BLOG # 2 MARCH 2022

This blog will examine what in our daily lifestyle could be setting up conditions that lead to chronic pain. A good place to start is to look at our posture because it shows very dramatically the health of so many of the muscles that are involved in chronic pain. 

Posture is the relationship of our body parts to each other. Panel A in the drawing shows what the normal, healthy posture should look like. A line drawn perpendicular (dotted line) to the floor should pass through the ears, the hip and knee joints and the arch of the foot. In this position, the muscle are perfectly aligned. None are excessively shortened or stretched. Panel B in the drawing, shows the early stages of a deformed posture. The head is being held too far forward.  The pelvis is tipped back and the natural curvature of the lower back is flattened out. In this position, it may not even be possible to fully straighten the knees. 

You can very easily tell what your posture looks like by standing in front of a mirror and turning to the side. There are only two choices. You are either in good alignment as shown in Panel A or you are showing postural deformities like those in Panel B. If you are showing postural deformities, you are well along the road to developing chronic pain if not already experiencing it. You can very easily tell what your posture looks like. Just stand in front of a mirror, turn to the side and take a look.

If there are postural deformities, what does that mean for our muscles? It means that some muscles are shortened while others are being excessively stretched and held under tension. In the abdominal area, the abs and the hip flexors are shortened and, by bending the body at the waist, are pulling the upper body and head forward. At the same time the back extensors which are located along the back of the spine are being continuously held under tension. Living in this state, is it any wonder that so many of us experience low back pain? With the head and shoulders tipped forward, it means that our chest muscles (the pecs) and the muscles in the front of the neck are shortened. At the same time, the muscles along the back of the shoulders and neck are being excessively stretched and under tension. This situation sets up ideal conditions for developing upper back, shoulder, neck and jaw chronic pain as well as a variety of headaches. 

How do such postural deformities develop? Our sedentary lifestyle customs come into play at this point. For example, whenever we sit, our abs, hip flexors, pecs, quads which are located along the front of the thigh and the muscles along the front of the neck are all held in shortened positions. Over time, this shortening will become permanent.

The design of most of the chairs we routinely sit in are major contributors to the problem. They are designed for style and esthetics but not for the human anatomy. The typical car seat design, which is also found in airplanes, buses, trains as well as in many household chairs, is shown in the photograph. It clearly illustrates three parts of the posture problem. First, the seat back joins the seat at a sharp angle making it impossible to comfortably place the curved buttocks  against the seat back. Second, the bump at the bottom of the seat back is too low and pushes the pelvis forward forcing us to sit in a slouched position from the moment we sit down and for the entire time that we sit in the chair. Third, the head rest is too far forward and forces us to bend our neck and hold our head too far forward. While sitting, we so often lean forward and hunch over a computer or reading material which further adds to the development of postural deformities. These are only a few examples that show how the events in a typical sedentary lifestyle inevitably lead to postural deformities and predispose us to developing chromic pain.

The big question here is what can be done about it? There is unfortunately no simple, one step answer. That we all basically lead sedentary existences is part of our daily lives and although we can certainly make changes around the edges like using a stand-up desk and standing up frequently, that lifestyle cannot be realistically changed or eliminated. 

Admonishing ourselves to “sit up straight” or “stand up straight” will not work. Sitting in poorly designed chairs for long periods of time inevitably leads to slouching and continued shortening of muscles. Once  muscles have shortened or have been placed under excessive tension, they will sustain any existing postural deformities and continue to further their development. Such deformities and the loss of range of motion in the affected muscles makes us susceptible to the development of chronic pain. Unfortunately engaging in many of our healthy activities like walking, jogging, swimming, bicycle riding and resistance training cannot by themselves solve the problem. 

However, there is definitely hope! The solution is to start a program that counteracts the destructive effects of our sedentary lifestyles that will restore the affected muscles to their normal, healthy state and recapture their lost range of motion. First, sites of contraction inside of muscles will have to be eliminated. Second, shortened muscles will have to be lengthened. Third, shortened muscles will have to be put through movements that will restore their strength and their ability to function properly throughout their range of motion.

How to do this is covered in detail in The Book and will be discussed in future Blogs.