My assumption is that you have already been thinking about how to apply these concepts to yourself and your practice. Many of you are also probably thinking about friends and family members you can help with this information!

The Evaluation

In our clinic, every evaluation includes a posture and alignment assessment. This is primarily because we treat people with pain. Not paying attention to posture is out of the question. We would be doing our clients a huge disservice if we did not address posture.

In your practice, posture is likely very relevant as well. If you haven't been thinking about it, I hope to get your ideas flowing!

Ergonomics

I was the therapist in charge of doing ergonomic assessments for every workplace in my OT work history. I loved it. Making a few simple changes could make a huge difference in someone's comfort. Posture is the same. However, I didn't learn some of these concepts until about 15 years ago. They layer extremely well into ergonomics, especially now that we have so many workstation-based jobs and many people are shifting towards standing/sitting combo workstations.

Too many people assume that a standing workstation is going to be a healthy option. Well, that depends. If you take a body that with poor alignment and posture choices and move it up against gravity in a mostly static position for long periods of time, you will actually end up with more problems than if you were sitting. I have seen this happen many times. Some people actually end up with more back, hip or neck pain.

If you provide employees with good information about posture before they transition to standing, the option of a standing station can be wonderful!

Wellness

More people are making the connection between how they care for themselves and how they feel. Posture is not an obvious concern for many people. Any practitioner practicing in the area of wellness should be shouting from the rooftops about the importance of posture!

Lymphedema

Poor posture can lead to fascial tension. Fascia tension can act like a kink in the garden hose of the lymphatic system. Enough said.

Mental Health

Our interview with Lisa Basile helped us make a clear connection between mental health issues and posture. The information from Amy Cuddy showed that posture influences our mood and how we are seen in the world. Helping our clients see these connections may increase awareness and lead them to making different choices that can support their healing and function in the world.

Women's Health

There are so many practices popping up for women's health. Where is this trend coming from? I'm so glad it is a trend, and many OTs are participating!

Posture is VERY important for women (and men) with pelvic floor issues. When the hips are not in alignment, the pelvic floor is not either. The same can be said with the knees or the spine. So many muscles connect with the pelvic floor.

When progress isn't being made with other treatments, posture should definitely be checked!

Pediatrics

I hope I have made the case that kids need posture education as well! Parents too.

Healthy Aging

I have many aging clients who have the habit of looking at the ground when they walk. This habit has started a cycle of leaning forward. Most are completely unaware of the habit. One client texted me after his morning walk and said how much more he was noticing in his neighborhood!

My guess is that most of your clients who are 60+ could use some posture advice and education!

SNF and LTC

We know that good posture is important for our clients in wheelchairs. We should also be mindful of our clients who are not. Forming treatment groups with good posture as the goal would be a great addition to any group serving older adults in facilities or in the community.

Our older adults need education as to why good posture is so important. It is connected to balance and all-cause mortality! Most adults have not been educated about posture beyond "stand up straight"! We can provide them with great information!

Hospitals, Acute Care and Rehabilitation

In these settings we are continually trying to be more and more efficient. What can we do to get them out the door faster and save the organization money. Adding one more thing may not always be possible. However, information about posture can be layered into other treatment sessions. Transfers, ADLs, walking, exercise, etc.

If you have a patient that is in for a respiratory or organ issue, posture education is important. The continuous pressure of poor posture on organs is something to be concerned about!

I have seen many clients who have had surgeries, especially on the front of their bodies, fall into a pattern of poor posture. It begins from a fear of hurting the incision or pain with the incision (or drain, or any other procedure). Then it becomes a habit that they are not even aware they are doing. Education. Education. Education.

I have seen clients who don't use a walker or cane correctly. They allow themselves to fall into the assistive device rather than use it to keep themselves upright and tall.

There are many other potential applications to these practice areas. Please put your ideas in the comments below.

Outpatient Ortho and Neuro

Often in outpatient settings we are highly focused on a specific issue. In the case of hand therapy, it may be a flexor tendon repair. This hand is of course connected to a person. This person is now pretty lop-sided and using their body very differently than before the injury. This compensation can lead to changes in posture that can stick long after the injury is healed.

We could say the same for many other issues and injures from shoulders to knees to everything else!

Education and awareness are key to helping clients in all areas heal.

Treatment Plan at a Glance

We've included a reminder of how we work with clients on their posture. You, of course, will find your own flow.

Conclusion

I hope everyone who take this course will share their ideas on how they see this information applied in practice. Please jot your ideas in the comments below!