What is posturology and how can it help you?
WHAT IS POSTUROLOGY?
Posturology is a multidisciplinary medical discipline that examines the main plumb lines of the human body. Postural pathology is an imbalance of these plummets, producing an excess of stress that causes musculo-articular pathologies and changes in the motor pattern.
Postural imbalance is caused by asynchronism in one or more postural sensors:
Proprioceptive joint sensors
CAUSES OF POSTURAL IMBALANCE
We are all asymmetrical, due to our physical composition, habits and lifestyle. Some of us compensate for this condition and are free of disorders. The same does not apply to some others.
In fact, some circumstances such as working conditions (prolonged, repetitive bad posture) or trauma can decompensate the postural system. In addition, asynchronism in postural sensors, such as jaw or visual asymmetry or even asymmetry in postural support, will produce a postural imbalance responsible for a series of pathologies.
Postural Impairment Syndrome occurs when the regulatory centres are unable to carry out a congruent synthesis of the information received by the various sensors. This syndrome indicates the discovery of damage to the sensory, transmission or information integration systems necessary to achieve postural balance.
WHAT IS POSTURAL DEFICIENCY SYNDROME (PDS)?
Postural deficiency syndrome (or postural plumb disorder) was described by Dr. Martins Da Cuhna in 1979. This syndrome occurs as a result of a disturbance in the balance of muscle tone and postural equilibrium.
PDS is characterised by a clinical picture comprising clinical and metric symptoms and signs of Stabil:
The patient complains of feeling unwell when standing: he/she staggers or experiences pain in this posture.
Stabilometric recording confirms that his performance falls outside normal limits (control of postural sentences is abnormal).
Clinical examination reveals an abnormal symmetry of his postural muscle tone (regulation of muscle tone activity is abnormal).
However, there is a fourth criterion which is indispensable for the diagnosis and which clearly distinguishes the posturologist’s approach from the conventional approach: by manipulating one or more sensory stimuli of the system, certain signs of asymmetry are immediately modified before the signs and symptoms of the syndrome are finally eliminated.
WHAT ARE THE PATHOLOGIES FREQUENTLY ENCOUNTERED IN POSTUROLOGY?
A highly variable symptomatology is the effect of postural imbalance. In addition to the frequent musculoskeletal complaints (neck pain, headaches, lower back pain, etc.), there may also be symptoms of perception deficits (dizziness, loss of balance, clumsiness, etc.) and cognitive problems (lack of concentration, dyslexic disorders, fatigue, etc.).
Many pathologies are related to postural imbalance. These include:
Chronic low back pain, recurrent sciatica, herniated disc.
Gonalgia, scapulalgia, frequently asymmetrical coxalgia
Repetitive neck pain with torticollis, back pain – Repetitive muscle injury
Polyalgesia and other fibromyalgic clinical features
Persistent pain after joint replacement.
“5 or 6 times a year, my osteopath realigns my vertebrae”.
Irritating heel spurs
Localised painful muscle hypertonicity resistant to treatment
WHAT TESTS ARE CURRENTLY PERFORMED IN POSTUROLOGY?
Barré vertical axis test
Bassani foam test
Tonic convergence test
Passive antepulsion test
Rotation test and head extension test.
HOW SHOULD A PATIENT WITH “POSTURAL IMBALANCE” BE TREATED?
he aim of postural treatment is to modify the input of the system by manipulating the postural sensors for an optimal reprogramming of the muscle tone. The aim is to alleviate stress pathologies and improve sensor performance.
Treatment of patients with postural imbalance is often multidisciplinary.
Postural treatment requires the involvement of several specialists working collaboratively according to the sensors involved in the pathology:
Balancing of the musculo-articular system: osteopath, physiotherapist.
Production of a plantar orthosis: chiropodist
Orthoptic rehabilitation: orthopaedic specialist
Prescription of optical prisms: ophthalmologist
Treatment of pathogenic scar tissue: doctor, physiotherapist.
Fitting of a cap splint or occlusal treatment: dentist
Tongue rehabilitation, phonation and ventilation: speech therapist, physiotherapist
Vestibular rehabilitation: physiotherapist, ear, nose and throat therapist
Stabilisation of the new postural state after treatment: physiotherapist, rehabilitation physician
Ergonomics advice to reduce the incidence of iatrogenic postures: posturologist
General practitioner and rheumatologist for preliminary diagnosis and coordination.
Each posturologist can therefore become the person who leads the multidisciplinary postural treatment, but should never replace the expertise of any of the other specialists.
All postural treatment must be complemented by appropriate rehabilitation to stabilise the new postural state.
This rehabilitation treatment will be specific to each category of postural imbalance.
Illustration: clinical case
Example of rehabilitation of a patient with a class 4 postural imbalance:
Sohier’s longitudinal and transverse decoaptation techniques for the hip.
Isometric contraction technique against the resistance of the internal rotators
Deep transverse massage of the contracted iliotibial band
Stretching of the contracted psoas and quadratus lumborum muscles
Toning of the quadriceps
Warming up of the dorsolumbar hinge (Sphinx exercise)
EQUIPMENT FOR POSTURAL DIAGNOSIS
Appropriate equipment is required for posture-related diagnosis as well as for efficient follow-up of postural treatment.
EQUIPMENT – THE BARRÉ VERTICAL AXIS
The Barré vertical axis examination is based on a diagnosis of postural imbalance. It is used not only to determine the patient’s postural classification, but also for diagnostic targeting of the sensors involved in postural imbalance. A centring platform, a tripod telescopic laser and a plumb bob are required for this test.
EQUIPMENT – THE BASSANI FOAM TEST
The foam test directs the postural diagnosis to the mandibular and/or visual sensors by shunting the foot afferents. A suitable foam pad is required for this test.
EQUIPMENT – THE MADDOX TEST
The Maddox test orients the diagnosis towards visual sensor asynchronism. It is also used to measure the effects of postural treatment on the visual sensor.
A “Maddox rod” and a light spot to be placed on the wall at a distance of between 2 and 5 metres.
EQUIPMENT – THE PODOSCOPE TEST
The podoscope test defines whether the footprints are symmetrical or asymmetrical. A suitable podoscope should have tangential illumination.
EQUIPMENT – THE SCAPULAR TEST
A manipulation table or a simple massage table is used for the scapular test.
Measurements are necessary not only to quantify muscle tone imbalance. They are also useful to quantify the efficacy of a treatment during the therapeutic procedure, as well as the efficacy of the treatment over time.
Measuring postural imbalance is also useful for sharing quantitative data information with the various therapists involved in postural treatment.
Finally, there is no possibility of publishing research in scientific journals without the inclusion of measurements.
EOS SYSTEM IN POSTUROLOGY
In posturology, the EOS system allows:
improve postural diagnosis by measuring postural imbalance (pelvic and spinal parameters)
measure postural compensation capacity
define individualised postural therapeutic objectives
evaluate the impact of postural treatment
facilitating multidisciplinary communication
The posturologist is particularly interested in analysing the adaptive capacities of the spinopelvic system, including the different compensatory systems (hips, knees, ankles) in order to implement a therapeutic strategy aimed at achieving the most economical posture for a given person.
A postural assessment will be necessary:
outside a pain phase
In orthonormal position: horizontal gaze, shoulders relaxed, hands resting on the front of the shoulders to loosen the shoulder girdle as much as possible.