Posture in Action by gdf57j


									Acture!                                      Posture in Action

                                                                       B y     T h o m a s   M y e r s

42   M A S S A G E & B O DY WO R K • O C T O B E R / N O V E M B E R 2 0 0 6
      he word posture, which comes from the                        posture toward Iran is evolving,” meaning attitude.
      Latin placement, is used to describe how                     But for those of us in the massage and bodywork
      we stand in space, and it is a good enough                   trade, especially those who wish to, or claim to,
word for common use: “His sunken posture                           change posture for the better, the term will not
conveys defeat.” Or for metaphoric use: “Our                       stand up to close examination.

   What we commonly call posture is instead a pattern
of movement. Moshe Feldenkrais coined the word
acture to describe posture in action (see Figure 2, page
44). First, standing or sitting still is, in fact, an action,
and we are never placed in stillness; we are always
moving, shifting, balancing, adapting—even in the
stillness of meditation. It’s in our nature; the utter
stillness of an actual posture will always be denied us
while we still breathe. Your first posture will be the
one you die in. (And even then the inner movement
continues—read Mary Roach’s crazy/wonderful Stiff
[Norton, 2003]).
   Secondly, we never do it exactly the same way twice, as
we adapt to a particular seat, or shoes, or circumstance.
Thirdly, the range of our posture varies with the time of
day (we’re all shorter in the afternoon, for instance) and
our inner attitude (fear, eagerness, fatigue).1
   So we have a range that we move through—a postur-
al set if you will. That range is familiar to those who
know us. See a friend walking a couple of blocks down
the street, or see someone doing anything—shoveling,
on a swing, pulling on boots—and your brain’s move-
ment sense can create recognition and identify that
person without seeing her face or hearing her voice.
   (The brain’s sense of seeing movement was the first
form of vision to evolve. The visual senses of line,
form, and color we take for granted came later. Our
brains are very adept at differentiating various move-
ments, honed over millennia of hunting and being
hunted. This information even takes a different path-
way, down through the reptilian brain on its way to
the occipital lobe. You can often sense movement bet-
ter by watching with your peripheral vision: look at
something else and assess the client’s movement from
the corner of your eye.)
   So, I use acture—not a real word, but it should be
—because I think Moshe hit this nail on the head:
posture is always in action, and the characteristic
relationships among body parts are commonly main-
tained in all kinds of different movements and                  Figures 1A and 1B.These photos show substantial postur-
actions. Reaching into the neurology, physiology, and           al change from pre- to posttreatment (Rolfing, as it hap-
the fascial “stuckness” of these patterns is the job of         pens, but similar results are obtainable with different
those of us who labor in the vineyard of changing               methods), but what actually has changed? What is pos-
posture.2                                                       tural change and how does one measure it?

                                       O C T O B E R / N O V E M B E R 2 0 0 6 • M A S S A G E & B O DY WO R K         43

                                                     Length and alignment are the overarching
                                                                values that allow posture/acture to
                                                           become an active contribution to your
                                                                   health, rather than a strain on it.

                                                                                  small, highly innervated muscles, as
                                                                                  well as activating their partner the
                                                                                  anterior scalene, is essential busi-
                                                                                  ness for most of our clients in order
                                                                                  to get their head on straight.3

Figure 2. Moshe Feldenkrais coined                                                The Two Diaphragms
the term acture to designate the                                                     Secondly, we can look for reci-
underlying structural and functional                                              procity between the two abdominal
relationships recognizable in all                                                 diaphragms—the respiratory
movements.                                                                        diaphragm and pelvic diaphragm
                                                                                  (pelvic floor). In a relaxed and bal-
                                                                                  anced acture, the two diaphragms
   That said, let us look at a few of                                             face each other, like the top and bot-
the greatest hits (or call it Tom’s                                               tom of a beach ball, or the two
playlist) in the realm of actural                                                 hands in someone practicing tai chi
issues with which we commonly                                                     (see Figure 4). Commonly, in a
deal. Since this is a column, we will                                             swayback (lordotic) acture, the two
have to address them shortly, but                                                 diaphragms will both aim forward.
each is written about more fully in                                               In the less common flat back
books and other articles, which are                                               (flexed) pattern, the two diaphragms
referenced here.                                                                  can aim backward, again missing
                                                                                  each other. Sometimes the rib cage
Actural Issues                                                                    can be shifted forward or (more
Head Retraction                                                                   commonly for us Westerners) back-
   The first, most common, and                                                    ward relative to the pelvis, and these
perhaps the most damaging, actural                                                two diaphragms again lose their
pattern is head retraction, com-        Figure 3.You do not have to travel        reciprocity.
monly associated with Head              far or practice for long to see how          This loss has detrimental effects
Forward Posture, or HFP (see            common the forward head is—the            on breathing, of course, but also
Figure 3). Chronic contraction of       source for a host of problems.            multiple and nefarious effects on
the suboccipital muscles, which                                                   digestion and organ function in
pulls the back of the head toward                                                 the pelvis, causing congestion
the upper neck and back, creates          Correcting this pattern of chronic      around the kidneys and sexual
many postural problems, all of          and reflexive upper cervical hyper-       organs which then creates deleteri-
which relate to HFP. Though HFP         extension is a mainstay of the            ous long-term preconditions for
is often associated with fear (both     Alexander Technique and the focus         disease. The pelvis’s relation to the
the startle response and the            of sustained interest in both osteo-      legs and the rib cage’s relation to
Landau [extension, flight] reflex),     pathic and chiropractic approaches,       the shoulders figure into this equa-
such a pattern can also be caused       as well as the Rolf-evolved methods.      tion, but the primary actor in this
by poor vision, the desire to please,   Without length in this area, the          arena is what I call the four pillars
airway obstruction, back pressure       eyes lose their coordination to the       (a bad name as they are heavy fas-
issues, or malocclusion of the jaw,     spine, and our natural spring and         cial tensile strings not compressive
to name the more common causes.         grace are lost. Lengthening these         bony pillars, but you know how

nicknames stick). The pillars are
the two lateral raphées in back
(see Figure 5A), just lateral to the
erectors, where the abdominal fas-
ciae and the back fasciae meet, and
the longer strings of fascia in the
front in the abdominal fasciae, just
outside the edges of the rectus
abdominis (see Figure 5B). Getting
the balance of these four pillars
right goes a long way to ensure a
better balance between the respira-
tory diaphragm and the smaller
pelvic one.
   Getting these two diaphragms
balanced one over the other is also
a natural result of good Pilates
work, which strives to strengthen
and balance what we just called the
four pillars via very specific abdom-           Figures 5A and 5B. Balancing the respiratory and pelvic diaphragms rests on
inal exercises. But it’s not just a             a balance among the four pillars: the left and right lateral raphé in back and
matter of looks: when the organs                the ribs-to-pelvis strap that lies just outside the rectus abdominis in front.
are contained in a balanced way—a               Illustrations by John Hull Grundy. Used with permission.
balance of the back muscles, the
psoas complex, and the abdomi-                  organs and glands in the abdomino-        issues and all your lovely and
nals—breathing is supported, the                pelvic cavity are properly pressured      skilled work on the shoulders
                                                and tend to work better, and the          themselves will fail to sort out the
                                                lumbar spine is freed to support the      problems, because the shoulders
                                                heavy structures of the shoulders
                                                and head above.4
                                                                                                         What we
                                                Pelvic Balance
                                                   The third major issue—we are
                                                more or less moving down the body,
                                                                                                 commonly call
                                                since each of these issues is impor-
                                                tant—is getting the pelvic balance                   posture is a
                                                right relative to the feet and legs.
                                                   (“What a minute! If your sub-
                                                ject is posture and you’re moving
                                                                                                        pattern of
                                                down the body, how can you leave
                                                out shoulders? Lots of people                         movement.
                                                these days have terrible shoulder
                                                posture.” Yes, that’s true—so
                                                much driving and computer jock-
                                                eying leaves many shoulders weak          hang off the neck and rest on the
                                                and out of place, and thus prone          rib cage, so without these central
                                                to injury and dysfunction. But if         supports, the peripheral
                                                you solve the first two issues            appendage can’t work properly.)
                                                we’ve brought up—lengthening                In a human, the pelvis serves as
                                                the neck and balancing the                the steadying foundation for the
                                                abdominal balloon—75 percent of           spine and simultaneously as an
Figure 4.The diaphragmatic and                  those shoulder problems will just         upper girder for the movement of
pelvic floor slings should balance              melt away without a lot of manual         walking. This unique set of design
each other like the top and bottom              work. It works in reverse as              constraints makes the human pelvis
of a ball. Illustration by Andrew Mannie.       well—fail to address these core           a puzzling marvel of biological ¨


                                                                                  Ida Rolf asserted that the pelvis is
                                                                                  horizontal when the bottom of the
                                                                                  tailbone was level with the top of
                                                                                  the pubic bone (see Figure 6).6
                                                                                     Personally, I find these measure-
                                                                                  ments too geometric, with insuffi-
                                                                                  cient recognition of the variation
                                                                                  among humans and what might
                                                                                  work for different people.
                                                                                     So I offer the following test as
                                                                                  one I use that allows for individual
                                                                                  differences and does not try to fit
                                                                                  everyone into the same box. It
                                                                                  offers up some surprising results
                                                                                  sometimes—people you think look
                                                                                  anterior tilted turn out to be poste-
                                                                                  rior and vice versa.

                                                                                     Cup your hand and rest it ever
                                                                                  so gently on top of your client’s
                                                                                  head as she stands quietly, almost
                                                                                  resting in her hair, just barely
                                                                                  touching the head, so that you can
                                                                                  be very sensitive to changes in
                                                                                  head position. From her “normal”
                                                                                  have her tilt the pelvis slowly ante-
                                                                                  riorly, then back to normal, then
                                                                                  posteriorly and back to normal. ¨

Figure 6. Ida Rolf and Florence Kendall say the pelvis is horizontal when the         In a healthy body,
anterior superior iliac spine and the public bone are in the same frontal
plane—but is that geometric measure really the best we can do these days?           the organs are free
engineering and the object of study          Pelvis means bowl, and an anteri-
for osteopaths, chiropractors, ortho-     or tilt means hip flexion—the pubic
                                                                                     to move over each
pedists, and the wide variety of          bone going down, so that the milk
movement teachers. Each seems to          would spill from the front of the         other like well-oiled
have his own key or secret to prop-       bowl. This pattern is, of course,
er pelvic function, but there is as       associated with a swayback or lor-
yet no consensus on proper pelvic         dotic pattern of the lumbars. In a
                                                                                    balloons with every
balance in acture.                        posterior tilt, the milk would spill
   Pelvic tilt refers to the angle        out the back, as the hips are extend-   breath, and the spine
between the pelvis and the femur.         ed, the lumbars are flat, and the
Let us ignore right/left tilts for the    posterior iliac crest is lower than
moment, and all its concomitant           expected relative to the pubic bone.
                                                                                  is sprung into the air
complex issues of leg length, sacral         But how far, exactly? Various
shear, and the effects on the spine,      posture experts, notably Florence        like one of Kenneth
in order to concentrate for a             Peterson Kendall, have postulated
moment on anterior/posterior              that the ideal neutral for the pelvic
tilts—the rocking of the pelvis           tilt is to have the anterior superior
                                                                                    Snelson’s tensegrity
forward and back on the heads             iliac spine and the pubic bone in
of the femurs.                            the same vertical (frontal) plane.5                     structures.

   As much as possible, confine the
client’s movement to the pelvis. If                                                      The more human
the client is shifting her knees,
dropping the rib cage back, or
retracting the head, the test won’t                                                     use of the human
work as well—for this reason, this
test works better the freer and
more supple the person is. If the                                                         body is the great
client is truly rocking just the pelvis
back and forth slowly, you should
feel the head rising into your hands                                                       challenge of our
and then falling away.
   Where is the top of the arc? The
point where the pelvis is in the
best position is where the head is
highest into your hand. That’s why                                                       medicine, I call it.
you have to be very sensitive and
poise your hand carefully just on
the head—so that you can feel
changes in height measured in mil-
limeters. If the client’s head is at its                                           bad positioning, but what happens
highest at normal, then the pelvis                                                 to feet in our society is positively
is positioned best for them. If the                                                iniquitous. Shut up in leather
height increases as she moves into                                                 coffins all day, or bound tightly in
an anterior tilt—remember, isolat-                                                 mis-sized running shoes while we
ing the pelvic movement, leaving                                                   pound on them, our society’s feet,
the rest of the body at rest—then                                                  while not as deformed as Chinese
normal is too posteriorly tilted for                                               women’s of former times, verge on
her. If the client lengthens into                                                  the same set of problems. I am not
your hand as she tucks her tail                                                    advocating an atavistic devolution
under, then normal is too anterior-                                                when I say we need feet more like
ly tilted. Confirm your findings by                                                monkeys. We need prehensile feet.
having the client do it a few                                                      Partially I mean just what I say—
times—you are looking for the                                                      toes should be more mobile and
more consistent result.                                                            able. Ruthie Alon (a mega-move-
   This functional (rather than geo-                                               ment teacher from the Feldenkrais
metric) measure of pelvic position                                                 tradition) had us tearing up news-
works well for me in practice, and                                                 papers into small strips using only
can be quite surprising sometimes                                                  our toes. What agile feet I had
when you compare it to the normal                                                  after that! Toes are so jammed
                                           Figure 7.The spine—indeed the
visual cues we use. The test                                                       together and superfluous in our
                                           whole body—is like a tensegrity mast.
answers the question: in what                                                      culture. Bring back the toes! The
pelvic position is the spine freed to                                              yoga teacher Kali Ray can inter-
be at its longest? The spine living its    to move over each other like well-      lace her toes (all five)—without
full length is the higher value, not       oiled balloons with every breath,       the use of her fingers—in fact,
having the pelvic angle conforming         and the spine is sprung into the        while in a handstand (see Figure
to someone’s idea of good posture.7        air like one of Kenneth Snelson’s       8, page 52)! Just sits there and
   In general, spinal length is a          tensegrity structures.8 Proper (and     does it while talking about yoga
strong value in good acture. Even          personally adjusted) pelvic posi-       philosophy. No, I can’t.10
a minor collapse or shortening in          tion is essential to both these           But such prehensility can also
the spine, and/or in the organic           deeper goals.9                          extend into the arch. Some feet just
core that hangs from its front, can                                                go flat, while others have the arch
have deleterious long-term effects         Prehensile Feet                         supported by the mechanics of the
on health and well-being. In a               Finally, is the issue of feet.        shoe or extra arch supports.
healthy body, the organs are free          Shoulders may have ubiquitous           Neither are vital, active arches. To ¨


create great arches that offer suf-
ficient support for the superstruc-
ture above, there needs to be a
slight but active “feeling your
ground” in the tarsum of the foot.
   I definitely do not mean a
white-knuckled grip on the
ground with the toes—that’s not
healthy. In a proper posture, the
toes simply rest on the ground—
awake, but not tense. But in the
foot itself, a slight feeling of gath-
ering—as if there was another
yoga banda in the feet—in the
middle of the arch lends an alert-
ness and springiness to the arches,
and harkens back to when your
feet were your “ear to the ground”
as we walked over uneven and
variable surfaces, not cocooned in
synthetic materials cruising over
man-smoothed surfaces. Try it
with your hand—the slight feeling
of gripping in the palm as if test-
ing or hefting an orange—and
then try to get the same feeling
with your feet. Keeping that feel-
ing in your feet as you go about
your daily business is a good medi-
tation for those with “dead” feet.

Spatial Medicine                                    Figure 8.Yogini Kali Ray, founder of TriYoga, with toes intertwined.
    rom living feet to a lifted cra-
F   nium, we have hit the high
points of posture as I perceive them, thirty years (just                         Thomas Myers has practiced integrative bodywork for nearly thirty
                                                                              years. He teaches workshops internationally on anatomy, movement, and
getting started) into my practice. Length and alignment                       soft-tissue work. His book, Anatomy Trains: Myofascial Meridians for
are the overarching values that allow posture/acture to                       Manual and Movement Therapists, was published by Elsevier in 2001.
become an active contribution to your health, rather                          He lives, writes, and sails on the coast of Maine.
than a strain on it.
   The more human use of the human body is the great                          Notes
                                                                                   1.You can read more about the art of changing posture in the Anatomist’s Corner article on The
challenge of our time—spatial medicine, I call it. How                        Anatomy Trains recipe (Massage & Bodywork, June/July 2004, page 80) or—as a self-help project—in
                                                                              Mary Bond’s new book Heal Your Posture (Inner Traditions, 2006).
do we get body mechanics right for a headlong popu-                                2.You can read more about acture in Moshe Feldenkrais’s The Potent Self, page 108ff. (Frog Books,
lace in an urban environment? Bad posture/acture                              distributed by North Atlantic, 1985.)
                                                                                   3.You can read about the suboccipitals in detail in Massage & Bodywork, October/November
contributes a large share to human misery, and it is so                       2002, page 98.
                                                                                   4. You can read more about the reciprocity of the diaphragms in a couple of my Anatomist’s
unnecessary. How can we most easily transform it?                             Corner articles in Massage & Bodywork:August/September 2000 (“Cups and Domes”) and
We are all working on this one person at a time, and                          February/March 2003 (“The Plywood Principle”).
                                                                                   5. Muscles,Testing and Function, 3rd edition, Florence Peterson Kendall and Elizabeth Kendall
we all know how slowly that works.                                            McCreary,Williams & Wilkins Baltimore, 1983, page 25.
                                                                                   6. Ida Rolf, Rolfing (Rochester,VT: Inner Traditions, 1977), 102.
   In our next column (and our last column in this                                 7. Some issues in pelvic repositioning are dealt with in Anatomist’s Corner columns in the follow-
series, at least while I write my next book), we will look                    ing back issues of Massage & Bodywork: February/March 2001,April/May 2001, June/July 2001,
                                                                              August/September 2001 (all on the psoas and its friends), December/January 2003 (the femoral trian-
at what I have found to be the most effective and natu-                       gle), and June/July 2003 and August/September 2003 (on the deep lateral rotators).
                                                                                   8. Jean-Pierre Barral and Pierre Mercier, Visceral Manipulation (Seattle: Eastland Press, 1988).
ral way to build good posture—from the beginning. M B                    &
                                                                              Snelson’s versatile artwork is available online at
                                                                                   9.To learn more about the body as a tensegrity structure, read Body3, available from www.anato-
   (Author’s note: With the cooperation of Massage & Bodywork, I am , or go to,, or
                                                                     for great pictures and models.
publishing a collection of the Anatomist’s Corner articles, including those        10. Ruthy Alon, Mindful Spontaneity (Berkeley, CA: North Atlantic, 1996); for information on Kali
referenced herein. To find this collection, visit     Ray, visit


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