NO SMOKING Great American Smokeout

Incorrect posture over the years can lead to debilitating stress on joints and muscles.
By LINDA MARSA
LOS ANGELES TIMES
Anyone watching Mike Kaplan walk across a room could see something was wrong. He strode stiffly, barely bending his knees, his shoulders rounded, his head hanging forward. Back in high school, when he played football, his knees had become so badly damaged that he stopped bending them when he walked because it hurt too much.
Now in his mid-50s, Kaplan, an educational company president, was so busy powering through life he hadn't given much thought to correcting his posture or gait. Then, last fall, the pain in his chronically aching back became so severe that simple daily activities, such as bending over the sink to shave, became difficult to bear. So he decided to do something about it, going to orthopedists and then other health professionals in search of help.
Although walking may seem as natural and effortless as breathing, many people, such as Kaplan, develop bad habits along the way. Perhaps it's the wear and tear of life. Some experts think that as children, we tend to mimic the posture of our parents. For others, some kind of injury or medical condition may alter the way we sit, stand and walk. It's a problem that's easy to ignore -- until we're fed up with how we look or faced with debilitating pain. A growing number of doctors, physical therapists and back specialists are recognizing the importance of good posture and balance.
Incorrect body alignment strains muscles and joints, damage that is compounded with every step. Considering that we take thousands of steps a day, even a minor posture error repeated countless times eventually may lead to chronic pain in the back, neck, shoulders, hips, knees and ankles.
Finding a therapist
Like many pain sufferers, Kaplan shuttled among specialists until an orthopedic surgeon referred him to Sherry Brourman, a West Los Angeles physical therapist and yoga teacher who specializes in patients with structural pain.
Brourman, the author of "Walk Yourself Well" (Hyperion, 1998), has devised a system of simple corrective walking techniques and exercises that aims to restore balance and natural movement patterns, allowing the body to heal.
On Kaplan's first visit, Brourman asked him to walk back and forth in her cozy living room, which doubles as her studio. She noticed right away that he had several gait defects: His feet were turned out too far, his knees and hips were locked, his arms were stiff, and his upper back was rounded so that he leaned forward for balance.
"His body was a string of compensation strategies," Brourman said. "There is an arc to each step where you go up and back down for the next step. With each step, you contract the muscles in the buttocks, which are the motor that drives the walk. Mike wasn't engaging these muscles at all."
Kaplan was dubious that something so basic as how he walked could be causing such problems, but he was desperate. "It seemed very foreign for someone to teach you how to walk."
New positioning
Brourman dismantled the elements of his gait and reassembled them, starting with his feet. "I always liken the feet to two cars -- all eight wheels should be getting an equal share of weight," she says. "Mike was walking on his outside wheels."
In weekly one-hour sessions over the next six months, she trained him to pull out his heels so his feet were pointing outward at about a 15-degree angle instead of 30 degrees, and to plant his feet as wide apart as his hips, distributing his weight more evenly. Kaplan tightened his ankles to keep them from turning inward. He learned to bend his knees and to rotate his hips with each step, shifting his weight from side to side. Finally, he worked on getting a more natural motion in his arms, swinging them forward and back instead of holding them stiffly at his side.
Brourman also taught him yoga poses that reinforced each gait correction. The exercises helped to stretch out muscles weakened by years of inactivity.
It felt unnatural at first, because Kaplan was altering deeply ingrained habits. "Coming here felt like ... learning this bizarre foreign language," he said.
And the retraining didn't end with his one-hour sessions. Brourman gave homework: 20 minutes of practicing how to walk correctly and 45 minutes of yoga exercises each day. The time involved suggests that people who practice Brourman's program have to be motivated enough to stick with the routine to gain lasting relief.
Although he's come a long way in six months, Kaplan has more work to do. He hasn't yet integrated all the movements into a graceful gait; his walk still tends to look exaggerated and self-conscious. "People make fun of me," he says. "But I don't care. I'm not in pain anymore."