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

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!

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