Bernard E. Filner, M.D., Pain Medicine, Rockville, MD
Treatment Approach

Postural Modification

“Stand up straighter!”

We may remember hearing the phrase most often as teenagers, but there’s good reason we should remind ourselves of this as adults. Poor posture can lead to pain and musculoskeletal disorders, which lead to more pain.

However, there is more to posture than standing straight. Though the skeletal system provides structure to the body, muscles can move it off course.

A significant number of people have a hyperpronation gait (Bryan A. Rothbart). When the foot is tilted from a horizontal plane to the hyperpronation position of ankles turned inward, then muscular bracing, initiated by the body’s proprioceptive mechanisms, leads to a postural “bioimplosion” that often results in a head-forward posture, abnormal turning of the knee joints, and improper pelvic rotation. The hyperpronation position causes instability and throws the body off balance, causing muscles, including those of the neck, to brace, which in turn can predispose the muscles to injury. The bracing of muscles, resulting from an excessively pronating gait, can slow or even prevent recovery from musculoskeletal pain.

The Pain Center often uses Posture Dynamic Insoles®, soft, comfortable, rubber insoles, to correct foot positions. Dr. Filner, who determines the appropriate insole to alleviate  the pain, has found that the proper insoles have often reduced his patients’ musculoskeletal pain.