Postural Re-Education

Postural reeducation forms a large part of our clinical practice at Dublin physiotherapy.

Posture is something which is frequently discussed and implicated in pain problems but often much harder to changing reality.

There are a wide variety of postural changes which can occur and which can affect most areas of the body from the shoulders, head and neck, lumbar spine, hip, knee and ankle.

In the upper back the most common postural change which everyone is familiar with is the slouched posture where the upper back is rounded, the shoulders dropped and forward with a poking chin.

In the lower back a flattening or rounding of the lumbar spine is a common clinical observation but we also see cases of an increased curvature in the lower back (increased lordosis) or a variation of this known as a “swayback” alignment.

The treatment for these different types of postures is quite different and dependent upon the cause of breakdown.

More detail on the causes of breakdown can be found here but suffice it to say that the reason postural breakdown is so prevalent is that it takes significant effort to correct and it requires precise identification of where and how the postural breakdown has occurred in order to design the most appropriate corrective regime.

The fundamental requirements to achieve proper postural alignment require:

Without these components it is not possible to achieve an efficient alignment.

Skilled physiotherapy requires identification not only of the structural cause of the pain but also identifying the mechanism of the breakdown. Not infrequently the cause of breakdown may not be in the area where symptoms experienced and therefore treatments directed to these areas have limited effect.

Trying to improve postural alignment when the basic flexibility of joints involved is not present will be futile.

Improving joint flexibility without improving the capacity of the postural muscles to hold the alignment would likewise be futile. Remember that improving postural muscle strength does not involve trying to make the muscles bigger in going to the gym. It does involve work but the work is more specific to improving the ability of muscles to support body weight.

Thirdly, having established joint flexibility and postural muscle strength, if our proprioceptive awareness (the mind’s eye) is not tuned into postural alignment, than the appropriate motor programs (skills) will not be stimulated. Failure to achieve this third phase is a common reason for ongoing symptoms related to poor posture.

Re-learning a good postural alignment often requires un-l earning established bad habits and re-learning a new sequence of skills and co-ordination just like golf, tennis or many other of the human development activities (such as sitting, standing, talking, walking or eating) which we have long since forgotten the effort required to learn.