The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain

J Bodyw Mov Ther. 2011 Apr;15(2):131-8. doi: 10.1016/j.jbmt.2011.01.011.


Manual and physical therapists often use a postural-structural-biomechanical (PSB) model to ascertain the causes of various musculoskeletal conditions. It is believed that postural deviations, body asymmetries and pathomechanics are the predisposing/maintaining factors for many musculoskeletal conditions. The PSB model also plays an important role in clinical assessment and management, including the choice of manual techniques and the exercise prescribed. However, the most important question is consistently being ignored--can a person's physical shape/posture/structure/biomechanics be the cause of their lower back pain?

MeSH terms

  • Biomechanical Phenomena
  • Humans
  • Low Back Pain / physiopathology
  • Low Back Pain / rehabilitation*
  • Manipulation, Chiropractic / methods*
  • Manipulation, Osteopathic / methods*
  • Models, Biological
  • Musculoskeletal System / physiopathology
  • Physical Therapy Modalities*
  • Posture / physiology