@s3n6a So sorry to hear about your brother.
Here are my notes about the posture. I think some of it is fairly standard stuff. I didn't do all of it, I'll add my 'personal experience' notes in
italics.
Posture training
1. Breathing exercise - laying down or standing up. 2x per day, min 5 mins each.
- Laying: on back with feet on chair/sofa. Legs and body make a “Z” shape. Fingers interlaced (not in the obvious way, total thickness should be 1 finger) and placed behind head near top, aiming to tilt chin forward and lengthen spine. Breathe in through nose, expanding lower stomach forward, out through teeth - top and bottom teeth touching tip to tip. Make a "shhh" noise.
- Standing: Feet a few inches from wall, slightly bent/relaxed knees, lean back against wall. Head remains off wall in neutral position. Clasp hands at belly button. Breathing is the same, push hands slightly into stomach on exhale.
I had terrible POTS so I only ever did the 'laying' version. Did it religiously for 2-3 years, not sure if it helped at all.
2. Laying position - mattress 5cm of low density foam, eg IKEA Tuddal topper, on top of stiff wooden board. See photo for laying position. Ideally don’t have upper shoulder propped up with anything. Should be totally relaxed and floppy.
This is the one I like the most. I still sleep like this every night, though I do spend ~20% of each night sleeping on my side with pillows. This is also my main resting position during the daytime. I allow myself to alter the position a bit to make it more comfortable for me (I usually tuck my hand or duvet under the higher shoulder. and am probably more 'on my front' than the position strictly calls for).
3. Sitting position - Feet on block ~8cm high for chair height of ~44cm. Aim is to have knees higher than hips.
Due to the bad POTS I didn't implement this and prefer to sit with legs crossed or up on another chair. I still do this, it's kind of necessary with POTS.
4. Standing position - feet shoulder width, right foot slightly further back than left (two fingers). Hands clasped around belt height, relaxed. Knees slightly bent/not locked. Aim to have pressure on both front and back of feet, think of two connection points (heel and ball of foot) with equal pressure on them. Shoes shouldn’t have significant up-curl at toes (ideally). Want good contact with big toe to ground.
Again, POTS, so standing is strictly limited! Never really bothered with this.
5. Sloped desk - 30 degrees for reading, writing, laptop. 23 degrees for computer keyboard, 13 degrees for computer mouse.
Once again, POTS! I work on laptop lying down in bed with it propped up on my stomach.
A few more notes and updates for the thread generally:
- I stopped wearing the prism glasses about a year ago and didn't notice any worsening.
- I stopped the Z-breathing exercise about 2 years ago and didn't notice any worsening. I enjoyed the routine of it though and felt it was a good thing to do for mindfulness/relaxation.
- I stopped using the IR insoles 4 years ago and didn't notice a difference.
- I have learned through trial and error that my body really doesn't like being supine (lying on my back). I always knew I found it uncomfortable, but when I did a 2.5hr MRI it gave me excruciating headaches which resolved quickly on standing. Similarly, I tried sleeping exclusively on my side for a while and felt noticeably worse in the daytimes. All this to say that I think I probably benefitted the most from implementing the front position for both daytime resting and sleeping. I was already a front sleeper, but not doing so in the daytime. I like the firm mattress too.
- I was diagnosed with POTS in 2022 and have been adding relevant meds. They have collectively given me a huge step up in symptoms. I didn't have the most obvious POTS symptoms so it took a while to figure it out, but it's easy to do an indicative test at home (Google: NASA lean test), so I highly recommend considering that.
I hope that helps. I guess the summary is that I only still do the laying position, and didn't notice getting worse as I stopped elements of the protocol. I did feel like I made an improvement that coincided with starting this protocol, but perhaps it was just spending more time on my front. Or something else unrelated!
Best wishes for you brother, I'm happy to answer any more questions.
I find with the sleeping posture - the more front lying one - I get more restful sleep. If I test for cranial nerve relaxation in that position I find I can fit more fingers in my mouth! 