Posture:Alternatives to the Prevailing Paradigm

Posture: Alternatives to The Prevailing Paradigm

By Steven Goldstein, B.A. Education & B.Health Science MST Musculoskeletal Therapy

Abstract:

In this lecture series we will look at an overview of the modalities that can be alternatives to a standardize approach for postural assessment, that is an external orientation or what we term as an objective view that manual therapists take when assessing and intervening with postural dysfunctions.

In the first part of the series we will identify what has been the prevailing view of posture from teachings of mainstream perspectives and in the second and third parts of the series introduce to you differing viewpoints that hopefully will assist you in your practice.

Introduction

All you need do is type the word posture onto an internet search engine and in .11 seconds you have about 1,720,000 hits. And as you scan the dizzying array of responses, one can retrieve information about postural related aids and devices that include postural balls, ergonomic chairs, or find information all about posture; how to maintain correct posture when meditating or how to maintain a balanced and correct posture according to a variety of disciplines and modalities.

Some self-help manuals like Kit Laughlin’s have an integrated approach utilizing his background in yoga along with rehabilitation and sports exercise, dance, gymnastics and forms of martial arts he has been exposed to that assist in postural transformation. 1

Other sites prefer a health-oriented corporate workplace approach to helping employees become more productive by maintaining a conscious awareness of how they sit when performing various activities for their daily work regimen. And these tips include keeping your eyes level, shoulders level and not shrugged, elbows resting close to the torso, etc., all seemingly to take what appears to be a scientific physiotherapeutic approach to maintaining correct posture.

If one scans the responses further, there are aids to assist in assessing posture by the manual therapist and postural professional; these include a $349 USD Postural Evaluation Kit that will include a program for keeping postural records of your client, a plastic postural grid that can be suspended from the ceiling or wall, suspension cord and plumb bob for alignment.  If you so desire you can use a PALM device known as a palpation meter.

“This device combines the ease and proprioceptive of palpation with the objectivity and reliability of calliper and inclinometer measurements. The calliper determines the distance in centimetres between two palpating fingers. The inclinometer will give you accurate measurement in degrees between two palpating fingers.”

As manual therapists, how do we make sense of all this information? For one thing, all of the sites I viewed seemed to convey and portray a physical orientation of what correct posture is meant to be.  That is, assessing posture from an external point of view. Secondly, the sites describe how to counteract poor posture by re-educating one’s muscles utilizing movement in the form of specific exercises.

Are their any other approaches to normalizing posture and how do they compliment or conflict with a standardized approach that these sites convey?

Traditional Approaches to Postural And Musculoskeletal Dysfunction

Static Postural Images

If we peruse various massage anatomy and physiology texts or modality manuals, we find laid out for us a process and procedure that is taught and adhered to, based upon postural assessment or analysis; that is, a step by step procedure of looking at the structural landmarks of the body, both in weight-bearing and non weight-bearing positions.

That is usually an analysis of the body form from a static standing position. If we look to analyse the body in motion, we usually refer to it as ‘gait analysis’.  This is the logical and normal approach that is taken, it focuses our attention and awareness on our client when they present themselves for observation and assessment of postural considerations.

Ideal Postural Alignment

Faulty Postural Alignment

Muscle Testing and Function

Kendall and McCreary (1949), one of the bibles in the field for muscle testing and function have wonderfully dated black and white photographs of men and women in relation to a grid and plump line bob.  The photographs describe ideal plumb line and faulty plumb alignment.

Accordingly the authors state a premise about muscle function in relation to posture;

“posture is the composite of the positions of all the joints of the body at any given moment. If a position is habitual, there will be a correlation between alignment and muscle test findings.  If a reasonable assessment of a joint position is made, then an assessment also can be made regarding muscles in elongated positions and that are in shortened positions.  In faulty posture, those muscles in slightly shortened positions tend to be stronger, and those in slightly elongated positions tend to be weaker than the muscles that work in opposition to them.” 2

With this quote we have all the components for addressing physiologic functions that affect posture and the dysfunctions that occur.   We include joint play, movement, habituation (nervous system adaptation), agonist and antagonist muscle function, all of which can lead us into a discussion about sensory-motor nerve function.

So why is it we view postural dysfunction by the use of symmetrical comparison of bony landmarks and usually in context of muscle shortness and contracture?  Well for reason, it suits us to consider posture in the context of symmetry.  And if we can balance muscle groups there is a sense that posture can self-correct.

This is generally how manual therapists approach postural dysfunction. But is there more to postural dysfunction than asymmetry and muscle contracture? It is often more complicated and interesting than detailed extrinsic explanations.

Patterns of Musculoskeletal Dysfunction

Postural and tonic muscles and Janda’s syndrome patterns
Anatomic and physiologic responses to stress

No discussion on posture can occur without an understanding of the function of muscles.  .

One contributor to how muscle function in patterns has been a Czech researcher named Vladimir Janda.  He describes the patterns that affect posture by understanding the relationship between postural type 1 muscles and phasic type 2 muscles.  Predictable patterns emerge that he elaborates upon that he named Upper and Lower Crossed Syndromes.

Essentially postural or tonic muscles shorten while phasic often weaken.

Type 1 or Postural fibres contract slowly and are able to burn oxygen more efficiently than phasic muscles, which allows them to work slowly, and steadily over long periods of time. Over time with misuse and disuse, these muscles will shorten.  This is a clinically important distinction in tonic muscles response to stress. 3

Phasic or Type 2 fibres of which there are two main categories will weaken under prolonged stress and the fibres will tend to lengthen.

Type 2a fast-twitch fibres which contract more speedily than type 1 and are moderately resistant to fatigue with high concentration of mitochondria (the fuel-producing refineries of the cell) and myoglobulin (protein that speeds up the conversion of calcium ions) Usually used in walking and sprinting. 4

Type 2b fast-twitch glycolytic (uses blood sugar) are less fatigue resistant and depend on more glycolytic sources of energy. Usually used in strength training such as weight lifting.

Upper Crossed Syndrome

Involves the following imbalance:

Pectoralis Major and Minor    All tighten and shorten    Tonic or Postural Muscles
Upper Trapezius
Levator Scapulae
Sternocleidomastoid

While

Lower and Middle Trapezius    All Weaken            Phasic Muscles
Serratus Anterior
Rhomboid Major and Minor

When this occurs they alter the relative position of the head, neck and shoulders as follows:

1.    Occiput with C1 and C2 hyperextend with the head translating anteriorly
2.    The lower cervicales down to 4th thoracic are now stressed.
3.    Rotation and abduction of the scapula occur as the upper trapezius and levator scapulae become shortened and contracted.  This inhibits the lower trapezius and serratus anterior.
4.    As a result the scapula loses stability, which puts excess demand on the humerus now involving the levator scapulae, upper trapezius and supraspinatus to maintain functional efficiency.

Janda believed that by identifying the shortened structures and releasing these, they will improve overall function and posture.

Lower Crossed Syndrome

The lower-crossed syndrome involves the following imbalance:

Tonic or Postural Muscles
Iliopsoas, Rectus Femoris, Tensor Fascia Latae and Erector Spinae group

All tighten and shorten

While
Phasic Muscles
Abdominal and Gluteal    All weaken

Resulting in a reaction that tilts the pelvis forward on the frontal plane. Flexing the hip and exaggerating lumbar lordosis.  L5-S1 will have soft-tissue and joint distress with accompanying pain and irritation.

Also on the sagittal plane:

Quadratus Lumborum     Shortens

While

Gluteus Maximus and Medius    Weaken

With the instability of the lower cross, the sacroiliac joint becomes unstable and you start to find piriformis involvement.  Thus piriformis syndrome can be present.5

Many researchers have studied how muscle function affects posture.  The understanding of the body’s adaptability and how fibre types can change based upon the demands that function places upon structure has been a prevailing approach.

Anatomic and Physiologic Adaptations to Stress

Several authors continue the discussion of posture by viewing physiologic changes from factors that result in a complex sequence of events activated as a result of stress responses to soft-tissue structures. 6.

1.    Congenital and inborn factors
2.    Overuse, misuse and abuse
3.    Immobilization, disuse
4.    Postural stress
5.    Inappropriate breathing patterns
6.    Chronic negative emotional states such as depression and anxiety
7.    Reflexive influences (trigger points, facilitated segments)

Others view anatomic approaches

1.    Laxity of ligamentous structures
2.    Fascial tightness
3.    Muscle tonus
4.    Pelvic angle
5.    Joint position and mobility
6.    Neurologic outflow and inflow. 6

As a result of these types of factors a sequence of events can occur that have dramatic effect and consideration for the manual therapist.

The events are systemic and physiologic.  Without listing the complete list, here are the highlights:

•    ‘Something’ leads to increased muscular tone.
•    If increased tone is anything but short term you have metabolic waste build-up.
•    Increased tone means simultaneous local oxygen deficiency.
•    Ischemia, although not a producer of pain, is a major contributor of pain.
•    Increased muscle tone over long period leads to a degree of increased oedema.
•    All these factors, retention of waste/ischemia/oedema all contribute to creating pain.
•    Pain reinforces hypertonicity.
•    Inflammation may result.
•    Neurological reporting stations in these distressed tissues bombard the CNS with information regarding their status leading in time to a degree of neural sensitisation and hyperirritability and hyper activity.
•    Macrophages are activated, increased vascular and fibroblastic activity
•    Connective tissue production increases with cross linkage, leading to shortened fascia
•    Chronic muscular stress results in gradual development of hysteresis in which collagen fibres are rearranged to produce an altered structural pattern.
•    This results in tissues that are far more easily fatigued and prone to damage, if strained.
•    Since all fascia and other connective tissue is continuous throughout the body, any distortions that develop in one region can potentially cause fascial deformation elsewhere.
•    Hypertonicity in any one muscle will produce inhibition of its antagonists and aberrant behaviour in its synergists.
•    Energy wastage leads to unnecessarily sustained hypertonicity and an excessively active musculature leads to generalized fatigue and local energy crises, i.e. Trigger points.
•    These in turn create functional changes that affect respiratory function and body posture!  7

When we observe the posture of a client, we have in front of us a very complex picture.  We are in a sense seeing a current end product based upon a variety of factors that have caused the body form to be in the condition your presented with.

We need to look beyond assessing and observing asymmetries or contracture of certain muscle groups. We need to take into account other considerations. These considerations are those that are directly linked with our internal sensory awareness and the physiologic changes that occur from an over stimulated and highly stressed nervous system.

Alternative Postural Influences

• Autonomic nervous system and soft-tissue release

• Alternative postural and autonomic influences:

• Sympathetic activation, habituation and response to stress

• Hans Selye’s theory

The Autonomic Nervous System

The autonomic nervous system ANS is best known for its regulation of the sympathetic SNS “flight or fight” response and the parasympathetic PNS “rest and repose” response.  The SNS and PNS work together to maintain homeostasis through a feedback loop system.  Excessive sympathetic “tone” (Shea 1996) or output causes most of the stress related disorders that physicians encounter.

What is important to manual therapists is the relationship the ANS has with soft-tissue release and postural dysfunction.

All soft tissue has sympathetic innervation.  There is virtually no parasympathetic innervation of your soft-tissue.  All of your cardiovascular system has a sympathetic nerve attached to it.  Therefore it is the regulator of your vasomotor system.  The rate and flow of blood is controlled by the SNS. So neuromuscular and cardiovascular systems are sympathetically regulated.

The vagus nerve, the 10th cranial nerve that innervates the head, neck, thorax and abdomen is a mixed sensory and motor nerve and has 75% control of your parasympathetic system, and has some control over the heart and viscera.  The parasympathetic part helps regulate the visceral system (digestive organs) and forms a link to your enteric (gut) nervous system.

The parasympathetic system is called the cranial-sacral system with the vagus nerve and in the pelvis the sacrococcygeal plexus. The sympathetic system is called the thoraco-lumbar based upon nerve root plexuses.

There is a tuning or mediation between the two systems.  Since the sympathetic is the highest consumer of energy in the body, producing more waste, and using more oxygen, it is considered the primary system of the body.  The viscera or enteric nervous system keeps digesting food and producing amino acids along with fatty acids and fuel for metabolism.  When we start to stress, abuse or misuse our bodies, not have proper exercise, all of this begins to tighten the soft-tissue. This in turn decreases activity of the viscera with much more over-stimulation of the neuromuscular system occurring.  Over time this imbalance becomes the General Adaptive Response (Seyle 1984).  Soft-tissue dysfunction becomes prominent, including ulcers, diarrhoea, irritable bowel syndrome, constipation, etc, and with continued habituation comes adaptation and comprising the immune system. 8

This has a profound effect on our soft-tissue and postural dysfunction.

Adaptation, Habituation and Response to Stress

Selye’s:

• General Adaptation Syndrome GAS

• Local Adaptation Syndrome LAS

At the heart of postural considerations is the important premise of habituation. A prominent theory introduced is based upon the research of Hans Selye (1956).  Selye has contributed in understanding how adaptation and habituation –GAS and LAS is in relationship to somatic and postural dysfunction.

” That musculoskeletal dysfunction is a result of adaptive demands exceeding the capacity to absorb the load, while attempting to maintain something approaching normal function.  Elastic limits may at times be exceeded, resulting in structural and functional modifications.  Assessing these dysfunctions patterns-making sense of what can be observed, palpated, demonstrated- allows for detection and guidance towards remedial action.”
The demands that lead to dysfunction can either be forceful, violent, single events or they can be cumulative influence of numerous minor events.  Each such event is a form of stress and provides its own load demand on the local area as well as the body as a whole
.
Selye called stress the ‘non-specific element’ in disease production. He described the general adaptation syndrome as being comprised of three distinct stages:

•    the alarm reaction when initial defence responses occur (‘flight or fight’)
•    the resistance (adaptation) phase
•    the exhaustion phase (when adaptation fails) where frank disease emerges.

GAS affects the organism as a whole whilst LAS Local Adaptation Syndrome goes through the same steps but ofcourse is local in its orientation.  Repetitive activities over long periods of time result in somatic and muscular adaptation that can result in chronic hypertrophy of specific muscle groups.  The same activity repeated over time sees the body respond to the demand by adapting to the needs placed upon it.  When the demands become excessive, that is usually when we see injury or postural dysfunction.  When an individual is acutely alarmed, stressed or aroused, homeostatic mechanisms are activated.  If the alarm status is prolonged or if adaptive demands are excessive, long-term chronic changes can occur and these are at the expense of optimal functional integrity.”

“ The results of repeated postural and traumatic insults over a lifetime, combined with somatic effects of emotional and psychological origin, will often present a confusing pattern of tense, shortened, bunched, fatigued and, ultimately, fibrous tissue.”  9

Part 2

Sensory Awareness and Movement Modalities

• Thomas Hanna and Somatics

• Moshe Feldenkrais

• F.Mathias Alexander

Thomas Hanna’s Somatics

Thomas Hanna (1928-1990) borrowed heavily from Hans Selyes, Moshe Feldenkrais and F.Mathias Alexander’s research to develop a modality that sought to counteract the habitual state of forgetfulness called sensory-motor amnesia.

Hanna goes on to say in his book on Somatics, “It is a memory loss of how certain muscle groups feel and how to control them.  And, because this occurs within the central nervous system, we are not aware of it, yet it affects us to our very core. The reflexes that cause sensory-motor amnesia are very specific.  There are three…named Red light reflex, Green light reflex and Trauma reflex.”

Red Light Reflex.  (Left)

Essentially Red Light reflex is associated with the abdominal muscles and what Hanna termed the Withdrawal Response.  It is associated with distressful events.  It is a protective response to negative events that threaten us.

From head to toe, the Red Light reflex involves the following movements:

Closing the eyes, tensing the jaw and face, pulling forward of the neck, lifting of the shoulders, flexing the elbows, clenching the fists, flattening the chest, tightening abdominal muscle, contracting the diaphragm and holding the breath, contracting perineum including sphincters of the anus and urethra, contracting gluteus minimus muscles to rotate thighs inward, thus feet are pigeon toed, adduction of the thighs, contraction of the hamstrings to bend knees, flexing and supinating the feet. (Each foot lifts and inverts, tilting up the arch) the sensory feedback of all these movements constitutes the subjective feeling of the Red Light Reflex: Fear.

Green Light Reflex (Right)

From head to toe, the green Light Reflex involves the following movements:

Opening the eyes, jaw and face, pulling backward of the neck, pulling downward of the shoulders, extending the elbows, opening of the hands, lifting the chest, lengthening the abdominal, relaxing the diaphragm and freeing breathing, relaxing anal and urethral sphincters in the perineum, contracting the gluteus medius muscle to rotate the thighs outward (feet are duck like), abduction of the thighs, contraction of the thigh extensors to straighten the knee to hyper-extension, extension and pronation of the feet.  The sensory feedback of all these movements constitutes the subjective feeling of the Green Light Reflex-Effort. 10

Trauma Reflex

The trauma reflex according to Hanna is a reaction of the sensory-motor system in response to pain.  It seemingly causes the body to tilt.  Hanna viewed scoliosis, as a sideways twisting that was a result to some trauma that has occurred sometime in a person’s life.  Triggered by an injury, a fall, severe damage to the body, surgery, and whiplash all cause a protective pattern around the site of the injury.

Hanna went on to create a series of Somatic exercises whose primary task is to focus your attention on the internal sensations of movement.  By paying attention, moving slowly and gently with the least possible effort, not forcing any movement, you can clear the brain to receive uncluttered sensory feedback, thus aiding in alleviating a variety of postural and somatic dysfunctions. 11.

The Feldenkrais Method

The Feldenkrais method is a system that approaches human development and the improvement of functioning through physical movement and directed touch. How we learn and form habits is of central importance in the practice of the Feldenkrais method.  Our posture and the ways that we move were learned, even if the learn is not conscious.  Thus, physical difficulties or limitations are seen from this perspective, as the result of either incomplete learning or trauma that can lead to dysfunctional habit patterns.  The Method utilizes functionally based variation, innovation, and differentiation in sensory motor activity to break down habitual patterns and allow new ways of thinking, feeling and action to emerge. 12

Some quotes from Moshe Feldenkrais (1904-1984), give a flavour of how posture is integrated in his approach.
“The way the mind and body are united has preoccupied human beings throughout the centuries. ‘A healthy mind in a healthy body’ and similar sayings show a conception of one kind of unity.[...]
I believe that the unity of mind and body is an objective reality. They are not just parts somehow related to each other, but an inseparable whole while functioning. A brain without a body could not think; at least, the continuing of mental functions is assured by corresponding motor functions.
[...]
There is little doubt in my mind that the motor function, and perhaps the muscles themselves, is part and parcel of our higher functions. This is not true only of those higher functions like singing, painting and loving, which are impossible without muscular activity, but also of thinking, recalling, remembering and feeling.
The advantage of approaching the unity of mental and muscular life through the body lies in the fact that the muscle expression is simpler because it is concrete and easier to locate. It is also incomparably easier to make a person aware of what is happening in the body; therefore the body approach yields faster and more direct results. On acting on the significant parts of the body, such as the eyes, the neck, the breath, or the pelvis, it is easy to effect striking changes of mood on the spot.
[...]
A person is made up of three entities: the nervous system, which is the core; the body – skeleton, viscera and muscles; and the environment, which is space, gravitation, and society. These three aspects, each with its material support and its activity, together give a working picture of a human being.
[...]
Individually acquired action (onto genic action) pertains to the senses. Such action can be altered or learned as one can become aware of the actual differences, such as the extent of the effort, its coordination in time, the body sensation, the spatial configuration of the body segments, the standing, the breathing, the wording, etc.
This kind of aware learning is complete when the new mode of action becomes automatic or even unconscious, as all habits do. The advantage of a habit acquired by awareness is that when it shows unfitness or maladjustment when confronted with reality, it easily provokes new awareness and so helps one to make a fresh and more efficient change.
My inmost belief is that, just as anatomy has helped us to get an intimate knowledge of the working of the body, and neuroanatomy an understanding of some activities of the psyche, so will understanding of the somatic aspects of consciousness enable us to know ourselves more intimately. 13.

Posture and Alexander Technique

It is a testament to the power of this method that it has endured the passage of time to still be extremely relevant and timely in a world out of touch with internal sensory awareness.
Born in Tasmania, F.M.Alexander (1869-1955) was a successful actor and reciter whose career was cut short by loss of voice during performances. With no help forthcoming from the medical profession, Alexander undertook an intensive examination of himself in action, convinced that the source of his voice problem lay in the way he used his body. A long period of research led him to discover certain principles affecting mind/body co-ordination applicable to every kind of physical activity.  With this knowledge he went on to cure his own voice problem and found hat he could also help others.

It was at this point that teaching his method became the main focus of his life.
Alexander arrived in England in 1904 and during the next 25 years built up a practice in London and the USA. He had many influential supporters among those were Sir Henry lrving, John Dewey, Aldous Huxley and Sir Stafford Cripps.
In 1931 he began training others to teach the Technique and continued to do so until his death at the age of 86.
Today the importance of Alexander’s discoveries is confirmed by the existence of a rapidly growing body of teachers of his method.

Quotations:

You come to learn to inhibit and to direct your activity.
You learn, first, to inhibit the habitual reaction to certain classes of stimuli, and second, to direct yourself consciously in such a way as to affect certain muscular pulls, which processes bring about a new reaction to these stimuli.’

Boiled down, it all comes to inhibiting a particular reaction to a given stimulus.
But no one will see it that way. They will see it as getting in and out of a chair the right way. It is nothing of the kind. It is that a pupil decides what he will or will not consent to do. They may teach you anatomy and physiology till they are black in the face – you will still have this to face, sticking to a decision against the habit of life.
There is no such thing as a right position, but there is such a thing as a right direction.

You can’t do something you don’t know, if you keep on doing what you do know.
Trying is only emphasizing the thing we know already Sensory appreciation conditions conception – you can’t know a thing by an instrument that’s wrong.
To know when we are wrong is all that we shall ever know in this world.

You are not here to do exercises or to learn to do something right, but to get able to meet a stimulus that always put you wrong and to learn to deal with it. 14

How does the Alexander Technique reduce stress?

F. M. Alexander identified the fact that most of us are in a perpetual state of “fight or flight syndrome”; also know as the startle response. If you have ever seen a newborn or young infant react to a loud, unexpected noise, you may recall their shoulders come up to their ears and their heads are pulled or fall back – they are clearly startled by the experience. In a few moments, as the event passes, they return to their prior state, which is relaxed, alert, and engaged.
As we grow up in our fast paced society, we face a constant onslaught of stressful events. We are in the process of recovery from one event when yet another stimulus hits our systems, and so we begin to function in a constant state of startle response. Because our nervous system adapts to the new level of stress, we cease to register it as too much and so never fully return to the easeful state of the newborn. Instead, we increase muscular effort throughout our lives. The analogy I use to describe this constant state of over-contraction is that of driving with the parking brake on. We use much more energy to perform simple activities than we actually need, which are a wasteful process.
F. M. Alexander’s recognition that his sensory feedback was unreliable gave him a window into changing his chronic overuse of muscle effort to a more efficient, appropriate level when accomplishing his activities. By learning to inhibit his startle response upon receiving stimulus, he was not only able to change muscle tension in his body; he was also able to change the biochemical messages being sent through his nervous system. What was once stressful when performed with the old habit patterns became easeful, poised and appropriate to the task at hand. This tool of inhibiting the old response is a skill that can be learned and enhanced with practice. This is how the Alexander Technique reduces psychophysical stress. 15

Part 3 Gravitational Orientations

• Rolfing

• Structural Integration: The Guild

• Structural Integration: The Institute

• Hubert Goodard and Tonic Function

Rolfing: Structural Integration

Structural Integration, the offspring of Ida Rolf, began by attempting to view the body three-dimensionally as an aggregate of blocks attempting to balance in the flow of gravitational energy. 16

Ida Rolf (1896-1979) had a decidedly different view of structure and posture.

Rolf states, “…The first question is, what is structure?  What is structure in anything? In humans, it is decidedly not posture, although most people seem to think the two words are synonymous.  Etymologically, the word posture contains an element of placement.  The root of the word is the Latin, ponere, “to place”.  The past participle, positum, means, “It has been placed”.  Applied to humans, posture implies that something has been placed, or for the most part forced, into space where properly and structurally it does not belong.”

”Shoulders back, guts in”, is a military adage.  It means to force you to do what does not come naturally. The minute you force yourself to maintain a posture of this sort, you betray that all is not well with your world.  You show the world that your structure and your posture are at war.

In any plane, physical or non-physical, structure implies relationship.  Living bodies are such forceful and intimate expressions of vital energy or its lack that the fact that they are also material manifestations in a three-dimensional world often disappears.

Balance reveals the flow of gravitational energy through the body.  Asymmetry and randomness betray lack of support by the gravitational field.  All these considerations are inherent in the word structure as it is applied to any three-dimensional system….In no world can the flow of gravity reinforce imbalanced, asymmetric structure.  Since it is segmented, the human unit is more plastic than an inorganic unit, and succumbs more quickly to the unequal torques of everyday life.” 17.

Rolf viewed the basis of balance in the face of gravitational influence to be best dispersed by the soft-tissue fabric that disperses it-Fascia. Much her life was spent in the pursuit of researching and understanding the role fascia plays in the organization and maintenance of human uprightness.

Schools of Gravitation Orientation

Ida Rolf’s influence in the realm of a broad worldwide movement along with the likes of Moshe Feldenkrais and Mathias Alexander has been significant. Be it those who have attempted to be the keeper of the realm such as her advocates in the Guild for Structural Integration whose mission is to keep intact the teachings and message Rolf promoted.

Her is an excerpt from the Guild’s website:

The Guild is dedicated to the traditional teachings of Dr. Ida P. Rolf. The product of her life’s work and teaching is the “Recipe”; a ten- session sequence of structural, fascial and educational goals which establishes order in human structures. Due to its efficacy in symptom alleviation, both physical and emotional, there is little doubt that the Recipe will survive in various forms as techniques; it is not certain that it can endure as art and craft without the special dedication of those individuals who are inspired by the potency of intention and wisdom of process concealed within. The Recipe is not technique. The Recipe is more than a discrete succession of myo-fascial goals and intentions. The Recipe is, rather, a process, based on a set of relationships, which establishes structural balance and order. These relationships are based upon sound theoretical physics as well as some traditional metaphysical hypotheses. Relationships belonging to the realm of art,  are non-linear. Technique is better suited to scientific and linear analysis. The Recipe, as taught in other schools, has been modified or, perhaps, specialized in several ways. Some of these modifications ignore the underlying priorities in Dr. Rolf’s teaching. The Guild is formed to insure that the Recipe does not lose its potency of intention, its expression as art, nor its comprehension as process

Dr. Rolf’s teaching emphasizes the concept of the personal line of vertical intention, the “Line.”
The Line passes through the centres of gravity of the body’s vertical blocks. The Line, in our concept of the Structurally Integrated human, does not pass through bone, except at the top of the head. In actual fact, this weight-bearing line does pass through bone in all but the most exceptional human structures. Indeed, it was Dr. Rolf’s observation that our species had not yet successfully completed its journey to uprightness. The Recipe is designed to offer personal assistance in this evolutionary voyage. The emergence of the unstressed vertical, the Line that passes only through soft tissue is evidence of progress toward this goal. The Line being defined as a set of theoretical points in space is not real, but experiential, and it can be, perhaps, must be, intentional. The horizon is the horizontal reference for the Line. The shoulder girdle and the pelvic girdle must contain true horizontal balance to define and support vertical extension. The Line goes through the top of the head and through the bottom of the feet to infinity. The Line forms a relationship between the field, which is man, and the field, which is earth, the field of gravity. The Line is transcendental, it relates the realm of material particles, of basic physics to the non-material, the world of energy fields. While Dr. Rolf’s metaphysical hypotheses concerning the Line are not original, her use of the Recipe as a tool for exploring them is unique. The idea of using a vertical line of extension to integrate one’s personal energy field with the energy field of the earth is a compelling idea with both practical and visionary implications. The Guild recognizes the singular importance of the Line as raison d’ etre for the recipe. We believe that effort to clarify and develop a clear sense of vertical extension should be a path for personal growth. And further, that instruction concerning the Line is an essential educational aspect of the practice of Structural Integration.

Whilst those that did not wish to remain true and in their words “static” to the teachings of Rolf, decided to evolve the teachings and continue the exploration of human uprightness that we refer to as posture along varying lines. 18

The Rolf Institute of Structural Integration excerpt about its ‘ raison d’etre’ has a similar flavour:

Rolfing® Structural Integration is named after Dr. Ida P. Rolf. She began her inquiry more than fifty years ago, devoting her energy to creating a holistic system of soft tissue manipulation and movement education that organized the whole body in gravity; she eventually named this system Structural Integration. She discovered that she could achieve remarkable changes in posture and structure by manipulating the body myofascial system.
“Rolfing” is the nickname that many clients and practitioners gave this work, and is now a registered service mark in 27 countries. Rolfing structural integration has an unequalled and unprecedented ability to dramatically alter a person”””””””””””””””’’s posture and structure. Professional athletes, dancers, children, business people, and people from all walks of life have benefited from Rolfing. People seek Rolfing as a way to ease pain and chronic stress, and improve performance in their professional and daily activities.

It is estimated that more than 1 million people have received Rolfing work.
Research has demonstrated that Rolfing creates a more efficient use of the muscles, allows the body to conserve energy, and creates more economical and refined patterns of movement. Research also shows that Rolfing significantly reduces chronic stress and changes in the body structure. For example, a study showed that Rolfing significantly reduced the spinal curvature of subjects with lordosis (sway back); it also showed that Rolfing enhances neurological functioning.  19

It is in this fertile ground of investigative bodywork that very interesting approaches to working with and treating postural dysfunctions are presented and practiced.  One such theory to postural dysfunction has come from the work of Hubert Goodard.

The Theory of Hubert Goodard

Course Notes From Body Wisdom Conference

I had the brief pleasure to attend one of Hubert Goodards mini workshops that he gave at the Body Wisdom Conference held at the Coramandel Peninsula in New Zealand in February 2003. I confess I was taken by his elegance and his approach to viewing posture.  One of the ideas that I came away with is how profound a person’s internal sensory awareness is to how people orient themselves in space.

Goodard had us become aware of both external awareness and breath along with internal awareness in breath.  He had us perform an exercise where you would coincide the rhythm of a persons breathing with very small movements of internal and external rotation of the lower legs.  Whilst the practitioner attempted to coincide that particular rhythm, the client would breathe in an external awareness and breathe out an internal awareness.  This awareness had interesting effects on various individuals.  Although all is anecdotal, I still found it interesting what other practitioners and body workers described as their experience.

Some reported an altered state of awareness (consciousness?); others found that at least temporarily there was improved mobility.  What is it that Goodard is trying convey and what to what end does it affect posture?

From the notes I took I will attempt to convey what he presented.

He entitled his lecture/workshop Posture, Breathing and Sensory Habits.  Goodard gave a historical perspective.  In our mind or head we have an internal awareness of how our body moves, a map so to speak that he labelled ‘schema’.  We also have a body image of ourselves that is internal in orientation but we can get a sense of when for instance, we look at ourselves in a mirror.

So we have a body image and we have the real body. The schema or map is our relationship with oriented space.

We have an ongoing relationship with our image, our map or schema and our real body.
That relationship is imposed upon our real body, or as Goodard referred to as the organic body.  Their exist a symbolic relationship we have with our organic body that includes our body image and our map.  We have opportunities to ‘touch’ this image and map which represents a potential for action.

And when we view postural dysfunction are we seeing our organic real body or our body image?

Goodard also look at breath as not belonging to the body but to the ‘relationship’ with the image and map.

So the schema then represents the ‘Where” we are, the ‘MAP”, in oriented space.
And where we are in our body. And where we are in the world. And where we are in our selves.

The body Image represents the ‘Who I Am”.

The schema or map is linked to our surroundings.

The first thing we do as human beings is grasping our orientation to that surrounding.  It is in our short-term memory at an unconscious level.  This is the proprioceptive activity versus the awareness of proprioceptive, this is our body image.  All of this proprioceptive activity, vision, sound, skin, inform the body schema and is completely linked to the surroundings.

He goes on the state that the Image of who I am can become disconnected from the surroundings.

He looked at long-term memory, the cortical, the word memory, this is the Who I am.
The who is connected with perceptual activity, with emotions (limbic system interface with the conscious and the unconscious) and with conceptual belief systems.

Goodard said the image of who I am is coming outside of ‘who I am’.  The feedback I receive from outside my self is how I build my body image.  He gave an example; we have a child without arms. The schema or map has no proprioception on the organic real body, but does have an image because of the reflection the child has of humanity with arms.

The self is exproprioceptive.  The question of the interconnection between the two is of tremendous import.

We know that there is a strong mind-body link with belief systems.  If you think, conceptualise a problem, i.e. breast cancer, it can physically manifest.  And the person with breast cancer will see a retracting breast in their body image that can create reduction in a physical sense.

Goodard believes ‘conception’ changes ‘perception’. This has an emotional component along with it.  Our brain has a somatic sensory and motor map in the cerebral cortex.  When there is a loss of sensation, other parts of the brain take over and the area is ‘lost’ (Goodards words).

If we discuss exproprioceptive awareness we can include the sense of sight.  We have

GAZE 
Fovea Centralis (rod less area of the retina that affords acute vision) vs. Peripheral Vision

BODY IMAGE 
Fovea relates to the Cortex whilst the Peripheral is Subcortical

So essentially Goodard is saying that our ‘Where’, our schema or map is peripheral, subcortical and not attached to language.  The ‘where’ in seeing feeds the body schema.  So that Gaze is an interpretation.  When we look at ourselves in a mirror we see our ‘self’ but the point Goodard makes is we are seeing our body image.  He said to look as if seeing someone behind the mirror.  That is look for your image.

SIGHT is SCHEMA-MAP

GAZE is IMAGE

Goodard used an example of when we have surgery.  We have scar tissue.  The metaphor or image is the body still feels as if the knife is still in the body.  We need to rebuild where the wound is in the body image.

Finally he made a distinction between the GROUND and SPACE.  He said we tend to strongly organize and identify with either one or the other.

I would be disingenuous if I said I understood from my note taking that a Frenchman speaking English as a second language, I understood what he was attempting to convey!  In fact I had more questions than any clear understanding.  So it motivated me to search out a clearer understanding of his work.  That led me onto various Rolfing sites that helped somewhat with my lack of understanding about his theory. 20

What follows is from the work of two advanced certified rolfers who have studied with and written about Hubert Goodards work, Kevin Frank and Arline Newton.  What I have gleaned is articles that were published in the mid 1990’s in Rolf Lines, a research publication for Structural Integrationists.

Tonic Function: Basic Concepts in the Theory of Hubert Goodard

I will draw heavily on Arline Newton’s published work of Hubert Goodard theory that appeared in the March 1995 Rolf Lines publication.  You can read and/or download the complete article from www.resourcesinmovement.com/Articles.

The basic premise that Newton states about Goodard is a key insight of Rolfing in general, that we need to have an appropriate relationship with gravity that is basic to our health.  From a structural point of view, this relationship is commonly described in terms of alignment.  From a functional point of view, it is described in terms of biomechanics, studying the movement of various joints and the impact of forces upon them.  Newton goes on to state,” … that both perspectives carry a kind of objectification, a denial (or ignoring) of human experience….Alignment and mechanics leave out the effect of what is occurring in the mind/body of the individual involved.”

Newton says the consideration of experience is phenomenological. That is philosophers wanted to study the perceptual experience in a purely subjective aspect.  Not at all accepting a traditional division of subject and object.  From this perspective the body does not exist separately from the body as lived.  A person does not exist separately from the environment but is embedded in it.  We do not live in a vacuum, so therefore it behoves us not to study the human form as if we do.

Action Systems

Newton visited the work of Edward Reed, who studied motor responses.  He observed most studies took place in a laboratory under artificial conditions.  Often to isolate specific movements, that is studied outside of the context.  In fact all movement is takes place in context.  And to some extent we now study the body in context especially when assessing performance athletes.  Reed suggested the study of movement be taken in terms of functions-which he called action systems.  These included the locomotion system that we amble around in, the expressive system that allows us to look and listen, and the semantic system that lets us speak.  The concept allows movement to be studied in terms that make sense.  These are purposeful activities that cannot be reduced to the sum of individual motor units.  And it cannot be studied separately from the function.  We begin to acquaint behaviour with structure and function.

The fundamentals of these action systems are the activities of lying, sitting or standing.
These basic activities enable of to survive and thrive and have a viable relationship within the gravity field.

Tonic Function

Goodard calls the body’s ability to organize itself in gravity, ‘tonic function’.

Tonic function is fundamental, and is at the root of every action.  It is taking place below the level of conscious awareness.

The example Goodard and Newton describe is you are standing and are asked to raise your arm.  What is the first muscle to contract when performing that action?  Most will imagine arm or shoulder muscles, but in fact the answer is the soleus muscle.  It is a key muscle in maintaining uprightness in gravity.  “Even before the intended movement occurs, the gravitity function is ensured.”

Anatomically tonic function involves the part of the body- brain, nerve pathways, fascia, muscle spindles, Golgi tendon organs and tonic muscles- all functions to coordinate the body’s negotiation with gravity.  What Newton will describe is that an individual’s particular tonic organization cannot be adequately described without taking more than anatomy into consideration.  It cannot be re-educated without a broader vision.

Uprightness

For human beings, the relationship with gravity is expressed in how we stay upright, or oriented.  This is one of the essential aspects of our uniqueness as human beings.  If we are unable to maintain uprightness, it becomes more than a problem with standing.  It is the fundamental basis for our emotional and psychological orientation with the world.

Newton equates uprightness as having a symbolic dimension.  It is a problem with significance and meaning in life.  Our language metaphorically as with touch, reflects this orientation, as we link verticality with morality; an ‘upright individual’, or a person of ‘good standing’.

If as Newton quotes Erwin Strauss in an article entitled Upright Posture,” …because upright posture is the ‘leitmotiv’ in the formation of the human organism, an individual who has lost or is deprived of the capacity to get up and keep themselves upright, depends for his or her survival, completely on the aid of others.  Ultimately without their help the organism is doomed to die.  A biologically oriented psychology must not forget that upright posture is indispensable condition of man’s self-preservation.”

What Newton claims is that when we view posture from this perspective we are tapping into a “primordial, instinctive relationship that is so profound as to be almost invisible.”

Tonic Function and Individual Development

The key concept that Strauss continues to elaborate upon is that upright posture characterizes the human species.  “Every individual has to come to terms with gravity and their own unique uprightness.  Psychologically this comes with the development of the ability to control movement.”

Newton states,  “the nerves and muscles that make up the tonic system-that register and respond to our changing relationship with gravity-these are the very same pathways that will fulfil this basic developmental function.”

Their has been numerous research done on patterns of movement and childhood development.  Newton sites Judith Kestenberg, a psychoanalyst trained in Laban movement.  Kestenberg describes the patterns of movement developed in infancy.  “The simpliest explanation for changes in muscle tension is the physiological interplay between agonist and antagonist muscle groups.  A free flow of tension occurs when agonists are not met with counteraction by antagonists.  The constraint in movement called the bound flow of tension, occurs when antagonists contract along with agonists.
A newborn infants toes stiffen periodically in bound flow.  His/her legss fling and bicycle in spurts of free flow.  An influx of suddenly emrging free flow, may enable him/her to hold its fist there for a brief moment.”

These movements form the basis of interaction with the enviromewnt.

The shape of the body changes during movement.  As we inhale and exhsale, it changes shape. We grow with the ingestion of food, and shrink with the expelling of waste.  We grow toward pleasant stimuli and shrink away from noxious.  Growing and shrinking are the basic elements of shape flow.  They alternate periodically, this rythymic alternation…provides a structure for the organisms interaction with their environment.

Goodard believes that tension flow and shape flow are basis of movement patterns.

And he suggests these are related to the tonic system.

Tonic Function and Communication.

Newton continues the discussion by quoting the previous authors that “we learn from movement studies that their is not only a correspondence between specific drives and specific objects, but also a correspondence between certain feeling tones and modes of expression.”

When we become annoyed, we express that by a furrowing of our brows, while pleasure is recognized by others when we broaden our face when smiling.

References

1.    Laughlin, Kit 2004 website http://www.pandf.com.au/pages/articles/articles.html
2.    F.P. Kendall, McCreary E.K. 1983 3rd Ed. p 270.
3.    Frank, Kevin, March 1995 ‘Tonic Function’ ROLF LINES p.3
4.    Chaitow, Leon, De Lany Judith Walker, 2000 Clinical Application of Neuromuscular Technique, Vol 1 Chap 2 Muscles p 22, Juhan, Deanne, 1987 Job’s Body: A Handbook for Bodywork Chap 5 Muscle p 128, Tortora, Gerald, Grabowski, Sandra, 2003, Priniciples of Anatomy and Physiology 10th Ed. Chap 10 Muscle p296)
5.    Chaitow, Leon, De Lany Judith Walker, 2000 Clinical Application of Neuromuscular Technique, Vol 1 Chap 5 Patterns of Dysfunction, pp 55-57
6.    Chaitow, Leon, De Lany Judith Walker, 2000 Clinical Application of Neuromuscular Technique, Vol 1 Chap 4 Causes of Musculoskeletal Dysfunction pp 43-44, Magee, David J., 1992 Orthopaedic Physical Assessment, 2nd Ed. Chap 15 Assessment of Posture, p. 581
7.    Chaitow, Leon, De Lany Judith Walker, 2000 Clinical Application of Neuromuscular Technique, Vol 1 Chap 4 Causes of Musculoskeletal Dysfunction pp 44-45.
8.    Shea, Michael, 1995 Myofascial Release Textbook, Expression of the Autonomic Nervous System pp45-46
9.    Chaitow, Leon, De Lany Judith Walker, 2000 Clinical Application of Neuromuscular Technique, Vol 1 Chap 4 pp 44-45.
10.    Hanna, Thomas,1988  Smantics: Reawakening the Mind’s Control of Movement, Flexibility and Health. Chap 10 The Sum of Neuromuscular Stress p68)
11.    ibid. Chap 13 How to Give Yourself the Maximum Benefit of Somatic Exercise p 97
12.    Johnson Don Hanlon, 1997, Groundworks, Narratives of Embodiment: Editor, Elizabeth Beringer article pp 81-82.
13.    Dr Moshé Feldenkrais, Body and Mind (article), 1980
14.    Alexander Website
15.    Lieb, n. Brooke, 2001Certified Teacher of the Alexander Technique; Member, American Society for the Alexander Technique (AmSAT); Faculty Member, American Center for the Alexander Technique (ACAT); brookelieb@mindspring.com o www.brookelieb.com Alexander Technique
16.    Rolf, Ida P., 1977 Rolfing, The Integration of Human Structures, Chap 2 Roadmap to Structure p30)
17.    ibid.
18.    http://www.rolfguild.org/mission.html
19.    http://www.rolf.org 2000 the Rolf Institute, 205 Canyon Blvd., Boulder, CO 80302, USA
20.    Goldstein, Steven, 2003, Course Notes on Lecture-Demonstration by Hubert Goodard.  February 2003 at The Body Wisdom Conference, Waimana, Coromandel, New Zealand.