INFOBULLETIN

Edition no.8

February2015

ADVANCE

Posturology represents the knowledge of the human posture, its related regulation systems and, based on feedback, the integral implementation.

Just back from the API Posturology Congress in Paris I was very pleased of what I have seen and heard there. My interest in ‘posturology’ started early nineties although this name did not exist yet. The relationship ‘posture – eye function’ and ‘posture – jaw occlusion’ was my own experience and at that time I thought to be the only one interested.

Knowing that ‘posturology’ is fast growing outside my country, it was surprising nevertheless to see how far some foreign colleagues really are.

I repeat my statement: posturology is not a profession but a vision. As soon as ‘postural colleagues from whatever discipline’ learn to look over there own professional barriers, they will be a better therapist for their patients. They do not have to learn all possibletechniques; they need to know which technique is the best for their patient and to look for collaboration.

KEEPING THE HUMAN BODY UPRIGHT(from proximal or distal?)

Introduction:

As a posturologist I have treated many patients suffering from chronic postural pain. More than 20 years I provided them with so called podopostural therapy(in)soles. On these tailored, flat insoles I glued slices of cork with a thickness of 1 à 2 mm. The theory behind this treatment claims that the glabrous skin of the footsole is very sensitive to all kind of stimuli and, during gait and stance, to pressure (mechanoreceptors). We can walk barefoot on the beach, in the street and in the bush, but most of us can not resist tickling of the foot sole. By providing patients these therapy insoles, therapists can influence their patients postural balance and, hereby, often their pain. Once the patient’s posture has been changed and their complaints havedisappeared, the insoles can be left out.

Proximal or distal?

First of all it is important that in ‘medical thinking the ‘same language’ will be spoken. This does not mean that for example every doctor must speak French, but it certainly means the same professional language! Keeping this in mind, I find the terms proximal and distal somewhat confusing. In medical science proximal means near/toward the trunk and distal means from the trunk.

Just imagine an old-fashioned shelter. You need at least four ropes (two at the front, two at the back) to create some stability. Each rope pulls the top of the shelter towards the ground.The traction force is directed toward the ground! Only because there are more ropes, each pulling to a different ground position, the shelter stands solid.

Standing on both feet, we consider them as the fixed point (punctum fixum) and the body then as the ‘swaying’ part (punctum mobile). So to keep the body upright, the long lower leg muscles, all together, need to keep the lower leg ‘upright’. The traction force of these muscles is then toward the ground: mm peronei, mm tibialis, m. triceps surae, etc. Just like the shelter above.

When we sit however, our pelvis is the fixed base (punctum fixum). Raising a leg, bent or straight, pulls this leg is toward the pelvis. Compared to the example before: the opposite direction! Physicians and therapists must be aware of this.To apply the right therapy you have to ask yourself: which way is the muscle contraction directed? Or in other words: what moves with respect to what? What is the punctum fixum and what is the punctum mobile? Proximal will then not be automatically the punctum fixum!

Please, give me your opinion!

Peter W.B.Oomens (Research on posturology).

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