Author’s Note: Daily patient recommendations have taken on a life of their own. I now have a personal acronym I share: BPS – breathing, posture and stretching. This is part 2 of a three-part series. Part 1 focused on breathing. Part 2 focuses on posture.
A patient’s posture is assessed immediately upon entering the clinic room. The way a patient moves shows how relaxed or uptight, confident or unassured, and uninhibited or restricted they are. Posture is one of those things that is hard to talk about – like diet and exercise. It can be an emotionally charged topic. This is perhaps due to all of those years being told, “Stand up straight with your shoulders back!”
People generally know they need to correct their posture, but I find they don’t know where to start other than the blanket advice they’ve been given over the years. When financial advisors want their clients to take better care of how they spend money, they recommend their clients write down every transaction. When a dietician wants to help a client lose weight, they have them write down what they eat. However, when it comes to posture, there doesn’t seem to be many ways to get people to have a healthy obsession with rectifying it. I have found that education seems to get through in the best way.
Postural Changes
There are two common postural changes that I frequently see in the clinic. The first has to do with the neck protruding forward, which rounds out the shoulders, stretches the upper back and hollows out the chest. This commonly occurs with reading, and the use of a computer, tablet or phone.
The second has to do with the command of sitting or standing up straight. Everyone knows not to slouch; however, the opposite has occurred. People now have the habit of pushing their bellies out in front of them, which may look like they are standing up tall, but is actually accentuating the poor posture of the neck and upper back. This swayback commonly occurs when standing, washing the dishes or chopping vegetables. People often “lock out” their back or rest their hips on the counter.
The Education of TCM
Teaching patients the impact they are having with day-to-day decisions can be empowering. Often, a patient with poor posture is coming in for a pain-related or emotional-related condition. Our job is to educate them how “locking” out their back is contributing to their lower back pain. The stretching of the upper back and hollowing of the chest are contributing to their feelings of anxiety and sadness. After explaining causation, the next step is teaching the patient how to play an active role in rectifying the problem.
Back to Baseline
I teach patients how to stand with their heels touching the baseboard, their ribs anchored to take out the swayback, and their shoulder blades against the wall. I then ask, with their chin lowered, to try and touch the back of their head to the wall. I take many of these cues from the Gokhale method, which teaches to not simply return to baseline, but also to elongate in the process.
Once a patient realizes they are to stretch the spaces between their vertebrae, while trying to touch their head, they will become discouraged. They will then cheat by raising their head to make it work. This is where the first letter in my acronym comes in. Breathing, as we saw, tells the body to rest and digest — or in this case, relax and allow a lengthening in the muscles to occur. Big exhales will allow patients to gently work on this baseline posture and gain some ground over a period of time.
Acupuncture, Posture and Breathing
Acupuncture, and the bodywork that surrounds it, is the perfect aid to correcting posture, and correcting postures is one way that patients can take healing into their own hands. After relaxing the tissue that surrounds accessory breathing muscles, I have realized that these are the same areas that get tight and affect breathing, and in turn affect emotional well-being. By asking patients to practice six-second exhales, as well as their baseline posture, they are directly affecting their emotional well-being – and this web of interactions.
Author’s Note: For more information on rectifying a protruding neck and swayback, please view this video by Licensed Acupuncturist and posture instructor Esther Gokhale.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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