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Blog Posting: 1-24-12
Dr. Jarrod L. Nichols, DC, CSCS
Advances in Posture Therapy
Addressing poor posture is a critical issue facing modern physical medicine. Postural abnormalities are common causes of pain and disability often overlooked and ignored by practitioners who treat patients suffering from acute and chronic musculoskeletal complaints. Despite the lack of formal education (within chiropractic, physical therapy and medical institutions) exclusively devoted to assessing and restoring normal posture most practicing doctors recognize the risks of poor posture and the benefits of good posture.
In order to recognize the characteristics of poor posture, one must first understand the aspects of good or normal posture. Fortunately, many researchers have discussed the significance of normal posture. A brief review of posture analysis follows. In the lateral view, normal postural alignment is defined as balance about a gravity line that passes through the external auditory meatus, acromioclavicular joints, greater trochanters and lateral malleoli. In the anterior view, normal posture is achieved when the body is divided into symmetrical halves with bisection of the following points: glabella, frenulum, episternal notch, xiphoid process, symphysis pubis, and a point midway between the medial malleoli. For the purpose of this article I will focus on perhaps the most important aspect of posture – the cervical spine.
The Forward Head Posture
Forward head posture is a clinical condition that has been recognized by numerous researchers as a significant factor in a variety of common musculoskeletal pain syndromes including but not limited to neck pain, tension-type headaches, migraine headaches and TMJ disorders. Unfortunately, the assessment of head posture in relation to the thorax and the subsequent analysis of the underlying skeletal geometry are topics that have been generally neglected in formal chiropractic, physical therapy and medical training despite the widespread deleterious effects abnormal posture has on our patients. The advent of posture-unfriendly devices such as smart phones, tablets, laptops and gaming systems combined with long work weeks and continually decreasing levels of physical activity cause us humans to be more prone to forward head posture now more than ever before – and our current health status validates it. Such a common multicultural problem warrants serious consideration and investigation into how we must adapt our treatment approach to reconcile this epidemic.
Clinical Interventions for the Forward Head Posture
As physical medicine continues to become more outcome- and evidence-based, doctors are beginning to take an honest look at the need to address postural abnormalities that may be the underlying cause of many common health concerns. Consequently, as the need for spinal curve correction increases so does the need for standardized therapy solutions that make it possible for doctors to achieve consistent, repeatable success.
Although various forms of spinal traction have existed for many years, based on the latest available research, it is clear that extension traction techniques have the best record of restoring normal spinal curves and are therefore becoming an integral part of clinical practice. Harrison (in 1981) was the first to use extension traction to restore the cervical lordosis. This represents the first therapy application in the literature demonstrating non-operative restoration of cervical lordosis. The pioneers of extension traction utilized therapy applications with and without a transverse load, many of which are still used in clinics today. Fortunately, recent technological advances have provided an opportunity to modernize and streamline extension traction.
The iTrac® extension traction therapy system manufactured by Pivotal Health Solutions utilizes modern hardware and software technology – merging time-tested spinal and postural research with an innovative therapy tool that enhances the modern office environment and provides patients a comfortable and effective solution to correct forward head posture and cervical hypolordosis.