What is poor posture?

Most people understand poor posture as slumping forward with rounded shoulders, and in the majority of cases that is probably true. So good posture could be defined as the opposite of this.


Standing and the natural curves of the spine

Consider the normal four curves of the spine as seen from the side standing: the curve in the neck (cervical) and low back (lumbar) should gently sway forward creating a Lordosis, and the curves in the mid back (thoracic) and tail bone (sacrum and coccyx) should gently sway backwards to a Kyphosis. Each area of the spine curving in the opposite direction to create a vertical wave as seen from the side.


Gravity

Now consider the gravity line (RED LINE) still seen from the side standing, which roughly falls through the middle of the cervical spine and next passes through the anterior of the lumbar (L2) and down to the hips. Deviation from these natural curves, and from the gravity line for extended periods of time either forward, back, to the sides, or in combination can have a profound affect on posture and health.


 

Sitting increases pressure in the back and tension in the neck



However, when you sit down the angle at the hips and pelvis decreases to about 90º, and unless there is a tilt forward on the seat, your pelvis will start to tip backwards pulling the lumbar spine out of its lordosis. Less than 134º between the gravity line of the spine and the femur will increases pressure on the low back as the lumbar lordosis is lost (Bashir, et al, 2006)1. As sitting and working often involves leaning forward with the back and with the head, this decreases the angle of the hips and pelvis to even less than <90º. This further increases pressure in the low back, and doubles the workload on the posterior neck muscles for every inch of forward head carriage. Frequent breaks are essential to relieve work related stress and fatigue.


Neuromuscular fatigue explained

Fatigue means lacking energy or strength, and may mean many things such as lethargy, malaise, tiredness, listlessness, muscular weakness and drowsiness. Poor posture can lead to inappropriate use and constant activation of prime mover muscles in the neck and shoulders, and gradual weakening and fatigue of the mid and low back muscles. Working or resting muscles use energy in the form of ATP, which has to be recycled and renewed at the rate that it is used (ATP)2. ATP is also used in inflammation as a neurotransmitter in the peripheral nervous system to send pain signals to the brain (Brandt, 2003)3. Over time the peripheral nerves may not keep transmitting pain signals, due to the lack of ATP available, and a chronic cycle of neuromuscular dysfunction can result in fatigue.


Chronic stress lowers immunity

Chronic stress has been demonstrated to lower immunity (Segerstrom & Miller, 2004)4.


Possible consequences:


  1. Bullet    Shoulder and neck pain

  2. Bullet    Low back pain

  3. Bullet    Fatigue and tiredness

  4. Bullet    Postural weakness

  5. Bullet    The inappropriate and overuse of muscles causing stress on the nervous system.

  6. Bullet    Lower immunity due to chronic stress.


Can anything be done?

Most definitely yes! One of most common reasons for patients consulting us are to have treatment and rehabilitation of the spine and posture.


Peak mental states are not possible with poor posture. Physiology is a key to motivation and outstanding performance.

Leom Woodal DC


Sherman’s Disease: the exception

Never the less, a person may have Sherman’s disease, a condition where the vertebrae in the middle of the back have slightly collapsed at the front, creating an excessive kyphosis (backward facing), which throws the head forward, sometimes shortening the back of the neck as a compensation. It is unlikely that dramatic changes in the spine will occur with any known treatment, but if poor posture as defined above exacerbates the Sherman’s, then improvements may be made. An X-ray or MRI will confirm a diagnosis.


Chronic Fatigue Syndrome (CFS)

Chronic Fatigue Syndrome (CFS) has relatively recently gained acceptance as a medical condition. If you think you have chronic fatigue syndrome, please speak to your GP. An exact cause does not seem to be known, though there may be an infection, perhaps candida albicans (yeast infection), a virus, a bacterial infection, or another pathogen. Candida is very difficult to eliminate and can lay dormant, and there is not enough proof to say that it does not cause CFS. Childhood stress may be another cause of CFS (Heim C, et al, 2006)5. Other conditions that may cause CFS symptoms, or actually have an unknown links, include malignancy, AIDS, liver disease, kidney disease, lyme disease, fibromyalgia, hep C and thyroid disease.  

 

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FOOTNOTES

1    Bashir W, et al (2006) The Way You Sit Will Never Be the Same! Alterations of Lumbosacral Curvature and Intervertebral Disc Morphology in Normal Subjects in Variable Sitting Positions Using Whole-body Positional MRI. RSNA Monday 27 November 2006 CODE: SSC20-07

http://rsna2006.rsna.org/rsna2006/V2006/conference/event_display.cfm?id=66601&em_id=8002197

2    ATP Energy Bank


The body’s chemical energy currency is ATP, and it is estimated that the average person uses about 1 kg of ATP in 24 hours. If for any reason you cannot consume and convert the appropriate substrates into ATP, or your supplies of ATP are being diverted to another organism, you may be start to feel tired. As you could end up in a vicious cycle of not having enough energy to think, make decisions and take action to get more energy. For some people it may be a simple act of choosing a food that will give them the energy they need. If another organism is hijacking your supplies of ATP for its own purpose you may need special help, advice or action to regain control of your internal environment. Anyone who has experienced extreme exhaustion unable to move limbs, desperate for sleep may have this ATP mechanism either depleted or broken down.


3    Bertrand  P (2003) ATP and Sensory Transduction in the Enteric Nervous System. The Neuroscientist, Vol. 9, No. 4, 243-260

Department of Physiology University of Melbourne Parkville, Victoria, p.bertrand@unimelb.edu.au

ATP is a neurotransmitter in the central and peripheral nervous systems and is also involved in peripheral inflammation and transmission of the sensation of pain. Recently, the regulated release of ATP from non neuronal sources has been shown to play a role in the activation of sensory nerve terminals. Within the enteric nervous system, which is present in the wall of the gastrointestinal tract, ATP plays three major roles. ATP acts as an inhibitory transmitter from the enteric motor neurons to the smooth muscle via P2Y receptors. ATP is released as an excitatory neurotransmitter between enteric interneurons and from the interneurons to the motor neurons via P2Y and P2X receptors. Finally, ATP may act as a sensory mediator, from epithelial sources to the intrinsic sensory nerve terminals. Thus, ATP participates in the transduction of sensory stimuli from the gut lumen and in the subsequent initiation and propagation of enteric reflexes.

4    Segerstrom, Suzanne C.; Miller, Gregory E. (2004) Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological Bulletin. Vol 130(4), Jul 2004, 601-630.

The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and down regulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.

5    Heim C, et al. (2006) Early Adverse Experience and Risk for Chronic Fatigue Syndrome Results From a Population-Based Study. Arch Gen Psychiatry. 2006;63:1258-1266.


Conclusions  This study provides evidence of increased levels of multiple types of childhood trauma in a population-based sample of clinically confirmed CFS cases compared with nonfatigued controls. Our results suggest that childhood trauma is an important risk factor for CFS. This risk was in part associated with altered emotional state. Studies scrutinizing the psychological and neurobiological mechanisms that translate childhood adversity into CFS risk may provide direct targets for the early prevention of CFS.