Especially the parents, seem to be tirelessly looking for someone who "improves" the posture of their children. At the same time, Physical Education professors are also increasing their awareness of maintaining good posture not only in sports, but also in in study and in life in general.
But why, on balance, is it necessary to evaluate the posture and dissect any compromises of the same?
For further information: Posture as paramorphisms and dysmorphisms (scoliosis, curved back, accentuated lordosis, flat or hollow foot, valgus or vare knees); at the origin, in fact, a central disorganization can be consolidated, disguised as a "lazy attitude", but in reality determined by a real incorrect posture - in one or more phases - and linked to "distant" organic causes.
Recognizing such pictures is not always easy, because often these problems apparently do not exist. It is sometimes difficult to explain certain pains (if not hypochondria), as well as the sensation of widespread malaise that cannot be traced back to apparent causes.
On the other hand, all these effects may belong to a bodily alteration of the postural system, subtly subtle and impossible to identify for a layman, but also for a doctor not specialized in the sector. It is therefore not surprising that certain unconventional medicines (in Italy) that frame the problem of the subject in a "global perspective - such as" Osteopathy, Traditional Chinese Medicine, Chiropractic, etc. - are often able to improve or resolve the matter.
Body structure and physiological functions can be mutually influenced, but this correlation is not always "superficial" or apparently "logical"; a "misplaced" tooth that causes bad occlusion, a lazy eye, an ENT problem affecting the eardrum or inner ear, a gastro-intestinal problem, a head injury, spinal pain, a surgical scar, etc. are all possible hidden causes of static disturbance of the human body - therefore, of the related complications such as painful symptoms.
, otolaryngologist, gastroenterologist, psychologist, osteopath, physiotherapist, personal trainer etc. A medical degree is not required.
The important thing is that everyone has the same reading key, a universal language, which allows to frame and interpret the messages of the suffering and disturbed body in such a way as to adequately intervene on the "primacy" of the problem, that is: the main cause.
The instructor / coach or personal trainer has a huge responsibility when planning and scheduling a workout, even if the need is simply to "do some movement". Motor activity is a therapy in all respects; it can help - in an almost miraculous way - but, done incorrectly (in all possible errors), it can cause substantial damage, especially in the long term.
That is why, before training it, the trainer has the duty to analyze the person by means of some tests, understanding any problems and trying to structure an adequate program that does not cause damage, or, if necessary, referring the subject to a specialist .
-Temporo-Mandibular (TMJ);The somato-emotional factor should also be mentioned, but the topic would become even more complex than it already is.
How does postural maintenance work?
All the receptors positioned in the aforementioned locations collect information both from the outside and from the inside of the body and adapt the subject's attitude in the most convenient way possible, with maximum performance - standing for many hours - with the least expenditure of power.
The human body is never in a state of complete immobility / passivity - cit .: "Only the marble statues remain motionless". Each body structure is constantly looking for its state of balance.
To ensure that the entire body structure is kept upright and stable, the Nervous System (SN) processes a series of information and sends it to the periphery so that the body has its own projection of the center of gravity - which is in front of it. to the 3rd lumbar vertebra - in the polygon of support between the feet - virtually drawn by 4 points that correspond to the 2 heels and the 2 external of the 5 metatarsals. To be clear, let's imagine a sort of quadrilateral in which the points of the corners are composed of the two outer toes and the two heels.
By projecting the center of gravity into this "trapezium", the body keeps itself in balance by swinging like an inverted pendulum, drawing a cone of about 4 ° degrees.
This first observation may already be useful information when evaluating a subject. In fact, a body that oscillates in an important way or in an anomalous way is to be considered perturbed.
Eyes closed and open
With eyes closed, these oscillations remain altered. It is estimated that, in physiological conditions, with closed eyes, these undulatory movements are more than double; this is because, by eliminating the information coming from the ocular receptor, the postural system calls into play fewer "adapters", therefore it uses more energy to keep the static erect. However, if the oscillations with closed eyes are really noticeable, more than necessary, we are faced with a problem that is "compensated" by the eyes.
Often, however, the reverse could happen: with open eyes the subject oscillates significantly and with closed eyes returns to "normal" conditions. In this case the eye is a disturbing element and often with the use of glasses, the oscillations are If this individual is already a wearer of corrective lenses, it is good to consider the idea of following a training program with glasses, or, if he does not use them, to refer him to an ophthalmologist; the latter also works in the postural field, to evaluate the idea of a lens that corrects the static alteration defect.
Temporo-mandibular joint
The same reasoning can be made for the TMJ (Joint-Temporo-Mandibular) which, in the condition of closed mouth and not occlusion, can give or not oscillations.
The situation that alters the trend of the wave movements is due to a possible disturbing cause. At this point, our duty would be to refer the subject to a dentist-orthodontist, aware from a postural point of view, who will opt for an intervention more appropriate to the case.
Again with reference to the mouth, a very important parameter is the neurophysiology of the tongue - in particular of its position - which, as many studies have shown (see Myofunctional Therapy), can completely alter posture; this could be verified by having the language itself assume various positions and observe the changes.
The vestibule parameter can also be evaluated further, in fact if the oscillations are further increased with eyes closed and mouth open or even if a loss of equilibrium is observed, it is probable that the subject suffers from complications of the vestibular apparatus; therefore, in case, it is advisable to refer to the ENT specialist (otolaryngologist).
The loss of balance, however, in addition to the fact of deriving from the vestibule or from a compression in the cervical tract can be traced back, in the most serious cases, to a cerebellar problem, therefore to the level of the cerebellum. In this case the trainer cannot do anything else than to inform the patient of what could be the causes of his problem and to consider the idea of undergoing a specialist visit to a neurologist, if the vestibular apparatus and the cervical tract are normal.
Of course, these deductions are not always as simple as they may seem; in fact, often identifying differences in oscillations is difficult to the point of not noticing alterations. Most of the time it takes more than 30-60 seconds to appreciate some interesting undulatory movements that give us useful information - it depends a lot on the "eye" of the observer - so a "careful and patient observation is certainly useful."
Other tests will be required but the personal trainer is not a specialist; he must instead behave as a "physical educator" who works on afferents and, possibly, indicate the lines to follow in case of obvious problems.
and lives "quietly" in that condition; it is well compensated. The observation of the client also on a sagittal plane is again important in order to evaluate an accentuation or reduction of the curves of the rachis; in particular, from this angle it is possible to appreciate a "front posture" or a "rear posture".
Both the one and the other are to be considered the extremes; in fact, there are many types of intermediate postures. Generally speaking, an anterior posture denotes a retraction of the posterior chain while in the posterior posture a retraction of the anterior chain, psoas and central tendon.
C "it should be remembered that a type of posture will hardly be so evident, but it is good to keep these considerations in mind especially when creating a training program and, specifically, with reference to muscle stretching sessions.
, to the Vertical called "di Barrè". It allows us to frame the origin of the problem as an indication.
By observing the subject in these terms, we would be able to address a problem that comes from above (descending), coming from below (ascending), with a mixed component (ascending-descending) or of a traumatic type.
The anatomical references will be the space between the heels, the sacral triangle and the occipital triangle. If the aforementioned parameters are aligned to the vertical this does not denote important disturbances of the static - or at least to these types of evaluation - and in this case the subject is "well aligned"
If, on the other hand, we are faced with a case A, it is possible to trace the problem back to the upper triangle; in fact, the triangle of the sacrum is in line with the feet but the occipital part is shifted to the left, and this denotes a "superior origin. Here it is possible to investigate further on the eye, jaw, ear, craniosacral problems, high vertebral, upper limbs and high visceral problems.
If we are faced with a case B, it is possible to trace the problem back to the lower triangle; in fact the triangle of the sacred is not in line with the feet and the head. In this case, the pelvis, lower visceral quadrant, hip, knee, ankle and foot can be investigated.
If we find ourselves in situation C, it is possible to trace the problem to a mixed component, both from below and from above; it will only be necessary to establish the priority in the sense of understanding which information is more disturbing.
If we find ourselves in situation D, however, it is possible to trace the problem back to a traumatic event typical of "whiplash" which alters the body statics. Often, these types of presentations can also occur in situations of emotional problems, such as trauma or shock.
A final example is that of well-compensated body alterations as shown in the figure, where despite an evident alteration of the curves of the rachis, the upper and lower triangles are in line.
In this situation we are faced with a condition of "autonomous body compensation strategy" which, according to many experts, should not be modified, except to give mobility to the structures that require it.
At this point, once you understand how to orient yourself, you can look for the receptor that had presented the possible problems.
of the fact that the primary cause of the disturbance can be hidden in it; therefore it is good that the specialist in question resolves any problems related to that parameter which, according to the postural evaluation, gave positivity.Near point of convergence test
Going to evaluate the ocular component, a simple test to try is that of the next point of convergence (PPC). This test evaluates the functional balance of the motor muscles of the eye which, due to a discussion of muscle chains and connection with the cervical tract, have a truly remarkable postural influence.
This test is performed by asking the subject to follow an object with his eyes from a distance of about 50 cm and then slowly reach the tip of the nose. The eye that is unable to follow the object until it reaches the tip of the nose must be investigated. In this case it is advisable to proceed by referring the subject to an ophthalmologist.
Cover Test
Another interesting test is the "Cover Test", in which one eye is covered and with the other one asks to observe an object at a distance of about 20 cm; then suddenly the eye is discovered and it is observed if the eye as soon as it is discovered it re-enters focus or has remained immobile like the other. The whole thing is repeated on the other side. The eye that "re-enters" as soon as it is discovered must be investigated.
and open the mouth in such a way as to appreciate the central line of the upper arches of the teeth with the lower one and evaluate their correspondence.
If there is no congruence, the lines become parallel to each other and we could be faced with a "Cross Bite" or crossbite that can cause perturbation.
You then proceed to evaluate any clicks at the opening and closing of the mouth or when you clench your teeth strongly, in order to appreciate a difference in tension between the chewing muscles. In this case, the client will be referred to an orthodontist.
Still on the subject of occlusion, it may be useful to evaluate the oscillations of the body or the active macro-movements of the subject, by clenching the teeth or with a thickness between them and to appreciate the differences between the first and the after.
Particular attention is also paid to the discourse inherent to occlusal classes; in fact, according to some orthodontists who work mainly in the field of posturology, predefined posture patterns are created according to the occlusal classes depending on whether the upper arch is very protruding compared to the lower one - 2nd occlusal class of 1st or 2nd division , usually appreciable with retrognathism - or if it is backward - 3rd occlusal class, usually prognathism In case of "normal" occlusion we speak of 1st class, where the arches do not show anomalies.
C "it should be noted that there is not always congruence between a type of occlusal class and the relative" postural design "; as usual, each individual is a case in itself, but for a statistical discourse the examples in the figure correspond with a good percentage.
What interests the trainer, however, is to understand the importance of the stomatognathic system with the whole body and its influence on the postural system.
from the floor that flow down the thighs; in this way it is possible to appreciate any difference in the amplitude of the range of mobility.The rotations are also evaluated by comparing them with the contralateral ones. Flexion-extension occurs and freedom of movement is taken into account. This is for the cervical, dorsal and lumbar tracts.
of that segment and restore freedom of movement.
The personal trainer, in this case, according to the knowledge of classical analytical stretching (Anderson style) or in the chain, should also try to restore mobility to those body segments that have not been very mobile and in any case be careful to prescribe exercises that cannot be performed in complete ROM (Range of Mobility), in order to avoid compensations that wear down the structures involved.
