Posturology -- quackery or legit therapy?

Factual Questions
1

My girlfriend suffers from chronic back problems. Now, her doctor has proposed trying out a new treatment, called ‘posturology’, to try and alleviate her issues. As far as I can gather, the theory behind this treatment is something like: these back problems are caused by poor posture, and this poor posture is in turn caused by the body misjudging its orientation in space, a poor sense of proprioception and spatial orientation, or something along those lines. The idea is now that through ‘re-aligning’ the body’s image (its self-perception – there’s no Qi or similar claims involved here, if there were, I wouldn’t be asking this question) of itself with its actual physical position and orientation in space, the posture will, over time, correct itself, or can be permanently corrected, causing the back problems to go away. This is done by ‘reprogramming’ out of tune receptors, as it’s explained here (there seem to be rather few English sources describing the therapy, and I’m not sure how good those are).

To that end, her doctor has proposed my girlfriend wear special insoles, as well as take eye drops. The eye drops, best I can gather, are meant to correct her inability to cross her eyes, i.e. turn both of them inward, which causes visual data to be interpreted wrongly, leading the brain to come to wrong conclusions about the body’s orientation.

Now, my medical knowledge is very limited, and in principle, this approach seems sensible to me – if actual and perceived body orientation are out of whack, there’s bound to be some resulting tension. However, there’s some hallmarks of quackery present that make me slightly sceptical – mostly, some grandiose claims of panacea-like results of the therapy, that the problems it is supposed to alleviate are something 90% of the population suffers from, and the whole on its face plausible, yet rather hard to substantiate mechanism through which it is supposed to work – how does one assess whether or not the body’s self-perception is out of whack? How does one know when it’s corrected? (Also, that the therapy’s main proponent and apparent inventor, a Dr. Bernard Bricot, is cited as ‘one of the top acupuncturists and orthopedic surgeons in Europe’ doesn’t really help matters much, either.)

So, medical dopers, what do you say – is this a reasonable therapy, or a waste of time?

2

Sounds like a bunch of BS.

Sorry, that’s all I’ve got.

3

My review of the literature would incline me towards avoiding practitioners of posturology. Especially if they advocate messing around with the ocular system to correct musculo-skeletal complaints.

4

Sounds like BS. About the only thing I agree with is that improving one’s posture can help minimize some types of back problems.

I’d advise that she go to physical therapy; even if her problems don’t go away in the short term, they’ll show her exercises that might help her in the long term.

5

It scores high on my BS-meter too. I would look for a good chiropracter. How do you a good one? Ah there’s the rub. My chiro himself says that most of them are quacks and he has tried dozens in the city (Montreal) without finding one he would use for himself. I found him when my family doctor asked me, very very tentatively, if I would consider using a chiro for my back problems.

I have been using him for 17 years and, except for a very serious back problem about six months after I started with him, my episodes of back problems have been very brief and very mild (while they had been becoming worse and worse for years).

So what has he done? Every six weeks, I get an “adjustment”. In addition, he gave me a series of “setting up” exercises. I do a half hour of these mostly stretching exercises every morning. For all I know to the contrary, the improvement is due to the exercises alone, but I am not about to experiment (but I wish someone would).

One hallmark of a good chiro is that he makes no claims to fix anything but back problems.

YMMV

6

I could find nothing about Posturology on the Skeptic’s Dictionary, but that doesn’t mean its not BS.

My understanding of human physiology has taught me that having good posture can help prevent back problems. The body is capable of doing some pretty amazing things to compensate for injury. These things can happen without you consciously knowing you are even doing it. The end result can be painful, if not remedied with proper physical therapy.

But, the whole idea of a perceived body orientation vs. actual body orientation smells of some pretty strong BS to me.

7

When I first scanned the page I read post-urology and skipped on to the next page and then thought what the … and returned. Does the answer have to be all BS or no BS? It sound to me as if it could be a foot problem. Were it me, I would ignore all the suggestions except getting better shoes.

8

There is at least some theory behind it. There is such a thing as a ‘central representation of body position vs vertical’ which can be messed up by inner ear and/or visual troubles (I’ll have to find cites, I should have some at work… I’m thinking in perticular about facial assymetry which will create an inbalance in the equilibrium signals from the inner ear). This may in turn create posture trouble and back pain. Foot problem may do that too.

Now this doesn’t necessary mean that your doctor is serious.
Special insoles, which are not orthotics ? I wonder what it is.
Eye drop for correcting vergence problems ? I never heard of it. Do you know the name of these drops ? It should be easy to google out if he gave her some kind of placebo, or what the actual purpose of these drops is supposed to be.

By the way:

  • IAMADoctor… but I’m a biologist specialized in inner ear, vestibular system, equilibrium and eye movements.
  • I have heard of glasses used to correct postural problems.
  • The perception of body orientation can be measured by having a subject sit on a tilting chair in darkness or in front of a defined visual display. The chair is tilted to a variety of leftward or righward tilts. The subject is holding a bar and is asked to maintain it vertical (or horizontal). This kind of techinique is classique in the lab.
  • There are plenty of serious people which work on analysing posture in patients. I’m thinking about the rehabilitation centers which restore walking after leg injuries/minor spinal chord lesion/brain injuries. Measuring postural stability and gait are common things in these centers.

This still doesn’t mean that your doctor is a serious person. Obviously this is a little difficult for me to juge. But I have to say that the description of their methods is quite fuzzy. And that, despite his participation to scientific work advertized here, he doesn’t have a single publication on pubmed.

9

As someone who works in ophthalmology (IANAD/N), I’m disturbed as hell about what could be in those eyedrops. I don’t know of any that would have the intended effect.

10

It’s possible I got this part wrong, I’ll have my girlfriend ask what kind of eye drops the doctor wants to prescribe.

Thanks for the opinion-forming fodder so far, everybody, and for taking the time of looking into the matter for me. I think that as of now, the best strategy will be to see how much the treatment is going to cost, and whether or not the insurance will cover it (though I seriously doubt it). If the latter’s the case, it’s probably not gonna hurt, and hey, there’s nothing wrong with a good placebo effect in any case. Else, it’s ultimately her call to make.

11

The website (and justifications for “posturology”) reek heavily of unsubstantiated woo. There is no supportive research cited, and the practitioners have a bunch of mysterious certifications (like “Certified Metabolic Typing Advisor”) whose origins and utility are questionable (this is common with quacks, who paper their walls with certifications not recognized by legitimate branches of medicine or obtained via mail order). I suspect that once she gets an appointment, there’ll be a push on to get her to pay for not only orthotics and eyedrops, but other “wellness” treatment including nutritional supplements which similarly will have no demonstrated value in relieving back pain.

This is about the best one could hope for - but there are better characterized and probably cheaper ways to get the same effect - including physical and massage therapy (she’d probably even be better off with a chiropractor who limits his/her practice to musculoskeletal pain relief).

12

BULLSHIT! Legitimately bad posture comes from chest and neck muscles that are too short, making it impossible (or difficult) to align the bones. Other, non-physiological, causes include lack of confidence (our posture plays a big role in our social instincts, much like a dog’s) or plain bad habit. Short muscles can be corrected through stretching and exercise (though it takes dedication, as any exercise). The psychological factors can be corrected too, perhaps using methods similar to those advocated, but I just don’t see where having non-crossing eyes, etc., comes into any of it.

The way I can see the “self-perception” thing making sense is in terms of habit. If you’re in the habit of slouching (again, with no physiological or societal cause), then you can say that is the position that the body “perceives” to be normal. If you’re in the habit of good posture, you will “perceive” a slouch to be weird. But it’s almost tautological to put it that way.

13

Btw, if you have short muscles, and you try to correct it simply by “trying” or by learning “good habits,” you won’t get far. Stretching muscles involves actually pulling on them.

You need two kinds of stretches. Brief, intense ones to tear up the connective tissue, and long, low-intensity ones to grow the muscles. Wearing heels and “learning good habits” can (if you try honestly) provide the long-duration low-intensity stretch. This is good. But if you still have all your connective tissue intact, you won’t get far. You’ll simply be unable to even get the muscles in a stretched position whereby they start growing.

14

Echothiophate drops are used on occasion in conditions of intermittent strabismus during near-work, similar to what is described in the OP, so that is a possible legit use.

Still, it’s hard to see how that will help the OP’s girlfriend’s back…

And yeah, lenses can be used to help with posture. In those cases it’s generally vertical prisms that are used. For example, if someone slouches a lot and tends to look down, prisms that optically move “the object of regard,” (a fancy way to say “whatever you’re looking at”) upwards will require the person to look up and, in theory, hold their head higher. That does not sound like what’s going on in the OP at all, though.

15

“Tear(ing) up connective tissue” through intense maneuvers (to the extent that this is possible) would have the result of causing bleeding, inflammation and scarring. I can’t see how that would improve posture. I am also puzzled by the claim that stretching causes muscles to “grow”, or that “short” muscles cause bad posture.

There are physical factors that can result in poor posture (osteoporotic fractures and resulting deformity of the spine being one obvious example). But I’d like to see evidence that congenitally “short” muscles are something that people with postural problems need be concerned about.

16

I’d very much like for this issue to be cleared up, as well.

17

It sounds pretty legit to me. Posture is definitely caused by proprioception. Our entire sensory apparatus is tied into how we interact with the world around us, and being able to better sense where we are in space will lead to better posture.

Orthotics are a good bet, especially if they are tailored orthotics for the individual.

Also, Chiropractic and Massage together would help a lot. (Personally I think Chiropractic is pointless without attendant myofascial work) There are lines of tension called ‘anatomy trains’ in your fascia that help support the body and keep it upright. Bad posture means that some areas are too lax and some are too tense. All postural deviations will have a hypotonic area corresponding to a hypertonic area. The best and most effective treatment for this on a short term basis is a massage.

It seems like posturology brings in a neurological basis, which people in this thread are blowing off because the cognitive aspects are kind of new and the wider body of knowledge has yet to be properly integrated.

Anecdotally, from observing my wife and my sister who both have poor depth perception, they both have a tendency to slouch, so I wouldn’t blow off the ocular aspect of it out of hand. But I can’t give a definitive answer because I am not a doctor and I don’t understand the neurological aspect of it completely.

But there is a reality that all postural problems are three-fold based upon learned behavior over time. Your muscles will retain the positions they are in based on simple growth patterns. If your muscle is used to being shorter than good posture requires, then it will remain shorter, ie, hypertonic. If a muscle is longer than normal it will be hypotonic. This can also be the result of tendons of irregular length, but you can adjust it muscularly with massage therapy and exercise. This is why getting a deep tissue, myofascial massage after seeing the chiropractor is a very good idea. They can tone the hypotonic and detonify the hypertonic muscles. In terms of deep tissue reducing hypertonicity often is a result of actually breaking up the muscle and reducing myofascial adhesions. Stretching is an important part of this. If however, you are doing this without a chiropractor the position of your bones will cause the muscles to return to their former shape naturally. So there is a synergy between bone position, muscle tonicity, and posture.

Now, proprioceptively your body learns its normal states, as proprioception senses deviation from what it considers to be the norm. So somehow you have to retrain the brain to accept the new alignment of the posture, otherwise the brain will send commands to the muscles to go back to their previous shape, as such they will pull the body out of alignment.

Trigger point therapy which is a form of massage works on this a lot, and Rolfing is very big on overall posture.

So, on the face of it the basic theory is sound. Posture is a combination of bone alignment, myological tonicity, fascial adhesion, and proprioceptive habit.

This talks about treating Phantom Limb pain with mirror therapy, so it stands to reason that if visual therapy can help correct Phantom Limb then it can be influential in the proprioceptive realignment of posture.
Phantom limb pain at Walter Reed: Mirror therapy works

EDIT: I am not advocating the eye drops, or advocating that particular Doctor, or even Posturology, just that some of the basics don’t strike me as all bullshit.

18

It doesn’t. Not unless you do it wrong (which in fact is sometimes a danger). Stretching as done by dancers, martial artists, etc. doesn’t typically cause injury even if it’s done to the point of significant temporary pain.

How can you be puzzled by that? Do you think dancers can effortlessly pull their legs to their ears because they were born that way? If you pull on anything, it will grow. Tooth braces cause bone itself to grow. In the case of dancers, the main muscle groups that are lengthened are the hamstrings and the groin muscles.

Short muscles restrict leg range of motion among people aspiring to dance (or kick). Short muscles can also restrict the range of motion of the chest, neck, and shoulders. Sometimes, the range of motion is so poor that a person cannot attain an attractive pose (although their poor posture is still very much functional). I know this because I myself suffered from it, simply unable to attain good posture whether I tried or someone tried for me. The limited range of motion also affected my ability to throw and play sports. It had nothing to do with my bones. Stretching out the relevant muscles has already yielded great progress.

19

I think we are mostly in agreement, except you seem to be saying that short muscles are simply the result of muscle contraction, and long muscles the result of muscle relaxation. While contraction/relaxation obviously affect muscle length and are important factors in posture, muscles can also be, overall, short and long. For example, I’d venture to say no amount of relaxation is going to let you do a full split (although relaxation is very important when doing one). You’re very welcome to go try one now.

20

It does actually cause injury. But small minute injuries. Generally the more intense stretches are required to reduce myofascial adhesions. Lighter stretches done regularly over a long period of time will have more lasting results. However, the immediate relief by destroying triggerpoints where the fascia has grown into the muscle can result in a dramatic and immediate change. But that shouldn’t be the long-term strategy. If you are tearing the muscles, jackmannii is correct that it will cause bleeding and inflammation, which DOES happen to Dancers and Martial Artists who over-reach.

Actually yeah, Dancers CAN pull their legs behind their ears because they were born that way. If your pelvis doesn’t support that movement, you can’t do it, period. Professional dancers are trained from childhood usually, when it’s pretty easy to do such stretches. I could put my legs behind my shoulders into my twenties without any training. I could probably do it again now if I trained.

Saying it has ‘nothing’ to do with your bones is nonsense. The whole structure is relevant. Yes, the retraining of the muscles is an important part, and you retrain your proprioception at the same time, so that’s helpful, but arguing that the alignment of the bones is irrelevant is a non-starter. I say this as a trained massage therapist, so your argument is actually in line with the bias of my discipline. But posture has so many contributing factors that you can’t just make some kind of broad one-size fits all claim. Obviously the myofascial angle is important, but it’s not the end all be all.