Postural analysis is imperative for appropriate physical therapy evaluation. Postural analysis involves assessing the body’s structure as it relates to the biomechanical demands of the system in addition to the neuromuscular control necessary to maintain that structure in order to be able to perform all functional activities throughout the day. Good postural analysis examines joint positioning in relation to the ground and to other joints.
Postural issues arise for a variety of reasons including poor neuromuscular control, dysfunctional biomechanics of one or more joints, restricted neural mobility, and even learned behaviors. Dysfunctional posture almost always leads to changes in movement patterning resulting in further compensation of the biomechanical and neuromuscular systems to perform functional activities.
Our approach to postural control has evolved from the work of Florence Kendall and Diane Lee among others. It addresses a phenomenon called tensegrity, which is usually thought of as an architectural term introduced by Carlos Castenada to define a structure in which the rigid components of the structure do not touch each other but are held in place by a series of tensioned cables, which help to maintain the shape of the overall structure. The rigid components of the body are the bones that are essentially held together at the joints by the tension produced from the muscles and tendons. This system can become dysfunctional when there is an imbalance of the supporting musculature resulting ultimately in overall structural alteration and even failure. Our treatment involves education of home exercise programs designed to restore the tensegrity of the body most often by addressing dysfunction or inhibition of the transversus abdominis, which appears to be one of the most important core stabilizers.
In addition to education regarding the transversus abdominis, we address other aspects of postural dysfunction based upon each individual’s presentation. Consistent performance of one’s home exercise program is essential to recovery of normal postural control because of the emphasis on neuromuscular re-education. It takes about 4000 repetitions of doing something correctly in order to affect a change in postural presentation!