The Posture-Balance Connection Part 4.

The Posture-Balance Connection is our Education, Coaching and Rehabilitation framework for helping people with problems of spinal pain, mobility, and balance.

Through this framework, I explain how it is that we are able to maintain ourselves upright and move with comfort and efficiency; what happens when the postural system which is tasked with keeping us upright starts to fail, and what the consequences are, and what we do to address it.

There is a lot of information here which I have separated into a 4-part series represented as four key principles.

In the first article in this series (the Posture-Balance Connection), I introduced the concept of centre of gravity, and discussed how the ability to manipulate our centre of gravity enables us to hold ourselves upright and move us in the direction that we wish to go.

In the second article (The Postural Deterioration Cycle), I described how our ability to manipulate our centre of gravity deteriorates, how it prompts a compensatory postural change so that we don’t fall backwards but which leads to stress on our postural system that results in muscle stiffness and ligament and joint pain. We also described how this deterioration creates a cycle of reduced stability and mobility that we observe as we age.

In the third article, we looked at how we examine centre of gravity by measuring how it is projected to the ground in terms of weight-shifting efficiency and what this means for the rehabilitation of chronic spinal pain, mobility, and balance.

In this fourth and last article of this series, we are going to look at what we need to do to restore centre of gravity, whether it is important for you to maintain your health and fitness, or it’s necessary for you to do your job, or because you have chronic spinal pain, or because you have a condition that’s affecting your balance and mobility.

The best place for us to start, is by looking at the Fourth Principle in our Posture-Balance Connection framework:

“For us to maintain ourselves upright and move efficiently without pain, we must UNDERSTAND what weight-shifting is, and have the TOOLS, SKILLS and FITNESS to control it effectively.”

The Importance of Postural Education
You might ask, ‘why do I need to know what weight-shifting is? I’ve never heard of it before, and humans have been standing upright for 10,000 years.’

You would be right, but humans of the last 10,000 years spent most of their time on their feet, their daily lives required a high level of postural proficiency and fitness to survive. Humans of the last two generations, in western societies no longer require postural fitness and proficiency to survive. Cerebral activity has replaced physical activity and therefore much of this inner wisdom has been lost or isn’t developing in the first place.

I have been in practice for thirty years and have seen increasing deterioration in our posture over this time. It is the primary reason why people seek out physical health care. Nowhere is this more noticeable than with our children who are not doing the physical activities of previous generations that hone these developmental skills.

So, we need to be re-educated.

Understanding what posture is, how to use your body in any given situation, and how to keep yourself posturally fit are now a necessary requirement for our modern world.

Yet a Google search will pull up virtually nothing of significant value to the average person looking for direction on how to improve their posture to prevent themselves from getting back pain.

What you get is tips, without a framework of understanding of the role that posture plays in your ability to maintain your balance and move freely.

We receive no education on posture. Most people think that they know what posture is, they think that siting up straight, or standing tall and pulling their shoulders back is what they need to do.

This never works.

It doesn’t work because the purpose of posture is to hold us upright against gravity and this requires the efficient manipulation of centre of gravity in order to keep us balanced on our feet. Not from being told how to hold a pose.

What we see visually when we look at someone’s posture, is the physical representation of how effectively we can do this. Holding a ‘postural pose’ is an attempt to mimic this process, but as soon as your task at hand returns to the forefront of your consciousness, you return to where your centre of gravity is located because postural control is a reflexive process. It happens below the level of conscious thought.

Posture tips never work in the long-term because posture must be trained by balance. You need to be taught where your centre of gravity is and how to manipulate it, so that it activates without conscious thought whether you are sitting at a desk, standing at a meeting, or putting your children in the back of the car.

I have been teaching the importance of posture for thirty years. Teaching posture is not unique to me; most osteopaths teach the importance of posture. However, my approach is different, because it’s informed by my training in neurorehabilitation and posturographical analysis and developed from treating patients with balance and mobility disorders from brain injury.

In neurological rehabilitation, everything has a hierarchy.

You have heard the expression, ‘you have to learn to walk before you can run’. This is a common wisdom that we understand to mean that certain elementary steps need to take place before we attempt more complex ones.

In neurological rehabilitation, there are neurological building blocks that need to be in place before attempting more complex activities. For example, establishing postural stability is prerequisite to walking.

This informs the process of our education and rehabilitation. Every step is laid out in a hierarchy dictated by its place in the neurological developmental process.

Our Postural Education Programs
Perfect Posture Online
We have a six-week self-help video education series called Perfect Posture Online. Perfect Posture Online is designed to help busy people to Move Better, Feel Better and Look Better. It teaches you how the system that holds you upright really works and retrains you so that your habits change naturally without you having to be forever thinking about posture.

Each week has a lesson designed to build on the previous lesson with simple exercises that take no more than seven minutes each morning to practice to then implement in your day. This is important, because to be effective, it must be simple to understand and quick to implement.
We use this education program for our chronic spinal pain patients for creating spinal stability, and we use it for our balance patients to teach them how to balance themselves effectively before we start rehabilitation.
Perfect Posture Online is available to everyone. It is suitable from ages 12-75. People with mild balance problems may need coaching support which we also offer online. For parents with children younger than twelve wishing to improve their children’s posture we encourage them to do the program themselves and then implement the lessons and exercises with their children at home.

Postural Ergonomic Program
We also have an online six-week training program tailored for people at work.
It includes our six-week program Perfect Posture Online, with additional training specific to your occupational requirements.
If you work in an office, or if you are a dental hygienist, you sit all day, but your postural situations are different. Likewise, if you work in hospitality, retail, or hairdressing, you stand all day, but your situations are different. The same goes for plumbers, carpenters, electricians, or pool technicians who are doing manual work but with different requirements, like driving or lifting in awkward situations.

Consulting and Ergonomic Training for Organisations
We are available to offer Ergonomic Consulting, Training and Recommendations to your organisation. Please contact us for further information about your requirements.

Postural Education for Schools
We are in the process of writing a PDHPE curriculum for Primary Schools K-6.

Please contact us for further information if you are interested in having a Postural Education program in your school’s PDHPE curriculum.

It must be noted that with all our online programs, we offer coaching NOT medical advice. It is not possible for us to provide medical advice outside Australia.

Our Rehabilitation Programs
Chronic Back Pain Program
For people with chronic spinal pain, the first requirement of the rehabilitation process is to get the inflammation down, repair the soft tissue damage, mobilise the spinal joints, improve flexibility, and strengthen the spine.
However, this is not enough, to fix a problem which in many cases has been years in the making. For lasting change, it is necessary to deal with the instability in the postural system and this means the rehabilitation of centre of gravity.
We measure centre of gravity in terms of Postural Sway and Limit of Stability testing which I described in the last article ‘The Importance of Measuring Stability’.
Once we have the measurements, we are able to provide the specificity of rehabilitation needed to create spinal stability.

As part of this program, we provide the education in terms of our online video education program Perfect Posture Online, as well as exercises to develop postural fitness so that you can maintain your stability throughout your day.

Stability & Mobility Rehabilitation for Brain Injury and Movement Disorders

My main expertise is in the rehabilitation of mobility as a result of brain injury. In neurological rehabilitation, everything has an order in which things need to happen. Also, specificity is vital both in diagnosis and in intervention.
One of the principal tools I use to achieve this is computerised posturography, for measurement of centre of gravity, and for immediate feedback of the effectiveness of what we are doing, and for the rehabilitation of movement in terms of weight-shifting.

Other Articles in this series:

Article 1: The Posture-Balance Connection.
Our ability to hold ourselves upright against gravity and perform any activity is wholly governed by the efficiency with which we are able to shift our weight.

Article 2: The Posture Deterioration Cycle.
When we lose the ability to weight-shift efficiency our posture deteriorates. This results in: Stiffness >> Pain >> Loss of Stability >> Loss of Mobility

Article 3: The Importance of Measuring Stability
For rehabilitation to be effective, we must be ABLE TO MEASURE weight-shifting efficiency.

WARNING: Balance training is not something to be taken lightly. Falling backwards can be catastrophic. When performing balance exercises, you need to seek the support of a professional who know what they are doing. If you are doing balance exercises, always make sure that you have something to grab onto whilst performing an exercise.

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