1.5 billion people around the world suffer from chronic pain making it now the number one reason patients seek medical care. I have definitely witnessed this fact in my practice. In fact, studies have shown that pain leads to more than 50 million lost workdays each year. The cost of pain including medical bills and lost workdays is estimated at $100 billion per year world wide.
The pain I am talking about is associated with a wide range of injury and disease and is sometimes related to a disease process itself. The pain that I see in the clinic is due to the dysfunction of the musculoskeletal and neuromuscular systems. Many of my patient’s pain symptoms arise from a specific cause and injury. However, just as many describe their pain as gradual in its onset without any known cause.
No matter the cause and characteristics of one’s pain, the costs of unrelieved pain can result in hospitalization, increased outpatient visits, addiction to opioids, and decreased ability to function fully leading to the lost income and insurance coverage. These are the realities of pain!
So, I ask you, “What can you do about this?” The simplest answer I can give you is changing your posture and how you walk as a start. Our postural habits or how one carries themselves as well as the way one walks reflects so much of our journey through life. From the habits and behaviors of everyday life due to being right or left hand dominant to bearing the compensatory scars of accidents and injuries large and small, affects your musculoskeletal, neuromuscular, and connective tissue systems. The compensation that results affects these systems and their output which is your posture and movement of the skeletal system.
Our bodies are designed to work against the force of gravity and its effects during our activities of everyday life. Our bodies work in a pattern of posture and movement from the bodies center of gravity, but it doesn’t take much for it to lose its way. If your tire goes flat on your car, you are not going to go very far. However, the body doesn’t work that way. For example, if the inside of your foot is injured, your body will compensate in various ways that will allow you to keep walking. The problem is that the compensation causes a shift in your center of gravity affecting the tension of your neuromuscular and connective tissue systems. The output is a change in your posture and movements.
The human body has a tremendous capacity to change. It can change from dysfunctional posture and movement due to compensation to a more natural, neutral pattern. However, it needs to have the right input to change. Simply speaking, you don’t have to accept your compensation as what it is. The first step to changing your posture and the way you walk is “awareness.”
Begin to take note of where you ache. What moves and what doesn’t move when you are walking? Does your right side feel the same as on your left side? More interestingly, begin to watch how other people walk and hold themselves. Try to develop a sense of what seems abnormal due to compensation and what is a normal, neutral pattern.
Posture is definitely underrated as a characteristic of a person’s daily life, but it can tell a lot about a person. Posture refers not only to the erectness of our skeletal structure, but also to our body orientation, direction of lean, and the degree to which our bodies are open and inviting.
A good, healthy posture while standing or sitting doesn’t necessarily mean the structure is straight up and down since the natural spine has curves, but it does reflect the spine is aligned and not twisted. There are natural curves between the thoracic (upper spine) and lumbar (lower spine) regions of the spine where the upper back curves slightly backwards and the lower back slightly forward. It’s all about balance. To be more technical, ideal, neutral alignment standing is when the ears, shoulders, hips, knees, and ankles align as if a plumb line were run from top to bottom along the lateral aspect of your structure. In an anterior and posterior view, the plumb line should also go through the body’s center of gravity which is the hypothetical point around which the force of gravity runs through to the ground. Ideally in standing, the body’s COG is located in front of the sacrum bone, at about the second sacral level or 2 inches below the navel. This is considered the neutral position because when the COG is located here in standing, the body is able to hold its posture without stressing the joints, muscles, and bones. What it really means is that the weight of the body is held by the bones and connective tissue and not by the muscles.
When the body is aligned over its COG, gravity will assist us in our posture and movements rather than being a stimulus to the muscles and tendons to alter their tension. Therefore, the second step to changing your posture and the way you walk is to learn how to use the power of gravity to your advantage rather than have it work against you.
Using a mirror is helpful. For standing, check where your COG is located by placing the tip of your index finger just above your navel. The height of your COG is three finger widths or about two inches below that point. Move your index finger of one hand to that point and then using your other index finger, trace a line around one side of your torso at the same height until you come to the midpoint of your back. Your COG standing is midway between your two index fingers.
To evaluate your COG standing further, inspect whether your navel falls equally between both feet or is shifted more to the right or left foot. It has been my experience that with a right handed person, the COG will have shifted more to the right and vice versa with a left handed person. Also, inspect to see if your navel is pointed straight ahead or turned to the right or left.
When sitting, learning the position of your COG is important too especially with all the negative information related to sitting. The COG is no longer two inches below the navel as in standing, but is located higher due to the fact your legs do not enter into the picture. Locate your seated COG by running a finger down your sternum (the flat bone in the center of your chest in which ribs are attached) until you encounter soft tissue. This is where the sternum ends and is closely positioned to your seated COG. Of course, it is located deep inside your chest cavity. Again, if you place your index finger on this spot and run the other index finger around your chest until it reaches the spine at the same height, a line running directly from front to back through these points is your seated COG. Again, you can use a mirror and inspect if your COG is perpendicular with the surface you are sitting on or has shifted to the right or left as we did with standing. Also, check to see if your navel and even your rib cage is turned to the right or left.
Come to realize that if one is standing or sitting in neutral position through their ideal center of gravity, the shoulder and pelvic girdles will be parallel with the floor. The head will be vertical without any lean or rotation. The body is then able to be symmetrical to the naked eye. However, I must let you know that the body is not perfectly symmetrical even if you are over your COG. That is just the way we are designed. But the more symmetry you see, the better the posture.
Imagine the structure of a house whose weight is carried down from the rafters to the side and supporting walls, then straight down to the foundation. A house that leans puts uneven stress over certain walls causing the risk of collapse. It is the same with the human skeletal structure. When the human structure is in a neutral position, the skeletal structure is parallel and perpendicular with the ground or the surface one is sitting on.
Good neutral posture in standing and sitting, promotes ideal breathing, circulation, and balance. Improper posture can lead to general discomfort, long term damage, and even deformities to the joints and spine of our skeletal structure.
Walking correctly is also a full body experience. If we move well while walking, the front and back of the body are equally broad and open, the legs are rooted equally to the ground as the head is lifting up to the sky, lengthening the skeleton and creating space in the joints. The lateral aspect or sides of the body are involved too because the arms are moving in all planes. The opposite arm and leg are always moving at the same time which creates a gentle rotation through the spine and your COG which is moving energy endlessly up and down the body in a spiral. When we do this while walking, everything starts to flow much more easily and we use gravity and ground reaction force to our mechanical advantage.
To begin walking correctly, imagine your bones are stacked evenly on top of one another. Your ears, shoulders, hips, and ankles would all follow a straight line down the body. Instead, most of us have our calves fall backwards and our thighs sink forward, our lower back overarches, our upper back rounds toward the back, and our head juts forward. This is not using gravity as our ally, but rather it becomes our nemesis. Something to overcome. When we find the whole body working together through its COG as it should, these imbalances begin to disappear. There are many different techniques to use when trying to walk correctly, but I will use a three point plan to help you get with the flow of gravity rather than working against it.
• First, imagine a string is pulling you up from the back of the neck that will extend your spine up towards the sky. The string should lengthen your back and soften the front while relaxing the throat and softening the belly. This lengthening up should allow you to feel space between the bones and joints of your skeletal structure.
•Think of another string pulling you back from the base of the ribcage. Your breathing should engage the back of your body as well as the front and sides; try to breathe into the middle or upper back. Visualize that you are walking backwards as much as forwards, balancing all sides of the body.
•Align your pelvic girdle on top of your legs and keep them that way. We tend to let the legs rather than the trunk lead the way. Actually, visualize that your COG is leading the way. When one leg is forward of your pelvis, the other one should be an equal distance behind it.
Walking is the best way to bring permanent change to the body because we were designed to walk. Also it is an activity that most of us do routinely on a daily basis. And when we do it, we do it over and over and over again. The human body and its nervous system will accept any pattern you put into it whether the pattern is good or bad. This is how chronic injuries develop out of seemingly innocent or unknown events. The injuries become chronic because the body adapts a new movement pattern due to unconscious compensations. Learning to walk or actually relearning to walk allows you to put a different imprint on your nervous system to move in the direction that is more neutral and natural.
If you have a good walking pattern and decent posture then everything is good. Your breathing becomes improved, your circulation improves, your nerve energy improves, you are just going to be happier about life. Everything works together when you have good posture and a walking pattern. If you walk, stand, and sit well, you are going to minimize the wear and tear on your skeletal structure. You’ll minimize the likelihood of chronic injuries and the likelihood of poor conditioned patterns. You won’t do as much compensation resulting in the imbalance of muscle and connective tissue tension. You will then be able to use your body to its potential.
So now is the time to make changes in your posture and walking. No matter your age, it is never to late to change. Age is just an excuse.