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February 19, 2013

I decided to go shopping with my wife (this is a rare task!) last weekend and wondered into a Retail Outlet shop. Thirty minutes later we had bought 2 reclining chairs at a bargain price after a massive discount!

This in itself means nothing at face value but the purchase was as a direct result of both of us complaining of an upper backache whilst watching television and myself the occasional deep ache in my right shoulder and hand. As a Physiotherapist I have come across many patients who have had similar pains and treated them successfully. There were a few however that did not respond to treatment and these individuals did give me a bit of a ‘brain ache’ at the time as I always found myself questioning my choice of treatment/management but in all those cases I always had to refer them back to their GP. One common managment theme was posture advice; but what does this mean?

A third party can always bang on about ‘good and bad posture’ but does this really mean anything to the patients? Are we wasting our time trying to get individuals to sit or stand in a certain way to relieve stress on body structures? On reflection, it maybe that as a clinician I have been too focussed on precision without concentrating on ‘engagement’; ensuring that the patient takes responsibility becuase within their busy day to day schedule there is no such thing as a ‘good posture’ but rather a ‘functional posture’ that allows them to complete everyday tasks. I sat in my old chair to watch television because the layout of my room is dictated by the size of the room, the type of furniture that I had and the important economic problem of costs to refurbish it. In other words my posture became functional to allow me to relax in my ‘favourite’ chair chilling out in front of the television. By the way, I do go to the gym twice a week so I do not consider myself as a couch potato.

I wonder what evidence there is out there to suggest that we continue to bang on about posture? Its like the question of low back pain being cause by obesity I suppose? I have reservations about the drive to introduce evidence based practice in Physiotherapy at the expense of everything else so I will need to keep an open mind about this especially when I have an advice sheet on posture on my website but I suppose it is worth looking into. I’ll keep you posted on developments!


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