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Jan 25 2020

Back Pain Expert Dr. Sean Wheeler Discusses Posture - A New Approach

Posture New Approach
Look what simple posture does to your appearance! (It’s not the glasses that hid Superman)

As a sports medicine and pain specialist who focuses on the neck, shoulder, and back issues, posture has been an essential part of my practice. In my office, our evaluation of posture plays an important role in both diagnosis and monitoring improvement in all the treatment protocols we prescribe. Years ago, I started a posture app that was available on the Apple store as Posture Check. There are a few people out there who still remind me that they have the app even though it hasn’t been updated for years.

Then about 5 years ago, I started a posture blog on the Google+ platform and had close to 80,000 followers. It was the #1 posture blog worldwide in the Google+ platform and was listed on their ‘featured’ page. Many of those articles are still available on my website and are still full of valuable outdated information.

What I believe is important in posture has changed over the last few years. If you were to read my articles concerning posture, you would see a pattern where I was extolling people to draw their tummy in and rotate their pelvis under them. Then work on building the endurance necessary to maintain this position all day. Now I would tell you the exact opposite.

In the past few years, our understanding of muscle tone has changed. Instead of asking muscles to contract all day, we instead strengthen muscles and then expect the tone, or resting contraction of the muscle, to increase over time. Think of the arch of the foot. You aren’t holding your arch up, but the tone of the muscles in your foot is holding your arch in place. The same goes for your posture. We expect you to assume the correct position, and then relax.

When I was telling people to draw their tummy in and rotate their pelvis under them, I was creating tension in the body and in their muscles. I like to say that the people who did exactly as I instructed were essentially holding in a fart for 16 hours a day. This breathe holding and muscle tension is not good for your body. Do we want your posture muscles strong? Of course, but this is not the way to do it.

When we evaluate low back pain, one of the things we look for is whether someone has begun to breath-hold with activities. It speaks to an altered stabilization pattern and identifies weakness. By creating breath-holding in patients trying to improve their posture, we may have been worsening their stabilization and causing motion (or lack of motion) patterns that weren’t helpful. One of the things we try to accomplish in physical therapy is the elimination or severe reduction of these breath-holding moments. I was creating breath-holding days.

Now the recommendations go like this. Sit up straight, draw your shoulders back some, allow an arch in your back and try to position your head over your shoulders. Now take a deep breathe and relax. Let your butt cheeks relax. Keep the same position, but just do it relaxed. You were made stable, let the muscles that are supposed to stabilize you do it without all the tension. In a more straightforward explanation: sit up straight and then breathe.

I will explain more over the next few months, but for now, let us just start with that. Now, for the people who followed my advice from my previous posture articles, go outside, find a place away from others and let yourself relax.

Sean Wheeler, M.D.

Your body is a finely tuned instrument. Like all finely tuned instruments, it must be properly cared for in order to play the beautiful music it was intended to play. Care for your body and use it correctly, and it will play music that is unique to you – your life song.

– Sean M. Wheeler, M.D.

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