Postural Study of Posterior Muscle Chain Retraction
If you suffer from any type of back or joint pain, this article may interest you. My name is Mauro Magnaghi, and at the time of writing this, I have 15 years of academic experience with the body in its various aspects and 20 years of professional and amateur experience.
Can you imagine understanding your pain?
Take a few minutes to read this article and experience the relaxing positions.
Throughout these years of working with the body in relation to movement and load, I have noticed that many injuries arise from poor posture and improper load distribution along our axes.
Personally, I suffer from two disc dehydration issues in the lumbar region, a lumbar vertebral deviation, and two disc protrusions—one lumbar and one sacral. At the age of 28, I suffered from lumbago followed by paraesthesia, which forced me to retire from high-performance sports. Not only that, but it was also a long and arduous process to regain a pain-free daily life and restore sensation to my posterior, foot, and toes of my left leg due to paraesthesia.
This injury is a lifelong condition. Surgery could have been an option, but it does not guarantee 100% recovery and is too invasive for my preference, particularly in such a sensitive area of the body. Instead, I opted for a physiotherapy-based approach consisting of three stages: first, finding a method to improve my pathological condition and alleviate acute pain; second, following the correct path to regain mobility, strength, and condition to perform pain-free activities I used to do before the injury; and third, but no less important, recognising the habits that led to the injury, being aware of them, and not repeating them.
Stage One: Passive Joint Decompression In the first stage, it is essential to decompress the affected joint areas passively. Why passively? Because part of the cause of the injury is active load, so we use the reverse process—”passive unloading.” Using the concept of “posterior muscular retraction” as the root cause of pain, we focus on relieving the area while considering biomechanics, preferred directions, support, and diaphragmatic breathing. We base this approach on the RPG (Global Postural Re-education) theory developed by French
physiotherapist Philippe Emmanuel Souchard. This technique provides access to internal areas, the core where compression radiates pain.
The first step is to create a zero-gravity effect in the core pain zone, removing forces and tensions from the area to allow the relaxation of soft fibres (muscles, cartilage, and ligaments). At the cellular level, tissue regeneration requires optimal circulation and blood irrigation with minimal energy expenditure. This is why the first stage is passive and focuses on decompressing the affected area and correctly aligning the body’s axes.
We have discussed loads, soft tissues, and axis alignment—three key terms throughout therapy and important considerations in daily habits (which we will address later).
Body Axes and Biomechanics
At birth, our bodies transition from an aquatic environment inside the placenta (where gravitational forces and pressures are nearly nonexistent) to an atmospheric environment where pressures and loads begin to affect us. As bipedal mammals, our natural development leads us to adopt an upright standing position. To reach this, we progress through several stages: lying down, crawling, quadrupedal stance, static verticality, and vertical movement. Throughout these stages, the spine undergoes modifications, marking transitions from one stage to another. The same applies to the waist, shoulders, shoulder blades, and limbs.
These modifications direct our tensions towards verticality with a particular tendency towards the front—two key factors to consider when implementing unloading techniques, which favour a supine or prone position.
Over time, these developmental stages continue until postural degeneration begins, leading to injuries. The tendency to lean forward and constant loading is the root cause. Our bodies likely warned us with pain before the injury manifested, but we chose to ignore it until the pain became unbearable and the injury became evident.
The Syndrome of Posterior Muscular Retraction
Load distribution becomes imbalanced, falling on our weakest areas—our Achilles’ heel, where the body cannot withstand the load and compensates to maintain movement mechanics. This results in the “syndrome of posterior muscular retraction,” alongside various injuries such as ligament stiffness, meniscal injuries, hernias, protrusions, scoliosis, frozen shoulder, etc.
This syndrome occurs when static muscles lose strength and elasticity while becoming rigid (mainly the short muscles). This happens because the body’s axes, once correctly aligned, begin shifting forward excessively. This can be observed in foot arches, knee and shoulder direction, and, depending on severity, spinal curvature angles or hip and shoulder insertions. Other symptoms include cramps, muscle contractions, limb numbness, lower back and cervical pain, joint pain, dizziness, and many others depending on the injury’s location and biomechanical interpretation. However, this article will focus on the body’s general condition rather than specific injuries.
The Importance of Diaphragmatic Breathing
To initiate rehabilitation, the first step is unloading, which involves positions that create zero gravity for the spine and diaphragmatic breathing to consciously relax constantly tense muscles, who are in constant tension and using disproportionate forces.
What is diaphragmatic breathing? The diaphragm is a respiratory muscle located below the lungs and heart that mostly contracts rhythmically and involuntarily. It is connected to our spine at the level of the dorsal spine. Conscious control of this muscle allows us to open the passage of oxygen beyond the lungs and into the stomach.
Diaphragmatic breathing involves inhaling air through the nose, opening a passage through the esophagus and sending it through the diaphragm to the stomach. This causes the stomach to expand and fill empty cavities in the hip and quadratus lumborum, pushing downward and below the diaphragm and upward on the rib cage. This type of breathing has physiological, anatomical, and psychological benefits.
Physiologically, it helps maintain optimal blood circulation and optimize oxygen distribution. Anatomically, it helps the thoracic and lumbar spine expand, consequently separating the vertebrae. It also exerts gentle pressure on the iliac crest, correcting hip position. Psychologically, it helps promote concentration and relaxation.
That will be a matter of focusing on diaphragmatic breathing while in position 1 (resting position).
Positions are anatomical forms of rest, each with a specific purpose. The common goal of these positions is to release tension in the soft tissue and regulate the angles of the body’s axes. How do I know which positions to use? Well, that depends on the type of injury, the therapy, and the order we need to access certain areas. We’ll use positions that retrovert our bodies, positions we used unconsciously in early childhood, specifically in the supine position.
1-Rest Position: Lying on a flat surface with arms beside the body, palms facing upward, and legs resting on an elevated surface at 90° at the hips and knees.
It is a position of complete rest, supporting the back on a flat floor with the arms at the sides of the body and the palms of the hands facing upwards, the legs will rest on top of a chair or some elevated place that allows us to have the knee and hips at 90°.
The goal of this first position is to rest the body from its vertical function. We primarily seek to give the spine zero gravity and thus regress its curves (lordosis and kyphosis) to a zero curvature angle. After the lumbar spine touches the floor, we align our arms at shoulder height, bending our elbows at 90°, and raise our hands upward. It’s important that our rrists touch the floor for the correct position. If our shoulders don’t allow our wrists to reach the floor, we open the angle of our elbows, releasing tension on our shoulders until our wrists relax on the floor. Finally, we lower our chin slightly, stretching our cervical spine.
2-Resting Frog Position: From Position 1, bringing the soles of the feet together, bending the knees, and allowing them to fall outward to release hip flexors, adductors, and abductors.
Consistent with position 1, we bring the soles of our feet together, bend our knees, and let them fall outward, opening our legs (this is called the direction of preference). This movement will cause the head of the femur to rotate around the hip, releasing the flexors, adductors, and abdominal muscles. This will increase mobility and reduce tension in the hip joint and spine at the sacrum, which is the most distal and difficult part of the spine.
The second step is to place your hands on your legs, generating pressure with your fingers to deepen the opening of the joint.
3-Legs at 90° (You can do this with your feet on the wall): Raising legs upwards and extending knees, ensuring no tension is felt in the lumbar region by adjusting knee flexion if necessary
After preparing the spine and releasing the hips, we will bring the legs upward, straightening the knees to place the body in a 90° position with respect to the hips.
Because this is an extreme position, the depth of the angle will increase along with the flexibility of the hamstrings and quadratus lumborum. To know if we are doing it correctly, as it can be counterproductive, we must pay attention to the following triggers: if we feel pressure or tension in the lumbar region, it means we should bend our knees to release tension in the hamstrings.
Place the weight of your legs on the last lumbar vertebra and the weight of your feet on the heels.
4-Leg Opening: From the 90° leg position, rotating feet outward and gradually widening the legs, adjusting to avoid lumbar pressure
From the 90° position, we’ll bring our heels together, rotate our feet outward for a few minutes, and then open our legs. Using the same principle as before, as long as the lumbar region doesn’t feel pressure, we can increase the angle. If we reach a certain pressure point, we’ll bend our knees slightly or close the opening angle. We’ll focus on relaxing the glutes, adductors, and psoas, allowing the weight of the legs to increase the angle by their own weight. Here we’re going to try to rotate the hip a little more and bring the sacrum closer to the floor.
The hip muscles near the belly will stretch due to the position of the sacrum. If we apply slight tension to the hip abductors in this position, we’ll tend to rotate the legs outward. After a while, we’ll be able to rotate the head of the femur a few degrees, giving a sensation of stretching: adductors, calves, pyramidalis, soft fibers on the inside of the knee, and subsequent mobility can be obtained as a result of this position