Not Functional.Now before you think I am off my rocker, here is some food for thought, first mentioned to me by Dr. Eric Cobb (of Z-Health fame): How many of you actually hurt when doing absolutely nothing? Who hurts when just standing there or lying down?
People complain of shoulder pain when bench pressing, back pain after cleaning or yard work, or hip pain when sprinting, yet to this day, I have never had anyone come in and say to me "Hey Colin, when I stand really still and do not move at all, my knee hurts." It just does not happen.
Which is strange, because nearly every client that comes to me wanting to improve posture does this because he thinks that improving his posture will take his aches and pains. Or someone else wants to improve her posture because she thinks it will help her move or perform better. Man, if only my shoulder blades were pulled back a little bit more, I would be able to dunk a basketball, run a 4.3 40, and bench press twice my body weight!
The problem I have with "posture correction" training is there is no ideal posture. Yep, I went there - and this is corroborated by research. For example, in Stuart McGill's Low Back Disorder: Evidence Based Treatment and Prevention, McGill notes that there appears to be no ideal posture for sitting, and the best seated posture is actually a rotation through different ways of sitting. This ensures that the load of supporting the body's weight is shared among different tissues. On the other hand, a static posture loads the same tissues repetitively, which over time can lead to pain and so-called "wear and tear."
The other problem I have with actively trying to correct posture is that posture should be an unconscious event. The brain chooses the way it feels the most comfortable to stand or sit, and in order to change what is considered comfortable, movement patterns need to be changed. Trying to fix caveman tendencies by thrusting your chest out and pulling your shoulder blades back is simpy going to move feelings of tightness and irritation from the supraspinatus and shoulder to the rhomboids and neck.
Which brings me to my final point - I realize would just be a critic if I did not supply an alternative. Well, if people generally hurt when moving, whether it be lifting weights, performing in an athletic event, or simply doing some work around the house, then would it not make the most sense to fix movement patterns? To run a dynamic assessment instead of a static one? Now, which type of assessment is up to the person doing the assessing. There are a lot of viable options and practically all forms of movement can show one abnormality or another. A simple FABER or Thomas test takes 10 seconds and gives plenty of feedback on how well the hips are doing their job. Something a bit more advanced like gait assessment can be used to evaluate movement on the whole body level.
I am sure there are some people reading this that are thinking: "I just want better posture so I look better," which is fine. Once movement patterns improve, whether it be through dynamic joint mobility, strength training, corrective exercise, or (preferably) a combination of all three, posture will get better. The body likes to save energy, and with efficient, pain-free movement, posture corrects itself.
With that said, it amazes me that someone with back pain will see a doctor or therapist, only to have their range of motion on a few muscles tested and then receive a few static stretches to work out 'tight' muscles. A client will bring me a sheet of paper looking something like this:
Client: "Yeah, my doctor says to do this every morning when I wake up and before I go to bed at night and my back will stop hurting."Me: "So how is that working for you?"
Client: "Not very good."
It is no wonder that the US loses billions of dollars of productivity yearly to back pain.
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