Issue link: https://www.massageandbodyworkdigital.com/i/867515
LOOKING AT FHP SPECIFICALLY By far, the most common postural shift you'll see in general practice is FHP. As such, this is the logical starting point. The biggest problem with this type of shift is that as the head moves forward, it becomes functionally heavier. Specifically, the head gains 10 pounds of weight for every inch of forward translation. 4 So, an average 12-pound human head carried 2 inches forward of normal would affect the body as if it weighed a whopping 32 pounds! It's not that the head is getting larger— the muscles that are involved in supporting the head have to work much harder due to the abnormal angle of carriage at the joint. If this concept is difficult to grasp, try this exercise: Pick up a 10-pound dumbbell and hold it upright with your elbow in full flexion to simulate the weight of the head pushing down through the bones of the spinal column. Next, lower the dumbbell by extending the elbow to a 90-degree angle. Does that 10 pounds feel any different in that position? Are the muscles of your arm forced to work harder to support that weight at 90 degrees? That's functional weight. Bodyworkers must always keep this relationship in mind: form will dictate function. That means we should be able to confirm what we're seeing in the postural window reflected in the functionality of our client. It should not be possible for the joints of the spine to move normally while held in FHP. As a rule, you will tend to find decreased range of motion and often pain with motion in individuals who have undergone postural shifts. The more significant the shift, the greater the dysfunction will be. In addition to the increased load on surrounding structures and decreased functionality, as the head shifts forward, the length-tension relationships of muscular and fascial chains throughout the body become altered. Due to the widespread interconnections of these chains, the effects of FHP are often far- reaching and show up in unexpected ways. Here are some of the conditions that have been associated with FHP: • Arthritis • Back pain • Carpal tunnel syndrome • Constipation • Decreased lung capacity • Decreased quality of life • Depression • Fatigue • Headaches • Heart disease • Increased blood pressure • Indigestion • Neck pain • Neurological problems • Poor circulation • Shortened life span • Temporomandibular joint disorder Text neck has the same type of effects on the body that FHP does. The functional weight of the head increases with increasing flexion of the neck, as when staring down at your phone. In this position, the functional weight of the head can increase to as much as 60 pounds. The massive increase in functional weight has significant and far-reaching effects on tissue quality, the length- tension relationships of muscles throughout the body, and overall functionality. Needless to say, these are issues that bodyworkers should address. ASSESSMENT A standing postural assessment (at left) is a gateway test. Every client you see should go through this before lying down on your treatment table. According to author Elizabeth Kendall McCreary, normal body posture is said to exist when there is "a vertical line passing through the lobe of the ear, the seventh cervical vertebra, the acromion process, the greater trochanter, just anterior to the midline of the knee, and slightly anterior to the lateral malleolus." 5 Following the postural assessment, we should have a basic idea of what our focus will be with this client. The picture will be clearer if we are able to correlate what we see with the information the client gives us in their history and with their primary complaint. Still, all we have at this point is an idea. Now, it's up to us to confirm our suspicions. Structure affects function, and if we can match up our functional testing with what we see structurally, then we have confirmation. If we are then able to correlate those findings with our palpation and relate that back to the client's history and/or symptomatology, we've got the perfect diagnostic storm. 52 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 7 ear lobe acromion process of scapula greater trochanter anterior 1/3 of knee joint posterior 1/4 of foot length Standing Postural Assessment Test