Manual Therapy: Why Isn’t It Working? | Posture Doctor

What I know from experience as a practitioner, is that there are roughly 10% of people that do not seem to get better from manual treatment and that no matter what they have tried or where they have been, the symptoms and poor posture seem to always return.

Recently I’ve been getting a lot of questions from my posture pupils. Often the questions overlap. It occurred to me, that I could share your frequently asked questions, so that our entire community of students benefit.

FAQ


Hi Paula, I appreciate you asking me what I’m struggling with atm. Currently – pain in my right hand side of my back, neck, shoulder – right down from the insertion in the hip all the way to the eye-socket! The more connected I am with my body – the more movement and dance I do – the more pain. Which is not exactly encouraging. It’s quite excruciating. Your email came at a great time – just when I was asking myself “What do I do to get this better now? Can I correct this now for good?” I’m seeing an osteo but fear it’s going to take ages and lots of money. He says I have a slight curve from left to right causing this. His treatment gave relief for less than a week. I’ve had this pain on and off since I was a teenager. I want to experience ease and balance in my posture and back SO much! Yours in anticipation & thanks,  

Diana

Dear Diana (and all of you reading this),

I want to address two very important points you make:

  • Can I correct this now for good?
  • Treatment gave relief for less than a week.

I too want you to experience ease and balance Diana and I know our community of posture enthusiasts, want the same.

Let me begin with the second concern – that treatment only lasts a week. Having been a practicing Chiropractor, I am very familiar with this frustration. I was also a patient – before becoming a practitioner – and I too, used to have the same dilemma with my own manual treatment.

What I know from experience as a practitioner, is that there are roughly 10% of people that do not seem to get better from manual treatment and that no matter what they have tried or where they have been, the symptoms and poor posture seem to always return.

Why does this happen?

Structural Problems


If you have been everywhere and tried everything with little or no change, there’s a strong chance you’ve been given only functional exercises to address your difficulties. 

Functional rehabilitation exercises do improve your general range of movement (you couldn’t turn your head very far, and now you can), your strength, balance and flexibility. These elements are very important, but they aren’t the whole story.

Your posture is dictated by your muscles, your bones (primarily the spine and pelvis), and the interactions between them. Though functional exercises are beneficial, they mainly affect the muscles – so they may miss the underlying cause of your bad posture: mis-alignments and unhealthy curves in your spine.

Further, when spinal issues are throwing posture out of balance, functional exercises can make strong muscles stronger and weak muscles weaker, and so the imbalances remain unresolved.  


Functional (generic) exercises work really well for someone like this, whose body has good symmetry. If, however, you give the same functional exercises to someone with asymmetry (like the image below), you make strong muscles stronger and weak muscles weaker, perpetuating the unbalanced posture. Not good!


Doing functional exercises with asymmetrical posture will frustrate you, as you will experience a lack of improvement. Asymmetrical posture is usually the result of structural problems that generic functional exercises and healthcare practitioners often fail to address. 

If you suspect you may have a structural posture issue, you’d likely benefit from a head-to-toe Posture Analysis and a program of correction that teaches you structural posture exercises, tailored to your specific posture needs.

Finally Diana, can you correct this for good? How much improvement we make with our body alignment is largely determined by:

  1. Our lifestyle – review this video to understand the 4 factors affecting how long it will take to correct our posture. 
  2. Our willingness to create a daily habit until our good posture becomes neurologically wired into the brain (Review the Neurology of Habits).
  3. Receiving a structural diagnosis, to determine whether or not we are in the 10% of people who have structural asymmetry and may require a tailored program of correction (Resources: What is a Posture Analysis?)

Don’t Give Up


We have all done this; it is called being human. The worst part of it isn’t that we give up, it’s that we didn’t re- commit to whatever it was we had committed to in the first place; in this case, correcting our posture.

It isn’t easy to stay committed to something when you don’t see immediate results. I know – it took me quite some time (20+ years and I still Posturecise daily) to start seeing real results.

But then again, I am a total posture geek; I don’t expect or advise you to be quite as obsessed!

Good Posture – How to Hardwire Your Brain | Posture Doctor

What if it was possible to hardwire our brains to sit up straight? The new science of habit loops may just be the answer to the eternal question: How do I correct my posture?

What if it was possible to hardwire our brains to sit up straight? The new science of habit loops may just be the answer to the eternal question: How do I correct my posture?

Charles Duhigg, journalist and MBA Harvard graduate, in his excellent book The Power of Habit  tells us that individuals are all very different, and so changing the patterns in our lives will differ from person to person. As a result, changing a habit isn’t prescriptive. Although Duhigg introduces the habit loop – formed of cue, routine and reward – this is more of a framework than a recipe. This framework helps us understand how habits work and provides structure to experimenting with how they might change.

I’ve taken Duhigg’s habit loop and applied it to the habit I like to call good posture. I believe that achieving good posture is more to do with the practice of creating healthy new habits, than it is about good genetics or good luck.


Further Resources:Posturecise – How to Create a Healthy New Habit for Life

Forward Head Posture – Alzheimer’s & Stroke | Posture Doctor

Is your forward head posture capable of making you sick? 

Rene Cailliet, an American born physician of French ancestry, was one of the pioneers in physical rehabilitation and is well known for his books on musculoskeletal medicine.

Rene Cailliet, an American born physician of French ancestry, was one of the pioneers in physical rehabilitation and is well known for his books on musculoskeletal medicine. He says:

You can realign your entire body by moving your head … your head held in a forward position can pull your entire body out of line.

He goes on to explain that the vital lung capacity is reduced as much as 30% with forward head posture.

Forward head posture also causes compression in the upper neck joints (which causes pain and irritation). In order to prevent your forward head from falling toward your chest, your muscles sustain continual contraction, which causes nerve entrapment and artery compression. It isn’t hard to see that there exists the potential for neurological and vascular complications as a result of forward head posture.



Further Resources: Forward Head Posture: Cause & Cure

Reverse Neck Curve – What Causes a Cervical Kyphosis? | Posture Doctor

When the neck curve kinks the wrong way, it pushes the head forward. With the head pushed forward, the lower spine is more prominent and vulnerable.

If you know you have forward head posture and also a hump on the back on your neck, you may benefit from x-ray investigation to rule out a reversed neck curve, also known as cervical kyphosis. When the neck curve kinks the wrong way, it pushes the head forward. With the head pushed forward, the lower spine is more prominent and vulnerable.

Some of my posture pupils complain about fatty neck hump and explain that it has a hard bony feel to it. What they are often feeling, is the kinked region of the neck. If this structural deviation has been there long enough, the body may lay down fat, in an effort to protect the spine – or at least that’s the way I like to simplify and explain a complicated process to my students.

If you’ve suffered long term symptoms that may include: headaches, stiff and/or painful neck, dizziness, arm and hand tingling or numbness, brain fog, difficulty concentrating, fatigue, round shoulders, teeth clenching, TMJ dysfunction or anxiety, and you’ve had any sort of past trauma that might have affected your neck – car accident (over 20mph) , a fall from a height as a child, off a horse, out of a swing, down a flight of stairs – you may find this video relevant.



Further Resources: Forward Head Posture: Cause & Cure

Spinal Anomalies (Like This) Can Cause Forward Head Posture | Posture Doctor

Congenital vertebral anomalies are malformations of the spine that you are born with. In some cases these spinal defects can deform the alignment of your spine affecting your posture, spinal cord and health and well-being.

Congenital vertebral anomalies are malformations of the spine that you are born with. In some cases these spinal defects can deform the alignment of your spine affecting your posture, spinal cord and health and well-being.



Forward Head Posture >> Learn More

What Causes Forward Head Posture & How Severe Is Yours?

Understand the specific cause of Forward Head Posture; use that knowledge to begin the appropriate mirror-image exercises and know when to seek treatment and/or further medical investigation.

Understand the specific cause of Forward Head Posture; use that knowledge to begin the appropriate mirror-image exercises and know when to seek treatment and/or further medical investigation.

Further Learning: Forward Head Posture: Cause & Cure



Hump Back | Neck Hump, Buffalo Hump, Dowager’s Hump or Kyphosis?

One very common euphemism is to call a neck hump a buffalo hump. I prefer the term neck hump, but they do mean the same thing; except the hump on an actual Buffalo consists of about 70 Ib of muscle used to move snow!

There are a lot of euphemisms used in medicine. I find euphemisms, when it comes to our health, patronizing.

I think my patients can handle the truth, so I don’t intentionally soften my words to ease a diagnosis. 

One very common euphemism is to call a neck hump a buffalo hump. I prefer the term neck hump, but they do mean the same thing; except the hump on an actual Buffalo consists of about 70 Ib of muscle used to move snow! The neck humps on humans – if due to a structural change in the neck – consist of fatty tissue not muscle. So the correct euphemism for neck hump is Buffalo hump, but I just don’t like it!

Further ResourcesThe Top 25 Posture Blogs to Follow in 2018



Achieving Tasks | Posture Hack #1

Yesterday I had a mini entrepreneurial breakdown … cue the violins.

You see, I’m a Chiropractor yes but also an entrepreneur. I run the entire business myself! Well, that is mostly true. I have a videographer who helps me with big projects; a remote IT guy I’ve never met, an accountant in England and Canada and that’s the lot!

By the way, this story is shortly going to relate to my  Top 5 Posture Hacks, so bare with.

The problem with being a creative entrepreneur is that NEW is always attractive. This entrepreneur can suffer boredom, perfectionism, the I’m not making a big enough difference in the world dilemma, the what is my purpose inquiry, and the business blues.

Yesterday I decided I needed to re-visit the Back To Basics of running a business and this is where your posture enters the story. I’d hit a wall. I was drifting and procrastinating and not getting the job done. Sound familiar?

Not living up to my business potential is not OK with me and I’m guessing, not improving your posture, is not OK with you either, but it happens. You viewed some of my videos, maybe you’ve read one of  my books or started one of my courses and now you find yourself back to where you were, before you found me.

Guess what? That’s ok … you’re human. You’re in a rut and I’m going to help you out.

So instead of watching something on Netflix last night, I reached out for support. I started reading blog posts and watching videos. Turns out there is just a few (wink) of us business men and women who have hit a wall!

You know that saying that goes something like this:

When you hit rock bottom, the only way to go is up?

I know, it’s a little cliché but it’s true. I’m guessing that like me, you aren’t down and out and right at the bottom, but merely in a rut – lacking motivation and needed a good dose of inspiration to revive your commitment to your health and body alignment (posture).

After an hour of web research and finding some pretty fab videos, I started writing …

text

I made a plan and I’d like to help you do the same. So I’m going back to basics and it occurred to me, that going back to basics is exactly what is needed for those of you who have fallen off the good posture wagon.

Over the next few weeks, I’m going to share my Top 5 Posture Hacks. When it comes to my posture, this is one area of my life that is always working and I’m going to tell you exactly how I make that happen.

Let’s start at the beginning. When I first began this health journey (about 25 years ago), posture wasn’t even on my mind. Chronic low back pain and headaches was on my mind. I didn’t know it at the time, but chronic back pain and headaches is often a sign of incorrect body alignment, or poor posture.

It would take me many years of Chiropractic treatment and about 7 years of study to understand how the structure of the body could go wrong and exactly what was needed to ultimately re-align my body (good posture), restore body confidence, reduce and ultimately eliminate my chronic pain.

Posture Hack # 1 – Create The Environment


Environmental cues are the objects in your surroundings that cause you to behave in a certain way.  Your decisions are largely influenced by what’s around you:

  • There is a TV in your bedroom, you go to bed watching TV.
  • You spend your free time with friends who gossip and you find yourself gossiping and feeling lousy.
  • Your kitchen is a cluttered mess; you eat a lot of ready-made dinners.

I’ve been wanting to meditate for years and have dipped in and out but have never been successful creating a daily meditation habit. When I looked around my house, there was nowhere that I wanted to meditate. There was nothing in my environment that called me to meditate. I decided to change that.

I took one of the smallest corners in my house and transformed it. I went out into the woods and found a beautiful log – a very large log – and dragged it out of the forest on my scooter.

Over the next few weeks, I cut, sanded and sealed and added legs. I bought a small rug, ordered a beautiful purple meditation cushion, hung two favourite paintings and a wall hanging – weaved in the Congo from Palm.

I now have a beautiful meditation corner and it is an absolute pleasure for me to sit quietly and meditate. It is no longer a chore!

We often think that achieving a task is just about getting out there and doing it. We believe that if we desire it, we will find a way to achieve our goals.

But our environment dictates what we choose to do. If you have objects around you that are distracting and leading to undesirable outcomes, then it becomes hard to make the right choices.

On the flip side, having an environment that only has desirable objects(like my beautiful meditation corner), that compels me to do what’s important to me – meditate.

So if you want to work on reducing pain, improving your body confidence and fixing your body alignment (posture), take a look around you and see how you can make it more convenient to do so.

Often, we think that change comes from within. We believe that achieving a goal is about changing ourselves. We often fail to consider how optimizing our environment to make better choices can make a large impact on our actions.

Design Your Surroundings to Encourage Action


Try some of the following ways to create an environment that calls you to Posturecise:

  1. Choose an area of the house that will become YOUR area to posturecise
  2. De-clutter the area
  3. Paint your space (check out my vibrant laundry room colour below)
  4. Buy yourself an attractive new workout outfit
  5. Put speakers in your area, so you can play music
  6. Hang an inspiring fitness poster or painting
  7. Add plants

What are you adding to your new space? I’d love to see a picture when you’re finished!

Is There Such a Thing as Good Posture? | Guardian Rebuttal

So is there really such a thing as good posture? We don’t talk about good blood pressure or good heart rate or good body temperature we talk about ‘ideal’ or ‘normal’ blood pressure, heart rate and body temperature.

So is there really such a thing as good posture? Well, good posture is a phrase that is perhaps less than ideal. We don’t talk about good blood pressure or good heart rate or good body temperature we talk about ‘ideal’ or ‘normal’ blood pressure, heart rate and body temperature. Just like there is a normal range for those vital signs, there is also an ideal for body alignment (posture) and an acceptable range of normal.

So in answer to Luisa Dillner’s article in the Guardian: Are you sitting comfortably: the myth of good posture I say this:

Let’s be very clear. There is a TON of research on alignment, spinal curves, spinal anomalies, degeneration etc. (Just pick up any copy of the Journal Spine, JMPT, Journal of Biomechanics, BMJ etc.) And when these factors deviate from normal, they change the ideal position of the body; away from ‘neutral’ alignment – where the body has a mechanical advantage against the forces of gravity and activities of daily living.

Structure dictates function


There is a well known axiom in anatomy, physiology and neurology that goes like this: Structures dictates function; or structure determines function.

When the alignment of our spinal curves – in the sagittal, coronal and transverse planes – are altered, there exists the potential to influence general health.

Take for example, Wolf’s Law by the German anatomist and surgeon Julius Wolff (1836–1902) in the 19th century; “states that bone in a healthy person or animal will adapt to the loads under which it is placed. That is why it is evidenced on spinal x-ray and MRI, that the areas of greatest spinal ‘misalignment’ (or in lay terms, poor posture), have the greatest degeneration of the discs, facet joints and vertebral bodies.”

Let’s use the common ‘postural’ diagnosis hyperkyphosis (aka Dowager’s Hump) – where the ideal alignment (posture) of the thorax has been altered over time.

A study in the J Orthop Sports Phys Ther (2010 June) Wendy B Katzman et al. Found the following:

Functional Limitations


“Excessive kyphosis has detrimental effects on physical performance, the ability to perform activities of daily living, and overall quality of life. Women with hyperkyphotic posture demonstrate difficulty rising from a chair repeatedly without using their arms, significantly poorer balance and slower gait velocity, wider base of support with stance and gait, and decreased stair-climbing speed—impairments that have been associated with increased risk for falls … have increased postural sway compared to those with normal posture.”

Musculoskeletal Alterations


“As kyphosis increases, there are concomitant alterations in the normal sagittal plane alignment that may cause pain and risk of dysfunction in the shoulder and pelvic girdle, and cervical, thoracic, and lumbar spine. Forward head posture, scapula protraction, reduced lumbar lordosis, and decreased standing height are often associated with hyperkyphosis. These postural changes increase the flexion bias around the hip and shoulder joints that can interfere with normal joint mechanics and movement patterns.”

Mortality


“Hyperkyphotic posture has been associated with increased mortality, with higher mortality rates associated with the severity of kyphosis.”

If we stop thinking of posture as the way we sit or hold our cell phones and think more about the science of posture as the ongoing alignment of the body and spine over time, we begin to understand why ‘good posture’ (ideal or ‘normal’ alignment) is so important.

So is there really such a thing as good posture Luisa Dillner? Absolutely!

The Truth About Standing Desks | What Desk Should You Buy?

If sitting is truly the new aging disease, should we all through away our desk, buy a treadmill and carry out walking meetings like business innovator Nilofer Merchant?

With the new surge in sitting research, ergonomics companies, standing desk manufacturers and wearable fitness tracker entrepreneurs are raking it in. If sitting is truly the new aging disease, should we all through away our desk, buy a treadmill and carry out walking meetings like business innovator Nilofer Merchant?