Stooping Spinal Posture

Stooping spinal posture: If you can’t measure it, you can’t manage it.
The final destiny of the aged spine is to eventually succumb to the relentless force of gravity. This final position will almost always involve some form of stooping over and this “picture” seems to worry some of my Baby-Boomer patients and terrify others. I try and reassure all of them but I must admit that I do have some concerns for some. Especially those patients who are beginning to or are already exhibiting a forward-stooped posture where the trunk inclines forward over the pelvis. This forward-stooped posture, when exceeding certain thresholds, is called anterior sagittal balance and is eventually associated with increased pain, reduced function and reduced quality of life.

I recall many years ago, after presenting a spine-deformity paper in Germany, having a robust discussion with a Japanese spine surgeon who questioned whether physiotherapy treatment could alter, reverse, prevent or delay these stooping over postures. I argued that in some cases we could and I am still working on the evidence. However, without a method of accurately and reliably measuring these stooped over posture the data will always be disputed.

I am grateful to finally be able to present the first paper towards my PhD researching sagittal balance. These spinal postures are typically measured by x-ray but as this exposes our patients to radiation and increased cost, this method is unsuitable for repeated measurement and monitoring. There are other non-radiographic methods. How do I know, I searched the worlds medical literature and wish to thank my colleagues on my research team.

The take-home message is that it is possible to measure stooped over posture. Come visit us in the clinic to see how our Formetric works or come visit us to see how we use a plumb-line and ruler. If you can measure it, then maybe you can start to manage it!

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Larry is a highly skilled physiotherapist who specialises in treating back and neck pain, postural issues and scoliosis. He is certified in Schroth and SEAS methods and through the Egoscue University. Larry has a background in elite gymnastics and springboard diving and also has many years experience in endurance running and triathlons. His specialist knowledge and techniques have seen him appointed as a gymnastics coach and physiotherapist at both the Olympics Games and Special Olympics.

His passion and driving philosophy is about achieving the best outcomes for his patients utilising an amalgam of the latest techniques and theories while recognising there may sometimes be a need for invasive procedures. Where deemed appropriate Larry will then refer to a specialist. To further his holistic understanding and approach, Larry is currently undertaking a Ph.D. in Spinal Deformity and regularly attends and speaks at international conferences and courses and clinics.

Fun fact: Larry is learning how to surf - so be careful next time you go to the beach! Qualifications: B.Sc (Physiotherapy); M.Sc. (Exercise Physiology); Advanced Certificates in Schroth (BSPTS) and Egoscue (PAS) and SEAS Larry is Level II certified (advanced) in the conservative treatment of Scoliosis based on the Schroth method. The training was conducted by Dr Manuel Rigo of the Barcelona School at Scoliosis Rehab Inc in Wisconsin. He has completed his SEAS scoliosis treatment training at ISICO in Milan. Larry has also spent time working with Dr Rigo in the Barcelona clinic. Larry also has advanced certificates in shoulder treatment, posture alignment therapy and acupuncture.