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 Postural Influences on Visceral and Somatic Function By Leon Chaitow, ND, DO (U.K.) We all know that poor posture is damaging to our physical structures, but are we as aware of the wider implications of postural distress on the total economy of the body, and even on organ function? To explore the topic in depth would take a book or two, so the best I can offer in this brief review are some (hopefully) thought-provoking snippets of information.One of the best discussions of the influences on the economy of the body, and on organ function of postural/biomechanical misalignment, was provided by the orthopaedic surgeon Joel E. Goldthwait in the 1930s in his classic book, Essentials of Body Mechanics.1 (Note: Search for this text via Web sites that specialize in second-hand books, if you possibly can. It’s marvellous.) The concepts described by Goldthwait, and subsequently developed by others (see below), are extremely relevant to all health care professionals. They demonstrate the inevitable progression that poor posture leads to as tissues adapt to postural imbalance, with the influences of aging and gravity adding to the picture. Goldwait gives a dramatic and graphic account of the process of decompensation in his book: "The main factors which determine the maintenance of the abdominal viscera in position are the diaphragm and the abdominal muscles, both of which are relaxed and cease to support in faulty posture. Because it is so graphic, I have added italics to the description Goldthwait offers of the slumped posture so apparent in many of our patients. You could draw the picture of the person he describes, I am sure! Obviously, a huge amount of study and research has continued into the widespread influences on health and of poor posture in the 70 years since Goldthwait published these words. One of the most interesting perspectives comes from Dr. Wolf Schamberger, who sets out in his book, The Malalignment Syndrome,2 a current, clinical and research-based view that totally supports the previous Goldthwait observations. Schamberger describes some of the inevitable changes that are associated with common asymmetries, as follows: "Malalignment of the pelvis, spine and extremities remains one of the frontiers of medicine. Schamberger offers examples of visceral problems emerging from malalignment of the pelvis, resulting, for example, in pelvic floor dysfunction: "Typical visceral problems that have been attributed to pelvic floor dysfunction include: incontinence of bowel and bladder attributed to a lax floor; constipation and incomplete voiding when there is excessive tension; dysmenorrhoea, dyspareunia, impotence and sexual dysfunction; and recurrent cystitis and urinary tract infection."3,4,5 Osteopathic clinical researcher M. Kuchera6 has looked at the effects on posture of gravity: "Gravitational force is constant and a greatly underestimated systemic stressor. Of the many signature manifestations of gravitational strain pathophysiology (GSP), the most prominent are altered postural alignment and recurrent somatic dysfunction. ... Recognizing GSP facilitates the selection of new and different therapeutic approaches for familiar problems. The precise approach selected for each patient, and its predicted outcome, are strongly influenced by the ratio of functional disturbance to structural change." M. Kuchera and W.A. Kuchera7 add a perspective that highlights some of the other key influences on what they term postural decay: "Posture is distribution of body mass in relation to gravity over a base of support. The efficiency with which weight is distributed over the base of support depends on the levels of energy needed to maintain equilibrium (homeostasis), as well as on the status of the musculo-ligamentous structures of the body. These factors, weight distribution, energy availability and musculo-ligamentous condition, interact with the (usually) multiple adaptations and compensations which take place below the base of the skull, all of which can influence the visual and balance functions of the body." Over time, adaptational changes as listed by Goldthwait, M. Kuchera, W. A. Kuchera, and Schamberger are likely to progress from the production of dysfunction, such as low back pain, to the evolution of actual pathological changes. These examples show how structural and functional features strongly influence each other and how other factors, including age, available energy, musculo-ligamentous status, and gravity all help determine the changes that evolve. Finally, patterns of use - in this example, changes created by poor breathing function - can have marked influences on structures and on organ function, on top of those imposed by the influences of poor posture. Garland8 has summarized a series of changes that follow from unbalanced breathing habits including visceral stasis/pelvic floor weakness, abdominal and erector spinae muscle imbalance, fascial restrictions from the central tendon via the pericardial fascia to the basi-occiput, upper rib elevation with increased costal cartilage tension, thoracic spine dysfunction and possible sympathetic disturbance, accessory breathing muscle hypertonia and fibrosis, promotion of rigidity in the cervical spine with promotion of fixed lordosis, reduction in mobility of the 2nd cervical segment and disturbance of vagal outflow ... and more. In order to evaluate posture, observations, palpation and specific assessments all are needed. The basic requirements include:
In a future issue of this publication, I will present some of the most effective palpation/assessment methods that can help us make sense of these changes, allowing effective treatment protocols to be developed. References
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All Rights Reserved, Naturopathy Digest, 2011.
Date Last Modified - Friday, 17-Oct-2008 12:10:58 PDT
The disturbances of circulation resulting from a low diaphragm and ptosis [‘sagging’], may give rise to chronic passive congestion in one or all of the organs of the abdomen and pelvis, since the local as well as general venous drainage may be impeded by the failure of the diaphragmatic pump to do its full work in the drooped body. Furthermore, the drag of these congested organs on their nerve supply, as well as the pressure on the sympathetic ganglia and plexuses, probably causes many irregularities in their function, varying from partial paralysis to overstimulation. All these organs receive fibers from both the vagus and sympathetic systems, either one of which may be disturbed. It is probable that one or all of these factors are active at various times in both the stocky and the slender anatomic types, and are responsible for many functional digestive disturbances. These disturbances, if continued long enough, may lead to diseases later in life. Faulty body mechanics in early life, then, becomes a vital factor in the production of the vicious cycle of chronic diseases and presents a chief point of attack in its prevention. ... In this upright position, as one becomes older, the tendency is for the abdomen to relax and sag more and more, allowing a ptosic condition of the abdominal and pelvic organs unless the supporting lower abdominal muscles are taught to contract properly. As the abdomen relaxes, there is a great tendency towards a drooped chest, with narrow rib angle, forward shoulders, prominent shoulder blades, a forward position of the head, and probably pronated feet. When the human machine is out of balance, physiological function cannot be perfect; muscles and ligaments are in an abnormal state of tension and strain. A well-poised body means a machine working perfectly, with the least amount of muscular effort, and therefore better health and strength for daily life."
About the Author: Dr. Leon Chaitow was born in South Africa and then moved to London, where he trained in osteopathy and naturopathy. Dr. Chaitow is actively teaching in America, Australia and Europe. Currently, he is involved in a major project developing a new textbook, Naturopathic Physical Medicine, collaborating with 15 leading naturopathic, chiropractic and osteopathic experts from around the world. Dr. Chaitow can be reached at 