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Standing, also referred to as orthostasis, is a position in which the body is held in an ''erect'' ("orthostatic") position and supported only by the feet. Although seemingly static, the body rocks slightly back and forth from the
ankle The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joi ...
in the
sagittal The sagittal plane (; also known as the longitudinal plane) is an anatomical plane that divides the body into right and left sections. It is perpendicular to the transverse and coronal planes. The plane may be in the center of the body and divi ...
plane. The sagittal plane bisects the body into right and left sides. The sway of quiet standing is often likened to the motion of an
inverted pendulum An inverted pendulum is a pendulum that has its center of mass above its pivot point. It is unstable and without additional help will fall over. It can be suspended stably in this inverted position by using a control system to monitor the angle ...
. Standing at attention is a military standing posture, as is stand at ease, but these terms are also used in military-style organisations and in some professions which involve standing, such as
modeling A model is an informative representation of an object, person or system. The term originally denoted the plans of a building in late 16th-century English, and derived via French and Italian ultimately from Latin ''modulus'', a measure. Models c ...
. ''At ease'' refers to the classic military position of standing with legs slightly apart, not in as formal or regimented a pose as standing at attention. In modeling, ''model at ease'' refers to the model standing with one leg straight, with the majority of the weight on it, and the other leg tucked over and slightly around.


Control

Standing posture relies on dynamic rather than static balance. The human center of mass is in front of the ankle, and unlike in
tetrapod Tetrapods (; ) are four-limbed vertebrate animals constituting the superclass Tetrapoda (). It includes extant and extinct amphibians, sauropsids ( reptiles, including dinosaurs and therefore birds) and synapsids ( pelycosaurs, extinct t ...
s, the base of support is narrow, consisting of only two feet. A static pose would cause humans to fall forward onto the face. In addition, there are constant external perturbations, such as breezes, and internal perturbations that come from respiration. Erect posture requires adjustment and correction. There are many mechanisms in the body that are suggested to control this, e.g. a spring action in muscles, higher control from the nervous system or core muscles. Humans begin to stand between 8 and 12 months of age.


Spring action

Traditionally, such correction was explained by the spring action of the muscles, a local mechanism taking place without the intervention of the
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...
(C.N.S.). Recent studies, however, show that this spring action by itself is insufficient to prevent a forward fall. Also, human sway is too complicated to be adequately explained by spring action.


Nervous system

According to current theory, the nervous system continually and unconsciously monitors our direction and velocity. The vertical body axis alternates between tilting forward and backward. Before each tilt reaches the tipover point the nervous system counters with a signal to reverse direction. Sway also occurs in the hip and there is a slight winding and unwinding of the lower back. An analogy would be a ball that volleys back and forth between two players without touching the ground. The muscle exertion required to maintain an aligned standing posture is crucial but minimal. Electromyography has detected slight activity in the muscles of the calves, hips and lower back.


Core muscles

The core muscles play a role in maintaining stability. The core muscles are deep muscle layers that lie close to the spine and provide structural support. The transverse abdominals wrap around the spine and function as a compression corset. The
multifidi The multifidus (multifidus spinae : ''pl. multifidi'' ) muscle consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis. While very th ...
are intersegmental muscles. Dysfunction in the core muscles has been implicated in back pain.


Expansion of pendulum model

Some investigators have replaced the ankle inverted pendulum analogy with a model of double linked pendulums involving both hip and ankle sway. Neither model is accepted as more than an approximation. Analysis of postural sway shows much more variation than is seen in a physical pendulum or even a pair of coupled pendulums. Furthermore, quiet standing involves activity in all joints, not just the ankles or hips. In the past the variation was attributed to
random In common usage, randomness is the apparent or actual lack of pattern or predictability in events. A random sequence of events, symbols or steps often has no order and does not follow an intelligible pattern or combination. Individual ra ...
effects. A more recent interpretation is that sway has a fractal structure. A fractal pattern consists of a motif repeated at varying levels of magnification. The levels are related by a ratio called the fractal dimension. It is believed that the fractal pattern offers a range of fine and gross control tuning. Fractal dimension is altered in some motor dysfunctions. In other words, the body cannot compensate well enough for imbalances.


Pathology

Although standing per se is not dangerous, there are pathologies associated with it. One short term condition is orthostatic hypotension, and long term conditions are sore feet, stiff legs and low back pain.


Orthostatic hypotension

Orthostatic hypotension is characterized by an unusually low blood pressure when the patient is standing up. It can cause dizziness, lightheadedness, headache, blurred or dimmed vision and fainting, because the brain does not get sufficient blood supply. This, in turn, is caused by gravity, pulling the blood into the lower part of the body. Normally, the body compensates, but in the presence of other factors, e.g. hypovolemia, diseases and medications, this response may not be sufficient. There are medications to treat hypotension. In addition, there are many lifestyle advices. Many of them, however, are specific for a certain cause of orthostatic hypotension, e.g. maintaining a proper fluid intake in dehydration.


Orthostatic hypercoagulability

Prolonged still standing significantly activates the coagulation cascade, called
orthostatic hypercoagulability Thrombophilia (sometimes called hypercoagulability or a prothrombotic state) is an abnormality of blood coagulation that increases the risk of thrombosis (blood clots in blood vessels). Such abnormalities can be identified in 50% of people who ...
. Overall, it causes an increase in
transcapillary hydrostatic pressure The Starling equation describes the net flow of fluid across a semipermeable membrane. It is named after Ernest Starling. It describes the balance between capillary pressure, interstitial pressure, and osmotic pressure. The classic Starling equa ...
. As a result, approximately 12% of blood plasma volume crosses into the
extravascular compartment The human body and even its individual body fluids may be conceptually divided into various fluid compartments, which, although not literally anatomic compartments, do represent a real division in terms of how portions of the body's water, solute ...
. This
plasma shift Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the int ...
causes an increase in the concentration of
coagulation factor Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism o ...
s and other proteins of coagulation, in turn causing
hypercoagulability Thrombophilia (sometimes called hypercoagulability or a prothrombotic state) is an abnormality of blood coagulation that increases the risk of thrombosis (blood clots in blood vessels). Such abnormalities can be identified in 50% of people who ...
.


Orthostatic tremor

Characterized by fast (12–18 Hz) rhythmic muscle contractions that occur in the legs and trunk immediately after standing. No other clinical signs or symptoms are present and the shaking ceases when the patient sits or is lifted off the ground. The high frequency of the tremor often makes the tremor look like rippling of leg muscles while standing.


Long-term complications

Standing per se does not pose any harm. In the long term, however, complications may arise.


See also

*
At attention The position of at attention, or standing at attention, is a military posture which involves the following general postures: * Standing upright with an assertive and correct posture: famously "chin up, chest out, shoulders back, stomach in". * Ar ...
*
Agonoclita Agonoclita or the Agonoclites in antiquity was a Christian sect from the 7th century whose distinguishing principle was never to kneel, but to deliver all their prayers standing. Etymology The name of this group is derived from the following Gre ...
, a former Christian group that said prayers standing *
Human position Human positions refer to the different physical configurations that the human body can take. There are several synonyms that refer to human positioning, often used interchangeably, but having specific nuances of meaning. *''Position'' is a gen ...
*
Prostration Prostration is the gesture of placing one's body in a reverentially or submissively prone position. Typically prostration is distinguished from the lesser acts of bowing or kneeling by involving a part of the body above the knee, especiall ...
*
Standing desk A standing desk or stand-up desk is a desk conceived for writing, reading or drawing while standing up or while sitting on a high stool. History Several writers and statesmen wrote standing up: Thomas Jefferson, Charles Dickens, Winston Churc ...
*
Bowing (social) Bowing (also called stooping) is the act of lowering the torso and head as a social gesture in direction to another person or symbol. It is most prominent in Asian cultures but it is also typical of nobility and aristocracy in many European coun ...


References


External links

{{commons category, Standing
Dizziness-and-balance.com – Description

apta.org – The Secret of Good Posture
Human positions de:Stehen