Positioned for Success

  • By Moira McDougall
  • 04 Jun, 2014

Poor posture influences movement and chronic pain

Our posture helps to position us for success and prevent chronic fatigue and pain
Our posture helps to position us for success and prevent chronic fatigue and pain

Are You Positioned For Success?

Health professionals are trained to objectively analyse presenting signs and symptoms, in order to offer possible solutions to all manner of ‘conditions’. Today I have been exploring Posture, and the role it generally plays in our daily functional activities, and specifically, in chronic painpresentations.

Why is this interesting?

Because we need to be Positioned For Success!

The way we habitually hold ourselves influences all our movements and ultimately affects how we go about accomplishing our everyday activities – whether we are working, playing sport or a musical instrument, relaxing or sleeping.

I did a bit of research around the topic of being positioned for success by being Cognitively/Mindfully and Behaviourally aware of our posture, and the influences we could pay more attention to.

It has been observed that poor posture is widespread in the general population. It appears to be an adaptive, self- perpetuating trait that most people lack the cognitive ability or desire to correct by themselves. (2)

Studies have shown that people in occupations that include prolonged periods of sitting may experience a high incidence of Low Back Pain. (1)

Commonly adopted relaxed postures are often passive in nature with a predisposition to “sway” standing and slumped sitting which can exacerbate pain. (4)

Increased pain  does not leave us positioned for success.

Recent studies conclude that

  • Forward head posture is the most common form of poor posture  related to a multitude of myofascial pain disorders  and cervical dysfunction. (2) This posture requires the person to flex the lower part of the neck forward and bend the upper portion of the neck backwards.
  • Adopting passive postures such as sway standing and slump sitting can exacerbate pain in individuals with low back pain. Lumbopelvic stabilising musculature is active in maintaining optimally aligned erect postures, and are less active during adoption of passive postures. The muscles of the lumbopelvic region become deactivated  and deconditioned , which increases the load on the lumbar discs and ligaments which in turn could leave the lumbopelvic region vulnerable to strain, instability or injury. (4)
  • Back pain intensity and referred leg pain could be significantly reduced after sitting with a lordotic posture, demonstrating that a change in posture could have a positive effect on pain location . Centralisation (a change in distribution of referred symptoms from distal to a more central location) was brought about by certain lumbar movements and positioning. (1)
  • Erect postural alignment in weight bearing positively facilitated the stabilising muscles of the lumbopelvic region. (4) Immediately we are better positioned for success in performing our daily activities.

We are not Positioned For Success when we adopt postures that are not energy efficient and structurally sustainable.
We are not Positioned For Success when we adopt postures that are not energy efficient and structurally sustainable.

POSTURAL TRAINING (BEING POSITIONED FOR SUCCESS) WORKS ON THE ASSUMPTION THAT AN OPTIMALLY ALIGNED SKELETAL SYSTEM REDUCES STRESS IN ITS STRUCTURES.  IT IS RECOMMENDED AS ONE OF THE INTERDISCIPLINARY TREATMENT COMPONENTS OF COGNITIVE BEHAVIOURAL THERAPY (CBT) FOR CHRONIC PAIN.

  • It usually involves exercises performed repetitively to stretch structures that poor posture tends to shorten
  • Strengthens structures that poor posture tends to weaken
  • Creates awareness of desirable posture (2)

 

Cognitive Behavioural treatment methods have been applied to the most common chronic pain conditions . Posture correction in daily life, by its very nature, is considered Behavioural Therapy as the individual is required to continually monitor his / her improved conditioned posture for success. (2, 3)

These CBT Programmes usually involve multiple components, including

  • Information to increase knowledge and awareness of the factors influencing the nature and typical course of chronic pain conditions
  • Basics of pain physiology with the emphasis on chronic pain
  • Biomedical and bio-behavioural management of the condition
  • How to self-monitor the signs and symptoms of the condition
  • Cognitive and behavioural therapies aimed at increasing physical and functional activities and adaptive responses to pain
  • Skill training such as the use of relaxation, biofeedback, hypnosis and other self-control strategies to modify the perception of pain and related body sensations
  • Information on the relationship between muscle fatigue, muscle tension and the psycho-physiologic aspect of stress
  • Introduction to cognitive and behavioural pain and stress-coping strategies (3)

 

Instructions for Posture Correction to be positioned for success may include

Sitting

  • Don’t slouch when sitting on a chair
  • Don’t sit with legs crossed
  • Don’t rest chin on hand
  • If sitting on the floor, sit upright by sitting on folded legs

My sitting posture may prevent me from being Positioned For Success
My sitting posture may prevent me from being Positioned For Success

My sitting posture may prevent me from being Positioned For Success

 Standing

  • Rest weight on both feet evenly
  • Don’t lean against a wall

 Sleeping

  • Sleep on a firm mattress
  • Sleep on your back
  • Keep your neck straight by supporting on a low pillow or flattened towel

 Eating

  • Bring food to mouth without tilting head forward
  • Chew looking straight ahead, not downward

 Walking

  • Walk with long even strides while swinging your arms

 Others

  • Don’t carry a heavy package with one hand
  • Don’t thrust head forward

Ref (3)

WITH THIS INFORMATION IN MIND, WE COULD BE MORE MINDFUL TO ENSURE WE ARE BETTER POSITIONED FOR SUCCESS, WITHOUT COMPROMISING OUR POSTURAL EFFICIENCY .

 

References

1. A comparison of the effects of two sitting postures on back and referred pain     M M Williams, J A Hawley, R A McKenzie, P M van Wijmen Spine Vol 16, No 10, Oct 1991; 1185-1191

2. Usefulness of posture training for patients with temporomandibular disorders E F Wright, M A Domenech, J R Fischer Jr J Am Dent Assoc 2000; 131; 202-210

3. Posture correction as part of behavioural therapy in treatment of myofascial pain with limited opening O Komiyana, M Kawara, M Arai, T Asano,  K Kobayashi J Oral Rehab May 1999; Vol 26; No 5;428-435

4. The effect of different standing and sitting postures on trunk muscle activity in a pain-free population P B O’Sullivan, K M Grahamslaw, M Kendell, S C Lapenskie, N E Moller, K V Richards Spine 2002; Vol 27; No 11; 1238-1244

 Which strategies do you employ to ensure you are Positioned For Success?

Please share and repost.

Self Manage Chronic Pain

By Moira McDougall 14 Feb, 2017

I recently visited an elderly woman in her home, in my community therapy role. So much had been happening in her world. During the weeks since my last visit she had experienced some serious health challenges, and her brother had died.

How could I be surprised that she had not managed to continue with the exercise and walking programme we had started?

She was tired, heartbroken and wracked with guilt, describing herself as “full of self-pity” because she was mourning the loss of her dear brother. This had also reminded her of the grief she experienced when her sister died a year previously.

I sat and listened with my Whole Heart.

 I was not there to offer solutions, to slap a band-aid over her aching heart, to make light of her feelings. I told her I believed it was good, right and proper to feel such acute loss and to express it. How else do we recover from our deep wounds?

She told me about her family, her ancestors who had migrated to New Zealand from an Eastern European country, just before the time of the Depression. She spoke of a grandfather who worked many menial jobs to provide for his family of seven children. Her parents also worked hard to raise her and her many siblings – a labour of love which she reflected on with great gratitude. She spoke of one of her sisters who had endured many trials and tribulations only to finally triumph – and she now lives overseas. She spoke with love of her own children – their successes and challenges.

In the telling, she called all of her Ancestors into that small lounge. I could feel them standing around her. I told her that I believed that talking about our Loved ones brings them close.

I can recognise the entrenched belief that being occupied fully, being accountable for every minute spent at the expense of any form of pure relaxation, has been ingrained in our psyches. No wonder, then, that this dear soul believed she was “full of self-pity” because her thoughts kept turning to those she loved dearly who were no longer here, in physical form. Because she could not do it for herself, I offered her the gift of my time, so that she could express what her heart was longing to share.

When it was time for me to leave, she hugged me tightly and thanked me for “just listening”. I feel I was the recipient of the greater gift. I heard her heart sing!

Do you feel taking time to grieve is selfish? Do you believe it is a form of self-pity?

I welcome your comments.

By Moira McDougall 12 Jan, 2017

You are going to win! With these words spurring me on, how could I not be a winner!

This morning I set out on my morning run, and it was hot already. Along the way, I passed and greeted a mum on her early morning walk, pushing her two small children in their stroller. The older child called out to me as I passed them, “you are going to win!”. How could I not honour that proclamation? How could I even consider feeling tired or discouraged with those beautiful words ringing in my ears?

This set me thinking about the many times I feel discouraged, as if I am wading through sludge. I have a strong work ethic, and set myself tasks and deadlines. This works for me when I have a good idea about a desired outcome, because it keeps me on track and I can measure my progress. But what happens when I am not sure about what I want to pursue or produce?

I am marooned in indecision, in not knowing, what my ‘next step’ is. Do you experience this too?

Business and personal coaching works wonders in helping one to define a pathway, helping to break down goals into manageable steps, in order to reach the defined outcome. This supposes that one already KNOWS or at least has an idea of the desired outcome.

One beautiful practice I was invited to participate in, invited us each to choose a Word to define a theme to focus on through the new year ahead, and to choose four Supporting Words to cushion or supplement the Word.

I have chosen SURRENDER.

Nothing works easily when I am pushing uphill, trying to do it all alone. I am not giving up, just practising being present in the moment, experimenting with ‘flowing’ rather than being rigid.

My supporting words are Grace, Gratitude, Courage and Insight – all qualities I will need to call on and include in my daily living.

Which brings me back to the proclamation “You are going to win!” We are all winners when we focus on what inspires us, what gives us meaning, and practice living in the present moment. And when we have others cheering us on!

“You are going to win!” – how does that make YOU feel?

By Moira McDougall 02 Jan, 2017

I have a heavy heart moving into this new year. Endings and more endings, because I am grieving the loss of two people dear to me.

My sister Anne has dementia and she is sliding further into the space between here and there. While she is still physically present, I miss her intellect, her sharp wit, her full presence. She is my older sister. I have known her my whole life. I never imagined that I would not be with her ‘fully’. She was the drawcard for my move to live in Christchurch.

She always looked after my younger brother and I; we looked up to her and trusted her guidance. As the eldest child, she copped the authority of our parents, and she fought hard for her independence. She is super intelligent, and my brother and I had a hard time following after her at school. She chose her own path, and with her husband travelled to places I have only ever dreamt of.

Now, I call on all my parenting and therapy skills as I navigate our relationship. She can’t remember what she ate two minutes ago, or whether she has eaten at all. She can’t dress herself. Her spatial awareness is impaired – steps are a challenge, and she doesn’t recognise familiar objects. Loud noises and busyness upset her, and her tolerance levels are reduced. Soon, she will need to be placed into full time care, which seems like a jail sentence. Excepting, there is no parole to look forwards to.

My heart is breaking. How did her Soul choose this challenge in this Lifetime?


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