The Chasm between Posture &
Chiropractic Education and Treatment (cont.)

What Constitutes Good Posture? (cont.) In the anteroposterior view, approximate skeletal symmetry allows division of the body into symmetrical halves with bisection of the following points: glabella; frenulum; episternal notch; xiphoid process; symphysis pubis; and a point midway between the medial malleoli of the ankle joints.

Of course, radiographic examination may also be helpful in evaluating a patient's posture since the x-ray passes through the patient's three-dimensional posture and is captured as a two-dimensional artifact on the x-ray film. The focus of this article is introductory and general in nature. The complexities of correlating a patient's 3-D posture with their projected 2-D image is a topic of much importance that will be discussed in a later article. For now, let it suffice to say that deviation away from the general guidelines described here could be considered as alterations away from normal posture, the outcome of which can ultimately lead to the development of pain and dysfunction.

Some of the Physiological Effects of Altered Posture:
Bad posture is a lifetime scenario for most people. World-renowned physiatrist Rene Cailliet,MD, has demonstrated that if the head weighs 10 pounds and is aligned with the external auditory meatus directly above the acromioclavicular joint, the effective load on the spinal tissues is 10 pounds. However, if the head is translated anterior, the weight exerted by the head is effectively increased by a factor of 10 with each additional inch of forward translation. That is to say, if the abnormal posture presented demonstrates two inches of forward head posture, the effective weight of the head to the supporting tissues is not 10 pounds, but 20 pounds; three inches of forward head posture results in an effective weight of 30 pounds, and so on. It is known that bone and soft tissue can suffer from such postural abnormality.

Research has demonstrated that when loads are altered, bone remodels to accommodate the imposed demands.9 Imagine for a moment the shape of the cervical spine of the woman in Figure II. It is likely that her lower cervical spine would be hypolordotic; a situation that could lead to the development of osteophyte formation. Indeed, it has been shown that subjects with hypolordotic cervical spines have a greater incidence of osteophyte formation10 that is probably due to the imposed demands placed on the hard tissue. (more)