3-7. Scientific evidence on the correlation of postural imbalance with pain
As in the attached file (You can download), 11 papers suggest that there is a minimal correlation between postural imbalance and pain. But will you just accept and walk away as science say so? What about your opinion? Let's do some critical thinking here.
This man has left shoulder pain and he has what's called 'scapular winging' where the inner side of scapula (wing bone) sticks out. It seems to be rolled forward (rounded shoulders) and downwardly rotated as well, which means its lowest angle gets closer to the spine (Refer to the right image above).
In the physical examination, he complains pain when raising his left arm, which requires an upward rotation of the scapula. Therefore, a physiotherapist helps the upward rotation of his left scapula with hands while asking the patient to raises the affected arm again and this time the patient does not feel any pain at all. Without the help, his pain comes back again. Based on this test result, the therapist would prescribe exercises to facilitate the upward rotation with some myofascial releases on rhomboids, latissimus dorsi and pectoralis minor (chest) that can contribute to rounded shoulders/downward rotation if tight (Refer to the images below).
On the other hand, it would be hard to find an expert who would insist 'According to science, postural imbalance and pain are not related, so it is okay to continue exercises where downward rotation is dominant.' In other words, contrary to the conclusions of related papers, the majority of experts are already acting with the 'neutral alignment' in their mind.
Of course, some may say that these exercise prescriptions are not intended to 'correct' the scapula to be neutral, but to improve the insufficient upward rotation function. However, muscles function best when they are at an ideal length (their neutral position), which has long been proven to be true. (Refer to the image below, sarcomere = muscle fiber)
According to this much stronger evidence, the upward rotation movement can be properly performed only when the scapula is in neutral so that all relevant muscles can also be in their ideal length that is not too short or too long. Then, it is expected that the probability of developing shoulder pain during upward rotation can be significantly reduced in the 'Raising arm' test. Therefore, postural imbalance and pain cannot be considered separately and postural correction can improve muscle function, hence pain.
To conclude, it is highly desirable to act in the direction of correcting postural asymmetry, even if science has failed to reveal the link between postural imbalance and pain. When you decide on something, it is ideal to try it anyway if it does not do any harm. Trying to correct your body shape? I am sure there is no harm in it.
Mr.Physio
3-7. Scientific evidence on the correlation of postural imbalance with pain
As in the attached file (You can download), 11 papers suggest that there is a minimal correlation between postural imbalance and pain. But will you just accept and walk away as science say so? What about your opinion? Let's do some critical thinking here.
This man has left shoulder pain and he has what's called 'scapular winging' where the inner side of scapula (wing bone) sticks out. It seems to be rolled forward (rounded shoulders) and downwardly rotated as well, which means its lowest angle gets closer to the spine (Refer to the right image above).
In the physical examination, he complains pain when raising his left arm, which requires an upward rotation of the scapula. Therefore, a physiotherapist helps the upward rotation of his left scapula with hands while asking the patient to raises the affected arm again and this time the patient does not feel any pain at all. Without the help, his pain comes back again. Based on this test result, the therapist would prescribe exercises to facilitate the upward rotation with some myofascial releases on rhomboids, latissimus dorsi and pectoralis minor (chest) that can contribute to rounded shoulders/downward rotation if tight (Refer to the images below).
On the other hand, it would be hard to find an expert who would insist 'According to science, postural imbalance and pain are not related, so it is okay to continue exercises where downward rotation is dominant.' In other words, contrary to the conclusions of related papers, the majority of experts are already acting with the 'neutral alignment' in their mind.
Of course, some may say that these exercise prescriptions are not intended to 'correct' the scapula to be neutral, but to improve the insufficient upward rotation function. However, muscles function best when they are at an ideal length (their neutral position), which has long been proven to be true. (Refer to the image below, sarcomere = muscle fiber)
According to this much stronger evidence, the upward rotation movement can be properly performed only when the scapula is in neutral so that all relevant muscles can also be in their ideal length that is not too short or too long. Then, it is expected that the probability of developing shoulder pain during upward rotation can be significantly reduced in the 'Raising arm' test. Therefore, postural imbalance and pain cannot be considered separately and postural correction can improve muscle function, hence pain.
To conclude, it is highly desirable to act in the direction of correcting postural asymmetry, even if science has failed to reveal the link between postural imbalance and pain. When you decide on something, it is ideal to try it anyway if it does not do any harm. Trying to correct your body shape? I am sure there is no harm in it.
For more information, click the link below (Free program)
‘[HEALTH 101] The Secret To Living A Healthy, Fit & Pain-Free Life’
www.mrphysio.net/p/health-breathing-and-core-basic…
7 months ago | [YT] | 72