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2018-08-25
Orthotics and Posture

Today we will chat on little debatable issue which is Posture and orthotics. How orthotics influences postural change?

We have already covered effects of poor posture and how to correct poor posture. Please click the link below to read previous blog on posture

https://www.kitchenerphysiotherapy.com/blog/How-to-improve-posture

Today with this blog we are analyzing the examination on whether orthotics influence spinal arrangement? How orthotics influence the components that control posture? And does orthotics helps to improve posture?

Let start with quotes and research

Roger Sperry, Ph.D. (Nobel Prize in Physiology and Medicine 1981) is quoted as describing that 90% of the brain’s activity is used to balance your body against the effects of gravity.

“Posture affects and moderates every physiologic function from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse and lung capacity are among the functions most easily influenced by posture.” American Journal of Pain Management 1994, 4:36-39

My question today is does Spinal Alignment = Posture?

Let me tell you Spinal Alignment is structural model and static while Posture is dynamic model and functional. Thus Dynamic model have influence on static model and vice versa

Hence it’s very important to examine dynamic model with static model.

There are num,ber of researches which says orthotics does not affect spinal alignment or kinematics of spinal alignment and similarly there other research which says orthotics affects kinetics not kinematics. Let’s understand this words.

Kinematics depict the investigation of movement without thought to the reason for the movement. Kinetics depicts the investigation of movement and it's causes, including torque (snapshots of power).Kinetics are crucial to understanding orthotics and posture because it takes into account the proprioceptive and muscular component of posture.

How orthotics may impact posture

What the vast majority don't yet comprehend is that orthotics affect muscle tuning, which isn't just basic to posture yet in addition how we absorb shocks. Our brain is fed information about impact forces and our body responds by activating (tuning) muscle groups to minimize soft tissue vibrations.

These delicate tissue vibrations are the reason for injury, as depicted by a scope of creators counting Dupuis and Jansen, 1981and Wakeling et. Al., 20021

Orthotics reduced vibration via muscle tuning, and therefore reduce injury. Muscle tuning seems, by all accounts, to be the body's reaction to foreseen development and the remedy to what is really happening. The internal muscle tuning contribution to shock absorption is even more important than the external effect of footwear and the type of surface.

In the context of muscle tuning, Nigg1 concludes that “the inserts/orthotics increased muscle activity in most cases.”

What does muscle tuning in the lower leg have to do with posture? Which muscle is the most active during quiet standing (which still involves micro-movements)? Soleus, a slow-twitch muscles that is key to quiet posture and gait. It is directly involved in how the body manages the center of gravity (aka center of pressure or center of mass) and posture. Therefore, what happens in the lower leg is directly related to posture.Nigg summarized research and concluded that orthotics have a minimal and inconsistent effect on kinematics, yet still have a positive therapeutic effect. The dominant theory surrounding themechanism for orthotics positive benefits is the measured amplification of the muscle tuning via proprioceptive stimulation.

Treatment to enhance posture should begin with adjusting and making new proprioceptive input, which will produce a new muscular pattern.
The proprioceptive input should also include foot, since the most dynamic muscles group in postural control is in the lower leg.

Hence I feel Treatments to improve posture should be multidisciplinary approach which should involve orthotics with other therapies like

  • Manual therapy: manipulations, adjustments • Strengthening • Stretching • Pilates • Feldenkrais • Alexander technique • Posture braces etc.

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