If you’ve been following this thread of questions you’ll know this is the last of the 3 questions:
o What is the effect of postural advice?
o What does it mean for the therapist/trainer?
o What does it mean for the patient/client?
I think the reason the ‘posture’ question has become such a problem issue is for two main reasons. First, ‘poor posture’ is very common for many reasons…desk jobs, poor training, etc and secondly because there is just so much information out there about it. It’s an easy target for blame when someone is diagnosing pain, it’s easy to spot and hard fo r anyone to deny. However, if someone has no pain one day and pain the next is it really logical to blame the whole thing on posture! I’m not denying it could be a pre-disposing factor, but it certainly isn’t the whole picture.
When a doctor, therapist or trainer pins the blame on posture, it leaves the patient/client in a difficult position, because the quick and easy blame game isn’t matched by an appropriately easy strategy for helping reduce the postures impact!! Sometimes the patient is only given the information about how bad their posture is, which is a problem, because they will be left to find strategies for themselves via media, friends, internet, etc. This often results in poor strategies because the patient is finding generically good postures and not an individualised solution to their problem. The other common alternative is that the paient is given a barrage of posture ‘cues’ as discusssed previously, which come with lots of problems…see the blog post ‘What is the effect of postural advice?’ for more on this.
As I have said before patients often come into the clinic and tell me how bad their posture is, usually because they have been told that by friends, relatives or a health professional. This is a tough situation because you are now battling against this previous advice as they are now consciously thinking about how they should be sitting and often they get obsessed by this and can’t let it go. This is bad news from the patient’s perspective, because it can get very confusing for them…what advice should you follow? It is only my perspective, but following the strategies in the last blog post ‘Posture: What does it mean for the therapist/trainer?’ you can start to break down the confusion and build a management strategy for their problem that gives them control.
Though I believe 100% in the strategies discussed for helping a ptients posture, I would still ensure that I followed my initial strategies, which are the timing and amount of advice given. This might be even more important if you are trying to ‘undo’ their current conscious strategies. Don’t go steaming in there and tell them what they are doing is all wrong…it’ll just cause a conflict within them and that is a battle you will never win!! From the patient point of view you want to gradually start introducing the new strategies to avoid further confusion and if you can, use the old strategies to your advantage, for example, if they recognise they are in poor posture it’s time to employ your movement/exercise strategy. This causes less confusion and will inevitably help speed up the process of ‘converting’ to subconscious strategies for improving their posture.
Once you have got the ball rolling at the right time and the right speed the momentum will start to gather pretty quickly. In conjunction with your other manual therapy and exercise therapy strategies they will begin to notice the difference…confidence in the strategies will increase and you are well on your way.
One of the main disadvantage of the traditional postural advice is that it tends to focus the patient on their pain…this is something you really want to avoid. The strategies I have outlined help to avoid this by simply using a recognition of poor posture as the cue to employ an exercise/movement strategy, which you have designed specifically to assist their problem.
Our Assess and Solve 2 day course will help with going deeper into these assessment strategies and solutions.
For a more comprehensive understanding of the strategies you might find the Diploma in Functional Therapy an interesting way to further explore these and many other therapy strategies.
Thanks for your time, please leave any questions or comments, I will always answer the best I can.