Designing Custom Posture Routines - An excerpt from chapter 6
Chapter 6: A.F.T.E.R. P.A.I.N - An Algorithm for Better Posture
“Learn how to use your nervous system.” - Timothy Leary
I studied both Engineering and Computer Science at New Mexico State University. Whether by chance or destiny, these two fields of study prepared me perfectly to be a posture therapist! It wasn’t the life plan I had carved out for myself, but the nature of my severe injuries drove me toward posture therapy instead. But how did these two seemingly completely unrelated fields help me become a better posture therapist?
A Systematic Approach
A posture therapist analyzes the body in a way that is much more similar to how an engineer might analyze a bridge or mechanical system rather than how a doctor or radiologist might analyze a set of images from an MRI machine or results from a blood test. Posture therapists seek to avoid the tunnel vision that can arise from focusing on individual areas of the body and instead analyze the entire body as a single unit.
Like engineers, posture therapists are interested in things like the center of gravity, symmetry of design, and how the body responds to various kinds of physical stress.
As it turns out, our approach to affecting postural changes uses an algorithm similar to what a computer programmer would use to solve a complex data problem.
Computer programmers use algorithms to solve seemingly impossibly large problems using iterations of the same process over and over, making the problems smaller and smaller each time the algorithm is repeated until a solution is reached. The great thing about algorithms is that they use the same overall strategy to solve problems regardless of the input. This is accomplished by tailoring tactics to match the input.
This is exactly how posture therapy works, as well! No matter which posture condition is being targeted, we can start with the same strategy but still tailor the tactics to the individual posture.
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The steps go in this order:
Address Symptoms
Front-plane symmetry improvement
Top-plane rotation reduction
Equalize side-plane center of gravity
Restore neutral pelvic function
Progressively strengthen from the hip flexors out toward extremities
Affirm bilateral equality
Integrate with other forms of exercise
Never stop repeating
You might be lamenting “I have to do all nine of these steps every day?!” Before you get overwhelmed, know that not all of these steps are strictly necessary in every posture routine you do every single day. For instance, certain steps can be skipped when you’re just doing a warm-up routine for another activity, or a variety of other reasons. In the following sections of this chapter, we’ll discuss each of the nine steps in detail, including when it is appropriate to skip various steps.
But before we do that, let’s address two important facets of this algorithm’s practical application: it is not only the choice of exercise that matters but also the order in which they are performed.
Choosing & Sequencing Exercises
At the risk of beating a dead horse, it’s important to note that there are several hundred posture exercises, so there are nearly infinitely many possible permutations to implement this algorithm to target various posture conditions and find substitutes for exercises that cause pain.
Many of these exercises work to improve posture in multiple parts of the body, so they may serve to combine multiple steps into one exercise. Or, they might have a valid place in multiple steps, the optimal placement depending on the individual case.
Here’s another reason why choice of exercise is important: just because several exercises might be described as helping to reduce shoulder elevation disparity, doesn’t mean they all work in the same way. Let’s look at an example.
A shoulder elevation disparity could be more closely related to a hip elevation disparity developed over the course of many decades. But another possibility is that it might be more closely tied to lateral flexion and rotation through the spine as a response to injury. If I choose an exercise that’s designed to fix shoulder elevation due to spinal rotation, but what I actually need is an exercise that fixes shoulder elevation due to a hip elevation disparity, I’m not likely to get great results.
Generally speaking, a well-designed posture routine will have at least three exercises or may contain as many as 15-20+ exercises depending on the individual, their pain problems, level of mobility, and lifestyle, among other factors.
I began to truly excel at this creativity in designing routines when I learned how to leverage my training in computer science when applying this algorithm. Sometimes, an exercise may be performed more than once throughout a routine but for a slightly different reason each time, like how many computer programs will sort a set of data multiple times within a single algorithm. Sometimes, I may repeat previous steps with new exercises as a type of recursive function in order to complete a later step. These are just some of the tricks I borrowed from common practices that computer programmers use often. There are many ways to get creative with this adaptable framework, but these are more advanced methods that aren’t really applicable to this level of discussion. For now, just know that these more advanced methods of routine design exist.
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Front Plane Symmetry Improvement
Now for the second step of our posture therapy journey. This step often serves as the de facto starting point for those who are new to posture therapy and have yet to discover exercises that treat symptoms directly.
As a quick reminder from our earlier discussion in the Posture Analysis section, let's review the deviations we look for in the front plane:
Lateral center of gravity offsets in the pelvis, thoracic spine, and cervical spine.
Differences in hip and shoulder elevations.
Bowlegged or knock knees (knees further out than the hips or closer in than the hips, respectively).
Tilting of the head to one side.
In the upcoming steps, including this one, as well as the ones dealing with the top and side planes, we follow a consistent rule of thumb: we start our correction process close to the hips and progressively work our way toward the extremities. In simple terms, if there are elevation disparities both in the hips and shoulders, we prioritize addressing the hip issue before moving on to the shoulders.
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The key here is gradual, incremental change over time. Small adjustments tend to yield better overall results, at least, this holds true in the absence of psychedelics. Remember, the body operates as a single interconnected system.
To help illustrate, let's revisit the list of deviations above, along with some exercises that target each one:
Pelvic offset: Try the Wall Stork exercise.
Thoracic spine offset: Explore Standing Windmills.
Cervical spine offset: Standing Windmills can also be beneficial.
Hip elevation disparity: Wall Stork can address this.
Shoulder elevation disparity: Consider Modified Floor Blocks exercises.
Bowlegged knees: Double Doubles can help increase bowlegged symmetry, while Double Switches can reduce overall bowlegged positioning.
Knock knees: To improve knock knee symmetry, opt for Double Switches to increase symmetry. To reduce overall knock knee positioning, Double Doubles can be effective.
Standing on inside/outside edge of feet: Short Foot to help restore toe, foot, and ankle function.
Tilting of the head: Look into Hooklying on Rolls, also known as Towel Settle.
Keep in mind that while the listed exercises are helpful for many, they might not be the ideal fit for every individual. Numerous posture exercises are available for a reason. Each individual’s posture deviation has unique underlying causes, and their pain or mobility restrictions may prevent some poses. Remember, you can find these exercises on my YouTube Channel, linked in the Online Resources Appendix.
Part of my job as a posture therapist is to figure out how to modify and, if necessary, substitute exercises to meet individual needs while achieving the same goals. Many newcomers to posture therapy feel overwhelmed trying to figure out why there are dozens of completely different exercises that can potentially help correct, for example, a duck-footed stance. But this built-in redundancy is actually a brilliant feature of posture therapy. It allows posture therapists to find ways to help people at nearly any level of ability.
This means that all of the exercises suggested above are potential starting points for correcting those deviations and are not likely to be complete solutions.
Once I have chosen exercises to address deviations in the front-plane, it’s time to look at the top-plane.
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