Rational Wellness Podcast 051: Improving Posture with Dr. Steven Weiniger

Learn how to improve your posture with Dr. Steven Weiniger who speaks with Dr. Ben Weitz. 

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Podcast Highlights

1:41  Dr. Weiniger explained that he noticed that his chiropractic patients would often improve but then their symptoms would return. He then studied with Dr. Vladimir Janda in the Czech Republic and also blended yoga and the work of Patanjali, Pilates, Alexander, and Feldenkrais into some systematic clinical protocols.

5:06  Dr. Weiniger said that if you train your body to do stupid things, your body is going to get really good at doing stupid things, meaning that you will become adapted to postures that place structural stress and damage your body. Dr. Weiniger talked about becoming aware of your body and strengthening your posture. 

6:50  Holding your body in an asymmetrical way will lead to abnormal stresses and wear and tear on your muscles and ligaments and calcium deposits building up in your spine and other joints.

9:28  I asked about forwards head posture, one of the most common postural flaws, and what are the health consequences and what to do about it?  Dr. Weiniger explained that you need to look at the whole body from the bottom up and make sure that it is all balanced. He talked about how headaches result from forwards head posture due to the shortening of the suboccipital muscles and the connection between the suboccipital muscles and the dura mater that covers the brain. He also talked about how from sitting with forwards head posture you get a shortening of the suboccipital muscles and a weakening of muscles in the front of the neck. You’ve got tight muscles at the top of the chest and weak muscles in the upper back.  That makes it very difficult to just change your posture since they have trained their body to sit differently.

16:33  Dr. Weiniger highly recommends taking a posture picture so the person can visualize how distorted their posture has become and gain awareness.  Dr. Weiniger talked about the Strong Posture Protocols that he teaches in his book Stand Taller Live Longer.  “So, you want to be addressing the three elements of balanced alignment and motion in a posture strengthening program to connect somebody more accurately with the reality of how are they balancing? How are they aligning, and how are they moving?”

26:53  We discussed lumbo-pelvic alignment and what posture is optimal.  Dr. Weiniger talked about how to create postural balance and how to work toward a pain free range of motion and balanced strength.

38:10  I brought up scoliosis and Dr. Weiniger explained that the focus of his program is not currently on scoliosis and scoliosis is more of a neurological thing to him. But doing a 7 week strong posture program is a good way to start. 

41:09  Dr. Weiniger said that practitioners can go to posturepractice.com . If you are a lay person, please go to Posturezone.com  or to PostureMonth.org  And you can also download the free posture app, PostureZone app onto your iphone or ipad.  

 



Dr. Steven Weiniger is a Doctor of Chiropractic with a specialty in posture analysis and correction. Dr. Weiniger is an author, speaker, and internationally recognized posture expert  https://www.bodyzone.com/posture-expert/  Dr. Weiniger has written Stand Taller Live Longer: An Anti-Aging Strategy available through Barnes and Noble  https://www.barnesandnoble.com/w/stand-taller-live-longer-steven-weiniger/1009154991?ean=9780979713606  and Posture Principles-–5 Principles of Posture. 

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling his Santa Monica office 310-395-3111.


 

Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with Rational Wellness Podcast bringing you the cutting-edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube and signup for my free eBook on my website by going to drweitz.com. Let’s get started on your road to better health.

                                            Hey, Rational Wellness podcasters. Thank you so much for joining me again today. We have a very interesting topic. Normally, we talk a lot about nutrition and functional medicine, and today, we’re going to talk about posture and it’s more of chiropractic oriented discussion but posture is just as important for your overall health and part of your anti-aging strategy as eating right, and exercise, and sleep, and everything else.

                                           Our guest today is Dr. Steven Weiniger. He is an internationally known posture expert. He’s trained thousands and thousands of patients and other doctors on improving their posture. His professional program is known as the Certified Posture Exercise Professional program. He is the creator of PostureZone, a free posture assessment app, and his latest book is Stand Taller Live Longer: An Anti-Aging Strategy. Steve, thank you so much for joining me today.

Dr. Weiniger:                     Ben, thank you for having me.

Dr. Weitz:                            How did you get so interested in posture? How did that become a focal point for you?

Dr. Weiniger:                     Well, I’ll tell you, as you said at the beginning that this is a chiropractic oriented, and you’re right that that’s where we started from but posture is very much health to everybody. The way that I started was as a chiropractor. People came to me with problems: neck pain, back pain, and we got it better but a lot of times their problem came back, and I worked on them again, and I got them better, and their problem came back. This is a common complaint of a lot of chiropractors.

                                           And I started getting into, kind of at the same time, both yoga personally because I had some significant flexibility issues and some issues with my posture and my body, as well as the work of Vladimir Janda, who was the originator of what’s been called the Prague school of rehab. And I spent time in the Czech Republic with Vladimir when he was alive and we observed that there are ways to train bodies to move differently. But if you don’t train the body to move differently, it’s going to start to move the way you’re training it to move, and that was one of the Janda’s big insights and the effect on that are more detailed scientific perspective with things like what’s called Upper-Crossed and Lower-Crossed Syndrome, which are a common posture observation within both the chiropractic and the therapy worlds.

                                          That there wasn’t a systematic way to address a patient and once we started working on melding the work of yoga, and Patanjali, and some other people in the posture world like Pilates, and Alexander, and Feldenkrais into something that was more systematic for a clinical protocol.  And it’s expanded. We started having a practice that we were seeing patients, and then doctors started to come because they were hearing what we’re doing and then we started teaching seminars to other professionals and they wanted the tools. So, we developed other tools and other things to help promote the idea that posture is important and you can do something about your posture, to strengthen your posture. 

Dr. Weitz:                          Yeah, I know, on a daily basis I get patients coming to my office with neck pain or back pain, and they say, “How did it start? I didn’t do anything. I didn’t strain myself. I didn’t lift anything.” And a lot of times, a common factor is they’ve been sitting with lousy posture for hours at a time, slumped, rounded shoulders, forwards head all these different postural flaws. Maybe they’re sitting twisted typing into a keyboard with a monitor off to the side. So, I’ve come to understand the importance of posture and trying to retrain my patients into using better posture and you’ve got a really detailed system for helping to do that.

Dr. Weiniger:                     Well, we do and then part of it is changing the perspective of what posture is because the word that you use kind of says it all. People have lousy posture. It’s putting it into a box where you almost are making pathology of it and it’s not a pathology. If you train your body to do stupid things, your body is going to get really good at doing stupid things. And when you’re focused on your phone or your keyboard, and you’re disconnecting from an awareness of your body, you become disconnected from it. So, changes happen that, “I don’t have to stop. I’m a little bit tight, I can keep on going,” and your body gets better and better at moving in those adaptive ways.

                                           I’m not saying that we should all get rid of our phones and go back to living a simple life because that means we are out in the fields toeing things and running around and chasing bikes in which is not the life that I see myself living but if you’re going to spend a big chunk of your time doing what we do, being more aware of your body so that you’re dealing with a less mechanically stressed posture and doing things to turn your body back the other way. It’s not a matter of just getting rid of the pain, it’s a matter of, “How can I strengthen my posture?” Because it’s not a good or bad.

                                           If I told you your posture was bad, you’d say, “Oh, yeah. I know that. That’s the way that I am,” and a lot of your patients, I’m sure have said that. But if you tell them, “Your posture’s weak, then that opens a little question in your mind of, “In that case, what we need to do? How do I strengthen it?” And that’s what we teach doctors to do with patients.

Dr. Weitz:                          Right. Well, really isn’t it about how efficiently we resist the forces of gravity because gravity, all day long, is pushing down on us and if we’re not properly balanced, then when I can efficiently resist gravity and there’s going to be abnormal stresses on our muscles, our ligaments, our joints.

Dr. Weiniger:                     Almost right. You said abnormal stresses, if you hold your body in an asymmetric position, it’s normal to have those mechanical stresses occurring in that asymmetry that’s going to normally result in asymmetric forces that’s going to make wear and tear. That’s going to make … Calcium deposits, that’s going to make stretching occur. That makes that the easier, mechanically speaking, posture to hold because all other things being equal, symmetry changes when you keep on molding it into an asymmetric position.

                                         So, if it’s somebody that has a marked forward head posture and kyphosis but if they’re laying on their back, their head is extended 30 degrees on a flat surface. You must stand with your head on top of your shoulders for that person’s architecture. That’s not their normal because they’ve worked hard, not intentionally, but they’ve worked hard to change their posture. One of the book that I wrote for the public, and that a lot of professionals use, a lot of CPEPs use to teach their patients and posture programs is based on five principles of posture, five concepts and the second posture principle is balance. Your posture is how you balance your body no matter how … If I’m standing all horribly posture bent forward but I’m standing, the question that we ask people is, “Is my posture balanced if I’m like this? Is it balanced?”

Dr. Weitz:                       No. It looks like you’re going to fall over to your left.

Dr. Weiniger:                  On an overall mechanical basis, is it balanced?

Dr. Weitz:                       Well, I guess you could say because you’re standing, it must be.

Dr. Weiniger:                  It’s not that you could say, but in objective reality, in looking at it from a rational empirical basis, if you are vertical, it is balanced.

Dr. Weitz:                       But you’re not necessarily loading joints on both sides equally.

Dr. Weiniger:                  That’s the point. It’s not symmetric. It’s not efficient. It’s not good long term but on an overruled by a mechanic’s basis, it is balanced. If it weren’t balanced, it would fall down. The principle is your posture is how you balance and that pattern of muscle asymmetry on multiple layers of functional compensation and structural adaptation it’s precisely what you want to be observing, looking at, and working with to address and to strengthen posture.  

Dr. Weitz:                       Why don’t we start by talking about one of the most common postural flaws, certainly, that I see in my practice, which is the forwards head posture and that’s the one where the person’s head is jutting forwards and that’s usually a result of sitting and looking at their laptop, or their iPad, or just using poor posture at their desk writing. What are some of the long-term consequences that can occur from forwards head posture, and then what are some of those strategies that we can utilize to reverse it?

Dr. Weiniger:                  I’ll answer that question but let me change the perspective just a little bit. If your posture is how you balance your whole body, and your head is going forward, even though you’re not thinking about it, something else is suddenly going backwards, or some things are going backwards, or there’s some other zigzag occurring. Your posture is a whole body phenomenon and I agree, the habit pattern of working on a computer, close-quarters texting where you’re looking down instead of up, strategies for addressing texting instead of wrapping your head down to your device, lifting your device up, looking more at it, then that’s part of being conscious of it. The challenge becomes if you only work on the top, then you’re making different compensations occur lower down the chain.

Dr. Weitz:                       Now, that’s while you’re standing, how about when you’re sitting?

Dr. Weiniger:                  When you’re sitting like you’re still balancing and the muscle patterns of asymmetry from standing to sitting, they’re not exactly the same. But if you don’t retrain one, the one that’s been longer standing is going to keep on being a bias towards the one you are trying to retrain. And since humans are made to move from a dynamic point of view, and it’s one of the things that Janda talked about with the Lower-Crossed being the most common postural syndromes, the force propagation is bottom to the top because you’re balancing on your feet.  And just like, if you had a stack of kiddie blocks, I don’t know if you have kids but when my kids were little-

Dr. Weitz:                       Yeah, I have older-

Dr. Weiniger:                  Again, how can you get the stack? And if it was wobbly at the top, you didn’t fix the one on top, you gotta go down to the bottom. Get up a stable base and work your way up. So, in terms of awareness about what a head posture, pulling your head back makes sense, the problem that many people going to have is because they’ve trained that forward head posture. Some muscles have gotten too long and some muscle have gotten too short, and that is symmetry in a front to back direction is what sets up a lot of the health consequences, probably the most. Excuse me.

Dr. Weitz:                       Yeah. You were going to talk about some of the health consequences of having forwards head posture. 

Dr. Weiniger:                  One of the most common everyday health consequences are headaches. And when your head goes forward, it’s going straight forward, your heads going to have to tilt down unless you lift it up again, and when you lift it up again the muscles at the very top of the spine, the suboccipital muscle between the occiput … Exactly, at that last little hinge you just did when your head jerked up the muscles you were using, the back part of your neck, just under the occiput. The occiput to C1 to C2, those muscles are going to have to become shorter and that chronic shortening of that group of muscles called the suboccipital muscles creates muscle tension.

                                        And a lot of people say, “Well, I’m just tense, that’s why I’ve got a headache.” If you’re holding your head in that position, especially if you get more fatigue, those muscles have to work harder. In ’97, they found out that one of those muscles, the rectus capitis posterior minor had fibers that went between the skull and the first part of the spine, and connecting onto the lining around the brain, the dura mater. The theoretic reason for this is, it pulls that lining backwards to allow for more open flow of the fluid around the brain and spinal cord called the cerebral spinal fluid.

                                        In addition, in 2012 at Logan College of Chiropractic in St. Louis University, they found that the other muscles in that area, rectus capitis posterior major, obliquus capitis superior and ligamentum nuchae, which were all part of the deep, deep tissue connecting the skull and upper cervical spine. They also have connections that travel into and between the vertebra, and that directly touch onto the lining of the dura, the meninges that contain the fluid that holds the brain and the spinal cord. So when you have that kind of tension, that can affect that fluid flow.

                                       This is probably the best explanation for why, when somebody has chronic headaches, they go to a chiropractor with a killer headache, they’re dying, and, “Oh, man. Doc, I feel wonderful. Thank you. It’s like you opened a valve,” because you literally took the pressure off the base of the brain, but that’s one of many, many things. Something else that Janda talked about is, it’s very rare to have forward head posture existing by itself–you almost always have an upper torso compensation occurring also where your shoulders are rolling in because the hands are rolling in.

                                          It’s kind of scissoring, it’s called a collapse of the kinetic box where your head should be level, and your torso should be level. When one goes forward and one goes back, you have muscles that are getting tighter and weaker at opposite sides of that box. So, basically, you’ve got tight muscles at the suboccipitals and weak muscles in the front of the neck. You’ve got tight muscles at the top of the chest and weak muscles in the upper back.  And once that kinetic box collapses, that becomes the position of needing less energy to keep it there because of that muscular imbalance.

                                          So at that point, it’s not merely a matter of, “Stand up like this, it takes less energy,” because that person has trained their body to be differently, they can’t do that, and just trying to go in that position, the response is always, “That doesn’t feel comfortable to me,” because in their perception, their body looks like this, but if you took a picture of it, that’s not reality. And this is one reason why we highly recommend posture pictures so that you have a benchmark of, “Hey, how’s my posture doing?” 

In terms of what you can do to begin awareness, take a picture, see what you look like and try to text somebody take a picture, if a selfie of yourself doesn’t work. Having someone do it, you can do it with the phone that you have. The free postures on app will let you do it but you need someone else to help you. And when they take the picture, try to stand tall with what you feel like is, “Yes, I’m standing tall,” which is probably better than your habit is and that’s fine because people will must always find when there’s a problem they’re blown away by when they thought they were standing tall, what the picture really says.

Dr. Weitz:                          So, after you take a picture, then what are some of the strategies that you do to try to help a client like that?

Dr. Weiniger:                     The protocols that we teach professionals and that we talked about in Stand Taller Live Longer, are called the strong posture protocols.  And the strong constant protocols work with the three elements of posture. We’ve talked about sitting posture versus standing posture. Posture is not just when you’re static, not moving. If you’re running, you’re going to have a running posture. Your running posture will have the patterns of your standing posture, your sitting posture, because your posture is not just when you’re standing statically, it’s when you’re moving dynamically as well. And the three elements of posture begin with, what I spoke about a moment ago, balance.  Your posture is how you balance your body.  It’s also how you’re aligning your body, and you align and you move your body in patterns of motion.

                                        So, you want to be addressing the three elements of balanced alignment and motion in a posture strengthening program to connect somebody more accurately with the reality of how are they balancing? How are they aligning, and how are they moving? So, in terms of posture picture, that’s a benchmark of how you’re aligning and beginning retraining your benchmark of your perception of, “Yes, I feel like I’m standing tall and straight, the camera says otherwise,” me just telling you to move differently, you’re going to keep on coming back, “Well, that doesn’t feel right to me,” because your body has what’s called a proprioceptive system.

                                       I know you know what I’m talking about with that and it’s not something that’s an intellectual and you can just change it because you want to decide to, it’s something that you need to have a program or some way to retrain it bit by bit, pushing it in a direction that is more accurate to reality. We use a very, very expensive high-tech tool to help connect somebody to reality, it’s called a wall, you may have one. Seriously, using the wall to focus your attention on one thing at a time, and because you can’t focus on more than one thing at a time because that’s what focus is, one thing at a time. You can’t focus on your head, your shoulders, and if you ever think of a golf lesson and had somebody try to-

Dr. Weitz:                         I golf every week. 

Dr. Weiniger:                    If you’re changing a sway, if somebody tells you three things to change, what happens?

Dr. Weitz:                         It’s really hard.

Dr. Weiniger:                    Okay, the best coaches pick the most effective thing to change. Focus on one thing and work on that. And we do the same thing with retraining posture. And this is what CPEPs do to retrain people’s posture, to help them find their weakest link in their chain.

Dr. Weitz:                         What part can chiropractic adjustments or other parts of a chiropractic treatment play in making sure you improve posture?

Dr. Weiniger:                    Huge, because when you have a collapse of the kinetic box, if there is a segment or the spine or a shoulder, and hip, especially lower extremity, a knee or an ankle that is not moving with symmetry, you’re going to have that adaptive motion pattern keep on recurring so the best results with retraining and strengthening posture include restoring motion to links in the kinetic chain that aren’t moving and parts we haven’t moved for a long time. So, you can then direct the exercise to that previously neglected, unused link and use strong posture exercises to strengthen it to move towards symmetry, beginning with the alignment of using the wall and focusing on one, what’s called the posture zone at a time. The first torso pelvis linkage, then head torso linkage, then lower extremity integration, and then upper extremity integration.

Dr. Weitz:                         What do you think about some of the chiropractic strategies that various chiropractic gurus have come up with to passively stretch the ligamentous structure back into a more efficient shape? Things like traction devices with a roll here, and a weight, and different types of things like that where you stay for a period of time, maybe with some weight or something like that to try to re-stretch the passive structures?

Dr. Weiniger:                    Not necessarily evil but if you’re only working on the passive structures and you’re not working to strengthen it, the moment you load it, if you’re adding more stretch, why is something that’s overly stretched already going to change? Your body is not just things that are as tight, it’s things that are tight paired with things that are lengthened. And if you’re not teaching it to actively move towards symmetry, you’re not going to be fixing it, moreover, in a kinetic chain because your body is a kinetic of chain.

                                       It’s not just your neck. I know a lot of chiros dial into forward head posture and that’s an important thing but if you’re not done with the whole body, you’re missing a big chunk of what should be addressed effectively strengthening in a kinetic chain. If there is a tight link and a loose link and you scratch the whole chain, which link moves first? Think about it for a second.

Dr. Weitz:                         Yeah, you’ve got to repeat that question for me. 

Dr. Weiniger:                    Okay. Before we talked about, in the spine, if a spinal joint isn’t moving, that means it’s tight, agreed?

Dr. Weitz:                         Yap, yap.

Dr. Weiniger:                    And so, within the entire chain, if one link is tight and one link is loose, and you stretch the entire chain, what does it stretch? Where it’s loose or tight?

Dr. Weitz:                         Yeah. I guess the problem is it’s liable to stretch the loose part because that’s already moving. So, that’s one of the reasons why chiropractic adjustments say, “Get in there and mobilize the-

Dr. Weiniger:                    Tangling.

Dr. Weitz:                         … junction,” it’s important.

Dr. Weiniger:                    And the thing about chiropractic, as we learned in school back in the day, is you need to find the restricted link of motion and then you need to take out the tissue slack. If you try to adjust somebody without taking it at the tissue slack, what happens is nothing because most is going to go up and down the chain and part of what in effect chiropractic adjustment is identifying a site and identifying the direction that it should be moving and tractioning it in that direction to take out the type of the slack in motion.

                                       If you teach someone how to move differently, you also need to be incorporating their personal awareness of how they’ve trained their muscular system to move, which means how they’ve trained then neurological system to move and to stabilize that muscular system to make the force move in a different pattern. The problem is, if the pattern that you’ve been moving in that feels normal to you and that’s what your posture truly is when you look at it from a global biomechanic perspective.

Dr. Weitz:                         And of course, the person who has forward head posture, they also usually have certain other postural issues, such as a collapsed thoracic spine, internally rotated shoulders, and you’ve got to address those concerns as well, right?

Dr. Weiniger:                    Right. In terms of looking at internally rotated shoulders is it because someone’s got a tight pec, or a weak serratus, or is the problem the rhomboid stabilizing that? But then how does that tie into the psoas, but in that case, we also have a problem with its glutes and piriformis is neglected and you can’t get what’s going on back on top with the upper extremity with coracobrachialis. And this is why, from our point of view, the approach of work on one muscle at a time becomes this, like, you’re keeping that very long chain.

                                       Whereas, working with global body awareness and motion to address how the global body is balancing, how it’s aligning, and how it’s moving and looking and focusing on one possible zone linkage at a time has incredible leverage from what patients and doctors, of course, do all the things to help them make a dramatic difference and how they feel how they move. Very often the sports performance as well if they’re athletes because we want to move the accurate to reality. And if you know you’re standing tall on screen, that’s the beginning point of all your motions. All motion begins with posture, all emotion ends with posture. So, that resting position is not just an arbitrary position, it’s your perception of where your body is in space and what you’re doing to keep it there.

Dr. Weitz:                       So, when you look down at the lumbar-pelvic region, what are some of the most common postural flaws? There’s a lot of discussion about the fact that you’re supposed to keep the proper amount of backwards lumbar curve. Some people train flattening neck curve. Other people work on making sure you have enough curve day. We have a Pilates program in our office and there’s always a big discussion of neutral, and what is neutral, and everybody defines neutral differently. Do you try to flatten the lumbar spine or recruit the deep abdominal muscles? Do you keep it slightly arched? How much arched? So, what do you see as some of the most important postural issues related to the lumbar-pelvic region?

Dr. Weiniger:                  You’re encapsulating the problem that we work to solve because one of the challenges is that different people playing these games, doing these things … Not playing games but doing work and therapeutic modalities like this have different personal histories and experiences, and when you step two steps back, it’s not about what the perfect lumbar curve is nor is it, to me, about the perfect cervical curve, it’s about strengthening the body that you have because … and you would despite the fact that your body might not be perfect. Moreover, if you’re like the rest of humanity, it probably never will be.

                                       We need to take care of back and treat you, or that we need to work out how to functionally strengthen the body that you have been given genetically and in the way that you’ve treated it and take those consequences of those actions and actions are consequences into effect, including things like injuries that have created patterns and strengthening how that unique system can function in daily life. So, to answer your question about lumbar curve, because the big question is that is, if it should be more, if it should be less, if it should be stabilized in this way, if it should be stabilized in that way.

                                       I said that the second principle of posture was balance. Your posture is how you balance your body. The first principle of posture, your body is designed to move. If you recall muscle anatomy, a muscle contracts, the quick motion. Muscles only contract. Muscles don’t push. Muscles are never ropes. So, if I’m pushing, it’s not my muscle pushing, it’s a combination of leverage of muscles being combined to create that but the muscle itself is only shorting. Within a muscle, the shorting happens because of shortening of a muscle fiber.

                                       A muscle fiber is an individual cell. A cell will shorten because a nerve impulse hits it and there is depolarization of the membrane, calcium ions rush in. You have two different fibers actin and myosin, and there’s a little head on one of the other. When the calcium rushes in it goes like this and it shortens. Anatomy 101, remember that from school? When an individual muscle fiber contracts, it contracts fully or it doesn’t contract. An individual muscle fiber cannot contract halfway.  Is that truth to you? Is that truth to everybody that knows anything about biomechanics?

Dr. Weitz:                       Yeah. I completely agree. However, there is certainly a lot of discussion about things that don’t quite fit into that paradigm, like somebody has a lot of tone in their muscles. They’re not necessarily … Their muscles are not stronger. They’re just more toned, or they’re harder, or they’re-

Dr. Weiniger:                  And that’s totally agreed. The resting muscle tonus will affect appearance, but in terms of gross anatomic function from Guyton’s Physiology on down, there’s no one that I’ve ever met that will say that the muscle fibers can contract fractionally, that a fiber can contract halfway. It’s fully contracted or not at all. 

Dr. Weitz:                       But when it comes to the lumbar spine, isn’t it the case that having the curve there, some amount of curve, gives the spine more resilience to be able to handle load? So, if you look at somebody-

Dr. Weiniger:                  The question about curve though I think is misplaced because the point that you’re making … The question is which is more stable? The argument is, this amount curve or that amount of curve, which opens the question of, “Which direction do you stabilize in towards neutral, which is where a lot of your Pilates that came from?” And if you have Pilates in the office, you might feel … and that’s where your orientation comes from and that’s why I went through that because we’ve had people from every different niche that look at posture-

Dr. Weitz:                       No. Actually, my orientation comes from weight training. I did the whole bodybuilder, power lifting, weight training thing and studied that for years and years and years, and even wrote a book called The Back Relief Book. So, I’ve really studied it from that. So, I kind of clash with the Pilates instructors a little bit.

Dr. Weiniger:                 And when you talk to them, one way despite the model that I’m still at right now, which is like hardcore science biology 101, maybe 102.  Data that you can’t possibly argue it. And my point is from in terms of principles of posture that pretty lights are also immutable, your body is designed to move. So, the best strategy is not to get really good at stabilizing in this angle, or this angle, or this angle, but teaching people how to move with fluid accurate control all the way through a functional range with that load and with stabilization in different directions. That’s why we use balls and a lot of tools to strengthen people. The whole motion track of these wrong posture exercises use balls but that’s only after we’ve started working with before that alignment and before that balance.  Because the way that you move is dependent upon how you align in order to balance-

Dr. Weitz:                      Let me ask you the same question.

Dr. Weiniger:                 I’ll come back to it. Working with full range comes first and then yes, a little bit of curve makes sense. How much curve? Depends what your body genetics are and that’s why feeling your body and working with that makes more sense than an arbitrary, “This is perfect and you should be like this.”

Dr. Weitz:                      Okay, let me add another layer or a different way of looking at the same sort of situation. When you’re working with a client with a specific type of injury or low back condition. So, let’s say in one case you have somebody who has a confirmed herniated disc in their lumbar spine versus somebody who say has bony stenosis, where the bones actually are narrowing the space where the nerves and the spinal cord comes out of and is leading to pain. Do you treat those two types of conditions in terms of the posture of the lumbar spine differently …? For example, if I have a patient with a herniated disc, we’re going to tend to use more of an extension strategy.

                                      Usually, I’ll test a person and you know if they feel more pain or they feel radiating pain when they lean forwards and leaning backwards doesn’t make them worse, I’ll tend to focus on having more of a curve in their lumbar spine or working on having them do more exercises that involve putting a curb there as opposed to the stenotic person where we’ll work on trying to flatten a lumbar spine. 

Dr. Weiniger:                 That’s not a bad direction. If you’re curious, sometime I might challenge you to try to work on that person a little bit differently and then observe if there’s any difference in your outcome. My anticipation is you’ll find that what you’re doing passively when you work with somebody, and passively is both chiropractic, traction, muscle therapy to unlock and to facilitate the possibility of motion in an arc is something that you do want to work with and with a plan and a direction. But once you unlock something, any additional exercise for a couple of times doing extension is going to be a good stretch to them and you want them to be able to have that kind of practice.

Dr. Weitz:                       Oh, sure. Yeah, we definitely do that.

Dr. Weiniger:                 But having them go in stretching directions that’s going towards their pain free range is the big idea, and using that pain as a diagnostic makes sense. But using the direction of that motion being with stronger posture to take out other compensations up and down the kinetic chain is one of the things that really makes a huge difference.  Because otherwise, if it’s a low back problem that was someone’s got a stenotic canal, the stenosis is likely not in just the lumbar spine.  Moreover, the symptoms did not just start with the onset of the problem.  The body has been compensating into that for a long time.

                                      So, there’s things don’t wind up and down the chain. So, when you look at the person that you’ve taken care of that’s got, for example, marked forward body lean as you were describing with stenosis and you look at their head, they’ve got that same kind of head forward posture with extension, and if you start to teach them how to incorporate that strong head torso position as well as doing the extension you’re doing, my anticipation is you’ll find the results are better.  Because you look at people doing it right now, most of them, if not all of them, are using some compensation in the top of their kinetic chain and below the kinetic chain.

                                         They do more knee bend and you’re saying something, “Well, you want to keep the knees more straight,” and one of the things that we do with the strong posture protocols is by tiering where you want to be focusing the effort, using what we call mass versus dry cueing, to focus some of the tension on this is the important thing right now to gain that control to the maximum of their biomechanic potential.  And then sequencing it in a direction, you can get a more profound change more systematically, because you’re making them focus on the things that they reflexively don’t want to move that are weak, because that’s where their reflexes are.

Dr. Weitz:                         Interesting. So, what about scoliosis or this curvature that some people have? Is that beneath the posture thing? Is that something you address as well?

Dr. Weiniger:                    I have addressed it. I’ve seen some cool things with it. Even though some CPEPs … CPEPs are Certified Posture Exercise Professionals the people that use the tools that we talked about and that teach … And they are chiropractors, largely, they’re also trainers and physical therapists, and Pilates teachers, and Feldenkrais teachers. And one of our CPEPs is Feldenkrais instructor of other Feldenkrais teachers, and yoga people, and anyone that looks at biomechanics like trainers. A lot of people, in their own practices, incorporate strong posture. I lost my train of thought, what were we talking about?

Dr. Weitz:                         Oh, scoliosis.

Dr. Weiniger:                    Oh, scoliosis. Scoliosis to me is more of a neurologic problem than a muscular problem and I know that there’s people that we trained in that direction using different kinds of braces that are potentially interesting, I know a lot of this stuff that’s been done historically is with surgeries and what not, and braces, and Harrington rods is … I’m less focused on that, some of the muscular as things going for scoliosis like Scott, and others in those directions, have reported decent results and we’ve looked at it but I’m not focused on scoliosis. I’m focused on overall body posture, because, if and when we come with a scoliosis program, there’s other things that I see that are not being effectively incorporated into it that should be and could be, and I think chiropractic should be a good part of it. 

I personally have had some wild, wild cool scoliosis cases but candidly, I’ve had some that haven’t responded as well. Incorporating things like kinesiotape, instrumented soft tissue mobilization are as some of the things that can be incorporated that makes sense. We have a lot of people that work in those realms and that’s good. I would say if someone haven’t grown scoliosis, beginning a seven-week strong posture program is an easy down and dirty way to begin and see what happens. Take a picture and see what happens, and that’s why taking the picture here is such a valuable way to benchmark rather than getting into how you feel and not what do you think, and it’s a lot easier than taking x-rays.

Dr. Weitz:                         Right, cool. Well, I think you’ve provided us with quite a bit of interesting information Dr. Weiniger. For patients, people who are viewing this or listening to this as well as practitioners, what’s the best way for them to get a hold of you?

Dr. Weiniger:                    Two different questions: if you’re a doctor or practitioner, go to posturepractice.com, that is information on CPEP, certified posture exercise Professionals program. It’s got the CPEP logo on it. If you are a member of the general public, I would suggest going to posturezone for overall information, and for both, I wouldn’t suggest going to posturemonth.org. May is posture month and we are the instigators, and they call me the chief posture evangelist of posturemonth.org. Posture is important and having a good awareness of posture begins with being aware, taking a picture.

                                          In fact, the campaign for 2018, for this month’s posturemonth.org a program is ACE your posture. A, stands for awareness, C for control and E for environment. Be posture aware, take a picture. As I said I like the PostureZone app and the app is … It’s not ready, it’s my camera. Basically, use the app to take a picture of somebody, not my office, but to take a picture of somebody and to measure where the body is in space, to measure … Can I share it with you? It’ll be good if I share.

Dr. Weitz:                          Yeah, sure, yep.

Dr. Weiniger:                     So, this allows somebody to assess somebody else’s posture, and can you draw lines on it as well? Okay, so let’s go back. I’m uploading up a picture-

Dr. Weitz:                          And this is a free app that we can download and put on our phone or our iPad.

Dr. Weiniger:                     It’s a free app. PostureZone is a free app for iPad, iPhone, and Android.

Dr. Weitz:                          Okay.

Dr. Weiniger:                     I don’t know if it’s going to work. If you can see this from there.

Dr. Weitz:                          Okay, yap.

Dr. Weiniger:                     Okay. I took this picture before … When you take the picture, there’s a line on the top on the bottom that you want to rotate it to make it level and that’s aside view, so it’s taking a side view. And I don’t even see the bracket, you can move around to bracket, the head, the torso, the pelvis over the feet, and you can double tap to make it a bit more precise in the pro version. To get a picture of where someone … Basically, your posture is how you balance your body. So, benchmarking when you’re trying to stand tall. It’s like as where’s your head or your torso, it’s where’s your head torso and pelvis over your feet because it’s about the whole body and then assessing the picture to benchmark the degrees of deviation of the head over the feet, the torso over, the feet and the pelvis over the feet when you believe you’re standing straight.

                                         And then you can save that in a folder and this is my messing around folder and compare today’s picture to prior pictures and see what kind of changes occur. If you’re a professional, the free version … If you’re a professional. It’s a one-time purchase, there’s no monthly things. I think it’s 29 bucks, and you can chuck the rate reports on and PDFs, and email amount and communicate to patients and people what their posture looks like and that’s what we do. If you’re a member of the public and you’ve got a question about your posture, if you look in the PostureZone app when you get it, there’s a button that says, “Find a posture professional.”

                                         And all hands on, there’s a CPEP near you that does strong posture work and that may be even be doing free posture pictures for the month of May, and if you would like to have a free posture picture, go to your CPEP and let him or her take your posture picture so you know what you will look like when you’re trying to stand tall.

Dr. Weitz:                        Cool. That app looks like something that would be really useful. I’m going to go download it as soon as I get off this call.

Dr. Weiniger:                   Fantastic. If I can give you a hand with it, let me know, doc.

Dr. Weitz:                        Thanks, doc. I really appreciate your time and we’ll talk to you soon. I’ll put your information in the show notes on my website.

Dr. Weiniger:                   And I forgot, buy Stand Taller Live Longer, its a prejudice but it’s a great beginning to understand more about posture.

Dr. Weitz:                        That’s great. Buy Dr. Weiniger’s book, Stand Taller Live Longer, and until then, we’ll see you next time.

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