Why Recovery Exercise Should Begin With Posture
TL;DR: Any SCI athlete with incomplete trunk control (and especially those who use a wheelchair) should prioritize postural work in their recovery practically above all else: any improvement in posture will make progress in the arms, hips, or legs easier. Let’s look more closely at why posture is a gateway to the rest of the body.
We’re big fans of starting with what you have, and pushing connection to where you don’t (yet).
This might seem obvious – “where else would I begin but with what I have?!” – but if we look around, it is common for rehab methods to ask the SCI athlete to skip steps: gait training before you can sit independently, weighted movements before they can be accomplished unweighted without compensation, etc.
The starting-with-what-I-have approach would instead recommend challenging an SCI athlete with, for example, a stable, unweighted seated posture by dynamically moving in and out of that posture, or trying the same torso position in a low-kneeling position. Leap-frogging to crawling or walking might be fun and help with visualizing long-term goals, but it may not provide an opportunity for creating lasting connection in those more advanced movements.
Two big reasons for the starting-with-what-I-have approach include:
Take advantage of myofascial connectivity. Muscular and connective tissues can “help each other out” when they contract locally to each other. Leverage the fact that everything in the body is connected!
Integration of new function into existing patterns. By adding to your movement repertoire with gradual postural progressions, you’re more likely to be able to incorporate new motions into your existing ones.
Since so many SCI athletes have partial or complete shoulder/scapular innervation but incomplete trunk innervation, postural work which seeks to integrate shoulders with trunk activation will help facilitate progress everywhere else in the body: up toward the arms (especially for cervical-level athletes) and down toward the pelvis, hips and legs.
Think of it this way: whether your goal is to stand or walk, perform floor transfers or tricep presses – but you know deep down that your trunk control could use some work – you can truly have your cake and it eat it, too. Better posture will make everything easier.
See examples of postural integration exercises on Instagram here and here!
We discuss the fundamental principles above in much greater detail in our Practical Posture workshop.