Introduction
La posturology is, to date, one discipline recognized and growing popularity, both between professionals in the medical field, both among identification.
An always greater number of subjects which relies on posture professionals, who work for the improvement of the interaction between body and space, indicates that theeffectiveness of the treatments / corrections results incontrovertible.
Especially i Parents, they seem tirelessly looking for someone who "best"the posture of the children. At the same time, i teachers of Physical Education which sensitize students on maintaining good posture not only in sport, but in study and in life in general.
But why, on balance, is it necessary to evaluate the posture and dissect any compromises of the same?
For further information: Posture
Postural alteration
Le issues, unfortunately or fortunately (depending on the point of view), they are not only dependent on anatomo-functional alterations such as paramorphismi e dysmorphisms (scoliosis, curved back, pronounced lordosis, flat or hollow foot, valgus or vare knees); at the origin one can in fact consolidate disorganization Central, disguised as "lazy attitude", but actually determined by a real one stance uncorrect - in one or more phases - and bound to organic causes "distant".
Recognizing similar paintings is not always easy, because often these problems apparently they do not exist. At certain pains it is sometimes difficult give one explanation (if not hypochondria), as well as to the sensation of widespread malaise e DON'T attributable to causes apparent.
On the other hand, all these effects can belong to a 'alteration corporeal of postural system, subtly fine and impossible to identify for a non-expert, but also for a doctor not specialized in the sector. It is therefore not surprising that certain medicines unconventional (in El Paese) that frame the problem of the subject in a perspective of globality - such as Osteopathy, Traditional Chinese Medicine, Chiropractic etc. - are often able to improve o solve the question.
Body structure and physiological functions are reciprocally influenceable, but this correlation is not always "superficial" or apparently "logical"; a "misplaced" tooth that determines male occlusion, for an lazy eye, a problem otorhinolaryngoiatric at the expense of eardrum or of 'ear internal, for an gastrointestinal problem, for an Traumatic Brain Injury, a spinal pain, a scar surgery etc, are all possible causes occult of static perturbation of the human body - therefore, of the related complications such as painful symptoms.
Who is the Posturologist?
Il posturologist is the one who deals with evaluation (diagnostics) e correction (rehabilitation) postural. Must have attended a course or master di posturology.
On the other hand, in many can occupy di stance: dentist, ophthalmologist, orthopedist, otolaryngologist, gastroenterologist, psychologist, osteopath, physiotherapist, personal trainer etc. A medical degree is not required.
The important thing is that everyone has the itself key di reading, a universal language, which allows to frame e to interpret the messages of the body suffering and perturbed in such a way as to adequately intervene on the "primacy" of the problem, that is: the main cause.
The instructor / coach or personal trainer has one huge responsibility when planning and scheduling a workout, even if the need is simply to "do some movement". L' outdoor Motor is a nucleoside a all the effects; it can help - almost miraculously - but, done incorrectly (in all possible errors), it can cause substantial damage, especially in the long term.
That's why, before training it, the trainer has the duty di analyze the person through some test, understanding the any problems and trying to structure an adequate program that does not cause harm, or, if necessary, referring the subject to a specialist.
Postural maintenance
Factors of postural maintenance
Postural alteration implies several factors. The informants area of static, therefore also yours perturbatori, they are essentially:
- Eye;
- Vestibule;
- Temporo-mandibular joint (ATM);
- Foot;
- Visceral system;
- Cranio-sacral system;
- Scars.
The factor should also be mentioned somato-emotional, but the subject would become even more complex than it already is.
How does postural maintenance work?
All receptors positioned in the sites mentioned above collect information both fromexternal that frominternal of the body e fit l'atteggiamento of the subject in the most way convenient possible, with the maximum return - remain standing for many hours - with the less expenditure of energy.
Il body human is not may in a state of complete immobility / liabilities - cit .: "Only the marble statues remain motionless". Each body structure is constantly looking for its own state di equilibrium.
To ensure that the entire body structure is maintained erect e stable, the Nervous System (SN) elaborates a series of information and email to the periphery so that the body has its own projection of the center of severity - which is located front to the 3rd lumbar vertebrae - in polygon di support between piedi - virtually designed by 4 points which correspond to 2 heels and 2 external to the 5 metatarsi. To be clear, let's imagine a kind of quadrilateral in which the corner points are composed of the two external toes and the two heels.
Description of the base polygonBy projecting the center of gravity into this "trapezium", the body keeps itself in balance by swinging like an inverted pendulum, drawing a cone of about 4 ° degrees.
This first observation may already be useful information when evaluating a subject. In fact, a body that oscillates in an important way or in an anomalous way is to be considered perturbed.
Description of an ideal cone according to the oscillations of the bodyEyes closed and open
Ad closed eyes, these fluctuations remain altered. It is estimated that, in physiological conditions, with your eyes closed, these undulatory movements are more twice as much; that is why, eliminating information from the ocular receptor, the postural system calls into play less "adapters", then employs more energy to to maintain the static erect. Se but the fluctuations with eyes closed really are remarkable, more than necessary, we are faced with one problems that comes "compensated"give it eyes.
Often, however, the reverse could happen: eg open eyes the subject oscillates considerably and eyes closed falls under conditions of "normality". In this case theeye it is an element perturbatore and often with the use of glasses, the swings come normalized. If this individual is already a wearer of corrective lenses it is good to consider the idea of ​​following a program of training with the glasses, or, if you do not use it, of postpone it from a oculist; the latter also works in the postural field, to evaluate the idea of ​​a lens that corrects the static alteration defect.
Temporo-mandibular joint
The same reasoning can be made for theTMJ (Joint-Temporo-Mandibular) which, in condition of closed mouth e no occlusion, may or may not give fluctuations.
The situation that changes the trend of the undulatory movements is to be traced back to one Possible cause uncanny. At this point our duty would be to postpone the subject from a odontologist-orthodontist, aware from a postural point of view, who will opt for an intervention more appropriate to the case.
Again in reference to the mouth, a very important parameter is the neurophysiology area of language - in particular his own position - which, as many studies have shown (see Myofunctional Therapy), can completely alter la stance; it could be verified by making assumptions various positions to the language itself e observe i changes.
The parameter can also be evaluated further vestibule, in fact if ad closed eyes and mouth open the oscillations are increased further or even if one is observed perdita dell 'equilibrium, is likely that the subject suffers from complications of the vestibular apparatus; therefore, in case, it is advisable to refer to the ENT specialist (otorhinolaryngologist).
The loss of balance, however, in addition to the fact of deriving from the vestibule or from one compression in the stretch cervical can be traced back, in cases more gravi, to a problem cerebellare, therefore at the level of cerebellum. In this case the trainer can do nothing but information the patient of what the causes of your problem and to consider undergoing one specialist from a neurologist, if the vestibular apparatus and the cervical tract are normal.
Obviously, these deductions DON'T I'm always like that simple as they may seem; in fact, often precisely identify differences in oscillations is difficult to the point of DON'T to notice alterations. Most of the time they are required over di 30-60 seconds to appreciate undulatory movements interesting which give us useful information - it depends a lot on the observer's "eye" - so careful and patient observation is certainly useful.
Other tests will be required but the personal trainer is not a specialist; he must instead behave as a "physical educator" who works on afferents and, possibly, indicate the lines to follow in case of obvious problems.
Posture Compensate
One point to keep in mind is that DON'T we must research necessarily statics alterations in all the subjects we evaluate. There are people who, despite a notable scoliotic attitude, and other bodily alterations, DON'T require interventions by specialists why DON'T present sufferings (see compensated scoliosis).
This is because that body has found his adaptation and lives "quietly" in that condition; it is well compensated. Customer observation also on a piano sagittale becomes important again in order to evaluate an accentuation or reduction of curve of rachide; in particular, from this angle it is possible to appreciate a "front posture"or one"back posture".
Main types of postures (Front-Back)Both the one and the other are to be considered extreme; in fact, they exist many types of intermediate postures. Generally speaking, an attitude of posture front denotes a retraction area of rear chain while in posture back a retraction area of front chain, the psoas and central tendon.
It must be remembered that hardly one type of posture will be like that obvious, but it is good to keep these considerations in mind especially when creating a program training and, in specific, with reference to the sessions of muscle stretching.
Vertical of Barrè
Continuing in the evaluation, another tool which is very useful and indicative is the report on a front plane, compared to a plumb line, To Vertical this "by Barrè". It allows us to frame, indicatively, the provenance of problem.
By observing the subject in these terms, we would be able to direct ourselves towards one problems that comes from above (descending), coming from bass (upward), a component mista (ascending-descending) or type traumatic.
I anatomical references they will be space between heels, sacral triangle and occipital triangle. If the above parameters are aligned to the vertical it DON'T denotes disruptions important of the static - or at least to these types of evaluation - and in this case the subject is "well aligned"
Classifications to the Vertical of BarrèIf, on the other hand, we are faced with a case A, it is possible to trace the problem back to the upper triangle; in fact, the triangle of the sacred it is in line with piedi but the part occipital is translated to left, and this denotes an origin top. Here you can to investigate further on eye, jaw, ear, Problems sacral skull, high vertebral, upper limbs and problems visceral alti.
If we are faced with a case B, it is possible to trace the problem back to the triangle lower; in fact the triangle of sacred DON'T it is in line with piedi and forehead. In this case we can investigate the hip bone, clock face low visceral, anca, knee, ankle e foot.
If we are in the situation C, it is possible to reduce the problem to one mixed component, both from below and from above; it will only be necessary to establish la priority in the sense of understanding which information is more disturbing.
If we are in the situation D, on the other hand, it is possible to bring back the problem to a traumatic event typical of "whiplash" (whiplash) That changes la body statics. Often times, these types of presentations can also occur in situations emotional problems, type trauma o shock.
A final example is that of bodily alterations well make up as shown in the picture, where despite a noticeable alteration of the curves of rachide, the triangles, upper and lower, are on line.
Body in line with the Barrè VerticalIn this situation we are faced with a condition of "autonomous body compensation strategy" which, according to many experts, DON'T would go modified, if not to give mobility sectors to the structures that require it.
At this point, once you understand how to orient yourself, you can to research il receptor who had presented the possibilities problems.
Eye tests
Tornado to the problems coming fromhigh, you will be able to perform test for the ocular receptor and, in case of anomaly, send the subject back to specialist.
Keep in mind that what the trainer does DON'T it's a "medical examination", but gods simple test to investigate the possible receptor that gives the positivity of postural disturbance and, in this case, refer the client to the "clinical professional". He is not interested in the pathology or medical problems inherent in that receptor, but simply takes note of the fact that the primary cause of the perturbation can be hidden in it; therefore it is good that the specialist in question resolves any problems related to that parameter which, according to the postural evaluation, gave positivity.
Near point of convergence test
Going to evaluate the ocular component, a simple test to try is that of next point di convergence (PPC). In this test we evaluate the functional balancing to the motor muscles dell 'eye which, for a speech by muscle chains e connection with the cervical tract, they have a'influence postural really remarkable.
This test is performed by asking the subject to follow with eyes un object From one distance di 50 cm about then slowly arrivare up to tip of nose. The eye that fails to follow the object until it reaches the tip of the nose, it goes investigated. In this case it is good to proceed by sending the subject back to a oculist.
Cover Test
cover testAnother interesting test is the "Cover Test", in which yes covers un eye and with theother it asks you to observe un object to a distance about 20 cm; then suddenly yes discovers the eye and it is observed if the newly discovered eye falls in focus or remained motionless like the other. Everything is repeated on the other side. The eye that "falls"as soon as you find out, go investigated.
Evaluation of the temporomandibular joint
Always inherent in the upper triangle, one should also evaluate theTMJ, then the subject is asked to tighten i teeth e open la mouth in such a way as to appreciate the center line of the upper arches of the teeth with that lower and you evaluate them correspondence.
Verification of the Correspondence of the Upper-Lower Interincisive LineIn case DON'T there is congruence the lines become parallel to each other and we could be faced with a "Cross Bite" or cross bite which can cause disruption.
We then proceed to evaluate any click when opening and closing the mouth or when yes strong mountain the teeth, for might appreciate one difference di tension between the muscles chewers. In this case, the customer will be referred to a orthodontist.
Still on the subject of occlusion, it may be useful to evaluate the fluctuations of body or macromovimenti assets of subject, tightening i teeth or with a thickness between them and appreciate the differences of the before and after.
The discourse inherent to the occlusal classes; in fact, according to some orthodontists who work mainly in the field of posturology, they create schemes defaults of stance depending on the occlusal classes depending on whether thearch top is very protruding compared to that lower - 2nd occlusal class of 1st or 2nd division, usually appreciable with retrognathism - or if it is backward - 3rd occlusal class, usually prognathism. In case of occlusion "normal" we talk about 1st class, where the arches do not show anomalies.
Types of Occlusal Classes and corresponding postureIt should be noted that DON'T there always congruence between one type di class occlusal and relative "drawing postural"; as usual, each individual is a case in itself, but for a statistical discourse the examples in the figure correspond with a good percentage.
What interests the trainer, however, is to understand the importance of the stomatognathic system with the whole body and its influence on the postural system.
Evaluation of the Spine
Continuing to investigate the upper part of the body, the mobility of the various ones will be tested segments of rachide, then the subject will be asked to perform some movements that give the opportunity to appreciate any anomalies in mobility sectors.
It is good to observe the movements di lateral flexion area of column da both i sides and annotate with a metro la distance of the hands from floor that flow lungo le thighs; in this way you can appreciate the eventual difference amplitude of range di mobility sectors.
Furthermore, the rotations comparing them with those contralateral. Occur the flexion-extension and takes into account the freedom di movement. This is for the stretch cervical, dorsal e lumbar.
Evaluation of the upper limbs
A quick overview of the movements of thearto top and we appreciate any anomalies. In this regard, please refer to specific books on "Joint-Muscle Test", so that you can evaluate the freedom of movement in all body compartments. In case of limitations functional in any area of ​​the body, it is good to send the subject back to a manual therapist who will know how to "normalize" the limited range of motion of that segment and restore freedom of movement.
The personal trainer, in this case, according to the knowledge of classic analytic stretching (Anderson style) or in chain, he should try, too, of restore mobility to those body segments that were not very mobile and in any case be careful to prescribe exercises that DON'T can be performed in the complete ROM (Range of Mobility), in order to avoid compensations that wear down the structures concerned.
