Muscles are NOT decision-makers. They are a response team.
Last week a client came in for an Initial Assessment. She’s a personal trainer and so she wasn’t surprised when during posture analysis I noted the right hip was higher than the left, and the right ribcage tipped down from ribs 10-12. She was aware; these posture issues were one of the reasons she’d come in, along with lower back pain. This posture dysfunction usually means the internal abdominal oblique on the side with the high hip is stuck in a shortened position. And it was very stiff. If you act like the muscle is the decision maker this is where you stop assessment. Massage out the tight spot and hope for the best. That’s not where I stop. For more lasting results and real change, we need to know what these muscles are responding to.
Full History is a crucial part of assessment
The Initial Assessment has many parts. Further testing and a full history revealed another possibility for what was causing this client’s torqued ribcage. Scar tissue around a rib on the left side that she’d broken in high school was adhering the ribs together and reducing her capacity to breathe. So why were the muscles on the right side so tight? The motor control center in the brain (the cerebellum) was using them to try to pull the ribs on the left side apart to make breathing easier. Breathing is a much higher priority than ‘good’ posture or some aches and pains in the low back. The muscles on the right side were just reacting, doing what the motor control center told them to do, trying to correct a bigger problem.
Posture doesn’t tell us everything we need to know
One more example from last week’s sessions. A client came in with a left shoulder persistently rolled forward (protracted). The front of the shoulder, in the pectoralis minor area, was very tender. But testing showed that the issue was not the shoulder. The back muscles in this client’s upper back were stuck short, extending it. It was a short section of muscle that was stuck so the upper back wasn’t visibly extended. And the tender chest muscle was following orders from the motor control center, trying ineffectively to correct his arched upper back with a shoulder movement.
In the upper back was a scar from a mole removal. These are deep scars that are often problematic. We released the scar and the shoulder moved back into a much more functional centrated position. Posture exercises to retract the shoulder would never have worked.
Posture Assessments
Releasing muscles that are painful rarely works as a long-term therapeutic strategy. Releasing muscles according to postural analysis works more often. However, when the typical solutions fail, don’t keep foam-rolling in the same spot, quit your endless stretching and do more analysis; take more history; test movement patterns and stability and investigate why. The answer is there in your body of evidence.
