Something that I have always been curious about is how the ADA (American Dental Association) has figured out, better than any other medical or non-medical organization, how to get the public to buy into preventative care?
Physical therapists are having trouble matching the societal demand of long workdays at desks and on phones, sedentary lives on comfortable couches watching TV and playing video games. These sustained postures are often at play for non optimal mechanical loading (i.e. excessive stress placed on joints or tissue that may cause other issues, down the line). If you sit or stand in slouched postures over time, it will have a negative effect on the way you move. Over time, this can lead to less overall movement, injuries and/or pain.
Additionally, our society tends not to value preventative therapy (Just ask your insurance company) or long-term maintenance after injury (Again, ask your insurance company). This challenges compliance which I think is especially true when it comes to postural corrective activities or exercises.
In a 2010 systematic review, K. Jack et al. (Manual Therapy 15 (2010) 220–228) found “Strong evidence that poor treatment adherence was associated with low levels of physical activity at baseline or in previous weeks, low in-treatment adherence with exercise, low self-efficacy, depression, anxiety, helplessness, poor social support/activity, greater perceived number of barriers to exercise and increased pain levels during exercise.” Clearly there are many factors that may affect the adherence to a home program and self care but, as therapists it is our job to work with our patient’s specific barriers to treatment and incorporate therapeutic exercise that help prioritize self management into their lives.
I was recently treating a dentist who came in and told me that he was feeling so good that he stopped doing his exercise even though he knew it was what he needed to do to keep his issues at bay. “Do you brush your teeth?” I asked him and he smiled saying “I know I know…I need to get back to my exercises.” I knew he brushed his teeth but why wasn’t he doing the work to take care of his body? So how do they do it? I asked my patient and he said “that it’s easy, they shame you.” I do not think that most people think about cavities or root canals when they brush their teeth, but bad breath? That’s gross. I am proposing that we make bad posture taboo. Forget about the health consequences and the time and money you spend on rehabbing avoidable injuries and remember to sit up straight! It may be as easy as being more conscious of your posture and moving differently a few minutes of your day.
Think about it, we all accept that brushing our teeth, daily, will help us to avoid teeth and gum disease but can’t seem to make the connection between better posture and 5 minutes specific exercises, a day. If you did daily therapeutic exercises, maybe your head wouldn’t be so far forward or your shoulders rounded. Maybe you wouldn’t have that achy hip or the bunion on your big toe (but hey, what do I know? I’m just an expert).
Care about your body and manage it as you do your teeth. Brush your teeth and stretch your hips. Floss and stack your posture. Use a water pick and get an ergonomic desk set up.
Mark Comerford, a researcher and teacher of motor control exercises (specific exercises designed to “re-teach” control of posture and motion) suggests we use a “Red Dot” method. Take a small sticker (red dots work but feel free to try anything) and place it in and on things you see throughout your day. The trick is not to place it somewhere you see all the time such as your office computer screen but, you can place that small dot on your mouse, trackpad or watch. Every time you see that red dot it should remind you to adjust whatever positions you may need tweaking. This small reminder throughout the day can help to incorporate your postural exercises just as you incorporate brushing your teeth!
The physical health of our society may very well depend on our ability to combat our modern lifestyles and postures.