Probably not as much as you imagine.
Recently I had a client provide me some feedback after our first couple of sessions that a friend had commented on their posture and how they looked like they were sitting and standing more upright. This is good news as it would seem that training with me has improved his posture.
Was it my goal to improve his posture?
Nope and to be honest the thought never even crossed my mind. My client’s goals where to get back into regular training, get a bit fitter, look a bit better and reduce some back pain has been niggling him for a few years now.
We went about training in the same way I train everyone, training movements that challenge all the major joints through all available ranges. Hitting major muscle groups through fairly generic gym based skills and hitting the smaller muscles through the many variations I layered on top of those skills. Don’t worry if that doesn’t make sense, I just trained him with my wicked smart “method” of getting him to move a lot and in many different ways.
Now to the back pain, I usually go about helping with it in two ways. The first thing to do is to educate my clients on what the most up to date research on pain science says, my part here involves using language that deescalates the situation. I reassured him that there was nothing out of alignment, nothing damaged or broken and that his pain will get better with time. The second part is to use movement to demonstrate that his body is stronger and more capable than he perceives it to be. He came in with the feeling that his right hip was weaker than the left and that this was contributing to a sore back. Within a single session I was able to develop his skill in loading the right hip, to move it fully and freely and not fear using it. Less fear of movement equals less pain.
Putting all this together I was able to provide a good workout, to have decreased his pain a little and as a seemingly improved his posture.
But what is posture?
This bit might get me a little bit of kick back from those who assign a high value to the importance of posture but to me it’s quite simply how you choose to stand or sit. Most of the time I think it just portrays how you’re feeling or how you’re wanting to present yourself to the world and over time it just becomes the way you always stand. Personality traits have much stronger correlation to certain postures than those postures do to pain or predicting an injury and someone forcing a personality change is something that you would see in a pretty unhealthy relationship. However if you come to me for help and want to change yourself then I am 100% behind you.
One thing we know for sure is that pain will change the way you move and subsequently stand or sit, so when therapists are dealing with people in pain posture is an easy target to assign blame on for the pain but which came first is really a chicken and egg type conversation. Did poor posture really cause the pain or is it more likely that someone in pain will adopt what is considered poor posture. Rounded shoulders and slightly hunched over also known as kyphosis is very like the defensive position a boxer might take up. People in pain take up defensive positions to protect themselves from harm and this would make complete sense as pain is an alarm rather than a measure of damage.
Improving posture is seemingly a good thing so why am I bothered with it?
When it comes to helping someone in pain, the language I use along with my client’s understanding of their pain matters a lot. I have spoken to so many people suffering from chronic pain who have been attributing it to poor posture and in my opinion wrongly so. Many people have told me that sitting at work is pulling on their spine, leaving their back muscles weak and this is what is causing their pain. Many blame a weak core causing a collapse of their posture and subsequently have been afraid to move, to simply bend forward as they fear it will cause another flare up. With such easy access to the internet people have easy access to a mountain of “information” perpetuating this belief that poor posture causes pain and a lot of it is based on an outdated model of pain it doesn’t fit with what we now know.
If poor posture doesn’t cause pain, then what does?
Pain is a complex, multifactorial and highly individual experience so I cannot answer that question for everyone with one broad brushstroke but the growing body of evidence not only demonstrates that poor posture doesn’t cause pain, but in fact indicates that merely holding the belief that it does is very likely to contribute to your pain. When you’re being fed information that a certain position is bad for you, that information on its own is more likely to cause pain than the position ever will. Factor that in with the fact that sitting is probably a huge component of your life and that you can’t really escape it as bills need to be paid and quite likely that the best way for you to earn money is from a seated position. This leads to an inescapable reality that you’re always going to be in pain. It’s a no win situation.
This is the why the poor posture causes harm message bothers me so much, because by pushing this idea then you could actually be making things worse for a lot of people rather than making it better. Whilst there are many therapists out there who help improve posture (like I did with my client) and simultaneously help that person out of pain, it’s too big a leap to rationalise it as improving posture fixes the pain. Pain is a multifactorial experience that posture is wrapped up in but it is not a root cause.
I don’t see a problem in using posture as an objective measure to demonstrate the benefits of training over time, similar to using before and after pictures to demonstrate weight loss or muscle gain. But how effective is shaming fat people to come in and train? Maybe posture is a sign that someone isn’t doing so great the same way as someone being overweight is and simply hammering them with your posture sucks, come see me before it’s too late is a shitty way to go about helping. From a business perspective I know that marketing from a fear based position is a very effective strategy as humans really respond to it. Look at how many politicians have had successful campaigns based on fear, on foreigners coming in to steal your jobs for example. It’s not actually happening, but you heard it, it sounds plausible, you believe it, you fear it and act accordingly.
What can you do if you’re in pain?
If you’re in pain and would like help then I can recommend a few things. Get in touch by commenting below the article. Seek out and speak to a pain specialist who’s up to date and operates from the bio-psychosocial model. If you’re not sure if they are just ask and see what they say. I also highly recommend watching the following videos.
The Faster team with a 30 minute video on training in pain.
Lorimer Moseley and the video that lead me down this rabbit hole.
A pretty in depth lecture from Dr Tasha Stanton on neuroscience and pain
Hope this blog has helped and please leave a comment if you have any questions on any of this.