What’s the connection?
As a Chartered Physiotherapist I am particularly interested in the contribution that improper posture and alignment make to pain and dysfunction, and how Pilates can help.
Posture is a complex interplay between neurological and musculoskeletal systems. Some of the factors which influence the interplay are habits, neurological reflexes, adaptations in the body, and time.
The habits of adopting certain postures can be trained. This about when we’re told to ‘stand up straight’ as children or during military training. People who sit slumped for long periods such as driving, sitting at a desk, using portable devices or doing hobbies such as sewing and knitting may develop poor postural habits.
Posture is essentially how you hold yourself as you sit, stand and move around. The danger comes when we become unaware of what our bodies are doing. Poor postures held for long periods of time are the biggest culprit when it comes to musculoskeletal stresses and strains. This poor posture can be the cause of low back pain, neck and shoulder pain and wrist pain or symptoms such as carpal tunnel – pain and numbness in the hands.
In my opinion, one of the most important things we can do is to develop our ability to ‘tune in’. We can increase our awareness of how we hold ourselves and how we use our bodies as we go about our day. And to do this regardless of whether we sit at a desk, hang washing, run around with the vacuum, drive to work, feed a baby or hit a golf ball!
Posture and Pilates?
The Pilates fundamental principle of alignment begins with the pelvis. We can consider the pelvis as the foundation with the centre of body mass located here. When the pelvis is neutral it brings the lumbar spine into neutral. This allows the spine to stack up above it in the most ideal ‘S’ shape. This also referred to as the natural curves of the spine.
This ‘S’ shape arrangement of the bones allows the spine to distribute the load most effectively between all the appropriate load-bearing structures: bones, discs, ligaments, muscles etc.
How do we know if the pelvis is neutral?
If you’re standing think of the pelvis like a bucket filled with water. In standing, rock the pelvis forwards so the water would tip out of the front. Then backwards so the water would tip out of the back. Come to rest in the mid position with the pubic bone, pointy bone at the front of each side of the pelvis and the navel in the same vertical plane. Now the pelvis should be neutral.
If you’re sitting, think of the bones you feel in your bottom if you sit on a hard chair for a long time. These are the ischial tuberosities and are at the bottom of the pelvis. Think of these bony points as the feet of the pelvis which ideally should point directly downwards when we sit. At the same time the pointiest part at the front of the pelvis, or ASIS, should point directly ahead of you. Now the pelvis is neutral. Not only that, but in consciously correcting your posture you will also have activated muscles in order to move into position, namely the abdominal muscles and the gluteal muscles.
The menopause pot
I recall hearing a friend mention the phenomenon of the ‘menopause pot’ this week. We’re talking about the belly here, not a piece of crockery! There is no doubt that the menopause has a raft of undesirable consequences and for many women weight gain is one. But it is absolutely the case that a forward-tilted pelvis is more likely to give the appearance of a pot belly.
Czech physician Vladamir Janda described a postural presentation that he called the ‘lower crossed syndrome’. This involves a pattern of muscle weakness and tightness characterised by weak abdominals and weak gluteus maximus, together with tight hip flexors and tight spinal erectors. This generally results in a forward-tilted pelvis when we stand and lo and behold a ‘pot belly’. Not only that ,but stand this way for long enough and your spine just may begin to complain.
We must remember that our movement habits emanate from our primitive programming which seeks the most energy-efficient way in which to go about our day. Just in case we need to run from a tiger at any point. Unfortunately this propensity for energy efficient movement means muscles are doing the least they possibly can unless we consciously intervene.
How can Pilates help?
To correct this postural presentation requires consistent effort. The general principles are to stretch and release tight/overactive muscles and re-educate and strengthen weakened/inhibited muscles. It’s crucial to develop our ability to ‘tune in’ and focus our attention on HOW we sit, stand and move.
The Pilates foundational principle of ideal postural alignment is incorporated into every movement. Learning how to position your pelvis in neutral and activate abdominals and glutes will improve your posture. It will also minimise the appearance of the menopause pot and can reduce your risk of suffering low back pain. This all sounds very technical, because it is. Hence the value of working with a Chartered Physiotherapist to ensure you are gaining the most benefit from the exercises that you do and not in fact reinforcing poor postural presentations.