Posture in PTSD
What happens in PTSD that causes postural distortions? If you’ve ever lived with PTSD or chronic anxiety, then you might have noticed that you tend to lean forward, have constant neck and low back pain, and typically pain that radiates down the back and front of your legs, especially on the right side.
What’s Happening?
Our muscles, nerves, organs, and blood vessels are lined in a thin sheet of connective tissue called fascia. Fascia is intelligent and adaptable depending on our situations. When we are in a healthy state, the fascia is not maladapted, and we are free to move in a healthy and upright manner. However, when we experience trauma, the nervous system will pull the body into the fetal position to protect our internal organs from the real or perceived threat. If we are not able to return to safety, either mentally or physically, the fascia will adapt to this fetal position pattern over time, and we will stay forward and misaligned until intervention happens.
What are the long term effects?
Many things happen in a PTSD pattern. One of the most important is that during a traumatic event our atlas will become misaligned. The atlas bone is the vertebrae that sits at the base of our skull, commonly referred to as C1. During a fight-or-flight moment, being able to turn our heads to pivot and see behind us, is important for our survival. The atlas will typically shift to the right, so that we are able to turn our heads quicker. Simply put, this is a mechanism designed to help us to survive. However, in PTSD, the atlas does not return to normal and the person will begin to experience chronic neck pain that radiates through the skull. They may end up with chronic migraines, and a permanently tilted head posture. This will also lead to TMJ and jaw dysfunction over time.
The second prominent thing that happens, is that the person experiencing PTSD will collapse to one side and also forward. This typically happens on the right side. Our diaphragm is located below the rib cage on both sides, with the larger diaphragm being located on the right. This collapse will cause short and shallow breathing patterns due the pressure being put onto the diaphragm. Short and shallowing breathing, can lead to further anxiety due to improper breath and the muscles not being properly oxygenated. A cycle has started, and until the pressure on the diaphragm has been removed, will continue to cause problems.
The third thing that happens is the psoas muscle will. become permanently contracted and over time, weak. If you’ve ever been in my office, you have heard me talk about the psoas. It is the only muscle in the body that connects the top half of our body to the lower half. In PTSD and the fetal position pattern, the psoas will contract forward and close off the stomach. Over time, the psoas becomes weak from the constant strain. The effects of this are improper digestion from the stomach being closed off, the pelvis becoming unstable and unable to properly balance, and the hamstrings over compensating to keep the person upright.
What the total Effect looks like
Over time, the person experiencing PTSD will have a forward head posture, a tucked tail bone, rounded shoulders, a head that Is tilted to the left, and hips that lean to the right side. All compensation patterns are unique to the individual, but this is the most common one that I see in my office. At this point, the person will normally have whole body aches and pain and a whole host of health maladies.
What your Trauma Informed Neuromuscular & Structural Bodywork therapist can do for you
The first thing that I do for my clients when they come in with a PTSD holding pattern is a full myofascial release up the front of the body. Since the collapsed and shortened form is causing breathing problems, opening up the front of the body is the number one priority. Getting proper breathing patterns restored is imperative for them to be ready to receive the work that is needed for the rest of the body. Structural bodywork is a fantastic option for PTSD because it addresses all the issues present in the body, and looks at the system as a whole, rather than trying to target one muscle that is hurting and creating temporary fixes that always result in the pain returning.
Bodywork is a fantastic option for PTSD because it addresses the fascia and structural problems, while creating a safe environment and working relationship between therapist and client. Over time, the client will begin to feel a more established connection between mind and body, a significant reduction in pain, and postural improvement.