What is a postural treatment? Our clinic specializes in rehabilitative treatments, and in particular, assessment and correction of postural imbalances that lead to dysfunction and acute or chronic injuries. In Part 2 of this series, we will discuss the process and benefits of postural change through Massage Therapy and Medical Acupuncture treatments, and give you examples of common scenarios of dysfunction and a basic outline of our treatment approach to these issues.
There are approximately 650 muscles in the human body which account for up to half of the overall weight of the body. Muscles give the body shape and form. Muscles move it and support it. Muscles contain and protect most of the blood vessels, and provide the bulk of the raw material for a complex system of chemical interactions allowing it to function and persist through time. Muscles contract and relax automatically, all day, every day, moving fluids vital to the maintenance of life.
Because the majority of musculoskeletal system is symmetrical, and because that symmetry normally maintains an equal distribution of the tension and load placed upon the bones and joints of the body, dysfunction and pain can generally be said to occur as a result of muscular asymmetry and the compensatory postural asymmetry which follows.
For example, if the muscles on the right side of your neck become tighter and thus shorter than those on the left side of your neck, greater tension and load will be placed upon one side of the spine, forcing the joints to stop moving properly. When this happens, the problem only worsens with time as the muscles spasm to protect the joints by stopping their movement all together. The difficulty with this, however, is that as some muscles spasm, the movement of other muscles is restricted leading to the eventual dysfunction of the joints which they are designed to support and move. As a result, soon the problem that began at the neck has led to problems at the shoulder and lower back and even the elbow and wrist.
From a treatment perspective, what this means is that it is not enough to simply reduce pain. If the muscular and postural symmetry is not restored, the process causing the pain will not be halted. The adhesions, contractures, spasms and fibrosis may be removed or resolved, relieving pain and restoring strength and length, but if the issue is not approached in such a way as to cause postural change toward the restoration of symmetry, the problem will continue to return, perhaps even for years.
For the majority of our elderly patients, difficulty maintaining balance, fatigue in standing or walking, and pain in the low back and hips, or shoulders and neck are the most common issues for which relief is sought. Pain or weakness that travels down the legs may accompany dysfunction and compression in the lumbar spine (low back). This can often be alleviated through treatments that focus on releasing the gluteal muscles and lengthening the low back, along with release of anterior hip flexors such as psoas and TFL. If there is weakness in the abdominal region, interfering with straight alignment, we may need to treat the diaphragm, as well. Removing this forward pull allows the patient to build abdominal and gluteal strength to support the low back, pelvis and associated joints.
Postural change in the upper back, shoulders and neck can be more complicated, and possibly require a longer treatment plan before a maintenance stage is reached. When assessing patients of any age, we look for symmetry of the shoulder girdle, possible internal rotation of the glenohumeral joints (shoulders), anterior clavicle rotation (collar bone), scapular protraction or tipping (shoulder blade), topography of the ribcage, forward head positioning either from straightening or excessive curvature of the cervical spine (neck), and rounding or straightening of the thoracic spine (mid to upper back). This is an area in which treatment for young to middle-aged patients will yield the best results, as prolonged postural dysfunction in this region tends to lead to structural changes in the skeletal system that may not fully resolve.
What we have come to realize, in our clinical experience, is that our field as a whole is really only just on the cusp of change as the scientific community continues to re-examine its implications in the restoration and maintenance of health, as well as its role in the medical community. For ourselves, as a Registered Massage Therapists, this means being a part of something very exciting and intellectually captivating, while at the same time being part of a medical field devoted to compassionate, attentive, patient-centered health care. For our patients, as well as for us, this means a better quality of life.
Carl Berry, RMT, CHT & Kaity Weichel, RMT, D.Ac.