The Truth about Posture and Back Pain

Let us start by understanding something very basic and binary. The body affords movement and posture primarily from two aspects of physiology.

1) Mechanical form and function

2) Neurological form and function

What this means in the most basic sense is that your body allows itself to move and organize through its structural capacity (tissue pliability, genetic form, hip shape, muscle length, etc...) and its neurological activity. The second one is a little more difficult to understand. Let us go one level more elementary.

Structural/mechanical is essentially if we took a person unconscious under anesthesia (or a cadaver if you want to be macabre) and moved their body about. How far their hip can rotate, if they can be placed into the splits, how far their spine bends, is all being dictated by the structural elements and their lengths and shapes.

Neurological is basically the system with the power turned on. It can limit motion well before the true mechanical end point. All we need to do is look at a person with acute pain (hamstring tear, disc herniation, etc...) to see that movement can be extremely limited by the brain.

So when we are trying to understand our own body's limitations we need to view it through these two lenses. Some areas could be restricted by structural or neurological...or both honestly. Other areas are inhibited which may be considered normal or could be causing issues due to instability.

Let's use the low back as an example to understand how this more deeply, and also see how things like this can progress over time.

Let's take a person, a very common one at that, who lacks hip mobility and rotation and also mid back mobility and rotation. They have a mechanical or structural restriction and doesn't allow them to move well in space. They have to compensate to run, to squat, to throw a ball and to go kayaking.

This leads the low back, the area directly sandwiched in the middle of the mid-back and the hips, to become unstable due to the constant mobility demands. The low back is overutilized to move. With time this can lead to pain, injury, discomfort, etc...but also with time the neurological system will be sensitized to start protecting this area from more damage. Basically, the brain will sense something isn't right in this part of the body and will start "locking" it up. The hamstring will "feel" tight. The low back will become more rigid and begin looking like a mechanical restriction, even though its real problem is too much movement and instability. The low back may present itself as the obvious problem, the culprit in this whole affair...when really it is the subject of bullying from the hips and mid-back.

So when evaluating...we must always evaluate form AND function. It takes many pieces of a puzzle coming together before the image can actually be seen. The body is similar. But we can uncomplicate it sometimes by simply looking for asymmetry from side to side and functional deficits compared to what is "normal".

Take a look at yourself.

Has that 2-minute hamstring stretch you've been doing every day for the last 9 months

— the one that hasn't gained you any flexibility — been telling you something?