"Dear Orthopedic Doctors", explain to me what science describes that prescribing insoles and corsets is an effective therapy for posture problems?
The question is of course rhetorical, I know I'll hear some inarticulate mooing in response, and the especially gifted will send me links to studies they don't understand, or that are done crookedly 😁
Let me take some time and explain the harm of such "therapy". And I'll start from an elementary base - how the peripheral nervous system controls muscles. That's physiology. What you missed or didn't understand in med school. 😉
So, there is the brain, there is the spinal cord, there are peripheral nerves. The brain decides what to do, for example, to bend the arm, an action potential arises in the brain, it is a nerve impulse, which as a relay race is transmitted to the right part of the spinal cord, and from it, through motor neurons(motor function), the signal gets to the peripheral nerves of the arm (for example, the radial nerve). As soon as the action potential has reached the biceps of the arm, it contracts, BUT for proper functioning of the body this is not enough.
There must be feedback from the brain, roughly speaking to understand that the command "bend thearm" is executed by the right muscles, for this you need sensory function of the nerves. All kinds of mechanosensitive and other receptors receive information about muscle contraction, fascia tension, etc. and transmit this information back to the brain. The point here is the following - if a motor or sensory function is disturbed, the brain does not receive enough information about the work of the desired muscle and switches on other muscles in the area to compensate for the function of the muscle that did not fulfill its "order". I've written about this before in a post about flat feet. For some reason, medics have not grasped this point.
Now, closer to practice, let me give you an example. What happens when we use a posture brace? Let's say our patient is a slouch. He's got some degree of kyphosis or scoliosis or text neck (because of the vasone).online lifestyle). In such a patient, some back muscles are stretched and do not function for contraction (motor dysfunction), while others are spasmed (sensory dysfunction) and do not relax as they should.
Such a patient puts on a corset according to the recommendations of the "doctor" - orthopedist. Tightens the straps, the shoulders go back, the person visually straightens up and does his or her own thing and lives his or her own life 🙂 And everything will be relatively okay as long as the person is in that corset. The trouble starts as soon as he takes it off.
As someone has already guessed, from a biomechanical point of view, such a corset will be a poor artificial alternative to some of the patient's muscles. And these alternative "muscles" will be constantly contracted (tightened straps). And what will happen to real human muscles?
Those muscles that were stretched and did not contract will stretch even more, because the corset has taken over their function. Those muscles that were spasmed will relax while wearing the corset, but will immediately spasm even more after you take it off. And this is me even roughly describing the bad details of this process, for example, I do not go into the consequences for breathing, because the diaphragm of the patient in the corset will not function properly. With insoles in shoes is a similar situation, I will not repeat myself, in the post about bad shoes I described the details.
We end up with a sicker patient than we had before we went to the doctors. It's like prescribing crutches to a person with gangrene. And you're gonna pay for it😕 In general, such treatment should be advised only to enemies, so that they quickly die.😁
