Posture has been a topic for ages. It conveys confidence and health. It speaks to our youthfulness and capabilities. It mirrors our sense of being and reveals our fatigue. It defines you before you are known and refines impressions and unrealized biases.
Posture is powerful in many spoken and unspoken ways.
But the pursuit of improved posture has been fraught with inconsistencies and contradictions. Improvements in posture both shown reductions in pain in some important studies1 and in other studies it has been shown that the evidence for posture causing pain is inconsistent and lacks causal proof.2 This has led many in the physical therapy world, including many I respect, to dismiss posture as a viable goal in the treatment of back pain.
However, The Body Guitar Theory challenges these findings as it adds to many long-held beliefs concerning how the spine and body are stabilized. In understanding the mammalian roots of the hip flexors and diaphragm and applying these to the upright S-shaped human spine, it becomes clear that the human spine is in a constant battle: a battle to stay upright against a set of muscles that can easily take over.
What situations lead to String muscle dominance over the Bracing muscles in the spine? Low back pain, aging, stress. To name the most common. Who is affected by one of these if not all? Everyone. If strengthening of Bracing muscles happens during good posture, then posture is a method of combating, not just back pain, but aging and a life full of stress.
Think of the way we use words to describe posture. If you tell someone to have good posture, commonly you would say “stand up straight, military stance.” Our spine is stabilized by two different muscle groups working in opposition, creating a pull against each other to create balance. One muscle group is sympathetic (fight-or-flight), and is seen in postures where one is standing tall, butt clamped, on their heels, chest breathing. If I say ‘military stance’ how could you not think ‘fight?’ This is the group of muscles that takes over when someone has back pain, stress, and during aging. How could using these muscles improve any of these problems when these problems lead to tightness in these muscles? Of course they don’t: these muscles are String muscles, which are the strings in our Body Guitar Theory.
The other group of muscles the Bracing muscles, which are like the wood in the Body Guitar metaphor. These muscles are parasympathetic (rest-and-digest), high-tone muscles that pull joints into themselves to create stability in a relaxed state. They are inhibited by pain in the joint and by forceful contraction of the String muscles. Prolonged pain or long-term stress leads to not just weakness of these muscles, but shrinking or atrophy. Strengthening involves removing the pain, focusing on relaxing the String muscles, and using these Bracing muscles to produce strength.
If we stand with good posture and relax our String muscles and this hurts, you are not ready to begin posture training. You must treat the pain first. If you stand and pain-free relax into the joint, you can then abdominal breathe to get the diaphragm moving, which decreases the contraction pull of the hip flexors against the diaphragm. You are beginning to maximally contract the Bracing muscles and, over time, will build blood flow back into these muscles, which increases strength and endurance.
As you do this, you will begin to discover flaws, which will be addressed in this article about Stability Gap.
So while many studies have been addressing posture through the years, it is with this new understanding of stability that posture will become what we thought it was all along: a measure of way more than standing up straight.
Get your body in tune!
- Kim D, Cho M, Park Y, Yang Y. Effect of an exercise program for posture correction on musculoskeletal pain. J Phys Ther Sci. 2015 Jun;27(6):1791-4. doi: 10.1589/jpts.27.1791. Epub 2015 Jun 30. PMID: 26180322; PMCID: PMC4499985.
- Swain CTV, Pan F, Owen PJ, Schmidt H, Belavy DL. No consensus on causality of spine postures or physical exposure and low back pain: A systematic review of systematic reviews. J Biomech. 2020 Mar 26;102:109312. doi: 10.1016/j.jbiomech.2019.08.006. Epub 2019 Aug 13. PMID: 31451200.