Posture and well-being

Edited by Dr. Giovanni Chetta

an ergonomic approach

Premise
Posturology: study of posture
Flat ground and posture
Foot and posture
Musculoskeletal problems of postural origin
Organic dysfunctions of postural origin
Postural examination and re-education
Conclusion
Essential bibliography

Premise

This relationship stems from a "physiological research" work that started about 20 years ago. It contains concepts based both on scientific evidence and on personal daily clinical practice and in collaboration with various specialists, with whom I have had and still have the honor of being able to work, drawing from this an enormous teaching.
This work has the objective, on the one hand, of spreading as much as possible the importance of a good posture for the psycho-physical health of the individual, on the other, of stimulating reflections and comparisons among the "experts".

Posturology: study of posture

In physiatry, orthopedics, dentistry, gnathology, ophthalmology, angiology, etc. we are now constantly talking about posture. In fact, the studies of posture, thanks to technological innovations, have made great strides in recent years. Posture is increasingly implicated, as we will see later, in many musculoskeletal and organic problems.
Lapostura is the personalized adaptation of each individual to the physical, psychic and emotional environment; in other words, it is the way we react to gravity and communicate.
Posturology thus inevitably becomes a multidisciplinary science that embraces numerous branches of medicine and technology.

The balance is guaranteed by important physiological mechanisms to which the vestibular functions (labyrinth), cerebellum, reticular formation, visual receptors and, to a lesser extent, auditory, touch and pressure exteroceptors contribute mainly, in addition to the cerebral cortex. (of the soles of the feet in particular) and of the proprioceptors of joint capsules, tendons, muscles and viscera (enteroreceptors) Furthermore, recent studies seem to confirm that renal baroreceptors may also play an important role.
Any cause capable of modifying the equilibrium, wherever placed along the cephalo-podalic axis, will have immediate reflexes, transmitted ascending or descending along the muscle chains, on all the other body segments, modifying them with rotations and / or translations of compensation. It is evident that any force (thrust, traction, rotation, etc.) acting on the cybernetic system "man", will have in response an attitude of compensation that will spread in a centrifugal direction, from the point of application of the force towards the surrounding body districts, up to affect the whole organism. This response, during its journey, dividing itself into a series of compensation systems and subsystems, will leave the sign, positive or not, of its action in the various body regions. Thus a reprogramming of the postural system and of the balance takes place which involves changes in the main afferent pathways, both physiological and, after a certain period of time, even anatomical.
Over time, all this affects proprioception with significant influences on "balance, therefore on posture. These" alterations ", in fact, are fixed at the cortical level, at various levels, through corpuscular biochemical memories (acetylcholine, noradrenaline, apomorphine, calcium ions and potassium etc.) which then become anatomical due to real contact between neurons (gap-junctions), both at the level of the central and peripheral nervous system; therefore, the function governs the structure. This phenomenon is called motor engram and represents the "set of motor experiences memorized by the individual as programming activating the feed-forward (anticipatory) system responsible for direct neuro-motor activation. The more we repeat, consciously or unconsciously, these gestures. programmed motors, the more we will reinforce, like neuroassociative conditioning, that motor engram. Based on the triggering force, the resulting motor dynamics may be in the physiological context or outside it. In the latter case, where the system is not able to cushion the compensatory thrust, the pathology can arise or lurk over time.
Postural errors, even modest ones, over time can cause first discomfort and then pathologies: overloads with consequent joint degeneration (arthrosis, meniscopathies, etc.), stiffening and degeneration of elastic tissues (tendinopathies, myopathies, etc.), entrapment of the nerves, respiratory blockages, digestive disorders, poor circulation, balance problems etc.
Task of posturology it is the restoration of correct motor gestures, in static and walking, reprogramming the postural tonic system in a physiological context, necessarily through an intervention and a personalized multidisciplinary program.

Flat ground and posture

"The flat terrain is an" invention of the architects. It is "suitable for machines, not for human needs (...) If modern man is forced to walk on the flat surface of asphalt and pavements (...) he is alienated from his natural and primordial contact with the earth. A crucial part of his being atrophies and the consequences are catastrophic for his psyche, for his balance and for the well-being of his whole person "Friedensreich Hundertwasser (Viennese architect, painter and philosopher), 1991.

Man is the only mammal to have conquered bipodalism; this condition that has allowed him the primacy among living beings: in fact the migration of the masticatory muscles in the caudal direction, has made possible the cranial expansion (no longer harnessed by the chewing muscles), therefore the development of the cerebral cortex.
The infant, thanks to the extensor muscle development, assumes the seated position and subsequently the erect position at 4 months. At about twelve months of life there is a gradual transition to bipodalism. The formation and growth of the musculoskeletal system are mostly the result of the complex and personal antigravity action of the individual. Unlike all other quadrupedal mammals, which stand and walk correctly shortly after birth, humans have to wait about 6 years to obtain a stable posture. At the age of 5-6, in fact, they they form and stabilize the vertebral curves and this happens thanks to the external proprioceptive maturation of the foot which is therefore the first responsible for the modifications of the vertebral curves in an upright position. The physiological lumbar lordosis is formed and stabilized starting from the formation of a physiological and stable plantar vault that frees the cephalic trunk from a state of hypertonicity, thus also determining dorsal kyphosis and cervical lordosis. The complete development of the postural function (postural tonic system) usually takes place around the age of eleven and then remains stable until the age of 65.

Our musculoskeletal system and our postural control system have evolved over millions of years to allow us to better adapt to the natural terrain, which is uneven. The cutaneous exteroceptors and the proprioceptors of the foot, as the only fixed point of relationship of our equilibrium system with the external environment, are of enormous importance in determining posture, and therefore in our musculoskeletal development.

Modern phylogenetic studies show that humans do not adapt to flat terrain. Given the enormous complexity, our organism functions as a cybernetic system, that is, a system capable of self-regulating, self-adapting and self-programming. On the basis of the information received moment by moment from the external and internal environment, he constantly tries to best pursue the goal of homeostasis (condition of dynamic equilibrium of the organism). Although it represents the cybernetic system par excellence, it encounters, like all systems of this type, an adjustment / programming error tending to infinity the more the input variables tend to zero and vice versa. In other words, the more the information environments that our body receives are numerous and diverse, the more it is able to pursue a fine and correct regulation of its functioning.
It is easy to realize that the input variables on flat terrain are significantly lower than those received by living on natural terrain. Consequently, the postural error on flat ground will be much greater than that made on uneven ground.
We can therefore consider the flat ground as a huge one environmental pollution; its negative influences on our health are indeed considerable. It is a fact that among peoples who still live in natural conditions (barefoot on uneven ground), such as some African or Mexican populations, back pain and neck pain are unknown and the teeth are usually well aligned. .
What the brilliant French physiotherapist Francoise Mezieres had guessed, before the advent of postural analyzes with specific and modern electronic devices, has been fully confirmed by the latter:"The" lumbar hyperlordosis is always primary ".