PHYSICAL THERAPY AND POSTURE

by John Macy, PT

In the practice of physical therapy posture is a concept frequently used in examining people and determining if treatment, particularly for back and neck problems, has made any changes in a person. Posture is defined as "the position or bearing of the body" (Webster’s Medical Dictionary ) and refers to the overall alignment of the various body parts to each other when the person is standing in a relaxed stance.

Posture is the result of many underlying processes and tensional relationships throughout the body. As such posture becomes a measure of the overall balances in the body and can be used as a tool to assess if interventions have resulted in a change in overall body balance. The ideal posture is assumed to be when the earlobe, tip of the shoulder, hip joint and outside bump (malleolus) of the ankle all lined up on a plumb line. The center of the knee is slightly in front of that line. This arrangement is viewed as indicating that a person’s overall structure is in good mechanical balance. Variations from this ideal give the therapist clues as to areas of the body that do not permit the full mechanical ability for which they are designed. It is the restoration of the mechanical abilities that then will permit the person to have "better" posture that is the goal of physical therapy with these people. The techniques to restore these abilities may include exercise, stretching, massage and other soft tissues techniques, modalities such as heat, ice and ultrasound, and re-education in movement patterns and positions during activities

Posture is also used as a feedback mechanism for the person as it is well recognized that prolonged positioning in "poor" posture can lead to mechanical problems, dysfunction and pain from structures that are mechanically stressed by the sub-optimal arrangement. A person may be told to be conscious of returning frequently to an optimal posture, i.e. "sit erect at the keyboard", to retrain themselves for doing tasks in a manner that places less mechanical stress on the body and lessens the chance of problems later.

Posture in Physical Therapy is a concept that is seen as a means to get a summary assessment of overall tensional and structural balance in a person. Variations from the ideal, while not necessarily a bad thing, can be a good indicator of underlying structural and mechanical problems in the body. The restoration of a person’s ability to achieve better posture is a frequent goal in physical therapy treatment.

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John Macy is a Physical Therapist in Omaha, Nebraska. He is also a teacher of the Alexander Technique. The primary focus of his practice is working with golfers, helping them with the specific movement problems that interfere with their game. Email: ptmacy@doctor.com

American Physical Therapy Association
A very comprehensive site with lots of information about Physical Therapy

Postural Restoration Institute
Innovative Physical Therapy approach to improving posture

Posture is Important
A physical therapist discusses posture and how physical therapy can help

Physical Therapy and Alexander Technique Homepage
This site relates the principles of the Alexander
Technique to the Practice of Physical Therapy

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