If you accept Newtonian physics you agree that, however else you may look at the human condition, the body functions as a machine insofar as it must balance.

If a body does not balance, it falls down. 

We balance unconsciously but, the use, and abuse, of the human body’s biomechanical elements results in breakdown over time. So, to retrain adaptive posture we must retrain how a body reflexively balances.

Adaptive postures cause mechanical stress, and although breakdown is not immediate, over time cumulative micro trauma leads to dysfunction and pain. Once the pain begins, people begin to notice, but by then the body has adapted.

Back pain and fatigue are common symptoms which finally bring a patient to see a chiropractor, and the effectiveness of chiropractic is attested to by the successful treatment of millions of people each year. In addition to the benefit of removing misalignments and other neurological effects of an adjustment, it takes less energy to keep a body upright against gravity when the parts are aligned. However, unless the chiropractor changes how the person uses their body, biomechanical problems stemming from adaptive posture habits commonly recur.

BALANCE (defined): The equilibrium resulting from the matching of torques, which can be organized in anticipation of (i.e. before), or as a reaction to (i.e. after), the effects of postural disturbance. Balasubramaniam and Wing, Dynamics of standing balance; Trends Cognitive Science 2002 Dec 1; 6(12): 531-536.

Posture exercises are exercises designed to decelerate and even reverse adaptive postural changes. Many problems chalked up to “the aging process” are more aptly described as what goes wrong over time. Being conscious of a problem is the first step to effect change. Posture can be strengthened with progressive, sequential posture exercises to retrain the neuromuscular system, especially targeting the intrinsic postural muscles.

It has been said that sitting is the 21^st century posture, but some say slouching is a better description of how many people spend their lives. Muscles work in pairs, and ideally should work in a balanced relationship. Strength, length and flexibility should be matched between paired muscles. However, when a muscle’s partner is too strong or too weak, too tight or too stretched, there will be greater joint stress as the body adapts to maintain balance.

Sitting keeps the hips in a flexed position. So, when a body spends most of it’s time sitting, hip flexor muscles such as the Psoas become chronically tight from the hip being constantly in a flexed position. At the same time, hip extensors such as the gluteus medius, maximus, minimus, and upper hamstring become adaptively weak. Besides the additional energy it now takes for the body to balance as the upper torso compensates, mechanical stress occurs.

The beginning of a posture re-education program is teaching a patient the ability to move their pelvis opposite the motion pattern of sitting hip flexion. Different posture re-education programs use a variety of names and techniques, but the core beginning motion pattern is a controlled posterior tilting of the pelvis. As with all sports, good form is the key to success. Ultimately, initiating a LifeHabit of controlled, standing pelvic tilts as part of a regular posture exercise program empowers the patient to keep their body moving, feeling and staying well with age.

Clinically, the challenge lies in cueing the patient to effectively move the pelvis without substituting adaptive motions such as bending the knees or flexing the thoracic spine. In a small office setting, a sequential protocol is the key to teaching patients efficiently and reproducibly. Trained members of an office team, including massage therapists and chiropractic assistants, can then assist in the patient’s posture exercise training. The team approach to posture exercise training also reinforces the message of strong posture, as well as the value of post-acute care.

Steven P. Weiniger, DC
Founder BodyZone.com

This article is the next in a series on integrating Managed Care, insurance, and personal pay in a practice treating patients for AcuteCare, RehabCare and WellnessCare. If you agree with the Patient Choice philosophy of care, and believe this is the intelligent path for our profession, I’d like to hear from you. Direct your email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .