Postural assessment: why isn't it so important?

Dr. Niccolò Ramponi explains why static postural analysis is much less useful than what you think

When we suffer from pain like the low back pain or the neck pain we are often subjected to one by the professional of the sector postural evaluation, in order to correlate any “wrong” postural attitudes to a possible source of pain. In fact, it is seen as the role of posture in the genesis of pain be a lot overestimated and how a static postural assessment is unable to answer our questions. Nor are there any “wrong” postures regardless. We talk about all this with Dr. Niccolò Ramponi, physiotherapist in Verona at FisioScience.

There static postural assessment represents the photograph of the posture of a subject in a given instant, in a given period of his life. We can observe the curvatures of the spine, the position of the head, shoulders and much more. But what we don’t consider is that our posture is different in every moment of our life. Not only that, even when we try to maintain the same posture it changes, unconsciously!

Posture changes

Our brain, in fact, makes continuous small changes for avoid the feeling of discomfort of a maintained posture. Think about it, do you think a soldier at attention is in a comfortable position? He is probably looking forward to relaxing and changing his posture. This is also the case at night, sleeping lying on the bed, when we move unconsciously to avoid putting weight on the very structures of the body. And it becomes a problem in people who cannot move as it leads to the development of pressure sores. All of this comes from gods Scientific studies made in recent years. One of these, carried out involving 353 people without symptoms and 83 people with back pain, evaluated the posture of the subjects in an upright position after movements in lumbar flexion, extension, lateral flexion and rotation.

The study showed that each time people stood up they had a slightly different posture compared to the one before the movement. And although the person was asked to return to the previous posture, even in subsequent attempts the standing posture changed! So, how useful can a static postural assessment be in a person who moves all day and will always adopt different postures?

Posture and pain

Another study measured the angle of the lumbar part of the back first in an upright position (static measurement) and then, in the same subject, throughout the 24 hours using sensors. What we have seen is that in the 24 hours people maintained a totally different posture from that measured in a moment when standing … So, do we really think it’s still that important to understand the person’s posture in a single moment? And subsequently, if we fail to correctly assess a postural alteration how can we think of correlating it to pain? And if each of us in a standing position assumes a different position each time, how can we think that a single static posture, among the thousands we assume, is somehow the cause of that pain? Probably this alone is enough to close the chapter of static postural assessments!

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