Perception vs Reality: From Quantum Truth to “Real Life”
PART II- Connecting Perception to Reality: the StrongPosture Framework
“Posture is HOW you balance your body.” The 2nd Posture Principle1 Stand Taller Live Longer (2008, Steven Weiniger)
Posture is the beginning point for locomotion, and as bipeds the imperative, the MUST, is to stay vertical.
Except for special cases like swimming, crawling and bungee jumping, for just about anything we physically TRY to do in life, we MUST stay vertical, balancing head over feet, with the torso and pelvis pretty much in the middle.
Balance is the interface between our internal perception of the body in space, and our ability to control and maintain that vertical position. If our perception is more accurate, and our control more true, we balance. If there’s an error between what we perceive, and our control of what we do, balance is less stable.
When the error between sensed position and motor control is too great, we fall down.
Functionally speaking, balance is the connection between incoming (sensory aka afferent) neurons of body position and outgoing (motor aka efferent) neurons controlling muscle contraction.
The Question of Balance
Our personal sense of body, and our sense of balance in particular, is an emergent sense, a neurologic construct.
On the sensory side, it’s synthesized on a moment to moment basis from visual, vestibular and proprioceptive inputs. On the motor side, it’s the precise skeletal muscle motor control required to maintain mechanical alignment with a net vertical vector force of zero. There’s a split-second coordination of sensory input from 3 sources with the sub-cortical firing of skeletal muscle fibers to keep the afferent input within an acceptable range translates as “keeping your balance”.
The astounding miracle is we do it without thinking!
The trade-off between aligning our body mass, position and motion to reflexively stay vertical is a dance with three postural elements: Balance Alignment, and Motion (BAM).
“The test is the exercise, and the exercise is the test.” Vladimir Janda
All exercise is not created equal. A recent study in the Clinical Journal of Pain looked at perception and chronic low back pain (CLBP) and concluded there’s “a growing body of evidence suggesting that disturbed self-perception is a feature of CLBP. It is plausible that altered self-perception is maladaptive and contributes to the maintenance of the problem and may represent a target of treatment for CLBP.”2
An implication of maladaptive altered self-perception: Exercise is good, but for chronic low back pain exercising may perpetuate and aggravate both pain as well as disability. Which is the promise of motor control exercises (MCE), training motion in a specific controlled pattern.
A recent MCE metastudy compared 16 other studies of motor control exercises and found “In patients with chronic and recurrent low back pain, MCE seem to be superior to several other treatments”3 …including general exercise and spinal manipulation.
Strong Posture, Must vs Try, & Perception vs Reality
StrongPosture® exercise protocols systematically focus attention with “MUST” vs “TRY” cueing to identify and strengthen the weakest point in an individual’s unique kinetic chain.
StrongPosture® exercise protocols systematically work to correct sensori-motor errors by focusing attention on a single BAM element of posture (Balance, Alignment, Motion) and a single PostureZone® (Head, Torso, Pelvis, Lower Extremity) at a time, and then aligning subjective perception of body position with objective reality. Each exercise is performed perfectly to an individual’s ability, within their pain-free functional range.
Compensations of other PostureZone components are minimized by strictly requiring exercises be performed while keeping input from other elements constant with exercises arranged in 3 tracks corresponding to the 3 Elements of Posture:
- Balance track, focusing on aligning vestibular input with reality
- Alignment track, focusing on connecting kinesthetic with visually observed alignment of the 4 PostureZones
- Motion track, using a ball for proprioceptive focus to objective reality while moving with balance and alignment
Assessing and addressing posture by focusing on one element at at time (Balance, Alignment and Motion) allows objective functional measurement along an continuum of strength and accuracy, and addressing improvement by focusing on strengthening and correcting to objective reality. And then by precisely defining exercises and requiring adherence to objective references, protocols train a systematic focus on one kinetic chain link at a time. And when rehabilitative exercises are protocoled with clear imperatives such as “you MUST do this”, and then “TRY to do that”, changes in ability to perform the therapeutic activity also become an objective measure to track improvement in functional posture control.
An inability to perform a specific progression can be diagnostic of asymmetric impediments to free motion, and suggest a therapeutic intervention such as spinal manipulation, muscle therapy or fascial treatment.
An example: restoring the potential to full range segmental motion by removing deep mechanical restrictions and facilitating neurologic control- the unique contribution of the chiropractic adjustment.
The systematization of correcting perception of balance, alignment and motion (BAM) to reality and then training these three postural elements tightly, towards symmetry, and towards that reality, explains the effectiveness many CPEP® posture specialists and other posture professionals have seen with chronic low back pain patients, as well as those suffering other NMS conditions.
1 Stand Taller Live Longer: An Anti- Aging Strategy, Steven Weiniger DC, BodyZone Press, 2008
2 Mislocalization of sensory information in people with chronic low back pain: a preliminary investigation.Wand, Keeves , Bourgoin, George, Smith, O’Connell, Moseley, Clin J Pain. 2013 Aug;29(8):737-43. doi: 10.1097/AJP.0b013e318274b320.
3 Motor control exercises reduces pain and disability in chronic and recurrent low back pain: a meta-analysis. Byström, Rasmussen-Barr, Grooten, Spine 2013 Mar 15;38(6):E350-8. doi: 10.1097/BRS.0b013e31828435fb