POSTURE AND WELL-BEING - ORGANIC DYSFUNCTIONS OF POSTURAL ORIGIN - SPORT-AND-HEALTH

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Posture and well-being

an ergonomic approach

Edited by Dr. Giovanni Chetta

Another problem arising from a muscle change, again due to a "postural alteration with non-physiological positioning of the pelvis, is the goose foot syndrome.

In particular, in the presence of valgus knee, our equilibrium system considers it more convenient that much of the stabilization work of the lower limb during walking, performed physiologically by the vastus medialis muscle, is carried out through the complex of the muscles of the paw d " goose (tailor that extra wheel, semitendinosus that inside wheel and puny which stabilizes the work of the first two). In this way the non-physiological work overload to which these muscles are subjected favors the onset of tendinopathy at the level of their common insertion (medial surface of the upper part of the tibia). In addition to pain, this syndrome naturally presupposes developmental load problems. unbalanced to the detriment of the whole lower limb and, in particular, of the knee.
Alterations in the position of the hips, intra or external femoral rotation, accompanied consequently by adduction or abduction of the femur, inevitably affect the knee. Here too, therefore, altered stresses and loads of all the components of the joint will be possible. Gonalgia, structural alterations of the knees in valgus or in varus, meniscopathies And gonarthrosis they are the most evident manifestations.

Organic dysfunctions of postural origin

To understand how the alterations of posture, therefore of the postural system seen in the previous chapter, can also affect the other organs of the body, it is necessary to introduce the concept of connective tissue or connective fascia. The connective tissue is actually a real second skeleton, this time fibrous, which connects all the various parts of our body. The connective fascia forms a ubiquitous network that envelops, supports and connects all the functional units of the body, participating in an important way in the general metabolism. The physiological importance of this tissue is actually greater than what is normally supposed. It constitutes about 16% of the body weight and takes part in the regulation of the acid-base balance, of the hydrosaline metabolism, of the electrical and osmotic balance, of the blood circulation (in particular venous) and nerve conduction (it covers and forms the supporting structure of the nerves and is home to numerous sensory receptors, including exteroceptors and nervous proprioceptors), thus assuming a fundamental role also within the balance system (tonic postural system). Through the connective fascia the muscles are structured and function like muscle chains. In conclusion, the connective tissue is a sure protagonist in the determination of the individual posture.
It is now easy to imagine how malpositions of the various parts of our body are able to create both physical and physiological tensions in the organs concerned.
Thus, for example, an incorrect positioning of the pelvis may cause difficulties for all the organs contained therein with consequent potentials urological, gynecological and visceral problems. In this regard, urethritis, caused by stasis of urine in abnormal loops of the ureters, and incontinence problems, resulting from the abnormal positioning of the bladder, have already been demonstrated.
Not only that, "excessive lumbar hyperlordosis can physically hinder the child's escape during childbirth. The child, in fact, in this situation, will easily find the pubic symphysis on the road, that is the skeletal part placed in the center of the lower pelvis of the mother, instead of the way out. These are, for example, the cases in which childbirth is facilitated if the mother is positioned curled up on her side (thus eliminating lumbar hyperlordosis).
Further dysfunctions may derive, as we have seen in the previous chapter, from the narrowing of the vertebral conjugation hole (intervertebral hole), due to vertebral misalignment, associated with muscle contraction and retraction (in particular of the deep paravertebral muscles), with consequent damage to the neurovegetative fibers and spinal nerves that directly or indirectly affect the thoracic, abdominal and pelvic organs.
Tensions, contractures and retractions in the cervico-dorsal and cervical muscles (in particular in the suboccipital area), often associated with postural and stomatognathic (and stress) problems, favor the onset of headaches, nausea, eye pain and loss of vision, dental pain, tinnitus, balance problems, memory problems, concentration and premature brain aging. These muscles, in fact, in addition to interfering with the cervical spinal nerves (directly or indirectly through the vertebral misalignment and the consequent narrowing of the conjugation hole), are able to create circulatory problems, in particular to the detriment of the vertebral artery (which crosses the transverse processes of the cervical vertebrae), and irritative. Regarding the latter, it is necessary to consider that the trapezius and sternocleidomastoid muscles are the only postural muscles to have cranial innervation, through the XI cranial nerve (spinal accessory nerve), whose irritation it is able to radiate pain in different parts of the head. A further irritative spine, this time at the meningeal level, is represented by the small inferior rectus muscle (small muscle of the suboccipital area which is inserted between the first cervical vertebra and the base of the skull) which is close contact with the dura mater and is capable of triggering headaches. It is also now established c h the nuclei of the V cranial nerve, trigeminal (mainly sensory nerve), affect up to the II-III cervical vertebra.
Finally, a hypertonus of the masseter, sternocleidomastiodeus and posterior belly of the digastric muscles is able to counter-rotate the temporal bones, hence the vestibular organs contained in them, causing functional uncoordination, thus contributing to the onset of labyrinthine dysfunctions.

Despite all this, the neck, a crucial area for the well-being of the entire organism (just think that it is through this "bottleneck" that the nourishment of our brain passes), is probably the most negligent (and stupidly) part of the body. neglected and abused by the lifestyle "imposed" by modern society.
Poor posture can result in poorly physiological breathing with consequent alteration of the respiratory muscles and in particular of the diaphragm muscle, which being in close contact with the vital organs of the abdomen and thorax conditions its physiology. Also a retracting diaphragm will favor circulatory problems, given its fundamental role as a pump for blood return through the action of pressure-depression on the thoracic and abdominal organs, and lumbar hyperlordosis, given its insertions on the lumbar spine.

With regard to circulatory problems of body fluids in the lower limbs, in particular, it is necessary to consider the presence of the vascular and nerve node located at the level of the medial malleolus of the ankle. This node is crucial for venous return but often, being subjected to tensions due to postural imbalances (foot resting in eversion), it is unable to physiologically perform its function. To this it should be added that an incorrect posture involves, as we have already seen, a non-physiological winding-unwinding of the foot during the step, therefore a possible propulsive thrust of insufficient venous circulation. During walking, in fact, the foot (Lejars' venous sole), the ankle and the calf form an "anatomical-functional unit that acts as a" peripheral heart ". Furthermore, it is necessary to remember the importance of the connective fascia in terms of circulation. Retractions and adhesions of the fascia result in circulatory obstacles.
The consequences of all this can be edema due to circulatory stasis, a sense of fatigue and restlessness of the lower limbs, varicose veins (varices), lymphoedema, phlebitis etc..
In reality, as the studies and research of posturology proceed, the problems related to posture appear more and more numerous. These, in addition to the purely physical and organic sphere, inevitably affect the psychic sphere as well. After the birth of psychoneuroendocrinoimmunology, that is the science that has objectively demonstrated the close integration of all the systems of our body, including the mind, it is no longer possible to deny the great influence that a certain posture can have in the psychic sphere of the individual. and viceversa.
Proprioception, self-awareness, derives from information from sensory receptors located in the tendons, muscles, joints and viscera, in the skin, in the vestibular system and in the eyes. The awareness of our "conformation" and spatial position depends on them; to some extent, to answer the question "who am I?", we must also answer the question "where am I?". Actions and movements play a central role in the processes of mental representation, starting from the embryonic stage. The embryo, in fact, is first and foremost a motor organism. In the embryonic, fetal and early childhood phases, action precedes sensation: reflex movements are performed and then they are perceived. The motor functions and the body, considered in many cultures as inferior entities and subordinate to cognitive activities and the mind, are instead at the origin of those abstract behaviors we are proud of, including the very language that forms our mind and our thoughts. Losing control over one's body means, consequently, losing control over one's thoughts and emotions. At the same time, the stress, and more precisely the negative stress or distress, raging in the "civilized" world always carries with it, well layered in the our unconscious, the atavistic survival instinct. The fight and / or escape remain the objectives of the physiological response to stress with the consequent muscular tensions in the limbs, shoulders, back, jaws, as tools that best perform this task. Such tensions. if prolonged for a long time, as happens in situations of chronic stress, they involve various consequences for the whole organism, including postural ones. Changing the posture therefore also means affecting the psyche and vice versa and, even if this is a world yet to be discovered, postural re-education must, by force of circumstances, take this into account.
Finally, it is good to remember the existence of primary organic dysfunctions, ie of non-postural origin, but capable of secondary postural alterations (pathologies of sight, hearing, vestibule, stomatognathic, respiratory, gastrointestinal, neurological, autoimmune, important scars, etc. .). In this case, it will be necessary to give precedence to the related specialized care and treatments (pharmacological treatments, vestibular, visual re-education, etc.) in the postural re-education protocol. Hence the "importance of" an accurate and complete initial diagnosis.