Human body posture works well when muscles are in balance the first sign of body imbalance is that muscles are no longer working together; they’re out of sync. Common differences in the lumbar spine stabilising muscles are stiffness (reduced stretch) and an apparent thickening (neurology at the spinal column is confused) of superficial muscles around the upper lumbar spine, that cause a reduction in the give of the spine known as the neutral zone (1). Whilst deep spinal muscles reduce in size. Making reactions slower (2) and thus spinal injury more likely. The imbalance of musculature can be seen in your posture. What has been noted as early changes to spinal postural balance is a shift of the centre of pressure (COP) forward (3). Not leaning forward like to brush your teeth but leaning forward from the ankles. An ankle strategy that becomes apparent when people stand with their eyes closed.
The basic postural screen can highlight much information if you know what to look for. Obviously it is difficult to see your posture COP is forward when you have your eyes closed. However, when being examined for your posture standing with your eyes closed is an important yet seemingly innocuous test. How we stand with our eyes closed can tell us much about past pain experiences and if your spine is going wrong (experiencing dysafferentated or nociceptive neurology).
Simple postural observation in the frontal plane can be complemented with other observations to identify the basics of postural dysfunction. When backs first start to go wrong watching how their owners stand with their eyes closed is important just as it is when people are getting back into balance with Care after experiencing a painful episode.
Those who are out of balance and have chronic muscle and joint pain will have altered posture in standing, in sitting, lying down and when they move. The nature of our central nervous system is to adapt, unfortunately this nature does not allow for an individual to find their way back (5), without assistance.
Stabilisation exercises have shown variable effects in deep spinal muscles in different postures measured with ultrasound (4) whilst Chiropractic Care has shown a ‘resetting’ of lumbar multifidus measured with ultrasound (6, 7) (increased thickness and improved recruitment) correlating with a bodily experience of reduced stiffness and soreness.
‘no person is an island…’
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- Panjabi MM (1992). The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disorders 5 (4) 390–6
- Panjabi MM (2003). Clinical spinal instability and low back pain. J Electromyogr Kinesiol 13 (4) 371–9
- Brumagne S , et al (2008) Altered postural control in anticipation of postural instability in persons with recurrent low back pain. Gait Posture 28 (4) 657–62
- Finta R et al (2019). Effects of Exercise Therapy on Postural Stability, multifidus Thickness and Pain Intensity in Patients with Chronic Low Back Pain. Developments in Health Sci 2 (1) 15-21
- Koppenhaver SL, et al (2011). Association between changes in abdominal and lumbar multifidus muscle thickness and clinical improvement after spinal manipulation. JOSPT 41 (6) 389-99.
- Fritz JM, et al (2011). Preliminary investigation of the mechanisms underlying the effects of manipulation: exploration of a multivariate model including spinal stiffness, multifidus recruitment, and clinical findings. Spine 36 (21) 1772–1781.