Understand the relationship between posture, stance, and gait

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Understand the relationship between posture, stance, and gait

Burl R. Pettibon 


Aberrant posture is one of the most misunderstood conditions by both the sufferer and the healthcare provider alike.

Focused postural classes are not offered in chiropractic nor medical curriculums; thus the importance of posture is not widely understood.
The common story from patients is that, as children, their parents told them to “quit slumping and stand up straight,” but what was not understood is that the muscles responsible for posture, stance, and gait are not consciously controlled. There are two kinds of muscle fibers in each muscle bundle: slow-twitch postural fibers and fast-twitch phasic fibers. They work and respond differently to various needs.

Postural problems

Rene Cailliet, MD, a specialist in physical medicine and rehabilitation at the University of Southern California, found the following regarding mechanical derangements of hard and soft spinal tissue: “Incorrect forward head posture leads to improper spinal function. Both the neck and lower spine have normal and necessary forward and backward curvatures relative to the skull and kyphotic thoracic spine and rib cage. Proper cervical and lumbar lordoses are necessary for normal muscle function. However, with a forward extended head, normal lordosis is lost both in the cervical and lumbar spine. The shoulders are rotated unequally up and down and come forward with the head position.”1
The head and neck in forward posture adds up to 42 inch-pounds of abnormal cervical spine leverage. This forces the entire spine out of alignment.
Forward head posture results in loss of vital capacity and chronic fatigue.
Lung capacity is depleted by as much as 30 percent. This shortness of breath can then lead to cardiovascular disease.
The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation are common sequelae of forward head posture. The gut is the largest endocrine organ in the body and 70 percent of the immune system is in the gut.2
Furthermore, forward head posture also causes an increase in discomfort and chronic pain. Motions of the first four cervical vertebrae produce endorphins. With inadequate endorphin production (i.e., pain reduction), many otherwise non- painful sensations are nociceptive.
Another result of forward head posture is a loss of normal spinal and body motion. One becomes hunched and the entire body stiffens, thereby lessening range of motion. Conversely, the better the posture, stance, and gait, the better and younger one feels and functions.
While most approaches to correcting posture focus on the spine, shoulders, and pelvis, the position of the head is the most important. Because the body follows the head, the body can be aligned by first aligning the head.2


Muscles involved in posture

The body has approximately 440 pairs of muscles, with 75 pairs of those being responsible for posture. These muscles are mainly under the control of the autonomic nervous system and the cranial nerves.


Cranial nerves and their function

There are 12 pairs of cranial nerves that connect directly with the brain rather than via the spinal cord and are not subject to direct compression or impedances by vertebral displacement. The eleventh cranial nerve is the spinal accessory nerve that is deeply embedded in the trapezius and sternocleidomastoid muscles, the major muscles of posture.
Proprioception is a process associated with kinesthetic awareness and balance. It is the result of vestibular, visual, and mechanoreceptor input from cranial nerves that are integrated in the cerebral cortex and cerebellum.
Mechanoreceptor input is the most important for proprioception because it produces local segmental reflexes and super-segmental proprioceptive reflex effects. These reflex actions cause muscles—especially postural muscle fibers—to react to inputs from the cranial nerves and to the righting reflexes that when properly stimulated can reflexively correct the upright spine in three dimensions relative to gravity.

A typical head-weight harness can hold up to 16 pounds of weight.

Burl Pettibon
Burl R. Pettibon, DC, FABCS, FRCCM, PhD (Hon), is a teacher, inventor, and researcher. He has written numerous papers and books on chiropractic care and research and has developed 25 clinics. He has also invented over 40 products currently in use by chiropractors throughout the world to make detection and correction of vertebral displacements both easier and more accurate. He can be contacted through pettibonsystem.com.

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