Written by Lydia Evans
The study of a posture is called ‘posturology’. Postures are a result of interactions between the central nervous system through afferent and efferent signals. These signals are initiated in response to the environment and what the nervous system perceives. As a result, it maintains balance and stability within the musculo-fascial-skeletal system and protects against deformity and threat/injury (Carini, F. I et al. 2017).
Full development of a posture takes around six years after proprioceptive completion of the foot and continues its stability until around the sixth decade of life. According to Orvitan, M. (2009), neurophysiological, biomechanical, and psycho-emotive factors contribute to posture. Posture is automatic and can represent how one expresses in current space and time.
The physiological curves of the spine in the neck, mid-back and low back are to maintain optimal balance and support. When these curves are in their natural state, they reduce energy consumption (Diebo, B.G., 2015). When the spine is under compressive and tensile forces by the muscles, or the nervous system and its perceived environment, the curves become excessive or reduce under stress, thus, extracting unnecessary energetic resources from the system. Posture isn’t just limited to the spine; when observing posture, the axial components must be considered, such as the skull and jaw, and the appendicular components, such as the pelvis, shoulders, knees and feet.
So, what is the result of postural stress from an environment the nervous system perceives, and what helps?
A study published by Murata K. et al. in 2020 demonstrated the effects of how neck position can affect global sagittal balance and potentially inflict various degrees of neck pain, difficulty in horizontal gaze, possible neurological symptoms, dysphagia, or ambulation distress resulting in a reduction in activities of daily living, and social interactions.
A systematic review constructed by Ochtman, A.E.A et al. (2020) showed that, based on the current literature, pelvic position was significantly correlated with improved ability and pain reduction in patients with sagittal malalignment caused by lumbar degenerative disorders that were treated with surgical correction of the sagittal balance. The study also showed that there is not enough direct evidence that surgical restoration of spinal malalignment would lead to a better clinical outcome.
A systematic review and meta-analysis published in 2022 by da Silva Santos, T et al. found that manual therapy can be recommended to improve forward head posture, thoracic kyphosis, and pelvic alignment.
Carini, F., Mazzola, M., Fici, C., Palmeri, S., Messina, M., Damiani, P. and Tomasello, G., 2017. Posture and posturology, anatomical and physiological profiles: overview and current state of art. Acta Bio Medica: Atenei Parmensis, 88(1), p.11.
da Silva Santos, T., de Oliveira, K.K.B., Martins, L.V. and de Castro Vidal, A.P., 2022. Effects of manual therapy on body posture: Systematic review and meta-analysis. Gait & Posture.
Diebo, B.G., Varghese, J.J., Lafage, R., Schwab, F.J. and Lafage, V., 2015. Sagittal alignment of the spine: what do you need to know?. Clinical neurology and neurosurgery, 139, pp.295-301.
Murata, K., Endo, K., Aihara, T., Suzuki, H., Matsuoka, Y., Nishimura, H., Takamatsu, T., Kusakabe, T., Maekawa, A. and Yamamoto, K., 2020. Relationship between cervical and global sagittal balance in patients with dropped head syndrome. European Spine Journal, 29(3), pp.413-419.
Ochtman, A.E.A., Kruyt, M.C., Jacobs, W.C.H., Kersten, R.F.M.R., le Huec, J.C., Öner, F.C. and van Gaalen, S.M., 2020. Surgical restoration of sagittal alignment of the spine: correlation with improved patient-reported outcomes: a systematic review and meta-analysis. JBJS reviews, 8(8), p.e19.
Oravitan, M., 2009. Posturology-fundamental concepts and practical applications. Analele UVT-Seria EFS, 11, pp.61-9.