Bulls**t about posture causes pain & suffering

Cheryl Lee was managing a pain problem, with mind-body practices. It wasn’t until learning about pain science and undergoing CFT that she learned to optimize these practices and also turned a corner in managing her own pain, being compelled to examine some beliefs, and change aspects of behaviour, lifestyle, movement and mindset.

With a background in yoga, Pilates, mindfulness and somatic movement, Cheryl now teaches mind-body movement practices in a way that is research-informed. Fascinated by the brain and nervous system, she is a lifelong learning enthusiast wishing to enable and empower others to ease pain, move better, learn to relax and get back to activities they love.

Cheryl wrote a blog on her experience of the messages around posture that are widely held in society and the effect these beliefs had on her low back pain experience.

Hold up your fist in front of you and clench it hard.

Keeping it clenched, how far you can roll the wrist forwards and backwards? How does that feel? Comfortable? Easy? Of course not. Would you be comfortable walking around all day with the muscles of the hand, wrist and forearm held in co-contraction? Of course not.

Yet many of us constantly do this to our trunk. We pull in the belly, erect the spine and pin the shoulders back.

Why do we do this? We want to look thin. We yearn to stand tall. We wish to project a strong physical presence. We’re aiming to improve our posture. We’ve been told slouching is bad and we ought to sit up straight. We’ve read about ‘core stability’ in health and fitness magazines. We’ve been advised at the gym, or even by health professionals, that we have a weak core.

Any way you look at it, beliefs about stabilising the core in order to get strong, protect the spine and have a good posture are rampant among friends, in communities, in society and in the media. Why on earth wouldn’t you follow advice that appears to be endorsed by everyone, everywhere?

I certainly followed it. I read all the health magazines, I had been on courses telling me it was so. I bought specialist books that echoed the message. I taught it.

Then I slipped. I fell on a wet, mossy flagstone, landing heavily on my left pelvis. I’d had back pain for a while before, but suddenly start getting scary neurological symptoms. My doctor sent me to A&E with suspected cauda equina, a potentially serious neurological syndrome which can result in paralysis if not treated early. I was kept in hospital under observation and given an MRI. Fortunately the symptoms cleared. I was discharged and told to work with the physiotherapy department.

My MRI revealed a spondylolisthesis. Various health care professionals told me to stop impact, reduce activity, and strengthen my core because it was weak and my spine was unstable, even though I was a Pilates teacher who did Pilates every day. One physio told me I was ‘broken.’ Have you ever sees a spondylolisthesis? Looks pretty scary, doesn’t it? I took their words and advice seriously.

I stopped going to the gym and taking classes. I did the prescribed exercises, even though they made things feel tighter. I got worse and was doing less, never feeling any stronger or more stable. Physiotherapy could do nothing more for me. The chronic pain clinic told me to start using a wheelchair. It was a hell that lasted 6 years, but that is another story.

So let me get to the point. I didn’t get a wheelchair. I kept searching. I found hundreds of people with stories like mine. Thousands. I found movement teachers, trainers, researchers and clinicians — with world class reputations at the cutting edge of neuroscience, pain science, the nervous system and movement — who understood the body differently. I was not broken. My core was not weak. My spine was robust and strong, not unstable. I had been following advice to sit straight, stand tall, stabilise, draw in the belly, splint my broken back. I was scared to bend, squat, or move quickly, so avoided it. My breath was shallow and ragged. I was scared about the future. This ongoing fearful situation had ramped up my body’s defences and jacked up the tension in my body, splinting me more than the exercises I had been doing.

The advice I had been given, the words that had been said, the beliefs I had taken on through my own learning had turned out to be nocebos — noxious messages with a detrimental effect on my health and well-being — that kept me locked in a prison partly of my own making.

The constant co-contractions, the fear, the movement avoidance — these had been huge factors in the pain symptoms. I learned to let go of my belly and back, and create space in my body; move with fluidity and ease; breathe fully into a soft, yielding belly; slouch and relax at the same time. I learned that I could contract my muscles with control, but also release them FULLY; that I could run, jump; ride a bike with a rounded back. I learned my spine and body were strong, and that I could get better.

I’m not an isolated case. This is universal. Let’s stop peddling old-fashioned ideas and bullshit about health. Stop selling movement and exercise by telling people they are weak and unstable. Instead, let’s empower, educate and help people to make sense of their pain, shake the labels, improve their function and move fluidly and fearlessly.

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