Low back pain – new perspectives
In the USA, low back pain is the second most common cause of disability and the most popular treatments are actually known to be unhelpful for most people. Read more
The myth of perfect posture
Greg Lehman is a physiotherapist, chiropractor and strength and conditioning specialist treating musculoskeletal disorders within a biopsychosocial model. I believe you sincerely have to give it to the guy. Rarely will you find that an individual becomes proficient in two health care professions. He is also a researcher as he has published more than twenty peer-reviewed papers in the manual therapy and exercise biomechanics field.
Self admittedly, Dr. Lehman has a strong biomechanics background yet he can appreciate the neuroscience aspect of the musculoskeletal disorders that subjects present with.
This begin said, he and many other practitioners have, I believe, a skewed perception of what is known of posture today. When they choose to address the question, things can get quite interesting.
This blog post will address some of the misconceptions about the notion of posture, as brought forward by Dr. Lehman.
About high-level runners
Dr. Lehman brings up the notion that some criticize the running pattern of some top athletes, as it seems to be that they over-pronate. I understand that pronation is a naturally occurring phenomenon and I have to admit that I would not know what over-pronation actually is.
About dead lifting heavy
Dr. Lehman brings up the fact that the first athlete to dead lift his bodyweight 5 times has a scoliosis. The idea that some would promote is that a scoliosis could get in the way of optimal performance. That being said, would you not think it could be interesting to see what this same gentleman could accomplish if he did not have scoliosis? Dare I say that there is a possibility that he could be even better, even if he, at some point, was the best?
Do we even know how well this athlete is doing today? Do we know if he is in a state of chronic pain… or not?
To proclaim that a certain way of doing things can’t be so bad because it represented the best performance, at some point in time is, I believe, short sighted.
About Paralympics athletes
It’s easy to see that Paralympics athletes accomplish phenomenal feats. And it’s easy for Dr. Lehman to say that, based on this reality; the body is obviously a phenomenal adaptation machine. I can agree with this and, yes, thankfully, the body can adapt. But what about if, for the same motor objective, the body could spend less energy and, on a neuroscience standpoint, create less noise? Would that not be suitable? Can we not agree that, for a specific motor task, there is a more economical way of moving? Why would we not work towards creating this scenario, even if the body can adapt?
When does posture matter and when it does not… as much
Dr. Lehman bring up that posture is more important with activities where high load are present. In this case, as he states, a dynamic knee valgus can injure the ACL and cause it to fail. He goes on to state that, for patello-femoral syndrome, posture is not as important. How interesting that I have noticed that, over the last 10 years, in the vast majority where such a diagnostic was pronounced, it happened to be on the side where the pelvis tilts. Is it a coincidence? Can the tilt of the pelvis force adaptation of the lower extremity under load? Can it be that this pathology develops over time whereas a postural imbalance also develops over time?
About sitting “posture”
Dr. Lehman, like many others, speaks of the sitting posture. A lot can be said about how to sit and if there is a good or a bad way to sit. That being said, to posturologists, sitting is positional and actually has nothing to do with posture, which is a reflection of basal tone. Our experience shows us than an improvement in basal tone, as illustrated by optimization of postural landmarks in the three planes of space, allows us to behave positional in ways where there is more freedom and liberty as well as less discomfort.
Postural interventions are not, whatsoever, in line with what is done in the context of clinical Posturology. Postural interventions are brought on by voluntary changes whereas posture is an involuntary motor act. And by modifying sensory input from feet and eyes, as it is done in Posturology, we create immediate changes in base tone that simply cannot be duplicated by asking individuals how to stand or move, for that matter.
Of Foot and Occlusion
One of the most fascinating discoveries for me when learning osteopathy and posturology was the interaction between the occlusion and just about any other sensory and/or motor system. Read more
Of Movement and More
In order to have access to movement, the cerebellum needs to compare the difference between what we intend to do and what is actually feasible. Read more
Knitting for happiness?
Who would have thought that, of all things, knitting could be useful for more than comfortable sweaters? Read more
Emotional Proprioception
If it is true that we recognize the importance of proprioception with respect to movement, we begin to realize that proprioception plays more subtle roles that affect us in a surprising way. Read more
The brain and the body
If it is true that we have long compared the brain to a computer, Alan Jasanoff, professor of biological engineering at MIT, explains why we must go further in this description which is, at least, incomplete. Read more
To speak… to connect
To come in contact with another individual can be perceived as a challenge, for some. When one considers that what is required can be neurologically taxing, could it be that this is more challenging for some than others?
What is required when addressing someone is twofold:
- Looking at them straight in the eyes;
- Speaking.
It appears to scientists that this is not so easy as one may think.
Scientists from Kyoto University, Japan, in 2016, tested 26 volunteers. When asked to make eye contact, the participants found it harder to come up with links between words.
The volunteers took longer to think of words when they were making eye contact, but only when difficult word associations were involved.
To add to this, in an effort to understand what is happening, in 2015, Italian psychologist Giovanni Caputo demonstrated that staring into someone else’s eyes for just 10 minutes induced an altered state of consciousness. Participants saw hallucinations of monsters, their relatives, and even their own faces.
A process called neural adaptation whereby our brains gradually alter its response to a stimulus that doesn’t change could explain this. You simply start to feel less of the stimulus since it is the same, ongoing.
This could be what’s happening in the case of the volunteers making eye contact.
Either way, one can think that if oculo-motor control is optimal, for once, it could be easier to engage, while thinking!
https://www.sciencedirect.com/science/article/pii/S0010027716302360
Inhibition: or how to not do
It’s interesting to me that, if curious or involved in performance, we think in terms of what we do, what we could do, what we can do and, but of course, what we should do. Read more
The motor cortex… and the kidney?
My favorite topic is not Posturology! Now, although that may come as a surprise to anyone reading this blog, one has to think that, if I can appreciate Posturology this much, it is because of its widespread and profound impact on physiology. While those impacts are mechanical in nature, this piece from 2012 could be a piece of the puzzle as far as an explanation for the systemic changes we can see clinically.
The kidney, as it is the case for the other visceral organs, is under the influence of the autonomic nervous system. If it’s true that the sympathetic branch of this system can be responsible for fight or flight responses in acutely stressful situations, it has been shown that there is sympathetic output with voluntary limb movement as a predictive response.
Some predictive responses fit with the concept of allostatic regulation in which a central command from higher brain centers that are the origin of the central command have not been fully identified.
What was found is that, in the rat, there was a connection between the kidney, sympathetic nervous system fibers and the cerebral cortex. A specific layer of the cortex involved is layer V, a major output layer of the cerebral cortex. What is even more fascinating to consider is that, in the various animals that were tested, in the majority of the times, these connections between the kidneys and the cortex were controlateral.
This connection between the cortex and the kidneys actually go beyond motor areas. For example, to some extent, the somatosensory cortex, the insula and even the medial prefrontal cortex were involved).
When one is seeking the physiology behind Posturology’ possible systemic results, one can now add this perspective to the list!
http://www.jneurosci.org/content/32/19/6726.long
