Lets Talk About Posture: Where to Begin

Recently, a new patient came in to see me at the Pilates Garage in Brooklyn with a list of complaints about her posture. She had been to a specialist who had lined her up against a wall painted with a grid, and explained her postural faults relative to the lines.

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I am in pain, she told me, because my head is forward and my feet roll in.?Of course, on some level that is true, because postural faults do cause pain, but there are also so many things that trace back farther than forward head and rolled in feet- so many kinks in the spine and daily habits that cause the body to posture into a forward head or loss of integrity in the feet. ?And so, it can be hard to know where to start when communicating with someone who wants to change their posture.

I am reminded of a Pilates school that I trained at, where we were taught that if a client had one shoulder lifted, we should tell the client to pull it down, and if one hip was rotated forward, we should ask the client to pull it back. Following the notion that things should be stacked to look right, we had the client hold these fixed corrections while exercising, while not letting the body fall into certain habits or twists or turns. I believe a lot of people get hurt this way. I certainly did.?

During another recent Physical Therapy session, I was being shadowed by a young PT who was also a Pilates teacher. During the session, my patient told me that because his toes angle out when he walks, he purposefully pulls them inward when running.??Oh no no, don’t do that… I said.?The surprise on the observing PT's face had me surprised. Frankly, I was surprised that in 2023, we would still think that contorting a healthy -albeit crooked- body to look straight would be the same thing as correcting one’s own posture, or that holding oneself in a particular way makes movement any more efficient. Holding is quite different than moving, down to the muscles used and the direction of forces.?A holding posture, is what models do to appear more upright, or tone their abdominals, but an organic posture is something much different- it has to do with how to carry oneself in a way that doesn’t produce unnecessary strain or tension.

Posture doesn’t need to be intimidating, complex or overly corrective, but it needs to match a person’s internal experience, which takes communication between patient and practitioner.?One of the most amazing resources to help clarify a person’s own notion of how to best stand on his own feet, can come from the inside, through the sensations of the floor, the feedback of touch, and other methods of interoception- our ability to feel ourselves. Like a baby who is learning how to move, we are designed to adjust our own bodies in relation to the feedback of our own sensations. ?

The connection, the breath, the ease… these are all of the reasons why posture should matter to a person.?When the alignment in the body is good—call it chi, or circulation, or breath—the posture should make it easier to relax, to let go of unnecessary tension… not to have to hold on so tightly.