Aberrant posture is one of the most misunderstood conditions by both the sufferer and the healthcare provider alike.
Focused postural classes are not offered in chiropractic nor medical curriculums; thus the importance of posture is not widely understood.
The common story from patients is that, as children, their parents told them to “quit slumping and stand up straight,” but what was not understood is that the muscles responsible for posture, stance, and gait are not consciously controlled. T
here are two kinds of muscle fibers in each muscle bundle: slow-twitch postural fibers and fast-twitch phasic fibers. They work and respond differently to various needs.
Postural problems
Rene Cailliet, MD, a specialist in physical medicine and rehabilitation at the University of Southern California, found the following regarding mechanical derangements of hard and soft spinal tissue: “Incorrect forward head posture leads to improper spinal function. Both the neck and lower spine have normal and necessary forward and backward curvatures relative to the skull and kyphotic thoracic spine and rib cage. Proper cervical and lumbar lordoses are necessary for normal muscle function. However, with a forward extended head, normal lordosis is lost both in the cervical and lumbar spine. The shoulders are rotated unequally up and down and come forward with the head position.”1
The head and neck in forward posture adds up to 42 inch-pounds of abnormal cervical spine leverage. This forces the entire spine out of alignment.
Forward head posture results in loss of vital capacity and chronic fatigue.
Lung capacity is depleted by as much as 30 percent. This shortness of breath can then lead to cardiovascular disease.
The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation are common sequelae of forward head posture. The gut is the largest endocrine organ in the body and 70 percent of the immune system is in the gut.2
Furthermore, forward head posture also causes an increase in discomfort and chronic pain. Motions of the first four cervical vertebrae produce endorphins. With inadequate endorphin production (i.e., pain reduction), many otherwise non- painful sensations are nociceptive.
Another result of forward head posture is a loss of normal spinal and body motion. One becomes hunched and the entire body stiffens, thereby lessening range of motion. Conversely, the better the posture, stance, and gait, the better and younger one feels and functions.
While most approaches to correcting posture focus on the spine, shoulders, and pelvis, the position of the head is the most important. Because the body follows the head, the body can be aligned by first aligning the head.2
Muscles involved in posture
The body has approximately 440 pairs of muscles, with 75 pairs of those being responsible for posture. These muscles are mainly under the control of the autonomic nervous system and the cranial nerves.
Cranial nerves and their function
There are 12 pairs of cranial nerves that connect directly with the brain rather than via the spinal cord and are not subject to direct compression or impedances by vertebral displacement. The eleventh cranial nerve is the spinal accessory nerve that is deeply embedded in the trapezius and sternocleidomastoid muscles, the major muscles of posture.
Proprioception is a process associated with kinesthetic awareness and balance. It is the result of vestibular, visual, and mechanoreceptor input from cranial nerves that are integrated in the cerebral cortex and cerebellum.
Mechanoreceptor input is the most important for proprioception because it produces local segmental reflexes and super-segmental proprioceptive reflex effects. These reflex actions cause muscles—especially postural muscle fibers—to react to inputs from the cranial nerves and to the righting reflexes that when properly stimulated can reflexively correct the upright spine in three dimensions relative to gravity.
Righting reflexes and optimal posture
The human body has five righting reflexes, which can cause muscles to correct spinal form and function when they are physically stimulated to do so.
Labyrinthine reflex—vestibular. Maintains the head’s orientation in space (medulla).
Optic reflex—ocular. Functions to keep the head in proper orientation to its gravitational environment (occipital cortex).
Neck righting reflex—joints of the neck. Orients the body in space (midbrain).
Body righting reflex No. 1. Orients the body in space (midbrain).
Body righting reflex No. 2. Functions to keep the head oriented to the body (midbrain).
According to researchers Wyke and Davis, muscles are the primary stabilizers of the joint. When rehabilitated (exercised) adequately, they are able to accelerate the recovery of musculoskeletal conditions.
The weighting system
By using weights, you can cause a person’s muscles to reflexively correct the spine and posture into three- dimensional alignment. Using the proper amounts and placement of head, shoulder, and hip weights can cause the righting reflexes to activate muscles, causing them to relax and contract as needed to pull and correct postural abnormalities.
A frontal head weight causes the posterior neck and upper-back muscles to contract, pulling the head back and shifting the skull and eyes up. This activates another righting reflex causing the involved muscles to contract, rotating the head and eyes back down into their normal position. The new position is now lordotic and perpendicular to gravity.
A typical head-weight harness can hold up to 16 pounds of weight.
Determine the amount of weight necessary for lordosis with a lateral weighted X-ray. Start the amount of head weight so that the person can easily tolerate it for 15 minutes, usually one to two pounds.
Increase the weight incrementally until cervical lordosis is achieved.
Then apply shoulder and hip weights if needed. The shoulder and hip weights should eventually be twice the amount of the head weight.
The weights cause correction of spinal displacement, which is the foundation for all postural muscles to normalize, strengthen, and maintain the resting upright spine aligned in three dimensions relative to gravity.
Head and shoulder weight
After cervical lordosis is at least 60 percent restored, then the frontal head weight can be partially moved around to the acute angle side of the cervical spine (usually the high shoulder side). The shoulder weight is then placed on the low shoulder side.
The combined weights cause the subluxated head and neck to laterally displace, aligning with the more stable thoracic cage. Then the head-shoulder combined weights cause a reflexive correction of the entire upper spine in line with gravity, from the center of the head and thoracic spine down to L-3.
Front or back shoulder weight placement is dependent on the patient’s hip and shoulder relationship. When the patient stands after sitting and their upper body is forward of the hips, place up to 80 percent of the shoulder weight on the front lateral side of the low shoulder. The body reflexively lifts up and back on the low shoulder, while the high shoulder rotates down and forward and the pelvis realigns under the weighted shoulders.
With the patient standing or sitting with the hips forward of the shoulders, place up to 80 percent of the shoulder weight on the back of the low shoulder. Reflexes cause the low shoulder to rotate up and forward while the high shoulder rotates down and back and the weighted hips and pelvis shift.
Hip weights
Head and shoulder weighting corrects the sagittal and A-P skull and spine down to L3. The addition of hip weighting corrects lumbo-pelvic deviations as the hips shift under the weight.
Using the same amount of weight used in shoulder weighting, place half of the amount into each of two separate hip bags. Attach the hip bags onto the patient’s hips with a belt.
Place one bag on the front side of the high-forward hip (the one appearing larger on X-ray) and the second weighted bag on the back side of the opposite hip. The position of the hip weights causes the pelvic girdle to be pulled and rotated into alignment. Reverse the position of the weights if they cause the hip and spinal alignment to worsen.
Take X-rays to confirm and measure correction of all or part of the normal cervical curve. Loss of the sagittal lordotic curve forces the involved vertebrae to buckle away from the weakest side into a screw-matrix displacement. This causes lateral spinal angles with muscles changing from phasic to postural muscles on the obtuse side of the angle and disused muscle atrophies with pain on the acute angle side.
It is critical that the cervical lordosis is the primary correction. Once lordosis is corrected, lateral displacement can be corrected and maintained.
Burl R. Pettibon, DC, FABCS, FRCCM, PhD (Hon), is a teacher, inventor, and researcher. He has written numerous papers and books on chiropractic care and research and has developed 25 clinics. He has also invented over 40 products currently in use by chiropractors throughout the world to make detection and correction of vertebral displacements both easier and more accurate. He can be contacted through pettibonsystem.com.
References:
1 Calliet R, Gross L. (1987). Rejuvenation Strategy. New York: Doubleday and Co.
2 Ahlman H, Nilsson. The gut as the largest endocrine organ in the body. Ann Oncol. 2001;12(Suppl 2):S63-8.
