Posture Part I: Does It Matter?

Posture is an extremely complex and nuanced subject that often gets oversimplified into “good” and “bad” posture. What is posture, and is there such a thing as good or bad posture? How much does posture matter when it comes to comfort, function, and overall well-being? 

Posture vs Acture

There is no one “correct” posture, as our bodies are dynamic, and it is literally impossible to stay in the exact same position if we are alive and breathing. The position that we are in depends largely on our environment and situation in real time. Moshe Feldenkrais encourages paying attention to dynamic posture rather than static posture. Feldenkrais uses the word “acture” as an alternative to posture, which he defines as the “ability to move equally easily in all directions without additional preparation for action”. This action-oriented word is perhaps a better description of human function compared to considering static posture. Our nervous system should allow us to be adaptable, changing our position quickly and easily depending on the demands of our environment. To achieve this, we need efficiency. It is not efficient for us to hold unnecessary tension in our backs to achieve an arbitrary “correct” posture, as this tension uses energy, is uncomfortable, and does not allow movement in any direction at any time. It places excessive and unnecessary forces across joints causing joint and tissue stress. Living in the other extreme of a slumped, folded-in posture is also inefficient, as this limits our readiness for action and can decrease spinal mobility over time. A sign that the posture (aka acture) that you are in might be inefficient would be the development of discomfort after sitting, standing or moving about for a while, indicative of musculoskeletal strain.

“Good” vs “Bad” Posture

A lot of our ideas about posture come from society, our parents, even teachers at school. “Stand up straight, shoulders back.” “Don’t slouch.” Beliefs like this cause us to work hard to try to keep an artificially straight spine, which we associate with “good” posture, and as soon as we stop paying attention to it we will slip right back to where we were. Our spine is not meant to stay in one effortful position for a long time, as this requires certain muscles to be working hard to maintain the position, thereby limiting our acture. Rather than muscles having to tense to maintain our posture, our spines should be able to “stack”, like a column of blocks with minimal muscular effort. When that is the case, each of our bones can receive support from the bone from below, rather than relying on muscles to maintain posture. (It should be noted that the spine is not exactly like a straight column of blocks, as we have a natural curvature inwards at the low back and neck, and outwards at the mid/upper back). Unfortunately, many people begin to lose this effortless stacking, and more effort becomes required to find an upright carriage. 

As we age, many of us begin to adopt a forward flexed posture known as kyphosis, characterized by an exaggerated rounding particularly of the thoracic spine. This condition and associated loss of spinal and rib cage mobility, contributing to increased strain on the musculoskeletal system and thereby impairing functional mobility (e.g. balance and agility, reaching overhead, turning with ease, lying prone). Kyphotic posture can even compromise our respiration, making it difficult to breathe deeply and effortlessly. This forward flexion is what many people consider to be “bad” posture. These changes happen very slowly over time, and sometimes we don’t realize it until we see a photo of ourselves perhaps at a wedding, or someone we haven’t seen in a while makes a comment about our posture. The posture in the moment is not what is “good” or “bad”, but the issue lies much deeper than surface level in how we developed habitual postures over time, and if we have lost the ability to effortlessly achieve different postural options.

Posture and Pain

Many people associate their pain with their posture, or their posture with their pain. The chicken or the egg relationship may be unclear in many cases- are we adopting a posture because we are in pain, or are we in pain because of our posture? The relationship between posture and pain is extremely nuanced and depends on many individual factors. However, the relation is clearly present and worth investigating for those of us with pain influenced by prolonged sitting and standing. Check out this research study to learn more about how postural awareness and pain are related. The researchers found a clear association between self-reported postural awareness and clinical symptoms in people with chronic spinal and shoulder pain. In conclusion, they found that improvements in postural awareness facilitated by participation in activities including mindfulness training, yoga, and qi-gong were longitudinally associated with reduced pain.

Inefficient Postural Tendencies: How did we get there?

It is not the posture itself that is good or bad, but rather how we got there. A person who spends some time slouching is probably not harming themselves in the moment, unless pain is present. However, is slouching the new normal, with spinal stacking no longer feeling easy and natural? Does slouching become the only option as time goes on and the joints and tissues become habituated to this set point? Is posture a source of frustration and having a negative impact on confidence and self-image? Is the habitual posture associated with pain, discomfort, impaired breathing, and a decline in functional mobility? If so, the posture has become a problem. 

Dysfunctional postural tendencies can happen over time, and can be influenced by many factors. Some people tend to gravitate towards certain postures more on a subconscious level, based on their own personalities, confidence in their bodies, insecurities, histories of trauma, lack of body awareness, and internalized societal norms. Other factors that can contribute are our society’s lack of celebration of embodiment, comfort, and regular mindful movement, and tendency towards encouraging productivity above all, disconnection from our bodies, and sedentary behavior. Additionally, our life is becoming increasingly lived within the context of an extracorporeal two-dimensional world that is situated below and in front of us, thereby facilitating a forward-flexed posture (smart phones and computers). Over time, our physical structures and nervous systems become very much habituated to our go-to postures, creating a negative feedback loop that makes it increasingly more difficult to achieve a variety of efficient postural options.

Where To Go From Here?

To answer the question of Does posture matter?, the answer is certainly yes. However, posture can not be simplified to good vs bad, as such a complex subject requires multifactorial considerations. Becoming more cognizant of your habitual postures and implementing strategies to improve your body awareness, movement hygiene, joint mobility, and sitting strategies can all be very helpful in improving posture or preventing postural decline. Tune in to the next blog to learn some practical strategies to bring into the rhythms of your life.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. https://free2move.com.au/improving-posture/#:~:text=Focusing%20on%20dynamic%2C%20not%20static,This%20may%20cause%20breath%20holding. 

2. https://feldenkrais.com/posture-or-acture/#:~:text=The%20word%20%E2%80%9Cposture%E2%80%9D%20originates%20from,coined%20the%20term%20%E2%80%9Cacture.%E2%80%9D 

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889545/ 

Chaos Vs. Rigidity: Finding Your Balance

All of us live our lives on a spectrum between chaos and rigidity. Some of us tend to live more in a state of chaos and constant change, while others tend to live with more rigidity and stagnation. If our life is overly chaotic, we may live in a constant state of fear, anxiety, hyperactivity, and reactivity. On the other hand, if we are too far on the rigid end of the spectrum, we may become inflexible, resistant to helpful changes, and even close-minded. We might have certain contexts within our lives that are towards one extreme or the other- chaos in our work life, rigidity in our home life, or vice versa. Perhaps we subconsciously bring structure and rigidity into one aspect of our lives, such as our fitness routine, in order to balance the chaos and unpredictability within other aspects of our life. 

Daniel Siegel, M.D., described this spectrum in his book Whole-Brain Child. Because living on either end of the spectrum can be problematic, it is important to find integration, or a harmonious place somewhere in between rigidity and chaos. This finding of balance can be described by considering floating down a river in a canoe. On one side of the river, there is no flow, only still stagnant water. This side represents rigidity- it is safe and predictable, but unfulfilling and devoid of energy. On the other side is white rapids, rocks, and dangerous currents. This side represents chaos, overwhelm, constant change and even danger. In this extreme, we can lose our footing and get lost without any sense of control. A good place to be is the center of the river. This area is a system that has flow and energy, while still allowing us to maintain a sense of control. This allows us to explore, experience new things, learn and grow. How can we find this in our lives?

It is important for anyone to practice self-study, which in yogic philosophy is known as “svadhyaya” (sva meaning “own” or “self”, adhyaya meaning “lesson” or “study”). Can you feel when you are moving more towards a state of chaos, or stagnating into rigidity and mindless repetition? Our emotional state can be an excellent barometer of where we are at. In the middle of the two extremes we find a state of flow, in which we experience the most joy, discovery, and creativity. We should all seek to build a resilient self in which we are strong and stable, but also adaptable, flexible, and open to positive change. 

Our self-care and movement practices are excellent strategies to direct ourselves towards this state of balance. The low hanging fruit is… are we taking care of ourselves? Are we sufficient in sleep, nutrition, hydration, movement, relaxation, and social connection? What are we doing a little too much of, and what are we doing not enough of? Within the context of our movement practice, we can find even greater finesse.

Consider the following: 

During many functional movements, we have to find a balance between mobility and stability, which can be likened to chaos and rigidity, respectively. Our hips are essential for providing mobility (ability to move in all directions) and also stability (ability to maintain or control joint position). If our hip has too much mobility and not enough stability, our movement would be out of control (chaos). If we have too much stability and not enough mobility, our movement would be stiff and inefficient (rigidity). The middle of the river is an excellent place to be, which allows us to move with both fluidity and strength. 

Consider the examples of unilateral movements in our previous blog. The single leg stand to reverse lunge is an example of how the weight-bearing leg must stabilize, but also allow for controlled movement to occur. A similar phenomenon happens every time we walk, go up stairs, and even kick a ball. Our weight-bearing leg must provide stability so we do not fall or strain our tissues, while also allowing our pelvis to move relative to our thigh bone, so we can move and participate in life. Consider this “movement snack”. Can you feel how the weight-bearing leg is controlling the movement with a balance between mobility and stability? When the stabilizing leg is well organized for mobility, that is referred to as skilled movement, and is a necessary component for moving with efficiency and ease. 

At the Wellness Station, we will help you become more in tune with your natural rhythms, and provide opportunities to help you find your balance between chaos and rigidity. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. https://www.mindfulwisdom.ca/blog/2021/8/26/finding-flow-between-chaos-and-rigidity 

2. https://rhettsmith.com/2013/07/brain-integration-finding-the-balance-between-chaos-and-rigidity/

3. https://www.ekhartyoga.com/articles/philosophy/the-niyamas-svadhyaya-or-self-study 

Walking Your Way to Better Health

It’s no secret that walking is good for you.

A natural and low impact activity that helps us connect more deeply to ourselves, others, and the world around us. Walking has been shown time and time again to boast some magnificent health benefits. The benefits tend to rise and peak around 10,000 steps per day, but any amount of walking is infinitely better than none. Research studies have demonstrated that regular walking can reduce the risk of heart disease, cancer, dementia, hypertension, and much more. It can also boost mood and mental health, bone density, balance, and aerobic fitness. Walking is great for your brain! Especially when done in new places, walking can promote neuroplasticity, bringing about remodeling in the white matter of our brain. This remodeling can improve memory, spatial awareness, and other higher level cognitive functions. When you combine a regular walking practice with a healthful diet rich in plants, social engagement, high quality sleep, and living true to your ikigai, you have found the fountain of youth.

If walking is so great for us, why aren’t we doing more of it? Many people may face significant barriers when it comes to walking. Some barriers may be environmental. Perhaps not living close to any safe walking areas, but rather an inner city with spotty side walks and heavy traffic. Or, perhaps it’s the weather. Many of us become Goldilocks when it comes to the temperature. Maybe it’s simply a lack of motivation. “I don’t feel like it.” “I don’t have the time.” Most commonly in physical therapy, the barriers are pain, as well as balance or mobility issues. Regardless of the barriers, it is important to become aware of them and address them accordingly.

For many of the barriers, it can be helpful to shift away from an “all or nothing” mindset. Many people feel like if they are going to walk, it has to be a long walk, and it has to be every day. Otherwise, what’s the point? The barriers become too great and instead, we end up not walking at all. A better strategy would be to find the middle ground between the all or nothing. How can I walk today? Can I sneak in five minutes after eating lunch and before my next meeting? Can I park farther away and take the stairs? Can I walk while I talk on the phone or listen to my audiobook? Perhaps if a long daily walk is daunting, set small realistic goals instead.

No matter how short the walk is, finding consistency in a routine is far more important than the actual distance walked. Perfect is the enemy of good.

Significant barriers to a regular walking practice as mentioned previously are challenges with pain, mobility and balance. At the Wellness Station, we can work together to figure out ways to get you walking without being limited by these challenges. Some factors to consider might be frequency and duration of walks, as well as implementing more rest breaks into walking. Or perhaps a mobility device can help take stress off certain joints or improve the ability to maintain balance while walking. Activity modifications can help decrease the barriers to a regular walking practice to help us get moving more regularly and with greater confidence.

Oftentimes, the movement patterns that we have developed can actually be limiting factors to the quality of our gait, which can contribute to pain and dysfunction. We learned how to walk once- we can learn some new ways! Relearning new motor patterns might start with a simple awareness practice.

Consider the following practice, perhaps walking around inside:

As you walk, pay attention to your footstep. Some things to be aware of are… “How do my feet make contact with the ground?” “What is my foot print like on each foot?” “How heavy or light is my step?” “How long is my step length?” “How wide is my step from right to left?” This awareness can be applied to many other aspects of the gait cycle and body parts which may include attention to the knees, pelvis, hips, spine, rib cage, shoulders, and head.

After becoming aware of the way in which you are walking, it is time to explore some changes. There are infinite ways to bring about changes into the mechanics of gait. Here are some examples:

• Slow walking. Simply change the speed of your walking to notice what it is like to walk in slow motion

• Walking in different directions. What is it like to walk backwards, or from side to side?

• Strut like you mean it. Introduce a fluid glide in your hips as you walk, and allow your arms to swing with your opposite leg. 

As you explore some variations in your walking, it is important to not play “fix it” with your body. There is no “right” or “wrong” way to walk, simply more options. As body detectives, throughout the therapeutic experience it is our job to find options that are more comfortable, thereby allowing us to sustain a healthy and active lifestyle. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. https://www.cnn.com/2022/09/12/health/walking-cancer-heart-early-death-wellness/index.html

2. https://www.nytimes.com/2021/07/14/well/move/exercise-walking-brain-memory.html 

What Does It Mean to “Explore Movement”?

The concept of “exploring movement” is extremely important for anyone pursuing therapy at the Wellness Station to understand. In a client interaction, I often make the suggestion for the client to explore a particular movement. This is sometimes met with confusion. What does it mean to explore? Am I doing the movement right or wrong? How many repetitions should I do? What next? By asking questions such as these, it is clear that the fundamental nature of the therapy we are providing is not yet understood. By understanding and applying movement exploration in the clinic and during home practice, clients will have a much higher likelihood of experiencing positive outcomes throughout the therapeutic experience and beyond. 

Exercise vs Movement Exploration

Many people who have not experienced the Feldenkrais Method or other somatic movement practices may have difficulty distinguishing between traditional exercise and movement exploration. Exercise is a broad term, and of course movement exploration could be considered a form of physical exercise. However, exercise has become more of a societal construct that implies hard work, high effort, rigid rules of what is “right” and “wrong”, and even a “no pain no gain” mentality in certain circles. While traditional exercise can play a crucial role in sustaining health and fitness, the manner in which many people exercise can actually contribute to various issues. Falling out of love with movement, because exercise starts to be related to effort and discomfort. Repetitive strain injuries from overdoing certain movements without incorporating variations. Triggering pain and inflammation in arthritic joints. Sometimes, the way exercise is performed is like trying to fit a square peg into a round hole. 

Movement exploration is a process that involves learning, attentiveness, and body awareness.

This is how we naturally learn to move, starting from infancy. It is the parent’s job to provide a safe environment, external props, and opportunities to explore, and the child begins to learn and develop in their own unique way. Child researcher and Feldenkrais Practitioner Esther Thelen demonstrated with her research that no two children move through the developmental stages identically, but in their own individual way based on the dynamic interaction between person, task, and environment (known as Dynamic Systems Theory). (1) Us adults are really not all that different from our younger counterparts, especially when it comes to how we learn to move. Approaching movement with curiosity and a sense of exploration recognizes that every person, task, and environment is unique, and therefore movement should be an individualized experience. Exploring movement allows people to recognize the unique characteristics of their own self, and develop various options that could be more helpful than the “right” way to do a movement that is taught through traditional exercises.

The fundamental difference between traditional exercise and movement exploration is that the former is goal-oriented, and the latter is process-oriented. (2)

It is not just about the destination, it is about the journey itself! Traditional exercise tends to be close-ended (one path leading to one desired result), whereas movement exploration is open-ended (multiple possible paths with no specific desired result, although positive results will still occur). By paying attention to the process of movement without only being concerned with the end result, we can learn to be mindful and attentive to our bodies. This helps to facilitate the learning process, which creates a virtuous cycle in which we begin to get to know our own selves with greater precision. 

A real-life example is hiking. Say you are to engage in a three mile hike to the top of a mountain, sprinkled in gorgeous wildflowers, waterfalls, and various paths to the top that will culminate in a panoramic view of glaciers and rocky peaks. In doing this hike, one might reflect on their intentions. Is the intention to walk three miles to get your “steps” for the day, burn 500 calories, and to check the box that you got to the top? If so, the journey itself does not matter. Might as well get on a treadmill for exercise, then drive to the top of the mountain later on. If the intention is to explore, then the journey itself is where the value lies. What feelings emerge as you soak your senses in the variable landscapes? What can you learn from fellow hikers along the way? What new discoveries will occur if an alternative path is taken? What is the qualia of the panoramic peak after engaging in such a journey? It should be noted that the two intentions are not mutually exclusive. One can value the benefits of the exercise (supporting muscle strength, cardiorespiratory fitness, healthy body composition, etc.) while also valuing the experience itself. 

Clinical Example: Spine like a chain vs bridging

To distinguish traditional exercise from movement exploration in the clinic, consider the example of the bridging exercise, often referred to as “spine like a chain” in Feldenkrais contexts. Even the language can distinguish some of the differences between the two methods. To “bridge” implies an end result, a goal-oriented approach. The goal is to lift your hips up into a bridge. On the other hand, calling it “spine like a chain” implies a process-oriented approach, in which attention is paid to the actual process of moving the spine one vertebrae at a time towards and away from the floor. 

Bridging (Traditional Exercise Context)

Lying on your back, bend your knees so your feet are close to your bottom. Now, engage your glutes to push your hips up towards the ceiling. Hold. Lower back down. Perform three sets of 10 repetitions.

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Spine like a Chain (Movement Exploration Context)

Lying on your back, bring your legs up into a bent position, paying attention to where your feet are relative to each other, and relative to your bottom. Press through your feet to observe how your body responds. Notice your tailbone will start to lift. Then release this pressure, lightening the feet, to notice how the body responds. Repeat, with more force pressing through your feet, and notice what starts to lift away from the ground next. Moving throughout your comfortable range, practice peeling one vertebrae at a time from the ground until a comfortable height is reached. Hold this position if desired to sense the stability of your muscles. Lower down in reverse order, one vertebrae at a time until the tailbone is back down. Repeat, resting often. Any variations are encouraged, such as changing where the feet are placed or what range you are moving in. Explore this movement until you are no longer feeling engaged, or your body asks for something different.

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Although the latter might be more wordy and perhaps confusing to some, it is a process-oriented approach that leaves space for the person to explore and discover. While the end-result of strengthening the core and hip muscles might be the same for the two options, the exploratory approach is more apt to facilitate additional benefits such as improved motor control, spinal mobility, and a refined ability to be present with oneself in order to sense and respond to the needs of the body throughout each moment in time. If one can approach traditional exercises through an exploratory lens, the greatest benefits can occur with a deeper enjoyment of the process and a lower likelihood of reinforcing strain-inducing movement patterns.

Challenge: How might one turn spine like a chain into a unilateral exercise? See the last blog “The Importance of Unilateral Exercises” for more on this topic.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Sources:

1. https://www.canchild.ca/en/resources/36-dynamic-systems-theory-a-framework-for-exploring-readiness-to-change-in-children-with-cerebral-palsy 

2. https://trans4move.com/blog/2018/6/15/movement-exploration-vs-exercise 

3. https://drlexgonzales.com/wp-content/uploads/2021/09/Blog_Segmental-Bridge-300x225.png 

The Importance of Unilateral Exercises

Most movements can be divided into two categories: unilateral or bilateral. Unilateral exercises are asymmetrical, in which one side of the body (e.g. one leg) is performing an action that the other side does not. Bilateral exercises are more symmetrical, in which both sides of the body are doing roughly the same thing. Both types of exercises are important and functional, but unilateral exercises will facilitate certain benefits that cannot be obtained from bilateral exercises alone. Some examples of unilateral exercises are: reverse lunge, single-leg bridge, single-arm overhead press, split squats, and single-leg deadlift. Examples of bilateral exercises include a squat, deadlift, barbell overhead press, push up, and bridge. In real life, we engage in both types of movements extremely often.

But, because life is rarely symmetrical, unilateral exercises tend to be more relevant to daily life.

Standing on one leg to pull your pants on. Reaching for the glass on the top shelf. Walking. Running.

Bilateral and unilateral exercises both serve a crucial role in functional fitness. While more force and power can be created with bilateral exercises, unilateral exercises require greater balance and stability. They can bring awareness to compensations and imbalances between sides of the body that can easily be overlooked during bilateral movements.(1)

For example, if one has weakness in the left leg characterized by a difficulty in distributing and generating forces, maintaining balance, or moving through a functional range of motion under load, a unilateral exercise will make this extremely clear. If one only ever did regular, bilateral squats, the right leg would continue to overwork, perpetuating a compensatory pattern that could contribute to issues down the road. While we should not expect that our two sides should be equal in their ability, it is helpful to be aware of our unique characteristics and engage in movements that will provide a stimulus for positive adaptations to occur. 

It is important to recognize that with most unilateral, “single leg” exercises, both of your legs continue to carry out an important job. Put simple, one is the mover, and one is the stabilizer. Contrary to what might be evident visually, it is the leg that is not moving that actually has the more difficult job. One leg is weight-bearing, and one leg is non weight-bearing (or bearing less weight than the other leg). The leg that is holding our weight is responsible for maintaining our balance and control of the movement, while the other leg is free to move through space. Consider walking. At each moment in time, one leg is holding your weight, foot on the ground, allowing you to move your other leg forward. By becoming more aware of where we are holding our weight, and which leg is free to move, we can refine our coordination, balance, and efficiency of movement. 

Mime Walking Example

Mime walking is a standing movement lesson that almost all Wellness Station clients learn early on. Many of us begin to have difficulty gliding our pelvis to shift our weight, which can be evident from a forward-flexed posture, short step length, and difficulty standing on one leg. This lesson helps to bring about greater elegance and ease to walking by teaching awareness of weight shifting from one leg to the other. The basic idea is to glide the pelvis to one side (e.g. right) so one leg holds your weight while the other leg lightens up, and then repeat on the other side. Once this concept is learned and felt in the body, countless variations and progressions can emerge that will translate into improved function and ease of walking.

Single Leg Stand to Reverse Lunge

To further progress mime walking, we can apply this motion into a single leg stand. We become aware that one leg is holding us up and controlling our movement and stability, while the other leg is free to move through space. Applying this into a single leg stand to reverse lunge flow is a dynamic way to improve balance, strength, and awareness of our differences from side to side. 

If lacking in steadiness and ease, gently hold on to a support surface with a hand (put your hands in the kitchen sink!), or don’t move the non weight-bearing leg through such a large range. 
If more challenge is desired, move in slow motion, increase the range of motion of the non weight-bearing leg, and/or hold a dumbbell.

Sit to Stands and Squats: Unilateral Bias

A basic squat or sit to stand movement can be changed to have a unilateral focus by holding more weight through one leg intentionally. Coming up onto the tip toes of one foot is a way to do this. 

If lacking in steadiness and ease, use a higher chair, and/or don’t come up as high onto the tip toes (keep more of the non weight-bearing foot grounded). Or, hold on to the kitchen sink as you do this motion. 

If more challenge is desired, use a lower chair or squat through a deeper range, move in slow motion especially on the way down, hold a dumbbell at the chest, or even practice hovering the tip toes off the ground. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Sources: 1 https://www.self.com/gallery/single-leg-exercises