as bad posture.

Symmetry (good posture)
Asymmetry (bad posture)

Deviations from bilateral symmetry may be linked to various stressors in pre-natal development … The extent of these deviations may reflect the inability of an individual to cope with environmental and genetic stressors. Fluctuating asymmetry is related with various genetic diseases and chromosomal abnormalities, such as scoliosis … Superior symmetry (ideal posture), therefore, signals the quality of genes that are more resistant to biological and environmental stressors such as disease, pathogens, and parasitic infection.

Wow! Now, you understand why attractiveness is such a huge motivation for so many of us.


The way we hold ourselves is a reflection of how we feel about ourselves. Not only do we look more attractive with upright posture, but science is beginning to show us that our brains are more capable of positivity when the body is in an upright stance.

I have always been struggling with my curved shoulders and this is because of my low self esteem and lack of confidence I suffered as a teenager.

In one study researchers found that people who were told to sit up straight were more likely to believe the thoughts they wrote down while in that posture, about whether or not they were qualified for a job.

Richard Petty (co-author of the study) said that: “Most of us were taught that sitting up straight gives a good impression to other people. But it turns out that our posture can also affect the way we think about ourselves.”

The end result of this study was that when students wrote positive thoughts about themselves, they rated themselves more highly when sitting in an upright posture because the upright posture led to confidence in their positive thoughts.

However, when students wrote negative thoughts about themselves, they rated themselves more negatively when in the upright position (vs. slouched position) because the upright posture led to more confidence in their thoughts, even though they were negative.

That suggests our thoughts are influenced by our posture, even though we don’t realize that is what’s happening. In other words good posture leads to less self doubt. Very cool!

From my experience, a desire to correct our posture stems from one of three motivations, that I call the Three Pillars of Posture Motivation:

  1. Pain
  2. Attractiveness
  3. Confidence

Motivation isn’t black and white, it’s black, white and shades of grey. There is of course great overlap, but it is highly likely that you are primarily motivated by one of these three pillars.

So, are you driven by carrot or stick? I’d love to read your comments on this one. Pop your thoughts below.

Why Women Have an Increased Rate of Low Back Pain | Posture Doctor

What was most interesting was that for men low back pain was associated with older age, low education (I’m guessing this suggests the likelihood of more physically demanding jobs), high blood pressure and smoking; but for women if was occupational and ergonomic factors.

Recently I came across this study about the factors that affect low back pain in men and women. This was a fairly large study of 600 participants. They looked at the prevalence of low back pain over a one week period. The men’s prevalence of low back pain was 40% and for women, a shocking 60%!

Low back pain occurs in about 60–80% of people at some point in their lives. Menstrual cycle fluctuations can influence pain sensitivity and may help to explain the sex difference. Further explanation may include, biologic response to pregnancy and childbearing, and perimenopausal abdominal weight gain.

Postmenopausal women also show accelerated spinal disc degeneration due to relative estrogen deficiency. While overall females have higher prevalence of low back pain (LBP) across all age groups, LBP prevalence further increases after menopause. Cue the violins for us over 50s.

What was most interesting was that for men low back pain was associated with older age, low education (I’m guessing this suggests the likelihood of more physically demanding jobs), high blood pressure and smoking; but for women if was occupational and ergonomic factors. Even more interesting is that those occupational hazards were standing posture leaning forward and sitting posture leaning forward.


These postures can be described as stooping and perching. They cause forward flexion of the spinal column; and flexion increases compressive forces, that can cause inflammation of spinal joints (facet joints) and disc degeneration and pain.

Even more interesting was this study on the effect of regular posture exercise in improving skeletal pain. The studied concluded that, shoulder pain, mid back pain, and low back pain were relieved with a posture correction exercise program performed for 20 minutes, 3 times a week for 8 weeks.

The reason why a regular posture habit reduces skeletal pain, is that correct posture minimizes the strain on the human body by maintaining balance of the muscles and skeletal alignment. Correct posture implies not inclining the body forward (stooping) backward, left, or right.

Further Resources: Posturecise – How to Create a Healthy Posture Habit

Posture School

If you’re interested in our posture community it’s probably because you look at your health differently. You’re different from most people and you want take control of your own health. You’re different from most people, because you are willing and motivated to take action. However, even though you are more action oriented (I know this because you are still reading), you may still suffer the same challenges as your common variety slouch potato.

My job is to support you before your posture becomes a chronic problem.

The symptoms

Here’s a summary of why you find it challenging to correct your posture:

Doing it wrong

We often jump in great guns with new posture exercises, not knowing if we’re even doing the exercises correctly.


Awareness seems to be a big problem. It’s not so hard to do the posture exercise, but 5 minutes later, we are slouching again.

Pain sucks

Sometimes trying to correct our posture is painful, which isn’t exactly encouraging.

Habit formation

It’s fine doing an exercise here and there, but putting exercises together into a daily practice seems challenging, to say the least.

Further Reading: The Neurology of Habits

Going it alone

There’s a lot of pressure on us to do it all and we find ourselves alone when we need others the most.

It’s OK not to be OK

We need to be OK with opening up and sharing our doubts and struggles. Poor posture affects self esteem and confidence, and this is a universal problem.

The cure

Invest in your well-being

We should hold ourselves accountable for investing in our well-being and development. We should set time and money aside to spend on wellness or self-care.

Remember the mind-body connection

We need to watch what we eat and consider activities such as Posturecise, meditation (even just 1 minute a day), and walking outdoors to help boost our mood, sharpen our focus and enhance our emotional resilience.

Enjoy micro wins

You know that course you are enrolled on at Posture School but haven’t yet started? Set aside 20 minutes and begin watching your first lecture. email me and let me know you did it. Micro win … YES!

Set mini goals

Ridiculously simple wins every time. Pick a favourite posture video, re-watch it, and do the exercise daily – at exactly the same time – for 7 days straight.

Connect, connect, connect

We need to surround ourselves with a trusted support network.

The low back pain study specifically dealt with low back pain, but I found it a useful reminder, that pain is often influenced by our posture.

Did any of the symptoms mentioned above resonate with you? If so, which of the cures will you be taking on? Make sure to pick one and make it a tiny habit, as small positive changes can have huge effects over time.

Are you ready to make posture correction a daily habit?

If you believe in healthy posture in the same way you believe in getting 7-8 hours sleep each night and eating right, AND you really don’t want to live at the gym, then join our tribe. The road to good posture isn’t a quick-fix strategy; it’s a life-long journey and investment in yourself and your health; and may determine how well you age.

Still not sure yet? Feeling like something is holding you back and you don’t know whether to invest in yourself by becoming a member? Then why not watch this video to get some inspiration:

Coffee and Bone Health – pH, Porridge and Posture | Posture Doctor

Recently a young computer scientist and student at Posture School, asked me a question about how our lifestyle – in particular caffeine – affects posture.

Thanks doctor for making this course. You mentioned caffeine in bad side of things for posture. I do not have other issues in my lifestyle but I do take a lot of caffeine. Can you please elaborate on that part? Divyendu

Most of us are a little surprised to learn that the foods (and drinks) we consume regularly, like bread, cheese, meat, sugar, coffee and milk, may be weakening our bones.

Our blood is slightly alkaline (the opposite pH to acid) and that is where it prefers to be.

Acid Alkaline Diet

In order to balance the acidity of a poor diet, calcium is leached from bone to balance our body chemistry and restore ideal pH. This is a very basic explanation, but for our purposes, it’s all we really need to understand.

Foods like strong cheeses, grains containing gluten, meat, caffeine, alcohol, artificial sweeteners, soda drinks and dairy weaken our bones over time. The body does better with more alkaline foods.

Which grains are least acidic?

Non-glutenous grains such as brown rice, quinoa, and buckwheat (yeah, buckwheat pancakes!!) are still considered acid forming, but rank lower on the acidity scale.

Calcium Rich Foods

To maintain strong bones, we need a good supply of calcium, and contrary to popular belief, dairy isn’t the best source. Diary is on the acidic side of the food chart, and is also not the easiest form of calcium to absorb.

Makes sense – humans drink milk from human mums and cows drink milk from cow mums. Some would argue, drinking milk past infancy is unnatural. However, I still enjoy milk in my Earl Grey tea!

Dark leafy greens, seeds and seafood are calcium rich foods. There are plenty of yummy non-dairy food choices, full of calcium.  

Vitamin D Foods

We also need Vitamin D for strong bones. We can think of the sun as food for our bones. Sunlight stimulates the production of vitamin D; so we need at least 20 minutes outdoors every day without sun screen.

Given that the body’s ability to produce vitamin D from sun exposure declines with age, vitamin D supplements (or drops like I use from my Naturopath) are recommended for people over the age of 50. Sigh.

If you live in a northern latitude (Canada, Russia, United Kingdom and Scandinavia), you have some months of the year with limited sunshine. In these countries, vitamin D producing sunlight can only be captured by our skin between the months of May and October. This leaves us Northerners in the cold, with declining vitamin D levels in autumn and winter. Again, vitamin D supplements are advisable.

Fish oils are a perfect source of vitamin D. This is the one supplement I think we all need. I take two teaspoons a day of high quality fish oils. Get the best quality fish oils you can afford. I prefer liquid; most are lemon flavoured and I think fairly tasty.

Further Resources: 10 Foods High in Vitamin D

Bone Health & Exercise

You hear it all the time, but weight-bearing exercise is absolutely crucial to strong bones. Riding a bike and swimming are great for your heart, but they are non weight-bearing, so they don’t help your bones as such.

Fast paced walking with good arm swing and maybe even some Velcro weights around your ankles, is an easy bone-building exercise. Running if you are under 35 (too hard on the joints over 35); weight-lifting, martial arts and dancing are all fantastic!

Good Posture

Your posture is crucial to the health of your bones. If your body is out of its symmetrical alignment than there is uneven pressure and stress on your joints and this can lead to wear and tear (osteoarthritis) in those joints.

What to do? >> Posturecise – How to Create a Healthy Habit for Life


Back to caffeine. Studies suggest high doses of caffeine – I consider that more than three regular-sized mugs (not three massive Starbuck’s sized) – contribute to loss of bone by increased urinary calcium excretion and a decreased intestinal absorption of calcium.  This overall calcium loss can influence the normal development of bone (bone density) and predispose some (often post-menopausal women), to fractures later in life.

Studies show that caffeine sources that most influence bone loss include soda and coffee. Tea may actually have a protective effect. Yeah Earl Grey!

What can you eat?

Paula’s Porridge

  • ½ cup steel cut oats
  • ½ tsp cinnamon
  • Handful of your favorite berries
  • 1 tbsp desiccated coconut (unsweetened)
  • 1 tbsp ground seeds (linseed, sesame, pumpkin, sunflower)
  • Add water (or milk) to give runny consistency
  • Cook on low heat for 20 minutes (to desired thickness)
  • Grate half an apple over top of cooked oats.
  • Add a little milk and maple syrup if desired.

Have a yummy strong bone recipe you love? Please share in the comments below.

Dupuytren’s Nodules: 3 Natural Remedies – Posture Doctor

I have Dupuytren’s Disease. Your Posture Doctor’s body is far from perfect. I wanted to share my diagnosis because many of you have journeyed with me since I left private practice to take my posture tips online, full-time.

About three months ago, I discovered a small lump in the palm of my hand. Having had a similar lump in my plantar fascia a year ago, I assumed my overly tight tendons have some calcific build-up.

Dr Paula Moore’s Dupuytren’s Nodule

I’ve also got a bunion on my right big toe – maybe you’ve seen my bunion mobilization videos – and an anatomical short leg that gives me functional scoliosis. I also have a video explaining the mechanism of short-leg scoliosis.

I’ve had chronic headaches since my early 20s, and I believe the underlying structural cause was initiated by an accident I had at age 9 when I was hit in the head with a wooden baseball bat, receiving eight stitches. Fortunately, my ongoing posture work keeps them at bay.

As a result of having an anatomical short right leg with scoliosis and being crazy active in sport up until university, I eventually had a disc herniation (slipped disc) while I was in practice as a chiropractor many years ago.


When I tell you that I know what it is to have problem posture and understand the frustration that regaining attractive upright posture takes time – there is no quick-fix solution – I MEAN IT! I feel your pain.

The imperfections of my body are, in many ways, the bane of my life, and yet I know they are also my gifts. For if my body alignment and health were perfect, I most likely wouldn’t have become a Chiropractor or gone on to study the physics of posture.

It has become my absolute mission to correct my own posture, and along the way, I’m continually reminded of my student’s struggles and humbled by my own.

Dupuytren’s Disease

Dupuytren’s Disease is a disease of collagen tissue dysfunction. It is genetic. My grandfather had it. My grandfather was a supreme court judge in Canada. I am certain he was the man, the word gentleman was modeled after. In fact, we called him Grandfather as children. He even wore a dress shirt on our picnics and enjoyed smoking his pipe as we played in the sand.

Apparently, as a child, I used to hold my hands with my fingers bent, just like he were. He had Dupuytren’s contractures on both hands. I was not particularly eager to hold his hand crossing the street because his bent fingers felt funny to me.

Last night I Googled, ‘nodule in the flexor tendons of the hand,‘ and Dupuytren’s Nodule popped up. I don’t know why I hadn’t immediately clued in, but I hadn’t.

There isn’t a lot known about Dupuytren’s Disease. The treatment options are minimal and invasive:

Treating the symptoms or cause?

Just like posture, you can treat the symptoms (forward head posture, for example, with a chin tuck) or the cause (the structural alignment in the neck – after x-ray diagnosis).

Oddly, Dupuytren’s Disease doesn’t really worry me. Do I need my hands?! Obviously, yes, I’m extremely active and write a lot. I could have an injection and watch the early sign (nodule) perhaps disappear. I know, however, that this approach fails to address the cause of Dupuytren’s. The problem is collagen. I am very interested in the WHY. Why is my collagen running amok?


Do you want to use a quick-fix youtube video exercise? I have plenty of those posture videos for you online. Or, do you want to address the underlying cause of your posture issues, and jump on board for the long run, and correct your posture for good?

Magnesium and Dupuytren’s Disease

I did some more research. This time I Googled, ‘Dupuytrens Nodules nutrition.’ I found Magnesium and Dupuytren’s Disease.

The article explained that my mother was a gene carrier for Dupuytren’s (thanks, mum), but more interesting to me was that some people had responded to topical Magnesium treatment. However, I realize that topical is still a symptom-based approach. I read on …

How does magnesium help?

The article explains that in Dupuytren’s Disease, collagen cells shrink or contract and that calcium is needed to allow this to happen.


The cell’s pulling mechanism requires calcium. In theory, magnesium might block the cells from pulling on the tissues by reducing the effect of calcium … magnesium might make the cells relax and allow a finger to loosen.

My next step …

Get magnesium levels tested! I’m going for a lab test tomorrow. The author goes on to explain:


Laser for Dupuytren’s Disease?

The next thought that I had was recalling my mother’s success with laser for her Plantar Fasciitis. I next Googled, ‘laser for Dupuytren’s.’ This is what I found:

A Toronto Chiropractor had some success using Low-level laser therapy and Graston Technique. The theory goes that laser stimulates tissue repair and promotes proper soft tissue alignment as it heals. This is controversial, but it’s got to be better than cortisone injections, which can degrade and further damage tissues over time.

Pairing the physical tissue breakdown of laser with the myofascial release used in the Graston Technique makes sense to me!

What is Graston Technique?

Graston Technique is a patented form of manual therapy that uses stainless steel tools to perform tissue mobilizations. It is a kind of soft tissue mobilization used mainly by manual practitioners – Chiropractors, Osteopaths, Physical Therapists, etc.

What am I going to do about my Dupuytren’s Disease?

I’m going to take action. Many of you, reading this post, have followed me for several years – Read my posts, watching my videos, and maybe even tried some of my exercises. But how many of you have committed fully to your posture correction and long-term health?

Enroll International Dupuytren’s Data Bank

What is the difference between those of us who dabble and those who really create change in our lives?

It’s simple, but it’s not necessarily easy …


Dupuytren’s Disease action plan

Done! Do I feel worried about my Dupuytren’s? Not really. Taking action gives me freedom from worry. When I am proactive about my health, I know I am doing everything I can to have the best healthy future possible.

Paula’s Dupuytren’s Nodule

I want to be skiing at 80, not checking into a nursing home.

What about you? Are you a victim of your circumstance or the doctor of your destiny … I hope the latter.

Further Resources: Posturecise (Level 1) – How to create a healthy posture habit for life

Foot Pain: Causes, Symptoms and Exercises – Posture Doctor

When the fascia fails to offer the appropriate shock absorption, too much pressure on your feet can damage or tear the ligaments; the fascia becomes inflamed, and the inflammation causes pain and stiffness.

What is plantar fasciitis?

Plantar fasciitis means pain in the bottom of the heel. Plantar is the sole of the foot; Fascia is the tissue; and itis is Greek for inflammation. For example, colitis is literally colon inflammation.

The plantar fascia is a thick ligament (ligaments attach bone to bone) that connects your heel to the front of your foot. It supports the arch of your foot and helps you walk.

What are the symptoms of plantar fasciitis?

The major complaint of those with plantar fasciitis is pain on the bottom of the foot near the heel. It usually affects just one foot, but it can affect both feet. Some people describe the pain as dull, while others experience a sharp stabbing pain.

The pain is usually worse in the morning when you take your first few steps, although it can also be triggered by long periods of standing or rising after a period of sitting. Climbing stairs may also be difficult due to heel stiffness. The pain is usually worse after exercise, not during.

Who gets it?

Plantar fasciitis a very common orthopedic complaint. Your plantar ligaments experience a lot of compression in your daily life. These ligaments act as shock absorbers, supporting the arch of the foot, unless the mechanics of your feet are altered in some way.

When the fascia fails to offer the appropriate shock absorption, too much pressure on your feet can damage or tear the ligaments; the fascia becomes inflamed, and the inflammation causes pain and stiffness.

You’re at a greater risk of developing plantar fasciitis if you are:

  • Weight – being overweight increases the pressure on your ligaments – especially if you have sudden weight gain, for example, during pregnancy.
  • Types of exercise – Activities that place a lot of stress on your heel and attached fascia. Long-distance road runners – off road runners are at less risk – jumping sports and ballet dancing for example.
  • Occupation – a job that requires being on your feet most of the day, such as working in a factory or a restaurant, and even teachers.
  • Foot mechanics – Having very high arches, flat feet or tight Achilles tendons.
  • Shoewear – Sudden change to your usual shoewear.

Active men and women between the ages of 40 and 70 are at highest risk, and it is also slightly more common in women.

What helps?

Home treatment:

Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes, three or four times per day to reduce inflammation. Using generic arch supports in your shoes (bought at most drug stores) and doing some soft tissue work and stretching exercises may also help to relieve pain.

Soft tissue work:

Soft tissue work may help to break up sticky tissue adhesions and stimulate healing. Use ice after each session.


Picking up a towel: Sit on a chair and put one foot on a towel. Now grip the towel with your toes and try to pick it up. Hold it for 10 seconds. Repeat five times.

Time required: approx. 2 minutes

Ball massage: Roll a tennis ball quite firmly back and forth over the sole of your foot. Treat the whole sole of your foot from forefoot to heel. Ouch – heads up, this is painful!

Time required: approx. 3 minutes

Achilles stretch: Find a sloping driveway or hill. Look for an angle approximately 45 degrees. This stretch is often shown on stairs, but I prefer to support the heel. If you have a carpenter in the family, have them DIY a stretch block for you.

Time required: 3 minutes

In-clinic treatment

You may benefit from seeing a podiatrist who specializes in custom-made orthotics. They can also recommend appropriate shoewear and exercises.

Your doctor or healthcare practitioner may also recommend ultrasound or Low level laser therapy (LLLT) which is painless and non-invasive; plus my mother swears by laser treatment, after her acute fasciitis resolved with just one session!

Further Resources: Balance Exercises You Can do From Home

Morning Stiffness | Do You Have Wear & Tear?

Sometimes called degenerative joint disease or “wear and tear”. Wear and tear is a euphemism for osteoarthritis (OA); the most common chronic condition of the joints. It occurs when the cartilage or cushion between joints breaks down; often leading to pain, stiffness and swelling.

In front of me you can see four models of the same two lumbar vertebrae, presented as textbook normal and phase 1, 2 and 3 of spinal degeneration. This is also known as osteoarthritis (osteo meaning bone), degenerative disc disease, or commonly wear and tear.

Normal vs. Phase 2

I don’t like euphemisms. I think you can handle the truth and that like me, you probably don’t like being talked down to. So let’s call it what it is … osteoarthrtis or degenerative discs or spinal arthritis. 

A normal lumbar segment has two vertebra and a healthy cartilage disc in between. If you look at the disc from the top, you can see that the gelatinous or gel-like toothpaste substance, is well contained within the cartilage rings of the disc.

There should also be good symmetrical bony alignment. You may choose to have a chiropractor detect whether or not you have any spinal misalignments. Early on, these subluxations are easily detected and corrected.

A normal spinal segment will also have healthy nerve roots. Lots of space for them to communicate with the body (your organs, bloodvessels and glands). Because our nervous system runs our body, we don’t want any interference from misaligned vertebra (poor posture) or degenerative discs.

Incorrect Posture May Cause Degeneration

Asymmetry in the body (incorrect posture) can lead to early degenerative changes. Posture is so much more than what we see on the outside of our body.

Phase 1

In Phase 1 of spinal degeneration, we may start to see wear in the discs. Evidenced only on MRI imaging, this is a kind of dehydration that occurs in the cartilage tissues..

The rings of cartilage that make up our spinal discs, start to break down. The gelatinous center begins to dry out, a little bit like the toothpaste that is stuck around the outside of the cap. There are likely no effects as yet (or mild effects) to your nerve system.

Phase 1

These people may not present with health problems at this early stage, or they may have some mild symptoms.

Phase 2

After a decade with incorrect posture from poor habits, childhood injuries, athleticism and manual labouring, it is more common to see people with Phase 2 degenerative changes.

Typically, discs are now very dehydrated. The gelatinous nucleus (the toothpaste-like substance) has often leaked right through the dried out cracks in the cartilage rings, that buldge into the space where the spinal cord lives. This is known as a slipped or herniated disc.

There is often nerve irritation in Phase 2. These people often present with leg pain (sciatica); as the nerves that exit the lower lumbar segments, travel through the buttocks and down the leg.

Phase 2 – Herniated or Buldging Discs

Further Resources: Sciatic Leg Pain Relief

They may also present with other health issues (bowel and bladder troubles), as these nerve roots supply our organs, blood vessels and glands in the pelvic region.

In Phase 2, the vertebral bones get closer together, and the ligaments and muscles become slack. There is now excess movement in the bony segments. They have become unstable, and the body responds by laying down more calcium to stabilise the segment. These calcium deposits or bone spurs aren’t generally painful, but lead to stiffness.

Morning stiffness is a strong indicator of spinal degeneration. After waking, it may take a few hours before a person with Phase 2 degeneration feels mobile. 

Phase 3

After a several decades with incorrect postural alignment, past accidents, poor lifestyle, we begin to see advanced arthritic (degenerative) changes. In Phase 3, the discs have completely dried up and can lead to total bony fusion between the vertebral segments of the spine.

Not only is this person extremely stiff, but their spinal segments no longer move independently. This person surprisingly, is often without pain but they are extremely stiff and immobile.

Phase 1, 2 and 3 can only be diagnosed by x-ray and/or MRI. X-Ray imaging show us bony changes and MRI show tissue changes. MRI is the imaging of choice for degenerative disc diagnosis, and x-ray imaging is gold standard for alignment and postural diagnosis.

If you have been diagnosed with wear and tear without an x-ray, you have been done a disservice, in my opinion. A good practitioner can probably accurately guess your diagnosis from signs, symptoms and examination, but they will never be able to accurately assess whether you are in Phase 1, 2 or 3. This is why I would never practice without on-site x-ray facilities.

My first Chiropractic Clinic Align

A person with Phase 3 may present with multiple health issues because the nerve roots are usually seriously comprised in this phase of degeneration. 

Obviously the right time to start paying attention to your posture is at the stage of postural misalignments – before the discs and nerve roots become compromised. While it is never too late to start creating a healthy posture habit for life, the longer we put off getted started, the more likely we are to enter Phase 1, making improvements more challenging and time consuming. 

If I can correct and improve my posture, given my bunion (argh), anatomical short leg, lumbar scoliosis and disc degeneration, anyone can. But please start today!

Curl Downs vs. Sit-ups | Posture Doctor

Traditional sit-ups are a great way to cause disc bulging, herniations and ‘pinched nerves’ that can lead to sciatic leg pain and visual posture changes in your body.

Is your ab workout hurting your back?

Traditional sit-ups are a great way to cause disc bulging, herniations and ‘pinched nerves’ that can lead to sciatic leg pain and visual posture changes in your body.

Your lower back can only take so many repetitions of crunching before the discs begin to degenerate and wear.

Try this instead:

Further Resources: Posturecise (Level 1) – How to Create a Daily Posture Habit for Life

Lost Your Balance? Try Motor Skills Juggling | Posture Doctor

As children, we develop balance, climbing trees, walking and running on unsteady surfaces, playing sports, games etc. As adults, we seldom think about balance and rarely practice it. When was the last time you climbed a jungle gym, walked over a log or tried to balance on one leg while brushing your teeth?!

Most people don’t spend any time thinking about their balance until it’s too late – when they actually start swaying when they walk; or worse, fall down and injure themselves. But balance isn’t just a concern for the elderly who are more prone to falls. Balance training is important for anyone who wants to age well, avoid future falls, improve athletic ability, coordination, stamina and overall fitness and health.

If you haven’t thought much about maintaining – or improving – your balance, now is a good time to start. Balance is a component of health that you should never overlook. Without it, all of the weight training and exercise in the world won’t help you.

In order to stay upright, constant communication occurs between your brain, eyes, ears and the nerve endings in your muscles.

As children, we develop balance, climbing trees, walking and running on unsteady surfaces, playing sports, games etc. As adults, we seldom think about balance and rarely practice it. When was the last time you climbed a jungle gym, walked over a log or tried to balance on one leg while brushing your teeth?!

Our vision works in tandem with the inner ear to maintain balance. If you take vision out of the equation altogether – by closing your eyes – it’s harder to balance because visual cues from our eyes give us information about where we are in space.

Inside the inner ear is a fluid-filled tube called the semi-circular canal and the movement of fluid within this canal alerts your central nervous system as to the position of your head.

So how is your balance? Let’s find out …

The 30-second balance test

Ideally, find a partner to time you, because your eyes will be closed. It’s also a good idea to have someone close by in case you fall.

  1. Stand barefoot on a hard floor. Now close your eyes.
  2. Bend one knee and lift the foot – if you’re left-handed, stand on your left leg and lift the right foot just 6″ off the floor; do the opposite if you’re right-handed.
  3. Ask the person helping you to time how long you can hold that position without wobbling or opening your eyes. Use the timer on your phone.
  4. Repeat the test 3 times, and then add up your total time and use the average. (For example, if test 1 was 4 seconds, test 2 was 6 seconds, and test 3 was 8 seconds, you’d add up 4+6+8 to get 18. Divide by 3, and your average balance time is 6 seconds.)

It isn’t surprising to see that the number of seconds decreases with age. In the 30-35 year group, for example, the average eyes-closed balance time is 22 seconds. For 50-year-olds, it’s 9 seconds, and 70-year-olds just 4 seconds. That’s because…

Balance declines with age

As we get older, our eyesight tends to diminish. This normal change in the eye’s focusing ability is likely the first step affecting our balance. Our muscles also age, and this atrophy (shrinkage) of muscle tissue makes reaction times slower. But there’s good news, because…

You can improve balance at any age

17 trials involving 4305 participants concluded that regularly engaging in well-designed balance exercise programs, even in the very old and frail, proved to be effective for fall prevention, and there is now ample evidence that this type of program improves balance ability.1

Try this

Practice balancing on one leg every day and several times a day. Brush your teeth on one leg first thing in the morning. Wash your hands at work, balancing on one leg. Wash the dishes on one leg (but please don’t break the dishes). Blow dry your hair balancing on one leg, and have family competitions if you have little ones – who can balance the longest? 

Don’t wait until you notice that you are starting to sway when you walk. Trust me when I say this – if you are over 50, it’s coming. Sigh … isn’t aging fun?!


  1. El-Khoury, Fabienne, et al. “The effect of fall prevention exercise programmes on fall incused injuries in community dwelling older adults: systematic review and meta-analysis of randomized controlled trials.” British Medical Journal. 29 October 2013; 347:f6234. Web. 

Why You Should Stop Doing Sit-Ups |Posture Doctor

Many personal trainers are still teaching the wrong position for core exercises – a position that will wear out your discs, cause premature aging and ruin your posture and balance long-term.

Your ‘core’ is comprised of a number of muscles working together to achieve and maintain a stable spine. A strong core and perhaps more importantly, a core with good endurance allow us to move with ease and mechanical advantage; in order to avoid injury!

Your core muscles include: rectus abdominis, internal and external oblique, transversus abdominis, but also – you may be surprised to learn – the quadratus lumborum, and the gluteal muscles.

Your goal when working on your core is to create spinal stability. Stability may be achieved by increasing core strength, but Dr Stuart Mcgill (Professor of Biomechanics at the University of Waterloo) reminds us that improving core endurance may be more important than strength. Endurance provides the ability to maintain a stable spine throughout a variety of activities.

Many therapy approaches have the objectives of strengthening muscle and increasing spine range of motion. This is problematic (Parks et al, 2003) since those who have more motion in their backs have a greater risk of having future back troubles. Strength may, or may not, help a particular individual as strength without control and endurance to repeatedly execute perfect form increases risk. Dr Stuart McGill

McGill goes on to explain that people with ‘troubled backs’ tend to have faulty movement patterns like “gluteal amnesia” and more motion in their backs and less motion in their hips.

With the goal of stability in mind, it would be prudent to strengthen gluteal muscles, increase range of motion in our hips and choose abdominal exercises that do not put unnecessary stress and strain through the low back and discs.

No sit-ups or crunches

It is for this reason, that I will NEVER recommend crunches or sit-ups. Both of these exercises involve repetitive flexion of the lower back (lumbar spine). Repetitive flexion can lead to degeneration of the spinal joints and discs over time.

Effective spinal stabilization should begin with a solid understanding of what stability is. “Stability has little to do with the ability to balance on a gym ball. Sitting on an exercise ball performing movement exercises is generally a poor choice of back exercise until quite late in a therapeutic progression,” says Mcgill. “True spine stability is achieved with a “balanced” stiffening from the entire core musculature.”

Reducing risk of injury

One of the most effective exercises for improving spinal stability is the abdominal brace. Many personal trainers are still teaching the wrong position for core exercises – a position that will wear out your discs, cause premature aging and ruin your posture and balance long-term.

How to Engage Your Core

The abdominal brace is a super little exercise, that teaches you how to engage your core whether you are standing in a line, talking on the phone or simply walking down the street!

Vital Lung Capacity Test – Best Hack | Posture Doctor

Good posture is a significant factor in maintaining a youthful body. When you are stooped over (says Dr Rene Cailliet – founder of rehabilitative medicine): “You not only look old but function that way as well … a slumping posture greatly decreases your vital capacity and your ability to move.”

Good posture is a significant factor in maintaining a youthful body. When you are stooped over (says Dr Rene Cailliet – founder of rehabilitative medicine): “You not only look old but function that way as well … a slumping posture greatly decreases your vital capacity and your ability to move.”

Vital lung capacity

Vital Lung Capacity (VTC) is defined as the maximum amount of air a person can expel from the lungs after a maximum inhalation. Here is a VTC test hack that I like to share with my posture students, as an effective way to measure progress.

Materials needed: Tailors measuring tape or string 

Don’t squeeze the tape too tightly around your chest.

The test:

Measurement 1

Wrap the tailor’s measuring tape around your thorax – level with your sternum (where your lowest ribs meet the middle breast bone). Breathe in and out several times, in a relaxed manner and after a full exhalation, bring the tape measure together (don’t squeeze the tape too tightly), look down and take the reading. Write down the number.

Measurement 2

Take several deep breaths in and out and then fully inhale, allowing your ribcage to expand maximally. Let the measuring tape slide gently through your fingers, as your chest expands. Once again, bring the tape measure together, look down and record the number – it should be larger than measurement 1.

E.g. Paula’s VLC measurements:

  • Measure 1 (M1) = 72cm
  • Measure 2 (M2) = 79cm

M2 should be 8-10% greater than M1

  • 8% of M1 = 5.76 (.08 x 72)
  • 10% of M1 = 7.2 (.1 x 72)
  • M1 + 5.76 = 72+5.76 = 77.76 cm
  • M1 + 7.2 = 72+7.2 = 79.2cm

Paula’s M2 should be approximately 78-79cm.

Paula’s M2 was 79cm, so her vital lung capacity is normal. Phew!

Use the Vital Lung Capacity test every few weeks (provided you are doing posture exercises regularly) to measure your progress. 

More self tests: Posturecise (Level 2) – with self tests and self treatments