Dupuytrens Contraction (Contracture)

Dupuytren’s contraction or contracture is a disease characterized by the deformity of the hand that develops over decades. A Dupuytren’s Contraction or Contracture affects the underlying connective tissue of the palm’s skin. It happens when tissues form knots beneath the outer layers of the skin, and over time, this would cause the formation of a thick cord responsible for pulling one or more fingers into a bent position.

Dupuytren’s contraction or contracture normally progresses slowly over several years. Sometimes it can develop over weeks or months. However, several people also experience a steady progression, while in others, it may start then stop.

Dupuytren’s contracture usually begins as a thickening and stiffening of the skin on the palm. As Dupuytren’s contracture progresses, the skin on the palm may look wrinkled or dented. A firm lump may form on the palm. This lump may be sensitive to touch but classically is not painful. In the later stages of Dupuytren’s contraction or contracture, cords of tissue form under the skin on your palm and may extend up to your fingers. As the cords constrict, the fingers may be pulled toward the palm and sometimes severely.

The ring finger and pinkie are commonly affected, though the middle finger may also be involved. The thumb and the pointer finger are rarely affected by this. Dupuytren’s contraction or contracture can occur in both hands, though one hand is frequently affected more severely than the other.

Causes of Dupuytrens Contraction or Contracture

Doctors don’t know what causes Dupuytren’s contraction or contracture. Some specialists have speculated that it may be connected with an autoimmune reaction, where an individual’s immune system attacks its own body tissues. Dupuytren’s contraction or contracture often go together with conditions that cause contractures in other parts of the body, such as the feet, which is the Ledderhose disease, and the penis which is Peyronie’s disease.

Risk factors of Dupuytrens Contraction or Contracture:

The following are the factors that cause a higher probability of an incidence in Dupuytrens contracture.

First of all, there is age. This commonly afflicts those of ages 50 and over. Then there is gender. Men are more susceptible to develop Dupuytren’s, and contractures in men are bound to be more severe than in women. Also, there is a particular ancestry that it commonly afflicts. The Northern European descent is at a higher risk of this disease as compared to any other race. Dupuytren’s is genetic, and a high probability of occurrence is existent, especially when Dupuytrens Contraction or Contracture is a heredo-familial disease. Smoking and alcoholism also increase the risk. Lastly, many people diagnosed with Diabetes have also reported increased susceptibility to Dupuytrens Contraction or contracture.

Complications of Dupuytrens Contraction or Contracture

Dupuytren’s Contraction or contracture can make the performance of certain tasks using your hand impossible. Many people, at first, do not experience much disability or inconvenience with predominantly hand-using activities such as writing. But as Dupuytren’s contracture advances, it can decrease one’s capacity to fully open the hand and make it challenging to grasp certain objects or get the hand into narrow spaces.

Preparing for an appointment for the patient with Dupuytrens Contraction or Contracture Usually, you may first ask for a referral from your family doctor to a specialist for this kind of affliction. Once you are ready to have that medical appointment, write the answers to the questions below to help the specialist diagnose and determine the appropriate treatment for your condition.

When did the symptoms arise? Have they been getting bigger or worse? Does something improve or worsen it? How does the contracture impede your activities of daily living?

During the physical exam, the doctor will have a visual inspection of the hands, relate them to each other, and inspect for any crumpling or puckering on the palms. The doctor will also palpate the different hands and fingers’ different regions to check for hardened lumps, knots, or bands of tissue.

Tests and diagnosis

The only diagnostic procedure employed to check Dupuytrens Contraction or contracture is composed of a simple maneuver, called the tabletop test, which can determine if a person has contracture in the hand. If a patient can lay their hand, palm down, and flat on a tabletop, the patient is then free from a contracture. Mostly though, doctors can diagnose Dupuytren’s contracture by simply visual inspection and palpation of hands.

Treatments and drugs

If the disease advances sluggishly, causes no pain, and especially if it has little to no impact on the ability to use hands for everyday tasks, you may not need any drastic treatment. With this, you may choose to wait and check if the Dupuytrens Contraction or contracture progresses, or you may have radiation therapy which is the most advisable for the early stages of this disease.

Treatment includes eliminating or breaking apart the cords that are pulling the fingers in the direction of your palm. This can be done in several different ways. The choice of technique depends on the severity of the symptoms and any other health complications a patient may have.

Needling is a method that uses a needle that is inserted through the skin to puncture and break the hardened cord of tissue that’s contracting a finger or fingers. Contractures can recur; however, the procedure can be repeated if necessary. Some specialists now use ultrasound to guide the needle. This advancement can really reduce the risk of unintentional injury to the surrounding nerves or tendons of the contracture site. The greatest advantage of the needling technique is that there is no incision, and it can be done on multiple fingers at just one time. Afterward, usually, very minimal physical therapy is needed. The disadvantage of this procedure is that it cannot be employed in some locations due to the risk of damaging a nerve.

The Food and Drug Administration also approves enzyme injections as a treatment for Dupuytren’s Contraction or contracture. The injections contain an enzyme, collagenase clostridium histolyticum (Xiaflex), which is geared for treating Dupuytren’s contracture. The enzyme in this medication relaxes and deteriorates the rigid cord in the palm of an afflicted hand. A day after the administered injection, the doctor will manipulate the hand to break off the cord and straighten the fingers. In many ways, this is similar to the needling technique except that the manipulation of the hand happens the following day instead of the same day for the injection procedure. They have the same advantages and disadvantages as the Needling technique.

Another option is to surgically get rid of the tissue in the palm which is affected by the disease. This may be in the early stages of the disease as the tissues cannot easily be identified. It may not be a preferred method for patients due to it being invasive, but it can prove very effective for patient recovery.

Flat Back Syndrome – Diagnosis and Exercises

If you’re over the age of 35 and have spent years either sitting behind a desk, diving, labouring, or otherwise being very physically active, you might have a condition commonly called Flat Back Syndrome.

If you’re over the age of 35 and have spent years either sitting behind a desk, driving, laboring or otherwise being very physically active, you might have a condition commonly called Flatback Syndrome.

What is Flatback Syndrome?

Flatback Syndrome is really not a syndrome as such. I prefer to call it flatback posture or the correct medical term, alordosis.

Lumbar Lordosis is the normal inward curvature in the lower spine. “Alordosis” means “absence of lordosis” – the normal curvature isn’t present, and instead, the lower back is “flat.” The pelvis is usually tipped backward (posterior tilt), associated with or causing the normal spinal curve to flatten. This is Flatback Syndrome


Copyright Posturo Global Ltd

Signs and Symptoms of Flatback Syndrome

  • flat lower back curve
  • forward head  
  • round shoulders
  • low back pain often described as ‘aching.’
  • groin pain
  • leg pain
  • spinal stiffness, especially on waking 

This list is only a guide. You may have many of the signs and symptoms listed, only a few or none of them. The list is to assist you in recognizing whether you have Flatback Syndrome.

What Causes Flatback Posture?

Incorrect Sitting

If you have spent years sitting incorrectly – sitting on your bottom muscles instead of sitting with your back aligned over your hips – you may have developed chronic muscular imbalances – short, tight abdominals, short, tight hamstrings, and weak hip flexors – pulling the pelvis into a tucked-under position (called posterior pelvis).

Slouch Back

Slouch Sitting – copyright Posturo Global Ltd

Disc Degeneration

Incorrect sitting and standing posture, poor nutrition, injuries, athleticism, and manual labor can lead to worn spinal discs and pain in a patient. The lower spinal discs should be wedged-shaped, which gives the lumbar region a healthy inward curve, known as lumbar lordosis.

Copyright Posturo Global Ltd

Interesting: When people say, ‘I’ve got lordosis in my lumbar spine,’ what they usually mean is that they have hyperlordosis or sway back. The hyper suggests an increase to the normal lumbar curve. We should ideally all have lordosis in our lumbar spine.

If the lumbar curve is exaggerated, it is a hyperlordosis; if it is flat, it’s an alordosis or without a lordosis. Saying you have ‘lumbar lordosis’ is actually saying you are normal. That always makes me laugh – in a kind-hearted doc sort of way.

When our spinal discs degenerate, they lose their natural wedge shape, causing a reduction in natural lordosis. This may result in flatback posture. It may also be common to see spinal curvature.

Herniated Disc

A herniated disc is just a severely degenerated disc, where the gelatinous, toothpaste-like material normally found contained inside the disc has leaked through the outer cartilage rings. This also causes loss of the natural wedge shape, which leads to a change in the normal lordotic curve.

Chronic Muscular Imbalance

Many of the muscles responsible for posture and body movement are found in “pairs.” One muscle (or group of muscles) moves a body part in one direction, while the paired muscle moves the same body part in the opposite direction. The two sides of such a pair are said to be “opposers” since the effort of one side opposes – works in the opposite direction to – the other side.

Both sides of a muscle pair’s efforts may also be exerted simultaneously (when sitting or standing relatively still) to provide the tension and support needed to hold a body part steady in a desired balanced position.

Further Resources: Balance Exercise for Beginners

When one of the muscles of a pair becomes stronger than its opposer, we say that the stronger one has become dominant. Dominant muscles tend to become short, tight, and over-aroused – or facilitated – neurologically. The weaker opposing muscle becomes long and under-aroused or passive.

Although these muscular imbalances are fairly predictable, individual differences do, of course, exist. Muscle imbalances commonly found in people with flatback posture include:

Dominant Short Muscles

  • Abdominals
  • Hip flexors

Passive Long Muscles

  • Hamstrings
  • Gluteals

Because posture and muscular imbalances affect the way we move, problems in one area lead to problems in other areas. Flatback posture often contributes to the development of round shoulders and forward head posture.

Other problems may result from the muscular imbalances found in flatback posture, including:

  • Sciatic leg pain (from inflamed, bulging discs)
  • Chronic lower back pain
  • Acute lower back muscle spasms (often one-sided)
  • Scoliosis
  • Degenerative disc disease
  • Deformity


It is not essential to know the exact cause of your flatback syndrome. Still, it suggests some daily posture exercise habit is needed to return mobility and optimal alignment to the spine. Spinal surgery correction or other surgical treatment is not ideal. However, surgery and physical therapy can help you, especially if you have a pinched nerve, neck pain, or other severe pain.

The patient’s objective is to ultimately restore good alignment by establishing healthy posture habits and daily routines. Good posture is a habit and one that you can learn to love. It also helps to avoid spine surgery or other intrusive treatments for the spine.

After Thought – Best Ergonomic Tip

Fully upright posture (90°) is hard on the discs in your low back, so avoid buying the “perfect ergonomic chair” that keeps you bolt-upright. Research has shown that reclining at a 135° angle is the least damaging to our lumbar discs when seated.

Before you jump and adjust your seat angle, recognize that such a position is impractical for working at a computer. You’d be so far back, you’d be straining to reach the keyboard, and you’d almost certainly increase your forward head position.

It seems that 110-120° is about perfect for reducing any forward head posture that could occur if you incline the seat back any further. Personally, I favor 120°, with lumbar back support.

In any event, do remember to keep your head back, nicely inline above your shoulders. Please don’t force it back; allow a gentle lengthening to lift your head back into alignment.

Review the chin tuck exercise for forward head posture if you are unsure.

Inclining your seat 5° downward at the front and using armrests can further reduce lumbar disc pressure.

Happy sitting!

Mattress in a Box | Sleepovation Review Dr Paula Moore

I was skeptical when I first sat on my Sleepovation Mattress because it felt softer than the firm memory foam mattress I have slept on for years. My first night’s sleep, I slept for 10 hours straight and didn’t wake to use the bathroom once! That was miraculous for me.

I was on my way out to buy a new memory foam mattress for my bed – which I’ve had before and loved – when Brian from Sleepovation emailed me asking if I would endorse the Sleepovation mattress. He said it uses the latest sleep technology.

Having never even sat on a Sleepovation mattress, much less had one on my bed, I wasn’t prepared to offer an endorsement, but I was happy to give the mattress a try. A true endorsement will only ever come from me if I love and use a product regularly.

Brian was cool with that, and within the next 48 hours, my Sleepovation mattress arrived in a box.

I love several things about this mattress and a few things I’m not so keen on. Here is my review of the Sleepovation Mattress in a Box. I’m not that keen to endorse something that can be so subjective. Please have a read of my pros and cons, do a little research, and then decide for yourself.

Sleepovation Mattress |The good

  1. Support: Sleepovation claims to be the first ‘pocket system’ mattress – also known as ‘tiny mattress.’ In theory, the individual suspension system (made up of 700 tiny mattresses) supports the spinal column and each bone separately. It cradles the body’s curves while providing enough firmness for the back’s muscular and bony structures. This should give pain relief and pressure relief on the neck as there is motion transfer between the different air channels. This is potentially great for spinal alignment, depending on your sleeping position.

    I was skeptical when I first sat on my Sleepovation Mattress because it felt softer than the firm memory foam mattress I have slept on for years. On my first night’s sleep, I slept for 10 hours straight in comfort and didn’t wake to use the bathroom once! That was miraculous for me.

  2. Cleaner: The Sleepovation has removable, washable covers – two in fact! The one you see with the blue zipper in the image above and an elastic mattress cover fits over the top of the quilted cover. This is a definite benefit, as a quality mattress cover can run upwards of $100 and is advised to give you unmatched cleanliness.

    You can also vacuum between each of the 700 tiny mattresses to remove dust. That’s pretty unique!

  3. Cooler: The individual pocket system allows air to circulate right through the mattress channels. I don’t suffer from being too hot at night, so it will be interesting to hear from some of you on this potential benefit.
  4. Motion Isolation: Because each of the 700 tiny mattresses moves independently, you shouldn’t get much co-sleeping disturbance from your partner. So far, I have found that to be true.
  5. Greenguard Certification: Greenguard products are certified for low chemical emissions, so they are considered acceptable for sensitive individuals. I don’t have any allergies myself, so that will be for you to decide.

Sleepovation | Less good

  1. No Slats: Because there are 700 tiny mattresses, box spring or coil underneath isn’t ideal, and neither are slatting because the individual segments can slip through. So you need to use a platform bed or buy a thin sheet of plywood to place over the top of your slatted base.

  2. Not Organic: The material and foam for the Sleepovation mattress are not organic. Organic mattresses are part of the luxury mattress market, and you can expect to pay upwards of $3,000 for one; and by the way, memory foam mattresses are also not organic.

    Typical (non-luxury) mattresses contain chemicals that are probably not that healthy for anyone but particularly unsafe for babies and children. Most mattresses contain petroleum-based chemicals, toxic foams, synthetic fabrics, and fire retardant barriers or chemicals. These chemicals can off-gas and expose your family to dangerous toxins while they sleep.

    Organic mattresses are often made of cotton or wool and use no chemical treatments, but do your research before you buy!

  3. Price: I consider Sleepovation in the quality mattress market, typically between the $1,000 – $2,000 price point. Considering the average person sleeps for 8 hours each night, I did a little calculating:

    8 hrs x 30 days/mth x 12 mths/year = 2,880 hrs sleep/year

    If you start sleeping on a quality mattress like Sleepovation at the age of 30 and live to be 84, that is:

    54 years on a quality mattress. 54yrs x 2,880 hrs/year = 155,520 hrs sleeping on your quality mattress this lifetime.

    155,520 hrs / 24 hrs (per day) = 6,480 days of your adult life spent sleeping! That is 18 total years of sleep from age 30-84! Slightly depressing, isn’t it.

    A Sleepovation Mattress typically costs about $1,500:

    $1,500/6,480 days = approximately 23cents/sleep on your Sleepovation Mattress.

    I’m ok with that. You?

Where to get your Sleepovation Mattress

>> SleepOvation Mattress discount: Use coupon code POSTURE to save $50.

You can also buy a Sleepovation pillow made up of 77 tiny pillows and is recommended to give you a good night’s sleep.


Infinite Moon Everpillow Review

Simplicity is the word that comes to mind. Infinite Moon has kept things simple with the Everpillow. There is a regular shaped pillow (The Original) for back sleepers and a curved pillow (The Curve) for side sleepers.

The Everpillow by Infinite Moon is yet another option of comfortable pillows available online. In my never-ending search for the perfect night’s sleep, one of my posture pupils brought this pillow to my attention.

Sleeping is a competitive market. There are ergonomic pillows, organic pillows, memory foam pillows, thin pillows, fat pillows, extra firm, extra soft, down-filled, goose-filled, and even pillows filled with cooling gel. With so much choice in the sleeping marketplace, it’s getting harder to be different. Infinite Moon doesn’t just make different pillows. They make a difference too.

Everpillow is more than just a comfortable pillow. When you purchase an Everpillow, you become part of a pretty cool story. More on that later…

Overview of the EverPillow

Simplicity is the word that comes to mind. Infinite Moon has kept things simple with the Everpillow. There is a regular shaped pillow (The Original) for back sleepers and a curved pillow (The Curve) for side sleepers. Notice there isn’t one for stomach sleeping, because as any good posture doctor will tell you, you should avoid stomach sleeping!

You have three options for the pillow fill you get. 100% natural latex, Kapok silk from the Java Cotton Tree – which is meant to be particularly good at resisting moisture and mites – or a combination of the two, allowing you to customize what kind of pillow you get. Nice!

Infinite Moon is a Movement

Infinite Moon’s business model is part of a movement called Emergent.

Emergent is a movement of people and businesses dedicated to transforming business and society. Over the last 15 years, our shared mission and 20/20/60 model has transformed local communities through more than 2 million dollars of charitable giveback.

The idea is that 20% goes to charity, 20% is re-invested, and 60% is profit for the company. I already loved this company before my pillow even arrived as one with a high level of ideals.

Infinite Moon Philosophy

If you like to choose the companies you buy from based on their philanthropic endeavors or impact on the world, then this might sway your pillow-buying decision. Infinite Moon has paired with a Denver-based company that helps transition people at risk back into the workforce. This includes people with addictions formerly incarcerated or homeless.

Everpillow is Natural

These days I’m a little cautious when I read 100% natural. Even the label no sugar added sadly, does not mean free from sugar. It just means they haven’t added any more sugar to the original recipe ingredients. Everpillow fill comes in 100% natural latex or Kapok silk. There are synthetic latex varieties, but natural latex comes from rubber trees. Kapuk silk comes from the Java Cotton Tree of Central and South America. I love the idea of sleeping on silk!

Kapok Tree silk

While I really like the EverPillow, there are 2 small things I would change or add. I’d like to see each pillow come with a slipcover. Although the pillow I ordered has a lovely organic cotton cover that feels like heaven, it is still the only barrier from drooling mouth to pillow fill. I usually buy my own slipcovers for all of my pillows, but I think it would be a really nice added feature to include one in the purchase.

The second thing I’d change is the shape of the curved pillow. I ordered The Original without the cut-out for the shoulder. I am a side sleeper, but I wouldn’t say I like the idea of a semi-rigid seam, but I didn’t test this model, to be fair. I’m not too fond of the aesthetics of funny-shaped pillows. I like symmetry – hence my affinity for good postural alignment. I like to make up my beds with nice sheets and pillowcases. A c-shaped pillow looks darn funny. Plus, I find The Original is nicely pliable. It easily forms into my shoulder—no need for a curve.

My Infinite Moon EverPillow Recommendation

I was pleasantly surprised with the EverPillow. I normally get contacted by companies who want me to test their ergonomic products. This was one of the first companies I actually contacted. I wasn’t sure what to expect, and in fact, the pillow stayed boxed for several weeks before I even opened it. Unboxing the pillow and customizing the fill levels to make my sleeping posture and alignment as close to ideal as possible was a very intuitive and enjoyable experience.

Everpillow is a quality product that is accurately priced. I like that they’ve made a real effort to be different and give back financially and directly to their local community. Oh, and I’m in love with Kapok silk; from the very moment, my hand dove deep into my silky pillow fill… heavenly!

Shop Infinite Moon

5 Easy Ways to Boost Body Confidence

The way we talk, sit, and stand carries a lot of meaning. Our unconscious gestures and body posture convey thoughts and feelings even more than the words that we speak. When confronted with conflicting signals (e.g. we speak confidently but our shoulders round and we slouch), others may rely on our non-verbal cues.

What do people see when you walk into a room? Hopefully, they see a confident, successful, happy individual. But if we’re not careful, what we communicate through our body posture, may not be the image we wish to convey.

Our body movements, gestures, alignment (posture), eye contact, skin flushing, breathing, and even perspiration all add to the words that we speak. When I was younger, I blushed easily, and it intensified when people commented on my flushed cheeks. I still blush as an adult, but now I can laugh it off without feeling horribly embarrassed.

The way we talk, sit, and stand carries a lot of meaning. Our unconscious gestures and body posture convey thoughts and feelings even more than the words that we speak. When confronted with conflicting signals (e.g., we speak confidently but our shoulders round and we slouch), others may rely on our non-verbal cues.

Check for inconsistencies. Our gestures should be consistent with what we are saying. For example, if a person speaks as if she is confident but fidgets with her hands when she communicates, she conveys conflicting signals. Unfortunately, the overarching message will usually default to our body language.

Be observant but don’t overanalyze every single gesture. Avoiding eye contact, for example, does not have to mean that a person is lying, insincere or nervous. It is possible someone may look away to recall better or narrate things when not looking directly at you. Trust what your instincts are saying about someone’s non-verbal communication. If you sense that a person is nervous or insincere, you are probably right.

Communication is the foundation of any successful relationship, whether it is personal or professional. If you want to communicate body confidence, power, and authority, practice these 5 communication cues:

1. Maintain assertive body posture.

The key to coming off poised and confident is in the way we hold ourselves. Forward head posture, neck hump, round shoulders and slouching, look less attractive to an observer than an upright, symmetrically aligned body. To stand confidently, stand with your feet approximately four to six inches apart. Distribute your weight equally on both legs, avoid swaying, stand long and tall and face the person/s you are speaking to.

Further Resources: Forward Head Posture – Cause and Cure

When was the last time you met a confident person who slouches? Exactly! When we sit or stand with expansive power postures, we boost our testosterone levels, and testosterone is associated with success and the winner effect.

2. Watch your hands

Placing your hands on your hips is a posture many people use, but this can give off an air of arrogance or impatience, just as crossing your arms can. If you tend to play with your hair, touch your lips, or jiggle coins in your pocket when you’re with a group of people, remember that our body gestures communicate more than the words we say.

3. Don’t cross your legs

Not only is crossing your legs bad for your circulation because it increases the pressure on your veins, but it also makes you take up less space and can look less confident. Don’t spread your legs to China – I recently suggested that a friend of mine sit beside me on the Go Train – and equally, don’t wrap yourself up into a corkscrew either. Imagine what this is doing to your pelvic posture. Yikes!

4. Pay attention to your face

Do you know what your face looks like when you are looking at, listening to, or talking to other people? Some people’s standard facial expressions can be stern, grumpy, angry, and sometimes nice and smiley. I love those people who look like they are smiling, even when they are not.

Mike Budenholzer, coach of the Milwaukee Bucks

This was Mike Budenholzer’s expression through the entire game against the Toronto Raptors this week. Fair enough, the Buck’s did lose (go Raptors!), but even when the Bucks were well ahead, this was his typical appearance. Hilarious! Kind of.

If you have a rather severe standard facial expression, people may avoid you, think you are mad at them, or get defensive around you. These are not good outcomes if you want to connect with people.

What can you do? Please pay attention to the comments your friends and colleagues make when you’re listening to them. Do people often think you’re upset because of your furrowed brow? Do strangers tell you to smile or cheer up? If this is the case, practice smiling in front of your bathroom mirror. And by the way, practicing this will probably make you smile for real. Apparently, it also helps – when listening to others – to keep your lips slightly parted, so you are less likely to interrupt. Try it!

5. Make eye contact

Confident, assertive people can hold a gaze. Too much eye contact may feel intrusive, rude, and dominant. We need to strike a balance. You know that feeling when you are at a business event and speaking to someone who is scanning the room for someone better? It doesn’t feel very good. Don’t be that person! Learn to listen with your eyes. People instinctively like people who listen to them.

The way we hold ourselves is often a reflection of how we feel about ourselves, so being more self-aware and maintaining good body posture (it helps when we practice daily posturecise) improves our confidence. Not only do we look more attractive with upright, symmetrical posture, but studies on posture are beginning to show us that our brains are actually more capable of positivity when the body is in an upright stance.

Important Test For Brain Health – One Leg Balance | Posture Doctor

An important test for brain health is the ability to balance on one leg. Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with vascular disease in the brain, specifically small areas of tissue death (mini strokes) without symptoms.

I made a new friend recently. She, like me, is 50 (something) and a bit of a tomboy, in that she has been active and sporty all her life. Then just over a year ago, she had a car accident and four days later when trying to answer a question at work, nothing came out of her mouth. She just couldn’t find the words. Moments later, she said to her colleague: I think I’ve hurt my brain.

There is a lot of current online buzz about brain health. Listening to CBC Radio this morning they were talking about particulate matter – from city pollution – and the cognitive impact.

Then I happened upon this study that found that an important test for brain health is the ability to balance on one leg. Yasuharu Tabara, Ph.D., and lead study author and associate professor at the Center for Genomic Medicine says that:

Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline.

The study consisted of 841 women and 546 men, with average age of 67. To measure one-leg standing time, participants stood with their eyes open and raised one leg. They  performed the leg raise twice and the better of the two times was used in the study analysis. Small blood vessel disease of the brain was evaluated using magnetic resonance imaging.

The researchers found that the inability to balance on one leg for longer than 20 seconds was associated with vascular disease in the brain, specifically small areas of tissue death (mini strokes) without symptoms. They noted that:

  • 34.5 % of those with more than two lesions (infarctions) had trouble balancing.
  • 16 % of those with one lesion had trouble balancing.
  • 30 % of those with more than two micro bleeds had trouble balancing.
  • 15.3 % of those with one micro bleed had trouble balancing.

“One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities,” said Tabara.

Although this study is not saying that poor balance causes brain disease and/or cognitive decline, the inability to balance for at least 20 seconds, may suggest brain abnormalities. So poor balance suggests poor brain health, but can improving balance improve our brain health as we age? Now that’s a great research question!

Personally, I like to err on the side of caution with my own health. I’m not comfortable with pill popping and I’m definitely not waiting for signs of aging (other than my quickly greying hair and ever-creasing skin argh). I’ve incorporated balance exercises into my daily posture routine.

Get the balance right

Balance shouldn’t be a concern just for the elderly who are more prone to falls (and the serious complications those falls can cause). Balance training is important for anyone who wants to age well, avoid 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.

In order to have good balance, we rely on the information given to our brain from three main body systems: our ears, the nerve endings in our muscles, and our eyes (vision).

As children, we develop balance climbing trees (where I spent many hours climbing up, up, up to collect long forgotten bird nests), riding our bikes, walking and running on uneven surfaces and playing sport and games. As adults, we seldom think about balance and rarely practice it.

When was the last time you climbed a jungle gym with your kids, walked along the slim surface of a forest log or tried to balance on one leg whilst brushing your teeth with the opposite hand (I love this one)?

The eyes have it

Your sense of vision is a big part of good balance. Vision works hand in hand with the inner ear to maintain balance. If you move your eyes or take vision out of the equation altogether, it’s harder to balance. You might be surprised how challenging it is to simply stand with your eyes closed. We play around a lot with removing vision during some of the more advanced balance exercises in our posture school.

Better balance means better coordination, POSTURE, core strength, agility and athletic skill. You even burn calories using balance training!

Balance training is good for people of every age, so don’t be afraid to start incorporating balance exercises into your daily workouts. Everyone can benefit from balance training and even better if our ability to balance keeps our brains young, sharp and disease-free!

Try walking off-piste

5 Powerful Strategies to Get You Unstuck | Posture Doctor

Change stimulates our brain. You can start small by changing one daily routine, brushing your teeth with the opposite hand, or doing ten shoulder rolls in the shower each morning. It really doesn’t need to be monumental – it just has to be different.

So this is a little embarrassing to admit … Saturday night I went speed dating! Eek, there I said it.

Actually, it was pretty fun. I’m an up-for-adventure kind of gal, so why not right?!

When you read to the end of this post, you will see why DOING SOMETHING DIFFERENT – and why there are some things we should just NEVER SAY on a date – relates to your posture and health.

I arrived at 5.20pm and actually found a parking spot in Toronto. Luck was on my side!

My speed dating event included a free cocktail, so as you can imagine, I immediately went to the bar for a little Dutch courage – a glass of bubby helped.

I had twelve dates – each lasted five minutes. I had prepared some stock questions in case of awkward silences:

  • What did you do this morning?
  • What was a favorite childhood past-time?
  • Canoe trip, Vegas or Mexico? Bet you can guess my answer.

I didn’t rely on my fixed questions; most of the conversations seemed to flow easily.


For any of you planning to try speed dating, definitely do NOT say this:

So tell me everything about you. (We only had 5 minutes)

Or this:

I don’t like being touched – eek, I was trying hard not to giggle at this point.

If you’ve ever speed dated, you know that at the end, if you put a tick in the YES box and they also tick YES, then you’ve got a match. I had one of those! But hey, some things are a little too private to share (wink).

Here it is – this is why DOING SOMETHING DIFFERENT might help get you unstuck. I’ve been single for a few years now. I’ve dated online, had friends intro me, and waited for the magical moment that perfect person walks into my life. Ah ya, hasn’t happened. So I did something different!

Where are you stuck?

Maybe you want to quit your job, move to a small town (I did this – highly recommend it), learn a new skill, or improve your posture?

I’m cheating because of course I know that you want to correct your posture, or you wouldn’t be reading this.

What have you tried?

Maybe you’ve enrolled in one of my courses? Bought my Posturecise DVD, tried a Pilates class, personal trainer, new mattress, sit-up-straight app or wearable??

What does DOING SOMETHING DIFFERENT look like for you?

Here are five things you can do, right now to empower yourself to move closer to the life you deserve:

1 Change Your Physiology

This one I borrowed from life transformation guru Tony Robbins. Tony suggests that feeling stuck and making progress are not interdependent. You can only be in one state at any given moment.

… the feeling of progress, stops when we feel stuck – and miserable – because ultimately, progress is the key to happiness.

He goes on to suggest that bad physiology reinforces negative feelings. As Tony says, “Motion creates emotion.” Changing your physiology means adjusting your body to alter your mindset. This can be something as simple as changing your posture so you are standing long and tall, doing something funny with your body like wiggling your bottom for 20 seconds, or something more intense like going for a jog.

2 Ridiculously Small Changes

Change stimulates your brain. You can start small by changing one daily routine, brushing your teeth with the opposite hand, or doing ten shoulder rolls in the shower each morning. It really doesn’t need to be monumental – it just has to be different. After a while, an accumulation of small changes (doing something different) will help you accomplish your goals, and you will start feeling unstuck.

3 Buy a Fancy New Journal

I can’t remember when it was that I fell in love with design and writing, but a pretty journal definitely romances me into creativity. I don’t journal as such. I write down things I’m grateful for, my to-do lists for the day, or ideas that bubble up at any given moment – that happens a lot!

I use my journal as a productivity tool for work and life mostly. It allows me to coach myself through challenging situations and walk away with greater perspective and clarity.

Don’t forget to buy a writing utensil that feels good in your hand – a chubby pencil was my choice, but a lovely pen, marker, crayon all work well. I like to write over breakfast and think of the day and week ahead and what I want to accomplish.

4 Begin That Course

Over 12,000 of you have enrolled in one of my online posture courses – you rock! How many of us have enrolled in an online course but never started? An unviewed course, is a little like a lightbulb that has been burnt out in your hallway for months, and every time you walk by, it reminds you that you suck – sad face.

It’s a little bit like the clock by my front door. It often takes me 3-4 months before I get around to changing the time after spring ahead fall back. Argh, why do we do that?!

Whatever course/s you are enrolled on, go now (or today) and watch the first lecture. I promise you, you will feel so darn good and you’ll probably end up watching more than one lecture – but only aim for the first lecture – anything else is a bonus and a bigger win!

Further Resources: Posturecise Crash Course

5 Walk

This one is probably my favorite one of all. I’m a big walker. I walk and walk and walk until the worries of the world melt away. I have one Golden Rule when it comes to walking – NEVER take your phone. Never!

The answer we’re looking for is often found in the doing. It feels weird to start writing without an idea, painting without a concept or walking, just for the sake of walking. It might feel wrong to quit a job we dislike or to start a business without having the perfect plan or to take up a musical instrument, when we don’t naturally have rhythm. And yet, that’s exactly what we should do when we’re stuck:


It doesn’t have to be right or perfect, but it will move the energy around, and lead you to new ideas, emotions, and connections you wouldn’t discover if you waited for inspiration to come and find you.

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:

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