John:

I would have to agree with you!  The position of posture is extreme that
seems to cause her LBP.  The reason is she is using her "ligaments" to
support this posture at end range and becomes pain just as if you tried to
hold you finger (MP jt) in full extension with overpressure, it would
eventually become sore.  So, finding the nuetral position and being able to
maintain it with muscular control is much more effective in relieving her
pain and improving her function whether it be sitting or running or
whatever.

Patrick Zerr
www.apluspt.com
The easiest way to prepare for the National PT Exam!
www.summitpt.com
Summit Physical Therapy; Tempe, Arizona


----- Original Message -----
From: "John Willenbruch" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, August 18, 2002 4:27 AM
Subject: A question of posture


> Right the honest bit first, I have not really kept up with the current
> debate due to being away for a bit.  But I did follow the first comments
of
> the debate.
>
> I was just wondering what the guys who do not think posture should be
> assessed think of this case study.
>
> 16 year old female with 3 years of central low back pain.
> She has better range of movement than normal.
> Physical examination/Xray/MRI etc all normal.
>
> Pain comes on whilst sat in class or while sat watching tele.
> Looking at her static posture she had a flattened lumbar spine and on
> maintaining this posture bought on her pain.  On correcting this posture
> she could sit for about 10 minutes longer without pain and when the pain
> did come on it was different, over 3 weeks of nagging from me and hard
work
> for her she was pain free.
>
> Personally I think her problem was one of posture.
> I know a case study is not research, but I think it effects practice just
> as much.
>
> Hope this has some relevance to the topic!!!
>
>
> John
>