RE: Posture, Strength and Injury?

[Guest guest]

After reading Dr. Siff's email, and following the link to Mr. Dorko's

article I came up with some questions that I think cannot be overlooked. If

I have misread or misinterpreted something, please accept my apology.

First, after reading the comment, " ... than the notion that static and

dynamic postures are directly related to muscular strength. This is not

true. " I had to take a longer look. Although I may agree that strength

alone may not directly be the sole factor, I think there are major problems

with this email and article that are telling us that we should take their

word for it that strength has nothing to do with static or dynamic posture.

If strength is not a factor in static or dynamic posture, I defy anyone to

remove the muscles from a body and show all of us that the skeletal can

display static or dynamic postures by itself. Leave the soft tissues in

place and do this not only with an anatomically correct skeletal, but one

with lordosis and other (abnormal) postures. There also seems to be

complete and total lack of consideration that coordination between, not only

the different abdominal muscles, but those of the low back, hip flexors, and

hamstrings should be examined.

Acknowledging that I haven't looked at the reference in total, I don't think

it's appropriate to accept the quotes presented without knowing what

" abdominal muscle(s) " means. Did they try to isolate one muscle like the

rectus? Did they include the obliques as part of the abdominal muscles?

Did they look at the coordination between them? And then what about other

muscles that originate or attach directly to the low back or pelvis? Is

there any mention of the quadratus lumborum, erector spinae, psoas,

internal/external obliques, the latissimus dorsi, or the hamstrings?

Further yet, did they even consider the interaction/coordination between any

of these?

The fact that research exists that says something we want it to say, or that

supports our beliefs doesn't necessarily mean that in the incredibly complex

big picture of the body, we can take one study which purports to exam the

relationship between muscle strength and posture and draw the conslusion

that there is no relationship at any joint in the entire body. Dr. Siff has

written many times about a scientific prinicle that says we should question

information presented.

Regarding the quote about the scapula, I'm surprised that they can make that

conclusion without any reference to the rhomboid, levator scapulae, and

other muscles. And what about dynamic? Did they lift the arm and check the

scapula?

This is no different than saying a person can't find a sunset, without even

considering the direction the person is traveling. You're not going to find

many sunset's traveling east. This leads into my next point.

" not only did we not find any correlation between muscle strength and

posture pre-intervention, but we strengthened weak muscles (abdominals) for

eight weeks (as well as prescribing full exercise programs intended to alter

pelvic tilt and lumbar lordosis) and found that after an intensive eight

week course of PT (3x/week supervised with home program bid), posture

(pelvic tilt and lumbar lordosis) had not changed at all. "

Again, what abdominals did they strengthen? The rectus? If so, they should

conclude that the rectus doesn't have an affect on posture. How did they

strengthen these abdominal muscles, with some kind of modified crunch? I've

witnessed horrible exercise/training in PT facilities that wouldn't have,

and didn't, produced any improvement no matter how long the patient tried to

perform the program. I wonder if the exercise program that the researchers

used would have, or has, produce the desired result in any study/situation

they've conducted. As one of my professors used to say, " So what " . Did

they even consider looking at the erector spinae? Could they, or a strength

increase in them, offset abdominal training and therefore the desired

result? I'm thinking of a study by Janda (I believe) that showed that

opposing muscles activity and tightness could be detrimental to

strengthening efforts of the primary group.

I bring these things up not to put any one down or to start a war, only to

bring to life how I believe research can be so misleading and harmful to a

given community. We must not forget that one of the most important goals of

science, and that includes research, is to understand something so well,

that we can predict the outcome. Science is not solely looking up a

condition on a chart and cross-referencing that to a single, all inclusive

cause. I would be willing to say that if I presented any of these

researchers with a specific situation, that none of them could predict, and

be correct, what would happen (except failure). I also believe that this

contributes to what I call treatment by statics, and not application of the

understanding of function to an individual patient.

Best regards,

Heppe, M.A.

Biomechanical Soluitons

http://www.biosolutions.net

San , CA

Posture, Strength and Injury?

This group periodically has discussed the myths of postural control,

breathing and abdominal training insofar as they are presumed to relate to

strength and back injury. One of our members, Barrett Dorko, writes an

interesting column ( " Dorko's Desk " ) on issues like this which concern

physical therapy. His article, " The Big Mistake " is well worth reading:

<http://barrettdorko.com/a_big_mistake.htm>

His article, inter alia, states:

<Physical therapy, like any other discipline, has its share of dearly held

beliefs. Perhaps none is stronger than the notion that static and dynamic

postures are directly related to muscular strength.

This is not true. The following references and commentary from peer-reviewed

literature support my contention that strength and posture are unrelated

.........

As of this writing (March, 2000), the most recent study I can find on the

subject is " Lumbar Lordosis and Pelvic Inclination in Adults With Chronic

Low

Back Pain " , Youdas et al, Physical Therapy, Vol 80 No 3 March 2000

Its conclusion reads in part " ..the magnitude of the lumbar lordosis and

pelvic inclination in standing is not associated with the force production

of

the abdominal muscles. "

Dr Mel C Siff

Denver, USA

mcsiff@...

[Guest guest]

Heppe wrote...

<<Acknowledging that I haven't looked at the reference in total, I don't

think

it's appropriate to accept the quotes presented without knowing what

" abdominal muscle(s) " means. Did they try to isolate one muscle like the

rectus? Did they include the obliques as part of the abdominal muscles?

Did they look at the coordination between them?>>

Hi ,

Can you explain how you evaluate " the coordination between " the abdominal

muscles? I realize there probably isn't a short sweet version of how this

is done, but if you could offer a paragraph or two myself and I'm sure

others would appreciate it. Thanks

From Barett Dorko's web site...

<< " not only did we not find any correlation between muscle strength and

posture pre-intervention, but we strengthened weak muscles (abdominals) for

eight weeks (as well as prescribing full exercise programs intended to alter

pelvic tilt and lumbar lordosis) and found that after an intensive eight

week course of PT (3x/week supervised with home program bid), posture

(pelvic tilt and lumbar lordosis) had not changed at all. " >>

Burkhardt...

From my perspective, I feel that there are a lot of athletic trainers and

personal trainers making " blanket " statements that strong muscles are

generally short/tight and weak muscles are generally too long. To me this

seems to be a very simplistic method being used by people to explain away a

variety of " postural issues " . Personally I think this may be part of the

big picture, but I can't imagine it's that simple.

The classic example is the pelvis that's rotated forward (anterior) too far

combined with excessive lumbar lordosis. Many would approach this and say

all you have to do is stretch the back extensors and hip flexors and

strengthen the abdominals and glute max.....and poof!! - PROBLEM SOLVED!! I

am not convinced altering posture is this simple.

A few years ago, I was having low back pain and was told that part of the

problem was due to tight hip flexors (i.e. classic example described above).

If posture *is* determined by how strong the agonist/antagonist muscles of a

particular joint are, I am quite surprised that my excessive forward pelvic

tilt would be the result of tight hip flexors. Why? Because as a long-time

heavy deep squatter it doesn't make sense to me that the muscles that flex

my hip should be stronger than those that extend my hip!!??

Burkhardt

Strength and Conditioning Coach

UC Irvine