Hey, I'm Hyper Mobile and if you're listening to this, I'm
guessing you might be too. Hi, my name is Alex and I'm your
Hyper Mobile host. And today we are talking all
about posture. Now, posture is a hot topic.
I cannot tell you how often I see social media content where
people are talking about posture, maybe some people who
shouldn't be talking about posture.
I cannot tell you how many times my patients ask me about
posture, and it's something which I used to be really
confused by because there's a lot of, quite frankly, very
conflicting and confusing information out there.
So in today's episode my aim is that you leave here more
informed and less confused about what you need to know about
posture than you did before you started listening to this
episode. Now before we go any further,
Please note that the information in this episode is in no way,
shape or form medical advice. You have a uniquely hyper mobile
body, a uniquely hyper mobile medical history and that is
something which you need to go speak to your medical doctor
for. But from an informational
perspective, I think the information here is really,
really going to help people understand things better.
Because at the end of the day, one of the hardest things about
being in a hyper mobile body is just quite frankly how confusing
it can all be As well. I do want to note that we have
some really cool things going on.
There's a workshop which is going to be happening in London
in late July, early August. We're still finalizing the dates
for that. There are a couple of things
that are always going on. We have the Discord Community
Hypermobile HQ with my HQ crew. It is a private membership
community for the scientifically minded hypermobile person to
share thoughts, feelings and ideas on what it's like to
really live in a hypermobile body.
And of course we have my newsletter.
It goes out monthly. We missed last month.
That's OK. We're getting back back in the
saddle or back on the wagon, back on track.
And be sure to sign up for that because I do put a lot of time
into it and there is some pretty useful information in there.
And I can promise you that you will not be spammed because I
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top of that because it might be really important with the way
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connected and it's a direct contact line from me to you.
Now let's get into today's episode.
Posture is one of those words that people say with without
even thinking about what it means without defining their
terms. For those of you who don't know
me, I'm auk registered osteopath, so I'm a
musculoskeletal specialist. I did a four year degree in
osteopathy in the UK, but prior to that I did a four year degree
in English literature in Canada at the University of Western
Ontario, now called Western University.
But posture and defining terms here is really, really important
because if we don't know what we're saying, how can we even
make any sense? So posture literally refers to
the position of a well, it can refer to a posture of anything.
You know, cats can of posture, right.
But in the context of today's episode, we're talking about
human posture. So it refers to the position of
the human body including the limbs and the the appendages.
OK, so we're looking at the position of of the physical you
and how that is oriented. Unfortunately, there's this idea
that posture simply refers to static posture.
So I'm sitting right now. That's a static posture.
If I was standing, that would also be a static posture.
But at any point in time, if if you're walking listening to this
episode, if we just freeze you, you know, we we capture you on
film, we freeze that frame. We're going to see you in a a
position and that's going to be a posture.
And there are are things that we can, you know, maybe pick up
from that posture information we can use.
You know that that's a a big part of gait analysis is
literally watching people walk or in my work that I used to do
more so with athletes, although I still do some of it, watching
people move. So posture is, as much as it can
be an isolated instance of someone's body position.
It can be I'm, I'm in every posture right now as I talk with
my hands because that's something I've always done
anyways. It's a word though that we need
to think about in in the context of of history and culture as
well. So there's there's more to it
than just like, you know, this kind of very simplified and very
reductionist idea that we have of good posture, upright, bad
posture, slouching. So our idea of a posture has has
changed throughout time and I'm going to take you on a little
bit of a A Magical history tour briefly in a moment.
But as well, posture and the idea of what constitutes a good
or bad posture depends on on which culture you're in and
which, you know, group of people you're you're with.
The posture that someone has at a dining room table in North
America is probably going to be different than the posture that
someone has when they're eating a meal in Japan, right.
So there, there can be differences in how we approach
things. The posture, going back to that
analogy of someone using the toilet and you know a place
where they have, you know, a porcelain throne, shall we say
is going to differ greatly from me if I'm on a wilderness
survival course in the the wilderness, it's it's going to
be different in that context. So let's let's dive on in.
Let's let's get to it because the history here is fascinating.
So if we go all the way back to ancient Greece, so 2000 or so
years ago, we have these people. You might have heard of them,
Aristotle and Plato, and they like to look at the world around
them and write down a lot of thoughts about it in brief.
And one thing that they did write on was posture in people.
And they noticed that people were very upright.
We are a biped species, you know, we we walk on two legs and
there are a few animals that kind of do that, but we do it in
a very pronounced, a very obvious way.
And they looked at animals which tend to walk on all fours or
kind of like slither on the ground or or move, you know, in
different ways, or they're kind of more horizontal.
And so they looked at humans and they looked at the animals.
And I I suspect as well that they were probably thinking at
this time of the Greek pantheon of gods, which, you know, we
have represented as humans, Zeus and Hera and Aphrodite, they're
they're all people. You know, they were thought to
be imaginary people. But there's this idea that being
upright, because we are people and the gods are people, it
brings us closer to divinity. It's it's less animalistic.
It's reflective of intelligence and some sort of elevation.
So we have this inherent idea, which is really influenced by
the religion at the time that upright is good and to be
anything other than upright is inferior as well.
It's important to note that people at the time of course had
illnesses like it's when you think about what it was like to
be unwell prior to now and even now.
It's not great for, you know, the vast majority of people
worldwide. And it, you know, it's not great
for a lot of people quite frankly.
But when you think of what it's like to have illness in age of
Greece, it was bad, bad times and there were a lot of
illnesses happening which would cause people to end up in a very
hunched over or slouched to that classically like bad posture
position. So people would look at like
their neighbour or whatever who was, you know, walking in a very
hunched over manner prob, you know, possibly because of their
untreated illness of some kind. And they would think
potentially, oh, that person is ill because they've done
something bad because we didn't understand viruses or bacteria
or other mechanisms of illness back then.
So they would say, oh, my, my neighbour, they are a bad person
and This is why they have bad posture and their bad posture is
reflective of them being bad. So anyone with bad posture is
bad and of course we can appreciate from our, you know,
current perspective that this doesn't make sense.
But back then, again, that way of thinking really reinforced
this idea that bad posture was bad from even just like a a
moral perspective. It was something which was very,
very negative. Now there are kind of, there are
different ways of looking at posture throughout history.
There's written text that you can look at.
There's how it's portrayed in art.
And if you're a posture expert listening to this episode and
you'd like to come on the show, I'd love to find a way for that
to happen. So please do reach out to me
'cause it'd be really cool to talk about posture throughout
history and how it's reflected when from the pictures, the
paintings of the Romans lounging, having someone drop
grapes into their mouths, to perhaps the Victorians with
their fainting couches or people in Indian art sitting cross
legged, right? Like there are all these
different portrayals of the human body in position and I
would love to talk about that. But anyways, when we get to the
1500s and 1600s, we have this idea of good posture and bad
posture continuing. And that's really reflected in a
word which crops up at the time, which is upstanding.
So if someone's an upstanding individual, like, we can pretend
I'm upstanding. They are someone who's like
honorable. They have very, very good
morals. They are.
It's something to aspire to. It's a positive thing.
If if you're an upstanding individual, you are an exemplary
human being. And for me, it was so
interesting to see this word crop up around the the 15
hundreds 1600s. And when you break it down, you
get up, up, right, right. And standing.
So there's this idea again that standing up is good as well.
We start to see posture talked about more.
We have the advent of the modern military and the development of
military drill of formation and more of the the modern sense
that we have today. And again, I'm not an expert in
military stuff, so I I hope I'm getting this all right.
But we start to see the idea of a a standardized posture really
come into the public consciousness of, you know, what
is a good posture. And of course from that military
perspective, if we think of that upright standing good posture,
the military upright posture is almost that in a bit extra.
It's like that chest a little bit up.
It's everything in neutral. It's that replicable posture,
which really for me as as someone who's not in the
military, is symbolic of that idea of uniformity and moving as
a unit and erasure of the individual.
So it's interesting again to see the the language start to change
as we start to have certain aspects of society change and
evolve which reflect our understanding and how we view
posture at that time. In 1741, we have the publication
of Orthopedia by Nicholas Andre and Nicholas Andre.
He comes up with this idea of the Andre tree, which has to be
one of, like the cooler, I don't know, eponymous words you can
come up with from a healthcare perspective.
So I don't know if there's anyone listening to this who
also dreamed of having AI don't know, a body part or a cell or
something named after them. Orphanides, like, who wouldn't
want to to put that on something?
But when it comes to the the Andrey tree, the idea that
Nicholas had was that, like trees, humans grow up first.
So we have the little baby, which is kind of like the seed
that makes the tree. And then the baby starts to get
taller and grow up like literally as in vertical.
And then as that human that you know that that teenager and then
that adult as they start to age and their health declines and
they, you know, become less, Well, we see that that downward
slope, that that hunch, that roundedness, that bad posture.
So his idea really did start to even further cement the idea of
good posture and bad posture. So his text really started to
cement the idea of good posture and bad posture with that tree
analogy, which people seem to be big fans of.
As we get into the 1800s, we have the advent of what we
consider to be modern physiotherapy and it happens in
Sweden. And it's important to know that
the guy who founded that, he had a big appreciation for posture
and he in his how he conceptualized physiotherapy
kind of working, he was thinking of military contributions, that
idea of a military posture as well as gymnastics.
And this really feeds into what is present to this day, this
passion for posture, shall we say, amongst musculoskeletal
professionals. And this idea of good posture
and bad posture. It's important to note as well
that around this time we had ballet really taking off.
And when it comes to groups of people who have thoughts about
posture and whose whole craft is built around posture,
ballerinas, any type of ballet dancer like this is an
individual who's had to spend a lot of time dedicated to making
sure that they're able to present certain postures in a
way which is consistent with the demands of their their craft.
So with ballet, again, I'm not an expert in ballet.
They kicked me out for being too tall when I was 4, which is only
the type of thing that could happen back in the 90s.
But anyways, when it comes to posture with ballet, there are
different positions and different movements, and like
the military, you have a core and the ballet dancers who end
up being in the core in particular, they have to all be
moving as one, A beautiful core. I don't know if you've seen Swan
Lake. I've been lucky and gone to see
the ballet a few times, but it moves as a as a unit.
And again, it comes down to that, like the sum of the parts
is what is it? The sum of the parts is greater
than it. It adds up and makes more.
OK, we don't want these. Like we don't want people
sticking out in a ballet corps, just like we don't want people
sticking out in a military unit. We want everyone to be moving as
one. And that really starts to become
very prevalent with the just the explosion of ballet as an art
form in Europe around this time. If we continue into the 20th
century, and I promise we're almost on this history tour, but
isn't it interesting how our ideas of things get shaped
through our existence over time? But in 1967, we have a professor
of public health, Professor John Keeve, and he talks about how
there's really no evidence for our fixation on good posture
because as you can see, it's it's been something we've been
thinking about for a long time and and people thought that
decide if we have a good posture, we have good health.
But he looks at the research that we really only start to get
in the 20th century. We really only started to get
this, the standardized studies that we're so used to today, the
randomized clinical trials, the systematic reviews, all all of
these studies that we're so used to, they don't exist prior to
the 20th century. So he starts to be able to look
at this research, and he says a quote which sums up my views on
posture, which we're going to get to in a second, as well as
some of my favorite tips. But he says, and I'm going to
have to read this quote because it's hard for me to memorize all
this stuff when talking to camera.
There are no scientific facts to substantiate the benefits of
this postural aesthetic ideal. Yet a great deal of attention is
devoted to correcting faulty posture.
And this is a quotation which really summarizes exactly how I
feel when I look at the research.
It's strange how there's this whole fixation on posture and
and everyone has bad posture and everyone must feel bad about it
and everyone must try to have a good posture and spend money on
devices and money on treatment and whatever for their bad
posture so that they can perhaps be good if they work hard
enough. For me it's very strange that
there's this pressure and this fixation really by the public as
a whole, but especially also the the manual therapy industry,
osteopathy, chiropractic, physiotherapy, whatever, because
it doesn't really make sense when you look at the research.
We'll get to the research in a a minute, but in terms of
industries around posture, we of course have the, the modern
industry of which I'm a part of these musculoskeletal healthcare
professionals, manual therapists, whatever you want to
call them. But you also have a whole
product based industry. So in the Victorian era and even
a little bit before we start to see these corsets with steel
boning in them to really force people into a very upright
posture. And we also see metal placed
into collars of men's shirts, which is wild and it was there
so that heaven forbid their chin droops.
You want that metal there to like be keeping it up, right,
Because it's not going to be comfy if you let your chin drop
down and it's steel within that collar.
So we have these, these industries develop and the
gadgets that are out there. A few weeks ago I was on my
commute home from clinic and I was, I was listened.
I was listening to some posture podcast to get some, you know,
ideas for this episode and see what's been talked about and
what hasn't. And and I heard this person
talking about their perfect this magical device which is going to
cure everyone's bad posture and people have to get it because
everyone needs it. And I looked it up and it was
like 400 lbs for a pair of basic like orthotics, which quite
frankly aren't going to help many people, if anyone.
It's ridiculous, the predatory nature of the industry around
posture in particular. So when it comes to any aspect
of anything to do with posture, proceed with caution.
Because the best way to make money in my opinion is to make
people feel really bad about themselves just and that look,
it's what the beauty industry does.
It's what a lot of the fitness industry does.
And again, I'm not saying every beauty company or every fitness
company is bad, that's objectively very not true.
But it's a very effective strategy to make people feel
really bad and insecure about something.
So you can then sell them a a solution and and we see that
play out with posture all the time.
Now when it comes to posture, it's such a complex and like
charged topic. I have to confess, this is my
third time filming this episode because I got really stressed
about it. So for the rest of this episode
or for quite frankly for any episode you listen to where I'm.
I'm here talking to you. I want you to pretend like we're
just like hanging out at, I don't know, a nice bar or a
coffee shop, just talking about real issues around posture and
my professional and and personal thoughts on them.
But this is as, as I said earlier, this is not medical
advice. These are my thoughts on posture
in general. But they are as direct and as
candid and hopefully as useful as I can possibly make them for
you. So that you can then go on, of
course to speak with your qualified healthcare provider
and and see if perhaps they help you.
I don't know, Think of some things differently, or maybe
just even understand your body differently.
But let's start with thinking about posture as a whole.
So we've talked about what posture is.
It's a body position. Posture does not have to be like
a standing posture, although it's certainly one posture that
someone can have. But posture is reduced into this
binary good posture and bad posture, and that does a
disservice to all of the complex and beautiful ways that the
human body can be positioned. Now, it's also important to
think though about is there even anything that is a good posture?
Does the concept of a good posture even exist?
Like, this is the type of thought experiment I want you to
go on. OK, So what is a good posture?
For me, a good posture is going to be one that serves that
person and the needs of their body.
It's going to be one that doesn't contribute to injury in
that person. It's going to be one in which
they feel comfortable. Maybe they feel happy in it even
because we'll talk about how posture can affect mood in a
second. Now, when it comes to posture,
there's a quote that I've I first came across it on social
media. But there's this idea of the
next position is the best position.
And I think at the end of the day that's a really good take
away from this episode if you're looking for just something to
remember. By changing positions and
changing postures regularly, you avoid the thing that I think
make well that I know can make any posture injurious to people,
which is being in one position for an extended period of time.
If you stand up with that, like perfect, which by the way
doesn't exist, but that perfect upright posture, and you're
doing that for eight hours, you're probably going to be
pretty uncomfortable at the end of that, if you can even make it
that long, which I know I couldn't.
If you sit slouched for 8 hours, again, you will probably be
uncomfortable, right? It's at some point around there,
so it's important to think about posture and the risk of almost
overdosing on a a certain type of posture which may be all
right in moderation, but which may start to injure people if
they do it for too long. And what is too long is going to
depend on the person. Now going back to analogies for
posture, because you know, I love analogies, posture can be
thought of almost like vitamins. So every single person needs
some vitamin A. If you don't have vitamin A, bad
things are going to happen to you.
But if you only have vitamin A and you don't have anything
else, that's going to be a big problem.
You're going to potentially overdose on vitamin A and be
deficient in all of your other vitamins.
So if we take that analogy and apply it to posture, yeah, being
able to have like a a relatively upright posture is is
beneficial. It's a good thing if it's
possible for someone to have an upright posture.
But if that's the only position you're ever in, you're going to
have too much of that upright posture and you're going to be
deficient in all of the other beautiful ways that your body
can move. What we want to do is achieve a
variety of postures. We want to find multiple
postures in which someone can comfortably position themselves,
and we want to make sure that we are avoiding the postures which
might be particularly injurious to that person.
So we'll talk more about that in a second, depending on your body
and what injuries you have going on.
We want to make sure that we enjoy and really indulge in more
of those beneficial postures which which you feel comfy in
and which you. Which you just find feel good.
If something feels good, it often is good.
At least that's how I approach a lot of the work that I do.
Now A question I get asked all the time is will fixing my
posture fix my pain? And this is typically coming
from someone who's been told by other manual therapists that the
reason that they're in pain is their fault.
They're the bad one. It's patient blaming, obviously,
but they're being told, you know, you have neck pain because
you were bad and you had bad posture and it's your fault.
And by the way, I just have to say that's such an easy way to
find excuses for not actually helping patients with their neck
pain is by saying it's their fault.
So it gives you a really good out if you're a manual
therapist. And it's kind of messed up, I
think, how people do that question one will fixing my
posture, fix my pain? And this is the kind of question
I get asked all the time from patients in particular who've
been told by other manual therapists prior to seeing me
that it's their fault that they're in pain, that they have
neck pain because their posture is bad and they should be
forcing their shoulders back and cranking their, you know, their
head up or whatever, and that that's going to fix their pain.
I've never seen that happen. Now, theoretically, could it
happen? Perhaps.
But I can certainly say professionally and anecdotally
that I've I've never seen a case where fixing a patient's posture
in isolation was what fixed their injury and fixed their
pain. I think it's also a very common
way to simply do patient blaming.
So if you are, if we have the example of a manual therapist
who for example is not able to fix their patients pain or
improve their symptoms or provide care which is beneficial
to that patient, it's a lot easier to blame the patient and
say hey this is actually your fault instead of saying, you
know what, I've reached limits of my professional expertise.
I'm sorry that I can't help you further, but I'm going to try
and find someone who can or I'm going to try and help you, you
know find some other option. And I'm sorry I can't be of more
assistance. I have to say that is my thought
on why that happens so often, but it does certainly happen.
Now, going back to the question, will fixing my posture fix my
pain? We already know, hopefully by
now, that there's no such thing as truly good or inherently good
or inherently bad posture. So the idea of fixing and and
finding that perfect posture becomes quite fantastical, quite
frankly. But we can certainly look at
someone's postures and body positions throughout the day and
try and think, OK, are these positions that they're putting
their body in? Are they serving this
individual, or are they injuring them?
Perhaps. So let's think of the example of
an office worker. And they're sitting in their
chair all day and they're really, really slouched.
Is that a good position to be in for eight hours or 10 hours
during the day? No, it's not.
It might be an excellent position for one hour or for
half an hour, but it's not going to be a good position to be in
for an extended period of time. Not because it's an inherently
bad position, but because it's simply almost.
Think of it like a repetitive strain injury.
The the volume is too great and it exceeds the ability of those
tissues to cope with that stress placed on them by that one
position without rest. If you want studies and research
by the way, please go check out my website
itshypermobilityhq.com. I will put a study on there
which really illustrates what I I mean when I talk about this.
But when we look at studies of medical imaging, I believe they
used MRI in the study I'm referencing and they're looking
at people's spines. They find that there is less
stress placed on the disk, that the force transference is
reduced when you have someone actually sitting in a slouched
posture because it, it just allows the erector erector spiny
muscles and some of the soft tissue to take some of that load
instead of having everything go through the spine if they were
to sit perfectly upright all day long.
So again, if that office worker was to try and say, you know,
I'm going to sit upright, bolt straight for 8 hours a day and
that's going to fix my low back pain, I would be very surprised
if that happened. And and often I find that
patients actually get worse after they take that approach
and try that. So again, we'll we'll fixing my
posture, fix my pain back to that question.
I'm going to say it's unlikely, but it's certainly something
that's good to think about. And I would think about it more
from the perspective of are the postures that I'm in potentially
challenging my tissues too much that they're injuring me?
And can I find a greater variety that's going to cause less
stress on my body and just allow me to kind of challenge
different tissues at different points throughout the day.
So I don't challenge anything too much, as the Greeks like to
say, everything in moderation. That is how I sum up that answer
to that question. The next question I have a
lordosis. Is that bad?
I get asked this question again of remarkable amount of times by
patients who see me in clinic. I also sometimes get messaged
about it. But anyways, a Lord people get
told having a lordosis is bad. What I don't know if this is a
fault of the physiotherapist or osteopathic chiropractor or
medical doctor or whatever. I don't know if this is a fault
of the healthcare provider that they're seeing or if this is the
fault of the patient, perhaps misunderstanding things but
everyone has a lordosis. In fact you have two hopefully
most people are going to have a curve in their low back that is
your lumbar lordosis and that just means that it is a a curve
that is concave. It literally just rounds in.
OK. It's the it's the the curve of
low back. You also have a bit of a curve
in your neck again and that is a bit of a lordosis.
We don't want a neck that's jutting out like that.
We don't want that kypholordic posture that we we see in people
who are perhaps if you think of like a really, really like old
person who's like hunched over and they're trying to keep their
neck up, like that's when we start to see a kind of hunchback
kyphrobatotic posture, right. But we do all have a or not we
all do. But most of us should have a
lordosis in our cervical spine in the neck that produces just a
gentle curve. And I'll explain why in a
second. OK And guess what?
We all should have a kyphosis. So a kyphosis refers to a convex
curvature. So it's just that little bit of
a rounding in the thoracic spine.
If you had a perfectly straight thoracic spine, that's actually
like, not ideal. You want a tiny bit of a
kyphosis there and the reason for this.
And I was going to get a model for this episode.
Maybe I'll do it for a TikTok or real one day.
But if you have a stick of spaghetti and you put pressure
on it, actually hang on, I'm just going to get a stick of
spaghetti a few moments later. We didn't have a stick of
spaghetti, but we have a rice noodle.
This rice noodle is pretty straight.
There's no curves in it, but if we take it and we put pressure
from the top and the bottom, even just a minimal amount, it's
gonna go like that. It snapped.
It did not cope well with that pressure.
If the rice noodle had a lordosis like kyphosis and then
a lordosis, so it makes like a little S shape, that's going to
help it cope with that loading, that pressure of of being
upright, the force of your weight plus gravity pulling on
you. That is going to cope better.
And we would, we know based on studies.
I'm sure they're out there, Check my blog post.
I'll try and put all the good stuff in there.
But we know that that's going to tolerate the force of being
upright better than a straight up and down line.
And actually the patients I see who have the worst low back pain
are the ones with the very, very straight spines.
They are the ones with the reduced lordosis of course the
people who have what some people will call like a a sway back
posture so on or they have a really excessive, they have a
hyper lordosis in their lumbar spine and excessive curvature.
So kind of tummy out and kind of bum sticking out.
Those people certainly will have more low back pain, potentially
not always again, but some of them will have more pain than
like the a person with an average spine.
But the spine, which I would want to not have the most, would
be a reduced lordosis in the lumbar spine, a very, very
straight spine. That's the type of spine where I
see the most problematic cases in the patient population that I
work with. So if you're someone with a
hyperlordosis and you've been made to feel really
self-conscious about it, there are other types of spinal
anatomy which I think are more problematic.
And I say that because I'm someone who has been told
repeatedly that I have too much curvature in my low back and I
find ways to make it work for me.
So there might be solutions out there for you.
Now in terms of other problematic spinal anatomies, we
do see as as well things like a scoliosis.
And I'm going to save that for another episode because that's a
whole topic of its own. But a scoliosis refers to
abnormal curvature of the spine. They can occur in different
planes. So you can have a scoliosis
which affects the spine forward and backwards side to side or in
a rotational aspect. We're going to save that for
another time. But of course, the scoliosis
certainly just complicate things.
And these are patients who require a specific care, they
require a diagnosis, and they require a little bit more
management than a patient with like an anatomically relatively
normal spine. Although I do want to stress
we're all a little bit weird. We all have a little bit of
abnormal stuff going on to some extent.
One of my eyebrows is higher than the other.
One of my legs is longer than the other.
Like we we're not pixels on a screen like we are.
We are people and building human bodies as complicated as is
maintaining them. Now one other thing I want to
say, going back to postures, it's important to think about
the person and how they're positioned.
And I I meant to mention this earlier, but I I completely
forgot. Did I tell you get stressed
making these? Anyways, we need to think about
posture and disability and posture and mobility aids and so
on. So again, this idea that upright
is good and anything other than upright is bad.
I think it's very, very ableist. I think that it really hurts
people who can't perhaps achieve that upright posture.
And it doesn't take into account people who, for example, are,
you know, wheelchair users in some respect, or people who rely
on different types of aids where they're using like rollators,
for example, or a cane. These are people where they need
to work with healthcare providers who are going to help
them have the best positioning of their body possible for usage
of the mobility aid which they need and benefit from to move
around. So we always want to look at
posture in the context of that individual patient and all of
the ways in which they're positioning their body
throughout the day to do what they need to do with their hyper
mobile body. The next question that I get a
lot is, OK, you've told me how I don't need to, like, fixate on
good posture versus bad posture, but I want good posture anyways.
I say good in quotation marks. Again, I want that upright,
straight posture. I just want it so I can like
have it for photographs or feel comfort or whatever.
What can I do? How can I achieve that?
And again, I don't think it's a bad thing to want that.
I think it's important that people who are able to have that
upright standing posture or a really good version of that, I
think it can certainly be beneficial for people to have
it. It is beneficial quite frankly,
if it's something that you can obtain.
I just don't think you should live in it 24/7.
Now the first thing I would say is that it's important to get
injuries addressed. So when you stand up, and I do
this with patients all the time in clinic, I'm like I'd like you
to try standing up really, really straight and tell me what
you feel. And you know what, as much as
precise orthopedic assessment is important, it's important to be
scientific. It's important to, you know, be
as strict with these things as you can be, as objective as you
can be. I do find it sometimes helpful
to ask patients like what's your body saying to you like just
like what's what's going on because it can be hard to feel
things. And you will probably definitely
understand that if you're someone who's hyper mobile, but
also what's your body saying to you, what are you feeling?
And very often the issues which patients report noticing,
they'll often come from kind of the interscapular region.
Interscapular region is one of my favorite medical terms ever,
Anatomy terms, you know that place between your shoulder
blades, that is your interscapular region.
So very often all of patients say, you know, it feels like my
shoulders aren't quite settled. And this goes back to a viral
TikTok I did back in the day where I talked about my
shoulders feeling homeless. And this is in these types of
patients, I'll very often see the shoulder blades slightly
forward. They'll be protracted, so
they'll have kind of that rounded posture.
These are people who will be told to try and, like, force
their shoulder blades in. But these are patients who will
see me and say, like, I've been trying to force them back.
I've been doing all of these exercises and I'm just not
making any progress. In these patients, I will very
often look at the the musculature and the the tissue
and the nerves between their shoulder blades.
So the dorsal scapular nerve, I'll look at the spinal
accessory nerve, I'll look at the scapulothoracic joint and
how that shoulder blade is sitting in the muscle and
connective tissue in which it is embedded.
I'll look at the rhomboid muscles and so on.
Because I I want to see like what's going on in the place
where they're feeling pain, which is a pretty reasonable
place to start for a lot of the issues that hyper.
What people present with. What I tend to notice is that
these patients very often, even if they have hypermobile
scapulothoracic joints. So the hypermobile
scapulothoracic joints will be people whose shoulder blades are
winging. But it's also really important
to know there are people who will report feeling like their
shoulder blades are almost glued on their back and they they
almost like can't move. So they might even have
hypermobile lenohumeral joints. So that's the shoulder joint out
that I'm pointing to it on the video if you're watching this,
but if you're not watching this, it's what people think of as the
shoulder joint. It's what you would call your
shoulder. But anyways they can even have
hypermobile glenohumeral joints, but hypomobile.
So less than ideal mobility, scapulothoracic joints.
And in those patients, those patients that have that really,
really stiff tissue in their interscapular region.
What I want to do is work with them on trying to improve or
positively affect that tissue quality, on trying to build
muscle and tissue, which as a whole is more functional to
allow that shoulder blade just to settle nicely in that kind of
down and in position. If you just do a little
experiment, if you're someone who is able to get your shoulder
blade a bit down and in, you will feel that when you do that
and you're standing, it's very easy to just have your arm by
your side. It feels kind of light, It's
just hanging out. But if your shoulder blade is
forward, if it's in that protracted position, you will
notice very quickly that your arm feels heavy.
So finding ways for people to get their shoulder blades down
and in, if it's possible for them is a great place to start.
And that's a whole complicated thing.
I'll I'll get into it more in another episode, but I hope that
gives you just an idea of one place I would look.
I'm also going to be looking at their feet.
So very often people who are hypermobile have abnormal foot
anatomy. Again, everyone's quirky, but
hypermobile people are often a bit quirkier and there are a
couple of different types of foot anatomy presentations which
I'll see. One of them is a four foot
virus, another one is a flexible flat foot.
But regardless, these are people who will very often have feet
where their arches are kind of collapsing.
So when you look at them lying down on a a table, they do have
an arch in their foot. When you assess them, you see
it's not a true Pez planis, it's not a true flex.
It's sorry it's not a true flat foot, but when you look at them
carefully you'll see actually they have a flexible flat foot
which is commonly mistaken for a Pez planis or they have a four
foot virus or both. But anyways what you want to do
with these patients, often it is work with them directly or work
with someone who is able to help them find an insole which is
just going to lift the the ground up to them.
So we stop that collapse because when that arch collapses, that
knee will cave in and that starts to put tension on the
hips and we kind of got a a downstream effect or an upstream
effect, perhaps I should say, if we're looking at the knock on
consequences of that. But thinking of foot anatomy
here is also important because if if your feet are in the right
position, you're kind of in trouble from the start.
That being said, I I can't think of a single time where I've come
across a patient who's been really happy that they've like
spent a lot of money on orthotics.
I think that it's really important to start with basic
interventions. I think it's important, you
know, if you can find someone who's going to make you perfect
orthotics, by all means to do that.
But a lot of these corrections are more straightforward and I
think more accessible than they're presented by the
healthcare and medical industries to be, quite frankly.
So ideally your healthcare provider will be working with
you because it's a relatively straightforward issue addressing
a flexible flat foot or a four foot virus.
But that's just my opinion. As auk registered osteopath, we
also want to be thinking about gaze and where your eyes are
going. And this kind of ties in really
nicely to a holistic appreciation of life in a
hypermobile body. So hypermobile people, they are
often a little bit clumsier. This goes back to issues with
proprioception and a few other things.
But then you know, of course there's a correlation with ADHD
and neuro divergent and other stuff going on, but we want to
really think about where you're looking.
If you go for a walk and you look down and you have someone
film you, you'll notice that there are probably knock on
consequences to your posture. You're probably looking a lot
more slouched than if you go for a walk and have your eyes level
looking straight out in front of you.
Your eyes determine where the rest of your body goes and your
body will do everything it can to perfect protect that
horizontal sight line. Being able to see is very
important for function. Obviously sight is a a very
important sense that we have or that's most of us have as
humans. So your body will do any
compensation necessary to try to be able to have you see the
world in front of you as much as possible.
So This is why, again, if we think of that kind of the the
stereotypical like little old lady or grandpa or whatever
who's really, really slouched over, they will then get that
extension in their neck. They'll get that kypholordotic,
that excessive kypholordic posture in their thoracic and
cervical or so they're mid back and and neck because their
body's trying to keep them able to look at the world around
them. They're trying to keep that gaze
up. So think where your gaze is when
you've done all of those things, when you've had the injuries
treated, when we've had any anatomical abnormalities in the
feet address we've thought about things like gaze.
We then get on to, of course, things like pelvic floor, which
can certainly have packed your posture, having tension and
appropriate attention. Not too much tension because a
lot of hypermobile people have issues with that certainly.
But having appropriate tone there in the muscles, having an
awareness and also when it comes to breath again, having good
breathing mechanics or just having even good enough
breathing mechanics, that can make a big difference as well.
And my final tip is to think about the actual bio mechanic
beauty of of movement in particular, because if you're a
hyper mobile person, any opportunity you have to dose
your body with good movement, with good mechanical stimulus is
beneficial. So I'm going to use a little
story time here. So back when I was about 20, I
was told that when I walk, I look like I'm carrying two
suitcases and I had a think and I was like, you know what I I
looked at some videos of me walking.
I was like, that's correct because basically my, my
shoulders, my, my upper body was not moving at all.
All of my movement was stopping kind of around my low back and
I'm one of those people who had the shoulder blades glued on the
back problem. I had a lot of neck pain and a
lot of kind of mid back pain and one thing that helped me, it
didn't fix everything but one thing that helped me and and
this is easier of course when you live in an area where maybe
you don't have too many people watching you walk or or you just
don't care, that'll work too. But I would try and walk and
really just feel and appreciate the rotation that was that was
going up my spine. So I would try and walk and make
sure my shoulder blades were moving and I was getting a
little bit of a rotation up that mid back as I was walking out.
My shoulder blades were moving as I swung my arms and that
movement wasn't stopping at my glenohumeral joint, so my
shoulder proper or my low back. So trying to just allow that
like diffusion of of movement from every step that I was
taking. And I know that sounds very like
we were or whatever, but just feeling that for me really
helped. And I think all of my clinical
work with patients and everything I've done with
myself, it's all about fighting for those 1% improvements.
So I do think that that was one of those little positive changes
which made a difference. And it's something which I think
of to this day. And of course I had to be very
conscious initially when I was doing it.
I had to think, don't look like you're holding suitcases when
you walk, walk like a normal person.
Like that's what I was thinking. Like just try and look normal
when you walk, which is so weird.
And it's that's not really the best line of thinking, but it
eventually evolved to try and feel that really juicy little
bit of diffuse rotation of your spine and gentle movement of
your shoulder blades as you walk.
And that went on to become my normal.
And I have to say it's really weird to go throughout a a
decade, a bit more than a decade.
But to have that experience of being someone who was being, you
know, not just being told, but who objectively, if you look at
photos of me and my late teens and stuff I didn't have, I
didn't look comfortable in my body.
You know, I don't like the whole good and bad thing.
You know that by now. But I didn't.
I wasn't able to. Sit in ways which just looked
comfortable and felt comfortable to me.
There were these abnormalities in my movement which weren't
serving me. So now to be someone in my 30s
which is able to sit in positions which I feel serve me
and feel comfortable. And they do, you know, they do
look good and photograph well. There's a reason why artists
like to have people in that very upright posture because it just,
it has a certain aesthetic look to it, right?
But anyways, it's been an interesting experience just to
see and appreciate how changeable that can be and how
it can go from being a really conscious thing to a an
unconscious thing. It's anyway such just a personal
note for me and that kind of wraps up to my my final tip.
This isn't a question, this is a this is a tip.
So we're finishing up our coffee or a drink or whatever.
The bar is closing. I want to give you the best
advice I can because I don't know if we're going to meet
again. I hope we meet again.
I hope you're back for next episode.
But don't think about posture in terms of good or bad.
Think about what serves you and what doesn't serve you.
So be selfish. I think more people need to
think about what serves them in different aspects of their life,
and posture is no exception to this.
So I want you to think about what feels comfy, what feels
good, what makes me feel powerful, what makes me feel
capable going back to a posture and what serves you.
I'm just going to give you a few examples of postures that have
served me. So right now I've been seeing
cross legged a lot of this episode.
I switched because I started. I started to kind of
uncomfortable in that position, so that's why I switched.
I'm going to grab another pillow actually, because that would
make me comfy right now. If you're a hyper mobile person,
you might notice that postural aids serve you.
You don't have to do it all alone.
You might notice that wearing a a corset or a stomach or serves
you. There are a lot of people in my
online communities who like different types of supportive
undergarments ranging from shapewear to corsetry.
Use that. It gives you a little little
brace, little support. Think again of propping things
up. I'm literally propping like my
body up on pillows right now. Why?
Because it feels comfy and I enjoy it.
That's why I'm doing that. OK, You will probably never see
me record an episode ever in that upright good posture
position. I don't like the feeling of my
legs being below my hips. It causes blood pooling and
feels uncomfortable, so I avoid that like the plague.
Other postures which serve me leaning on things.
If you've seen me in clinic, I I'm like a little like avoiding
standing upright ninja like I can do it.
I do it for photos. I do it when it serves me, but
I'm leaning against the wall as much as possible because I'm
tired sometimes as well. One posture, one body position
which comes to mind which really served me at a time when I
really needed it was back in my early 20s.
I had the worst neck pain. This was the thing which really
sucked. The most for me was this
horrible intense neck pain and these tension type headaches
with migrainous characteristics that were of a disabling
intensity in the sense that I could not leave the house for
days at a time when they would happen.
They were awful. I would just lie in bed with a
pillow on my face for days waiting for them to stop because
they sucked that much. Couldn't eat because of the
nausea, eye pain, tooth pain. It was horrible.
Worst thing ever. I hated them.
They suck if you have them. I'm so sorry.
They're the worst. But one of the positions which
really helped me. And again, it's not going to be
appropriate for everyone. It's not going to be appropriate
for people perhaps with serious eye issues in particular.
So please go talk with your medical doctors.
Please go do that before you ever do anything that you hear
me talk about on the show. But I had a treatment table at
the time because I was doing my osteopathy degree.
So I had a treatment table in my home and I would have these
headaches and I would just go lie like tummy on the table,
face in the face hole, face down.
I'd put the iPad on the floor. I think I had a footstool to
bring it up slightly closer and I would just lie there and like
just watch ATV show. And that position really took
tension off my neck, and having that position as an option
helped. So again, I wouldn't stay there
for 8 hours, but I might go watch ATV Show for like half an
hour or an hour there and it just felt like it gave my neck
musculature and nerves a break from whatever was causing them
injury at the time. So that's an an example of kind
of a a creative or weird posture which I found which served me.
I haven't done it in years but it's pretty darn comfy and it's
something which you certainly might want to consider and speak
with your medical doctor about of course and as well the whole
cross legged thing. So I mentioned sitting cross
legged earlier. I do it all the time.
I like to make people comfy in my clinic room.
So if patients want to sit cross legged, I don't mind.
You sit in a way that's comfortable, but do not sit
cross legged for hours on hours that will injure you.
Do not do what I did and go for like 20 years only sitting with
your legs crossed one way. Everyone's kind of going to have
like a preference one way or the other because of variations and
mobility and their hip joints or whatnot.
So switch sides and do it evenly.
Find ways to enhance that position.
Put pillows under your knees and so on.
See if you can have a supported posture.
See if you can find a position. That's what I call true REST.
So that just means having enough stuff to prop you up that you
can really just go floppy and you're supported.
Which feels so luxurious and so restful.
I have some content on it on my TikTok, maybe on my Instagram,
but go check that out. Maybe I'll do a blog post on it
one day on my website. But finding positions of
supported REST where you can actually rest, of course, is
also key. But again, it all comes back to
that last tip, which is find what serves you.
Ask yourself, is this helping me?
If you're one of those people where they claim that standing
perfectly upright and sitting bolt upright their entire waking
existence, if that serves you and you're comfortable doing
that, that, by all means do that.
But at the end of the day, be critical.
Be thoughtful, Be curious. And I I hope that through doing
these things, you will find ways to position your body that work
for you. Whether you're someone who you
know stands on your own or someone who uses mobility, it's
it's all about finding what works for that person, for that
individual. And I hope that as we're
wrapping up today's episode, you have felt my passion for posture
and that it has inspired you to think more about your own
hypermobile body and how you are going to position it throughout
your day. Take care.
Thank you for being here. Be sure to sign up for my e-mail
newsletter list. Seriously, it's how we keep in
touch with with each other. Lots of exciting things coming
up and I'll see you next time. Bye.