08/06/2023
I came across this article on one of the Alexander Technique fb groups I follow. Sometimes I have a very strong response to articles about posture. They make me feel as if I should blast my thoughts out into the universe. This piece has some good points, but I do want to add some margin notes.
Posture has been a hot button topic for donkey’s years. I was not immune to the words uttered within my own family, especially since i also heard them from my friends’ family members. “Stand up straight!” and “Don’t round your shoulders!” are firmly rooted in my childhood memories. I remember thinking my posture was just fine until I started my pilates teacher training and took Alexander Technique lessons for the first time.
When people come to see me, wanting to address their posture, or back pain, or hip pain, or shoulder pain, one of the most common things I see is people messing with the natural curves of their spine. As the article states:
“But the precise S-curve of your spine is individual to you. It’s in your genes,” says O’Sullivan. “It’s like our signature. It’s just how we are. This idea of homogenising us, I think it’s more social.”
This is pretty much how it goes. The spine is not straight and, as I learned rather quickly after meeting a woman who had Harrington rods in her spine that had removed ALL curvatures (including the ones present in a healthy spine), those curves are what allow us to stand up and balance our head over our feet, allow us to sit and balance our head over our sitting bones. The woman with the Harrington rods had no lumbar curve, which meant she couldn’t stand up straight at all: her version of “standing up straight” would always be about 25 or 30 degrees forward, off the line of gravity.
The first step to a healthy spine is to gently restore the natural curves. However, this brings up the next red flag item in the article:
“There is some evidence people with chronic back pain have weak back muscles. When you image them, you can see the muscle has become withered and infiltrated by strands of white fat. It’s not clear yet why this is. But it doesn’t seem crucial to back pain, because when doctors devised special training programs to strengthen those muscles they found they didn’t help anyone’s back pain.”
The “withered” muscles to which the author is referring, that are “infiltrated by strands of white fat”, are likely the deepest layer of our back muscles. They are withered because they are completely ATROPHIED: they completely forgot they had a job description (not unlike what happens to your muscles when you break your leg and everything is trapped inside a cast for 6 weeks).
The back of our body has three layers of muscle. The deepest layer is the most intrinsic, and these are what we refer to as the “postural muscles”. Because they are so deep, we have a very poor sense of them (we can’t see them in the mirror, for example, and flex them and see them working), and we end up using the muscles we CAN see, the muscles we CAN access. This invariably leads us to use our superficial muscles to support ourselves, and the real job of those superficial muscles is MOVEMENT, not “let’s hold ourselves up”.
Apologies for being repetitive, but the author of this piece states that these atrophied muscles DON’T “seem crucial to back pain, because when doctors devised special training programs to strengthen those muscles they found they didn’t help anyone’s back pain.” They are missing one crucial piece: those special training programs don’t teach people how to discontinue using their superficial muscles for support. So it’s all very nice to focus on strengthening the deepest layer, but if you don’t discontinue the superficial holding pattern, you will never have a healthy, movable spine. It becomes tension with an extra layer of tension. Instead, consider the possibility that the over-engagement of those superficial muscles is the reason why a person’s back pain never goes away.
The essence of Alexander Technique is ease and efficiency, lightness and availability, and most importantly, freedom to choose. If we choose not to support ourselves with superficial muscles that are designed to allow us to move, then those deep postural muscles will have to step out of retirement and relearn how to do their job. It’s not a quick fix, but it will make a world of difference.
For ages, bad posture has been assumed to cause back pain. Now some physiotherapists are rethinking what we should be doing with our spines