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The Postural Landscape

By Paul Schell

Form & Function

With the introduction of the Egoscue Method as an elective at the Pacific College of Oriental Medicine, a synergy of health promotion was born - the extent and closeness to which the philosophies are linked, I was unaware. Coming from a traditional university training that prepared athletic trainers and physical therapists, and then going to work at the Egoscue Method Clinic was an eye-opening experience. It helped open my eyes to how the body works as a collective, versus symptomatically at its individual parts. Armed with the knowledge that helping clients to asymptomatic, healthy and active lives should include evaluation and treatments that mirror the whole body concept is one that both Egoscue and Oriental Medicine share.

In The Web That Has No Weaver, Ted Kaptchuk explains, "In each person, as in every landscape, there are signs that, when balanced, define health or beauty. If the signs are out of balance, the person is ill or the painting does not work." With Egoscue, this painting is that of the human body and its posture. The abilities and relative functions or dysfunctions (mainly musculoskeletal) can be observed through static postural assessments.

The human body is built for motion. Limit the motions and soon the limits will take away the ability for movement without consequences. For example, if you do not continue to have need of reaching behind your back, then you may find when the need arises that you cannot (and may find yourself rubbing your back on the nearest wall corner). The shoulder, trunk and spine, knowing what is required for the motion, will only do as they are trained. Train them to sit in a slumped chair for hours, upon days, upon months, and they will become very good at slumping (and not moving).

Form follows function. The "painting" of a fully functional human body must be considered in its full upright position (Figure 1 & 2). The head centered over the shoulders, level shoulders symmetrically loaded over the hips, spine and trunk centered over level pelvis, and hips, knees, and ankles aligned vertically with feet pointing forward. Top to bottom function ready to spring into action when called upon.

Our lifestyles, while full of niceties and conveniences, are also to our physical detriment when lack of overall motion is considered. The human body, composed of dynamic cellular processes and living tissues, grows and develops on the stimulus provided. The average environments of today provide far less movement than which is necessary for health, and much less proper motion required for the body to maintain its functional integrity.

The consequence of the lack of motion shows in symptoms such as pain, ache, tension, numbness, burning... and the list goes on. It is our interpretation of these signals that must first be challenged the goggles through which we view the client with symptoms. The landscape of this posture is a relatively common occurrence in today's society with rotation of the trunk and pelvis, one shoulder elevated, knee caps pointed in different directions, and feet averted. To the eye trained to look at posture and relate musculoskeletal function, the stress and strain combined with identifying various musculoskeletal dysfunctions shout, "Help me!"

The body is crying for movement. Achy joints, sore muscles, headaches, tension in the back, neck and shoulders are all symptoms of improper function and lack of motion. The posture, when looked at as a whole and not simply that of the symptom location, shows dysfunction is present and thus gives a window of opportunity for providing proper stimulus. The fact that motion may have a negative consequence (i.e. pain), gives us confirmation that the body is not working according to its design - a design we all share and is inherent to each of us.

Test Yourself

Take a look in the mirror and observe your own posture. Look for level shoulders. Observe if your head and trunk are centered over the feet. Are the knees knocked or bowed? Are your feet pointing straight ahead? Are these segments symmetrical? If you experience pain, the answer may have been looking you in the mirror for years!

As posture deviations exhibit dysfunctions, try these simple exercises to test your function. You may use these with your clients as well. If you have difficulty with any of them, you may discontinue and try at a later time. Take into account, however, that these exercises simply represent "reminders" of proper function, and we are all designed to be able to accomplish them. Therefore, if you encounter resistance while performing them, then you must assume that what is supposed to be a gentle reminder has become a large task for your body - representing dysfunction. But be encouraged - continue to remind your body of proper function, and it will return.

Standing Elbow Curls

Instructions: Using both hands, curl the fingertips and raise the hands palms-out so that the flat area between the first and second knuckles rests on temples in front off the ears; the thumbs extended downward. Draw the elbows back evenly and in line with the shoulders. From this position, slowly swing the elbows forward until they touch together in front. Keep the knuckles in contact with the temples, the thumbs fully extended, and the head fully erect. If you find your head moves back and forth, stand up against a wall, slow down, and breathe deeply. Do 25 repetitions.

Cats and Dogs

Instructions: Get down on the floor on your hands and knees. Make sure your knees are aligned with your hips and your wrists with your shoulders. Your lower legs should be parallel with each other and with the hips. Make sure your weight is distributed evenly. Smoothly round your back upwards as your head curls under to create a curve that runs from the tailbone to the neck (this is the Cat position). Then, smoothly sway the back down while bringing the head up (this is the Dog position). Make these two moves flow continuously and smoothly up and down. Do 10 repetitions.

Static Back

Instructions: Lie on your back, with both legs bent at right angles on a chair or block. Rest your hands on your stomach or the floor, at 45-degrees from your body, with palms up. Let the back settle into the floor. Breathe from your diaphragm (that is, do stomach breathing). The abdominal muscles should rise as you inhale and fall as you exhale. Relax in this position for 5 to 10 minutes. 4.Foot Circles and Point Flexes Instructions: Lie on your back with one leg extended flat on the floor and the other bent toward the chest. Clasp your hands behind the bent knee while you circle the foot clockwise thirty times (keeping the other foot on the floor with the toes pointed straight towards the ceiling). Reverse the direction of the circling foot and repeat. After circling both directions, and using the same foot, bring the toes back toward the shin to flex and then point the toes away, repeating twenty times. Switch legs and repeat (30 circles each direction and 20 point/flexes). As Kaptchuk continues in describing the balance for defining health, "What is yin in one person may be yang in another." The exercises then represent, for some a labor of dynamic movement and for others static stability. In order to achieve postural balance and maintain the health of the musculoskeletal system, which interacts with and supports the internal systems, one must provide necessary stimulus.

It's an honor and a great opportunity to further help clients/patients by offering the Egoscue Method to Pacific College students. You may find out more about the Egoscue Method at www.egoscue.com or contact me directly at paul@egoscue.com.