Thoughts on care and prevention

Take a Look at Yourself

I have no idea who Dave Cloverdale is and I’ve never heard the song, but I’ve found that quoting a song gets people’s attention.  Hence I googled “Take a look at yourself” and that was the first option.  Did it work?  None of the songs in my extensive Cher library served my purpose, although I think I might be able to use her later in this article.  Stay tuned.


I last wrote an article on posture three years ago so it’s a good time to revisit and refresh it.  Plus I get to reuse the Oompa Loompa picture I used back then. Here goes:

How we hold ourselves in space at rest (static) and while moving (dynamic) is the most important predictor of the shape of things to come.  Posture is determined by voluntary muscle contraction, just like walking, talking, and playing ping-pong against my 13 year old nephew who now beats me two times out of three because he’s getting older and I’m just, well, getting old.  These muscles are controlled by nerve impulses from the motor cortex of the brain.  As the brain is pretty busy, it’s always looking for ways to be more efficient. There are countless nerve impulses going to our muscles at any given time, and as the ones for postural muscles are sent in patterns that fire over and over (called engrams), it makes sense that the brain would subjugate the firing of them to more “menial” parts of the cerebral cortex.  Since I love metaphors, think of the Oompa Loompas.  Willie Wonka has a lot on his plate, what with turning kids into blueberries and all, to worry about minor details like checking the carbonation levels of the fizzy drink, so the day to day tedious operations of the chocoate factory are carried out by the Oompa  Loompas and he doesn’t have to think about them.  He’s free to experiment on new technologies, gold bar contests, finding an heir…

I’ll go easy and split the posture articles into areas. This time, let’s talk pelvis.  Why start with the pelvis?  Two words: CORE STABILITY. Now change one of those words to “PROXIMAL”. And now add the rest of the phrase: PROXIMAL STABILITY for DISTAL MOBILITY. I’m sure this phrase is heard countless times at the water cooler, on the playground, in board meetings, etc., but just in case, I’ll explain: in order for the rest of our bodies to function correctly, meaning shoulders, arms, neck and head, hips, legs (the distal, or “further out” parts), the proximal, or nearby, areas, our core, must be positioned correctly.  Instability or less-than-optimal positioning in our core will affect everywhere else.

When I quoted “Take a look at yourself,” the purpose was, as you may have guessed, today’s homework:  stand sideways in front of a mirror long enough so you can see your hips and pelvis.  Looking straight ahead, stand in a position that feels “normal” for you at rest.  Then turn (only) your head sideways so you can see yourself in the mirror.  Look at your waist. General landmark to focus on is your beltline or waistband. Compare to the these images:

Your pelvis is shaped like a bowl with the waistline being the rim.  Is your bowl tilting forward like in the picture on the left or is it level like the picture on the right?

Is there belly protruding in front of the body, pulling the center of mass forward?

Do you stand in a sideways V so that your shoulders are lined up with the ankles but behind the hips or are shoulders, hips, and ankles in a line?  These are the things to look for.  There are others, like shoulder carriage and hip rotation, but today we’re only concerned with the pelvis.  This comes first as changing the core will change everything else.

If you find your pelvic posture resembles the picture on the right, woo hoo!  If not, it’s not the end of the world, but it could be time to think about making some changes.  An anterior pelvic tilt (bowl tipped forward) or a sideways V (posterior weight bearing) is stressful for the spinal joints of the low back vertebrae and sacro-iliac (pelvis) joints. They are also a sign of shortened and/or tight low back muscles, hip flexors, and weak abdominals and glutes.  And by weak, we don’t always mean weak (I love this part of my job).  Weak can mean functionally weak.  Look again at the picture above on the left.  This gentlemen has a flat abdomen and is in good shape.  His abdominals are probably strong, but they aren’t doing a great job holding the pelvis up (function).

Keep in mind that pain is often a late symptom of something that’s been developing for a while, so whether or not there is pain, if you see any or all of the signs above while standing sideways in front of the mirror, I can’t think of a better time than the new year to make some new resolutions (written slightly with my tongue in my cheek).  Just as Mr. Wonka sometimes has to fire an Ommpa Loompa for not doing his job correctly and has to temporarily micro-manage the operations at the factory, sometimes it’s good for us to raise the postural engrams out of the Oompa Loompa Cortex back up into the conscious cortex until new Oompa Loompa engrams can be trained.  Man, I love a good metaphor!

At the risk of arrogantly thinking this is like a “Who Shot JR” cliffhanger, I’m going to stop here.  In the next post I’ll talk about some easy ways to start to change things, in terms of easy stretches and quick exercises.  For now, the only homework is to “Take a look at yourself” and just observe.  That’s it.  Just observe for now.

I’m sorry I didn’t get to get to quote a Cher song this time but I went off in a different direction than originally planned.  Next time!

Dr. Joe  (and I wish everyone a happy new year!)