To coax the most out of the human body during training or actual performance, there are certain principles, or building blocks that must be present. Good breathing, proper nutrition, hydration and intensity are just a few of these principles. But, at the top of the list is good posture.
Proper posture extends performance, reduces injury, speeds healing, builds more muscle and increases efficiency. Good posture also releases more energy to the primary muscles of the task at hand by not having to engage “secondary” postural muscles.
What is Good Posture?
For the purpose of this article, the focus will be on postural alignment from the side. Normal, neutral posture is present when a plumb line passes through five anatomical landmarks: Center of the ear, center of the shoulder, greater trochanter, center of the knee and just in front of the ankle.
This is illustrated in the picture on the left. Notice how straight the black plumb line is.
The most common abnormal posture profile is illustrated on the right. The head sits forward of the shoulders, the upper back has drifted backward and the pelvis has tipped forward. This is commonly known as Forward Head Posture (FHP). Notice the straight plumb line we expect to see in good posture now has a substantial curve in FHP. It’s been estimated that 80% of the general population has varying degrees of FHP.
Why Forward Head
Posture Is Detrimental to Athletic Performance
First and foremost, FHP places an abnormal stress on every core muscle. For example, in FHP the pelvis tips forward, causing the hamstrings in back to stretch and pre-load. This tilting also causes the Quads in front to shorten and become weak. Here’s an illustration of that.
The hamstring muscles attach to the bottom of the pelvis, the ischial tuberosity. The Quads attach to the front of the pelvis.
When the pelvis tilts forward in Forward Head Posture, it causes the hamstrings to stretch and the quads to shorten. Physiology of the body tells us that a muscle that is stretched and held in that position for a long period of time becomes weak (Stretch Weakness). Conversely, a muscle that is shortened and held in that position also becomes weak (Short Weakness). Having these two things happen to antagonistic muscle groups is quite detrimental to performance.
If one only focused on the effects of FHP on the hamstrings and quads, the need to identify FHP in the athlete becomes apparent. However, due to compensatory changes in the spine and other areas, these kinds of muscle changes occur up the entire kinetic chain, causing compromises in the integrity of the low back, changes in breathing, changes in shoulder positioning, range of motion deficiencies, and instability of the neck motor unit. As far as the professional athlete and weekend warrior is concerned, there is nothing good about bad posture.
The Posture Reprogramming SystemTM
Forward Head Posture can be corrected. Recognizing FHP is the first step in correction. While a quick visual check to see if the head is resting over or in front of the shoulder can provide a visual clue of the presence of FHP, it cannot quantify the full extent of the problem and it can’t be used to track progress. To do that, you need a method of capturing and measuring posture. The Posture Reprogramming SystemTM developed by the author utilizes a software program called Posture ProTM to analyze static posture and to track progress over time. By capturing digital images of static posture and using the Posture Pro software to plot screen coordinates that represent anatomical landmarks known to be either level or plumb in neutral posture, the operator can establish baseline posture. Future exams can then track progress by comparing to the baseline values. Posture Pro has several methods of tracking progress. One of the most effective methods is to create a plot graph of all the exams.
Yes, You Can Change Posture in as Little as Four Weeks
The author has found the profession’s biggest hesitation to focus on posture is the lack of posture correction education, either in or out of school. For the past ten years, thousands of doctors of chiropractic around the world have been changing posture using a three-fold approach. First, is spinal mobilization. This is a general spinal manipulation of the spine and pelvis to ensure joint mobility in advance of the changes about to happen in the muscles. Second is the patient performing a specific set of exercises and stretches to target the muscles involved in FHP. These maneuvers were developed by John Christman, Ph.D., and refined by the author. The third protocol is the prescription of a set of Posture BlocksTM (Patent Pending). These foam cushion shapes are designed to use the weight of the body, the pull of Gravity and the resistance of the foam to stretch and relax different areas of the FHP target area. Using spinal mobilization techniques, specific muscle stretches and exercises and utilizing a special therapeutic cushion at home, the muscles attached to the pelvis, shoulders, spine and head can be reprogrammed back to their original neutral positions. In a healthy, motivated person, this can mean a return to neutral posture in about four weeks.
Reimbursement for Posture Reprogramming
Although there is an ICD-10 code for Abnormal Posture (R29.3), third-party reimbursement for abnormal posture is rare and is generally considered an out of network service. Most insurance companies will allow its use as a compound or complicating code. This essentially means that Posture Reprogramming is a cash-based service. The fee is based on the results of the posture exam. The Posture Pro software will generate a Posture NumberTM, which is the accumulation of deviations from normal. The general fee guideline is $50 for every Posture Number unit of deviation. For the average patient, that would be in the $500-$1,000 range for the Posture Reprogramming.
Using the Posture Reprogramming System, a doctor of chiropractic can market this service to health clubs and high school, college or professional sports departments, as well as private athletes, as a method of performance screening and enhancement.
Joseph Ventura D.C. is the owner of VenturaDesigns a private company specializing in Chiropractic Consulting services and software development, He is the developer of the Posture Reprogramming System, His full bio can be found at www.posturepro.com/bio2.htm. He can be reached at