by Erik Dalton, Ph.D.
Postural homeostatic lessons are learned by the central nervous system (CNS) early in life. As the child grows and develops, visual and proprioceptive input continues to supply the brain much needed information about where the body is in space (Fig 1). The notion of ideal posture suggests there is a perfect distribution of body mass around the center of gravity.
In the real world, posture is both static (structural) and dynamic (functional). It is static in its alignment of body mass with respect to gravity and dynamic because this alignment must constantly adapt to the person’s changing postural demands.
Over time, human static postural alignment begins to conform to inherent connective tissue changes (Fig 2). Altered body alignment also results from cumulative functional demands placed on it by static and dynamic postural conditions. Both static and dynamic postures are influenced by and influence soft tissue functions. Therefore, all physical examinations must include dynamic postural alignment analysis in the upright weight-bearing position as well as selective tension assessments of the soft tissues. Visual, palpatory, movement, and segmental motion testing are vital to understanding structure-function interrelationships. This combination of exams provides clinical clues about the inherent capacity of the client’s neuromyofascial system to balance and maintain biomechanical alignment (see attached video).
Simply put, compensation is the counter-balancing of any defect of bodily structure or function (Fig 3). A compensated posture is the result of an individual’s homeostatic mechanisms working smoothly even though it lives in a body with less than ideal posture. The brain’s sophisticated computerized software system provides instantaneous compensatory information which allows the person to operate as efficiently as possible in less than perfect circumstances.
Fortunately, in the early stages, the individual with structural compensation appears to function normally despite some occasional aches and pains. Most of our client’s bodies are compensated in one way or another…some require a greater degree of ‘innate’ compensation just to carry on in a productive manner.
When unresolved structural compensations overwhelm a person’s homeostatic thresholds, strain patterns work their way through all systems of the body in an attempt to maximize function. Spinal compensations require constant CNS monitoring via proprioceptive input. If a joint’s mechanical behavior is altered due to instability or excessive mobility, neuroreflexive changes may create or reinforce
aberrant muscle imbalance patterns…or vice-versa (Fig 4).
Long-standing overactivation of abnormal joint reflexes elicits a change in spinal cord memory that burns a groove in the neuromatrix causing faulty information to flood the brain. Soft tissue length/strength imbalances manifest when the brain begins to rely on this faulty information about where it is in space to determine its alignment (Fig 5). The process has implications for treatment that includes postural and functional reeducation and retraining; this should be progressive and consistent if it is to succeed.
Because of an accumulated history of traumatic, genetic and habitual processes requiring compensation, few clients will present with ideal posture and few function optimally. Therefore, a primary goal of manual and movement therapy is to revitalize and functionally re-balance the neuromyofascial system so contractile tissues and joints work at optimal levels of motor unit recruitment and synchronization.
Erik Dalton’s Advanced Myoskeletal Techniques will revolutionize your approach to treating complex pain and injury conditions. The 344 page full color illustrated book eloquently blends exciting new muscle/joint research with eighty innovative hands-on techniques…a perfect addition to any sports medicine, structural integration or medical massage practice.
Additional contributions from manual therapy leaders such as Aaron Mattes, Whitney Lowe and Ross Pope, DO enhance this intelligent, user-friendly text making it a great boon of reading for the professional, passionate therapist.
This article is from the Myokskeletal E-technique newsletter.