Thoughts on movement for postural information. Squatting.

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Quite a mouthful of a title, however, I hope that this will become slightly more clear as I ramble on.
We were over at Strength and Performance gym yesterday and I was beginning a new programme which is going to be going on for the next 4 weeks. One of the exercises here is the Front Squat, not a massively technical lift like some of the Olympic lifts, but technical enough to do you a fair amount of damage should you do it wrong.

If you ARE doing it wrong, and persist in doing it wrong, upping the weight because you think you can, eventually something is going to give. If your biomechanics are not very good, its probably not going to be your legs (the main bit that is doing the lifting) that are going to blow. Most likely its going to be your back.
So.
Its probably quite a good idea to get the action right before you start piling on the weight and potentially doing yourself a mischief.
One of the reasons why I'm looking to squat with Sean and Z from S&P is because they have a perspective I do not. They are Strength coaches and can see a million different things about how I am moving and how I should be moving, and what I need to do to move correctly. Standing still, in a static position I don't seem to be particularly wonky, nor do I seem to be particularly prone to odd movements. If I Goblet Squat with a dumbbell, even with the movement, I appear to be quite well balanced and move quite well.

We started with a bare olympic bar, 20kg and some interesting things started happening. As you can see from the standing still with the bar relaxed across me, its dipping down to the left without me doing anything.

At the top there is a slight imbalance, left being lower than the right

During the actual squat, my hip flexors don't appear to be moving properly. The right side seems to move fine, and drops down into position, but the left side is doing something odd. The way I am moving appears to suggest that the Glutes or the Hamstrings are too tight and are preventing me from getting down into a decent squat properly. Because of this inhibition, I sink lower on the right, the left leg is slightly abducted, and my entire trunk sways to the right, but the shoulders dip to the left.
Double trouble.

during the squat, there is a continuing left/right balance problem

At the bottom of the squat, my body is swaying off to the right, bar leaning to the left, right ischial tuberosity lower than the left, left leg abducting out to the left.

Looking at the photos I decided to do a bit of stretching. Looking at my glute stretch, on the right I can get my knee to my chest easily, not an issue in the slightest. The left is a different story, but in an interesting way. I can't get my knee to the chest, but I don't feel like there is a stretch coming on in my glutes or in the hamstrings. It feels like my hip flexor area is "blocked", as if there is something in the joint that is not allowing full flexion of the hip. It's almost like the tissues are approximating because there is not enough space in the joint capsule. Because of this, the squat doesn't sit down as far as it should, and if I decided to ignore this, and carry on sticking weight on the bar, at some point, the compromised back would decide not to work and I'd end up in a pretty rubbish situation.

We have decided that for the moment, its worth looking at improving the flexibility of the hip flexors, which includes working on the lift pattern - movement will help improve hip flexibility, but not to increase the weight until I am closer to a more optimal squat pattern. I know a number of people that would have said - ah, we are close enough, I want to get my lift up, lets rack on the heavies... Not a good plan. I'm in this life for the long shot and want to keep my body performing optimally for as long as I can.
Look long term, think big picture.

(though sometimes, that has to be replaced with the "go big or go home" mantra...!)

Desk Jockeys

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By this I mean a desk-bound employee pushing papers and typing at keyboards all day long. Low exercise levels (just on the job, we're not saying you're lazy), restricted movements and repeated actions, none of which are all that good for your posture.

So what does poor posture mean for our bodies? Well, muscles can become weak and elongated, short and overly tense, switch off completely because others have taken over their role or just generally dysfunctional. You might experience muscular pain, joint stiffness, headaches, a sense of not being quite right, or suffer from RSI (repetitive strain injury). Whatever the cause, poor posture isn't good for muscles, tendons, ligaments and joints, and the effect is felt all over your body.

Here's how it goes....you come to work, just like you do every day. Switch on the computer, check your in-tray, in-box, action list, make a coffee and settle in to the day's work. I know. I've been there. You do the same things over and over again, day in day out. Your chair stays in the same position. Your phone is probably a little out of reach because otherwise it gets in the way of the keyboard (go on, check how far away it is). Papers are piled up on either side of you. The filing piles up. If you're lucky (or perhaps unlucky) to have a paperless job then you just come in, sit down and keep your arms in the same position for what, 2-3 hours at a go? Longer? Basically, apart from the coffee breaks, a quick wander around the office and lunch (that is if you take lunch away from your desk), you're sat at your desk with your body fixed pretty much in one position.

Is that good for you? No. We've posted elsewhere (Fascia. Fascianating) about how fascia is kind of like plastic, needs to be able to glide freely and how it becomes stuck and bound together with inaction.

Now consider your desk set up and seating position. In the position you're in, with limited movements, think about what your shoulders are doing. Really take a few moments to notice how they are positioned. Now your neck. What's happening there? And what about your pelvis?

Lets look at each of those in turn.

Shoulders: most likely they'll be rounded forwards, hunched over. In general, this means the muscles on the front of your chest are short and tight (predominantly the pecs but also muscles in your neck and obviously shoulders) and those at the back will be weak and long (upper trapezius, rhomboids – in between your shoulder blades). Because your shoulders are forwards there could be a tendency for your mid back curve to be increased, putting pressure on your spine.

Neck/head: the ideal position for your head is with your ears directly above your shoulders. I'm betting your head is forwards meaning the chin is forwards and muscles at the back of your neck are long and weak, or maybe not firing effectively.

The average head weighs about 10lbs. For every inch your head is forwards your muscles have to cope with an additional 10lbs of weight – so for a 2 inch head forward position your head is effectively weighing the equivalent of 30lb – 3 times the weight that it should be!! Now imagine the strain that your muscles are trying to cope with, there's no wonder after years of sitting at a desk that a stooped forwards position leads to muscular pain, headaches and dysfunction. When your head is positioned correctly gravity distributes the weight downwards and your muscles don't have to work anywhere near as hard. This is because gravity is working in a good way, rather than pulling your head forwards and downwards.

Pelvis: are you slouching, in which case your pelvis will be tipped backwards (posterior tilt). Don't just think about what you're doing right now but about how you sit day in day out. Because you are now aware of it you probably sat upright a little more, this is perfectly normal, but what we're after is for you to think about how you usually sit. Good posture need not be sitting bolt upright, just keeping your spine in a neutral position is good. Going back to slouching, which I think it's fair to say from experience, after way too many years in an office myself, that the majority of people do slouch. What's happening to your muscles? Well, for a start, just sitting for long periods leads to short hip flexors – the muscles that bring your leg up in front of you. When you think about it it is common sense – your legs are bent in a sitting position so the muscles which bend your legs will be held in a shortened position, even if they're not contracting. Your glutes are inactive, they forget what their job is. Because your pelvis is tucked under your hamstrings (the muscles on the back of your thighs) also shorten. Even if you stand up and sit down a couple of times, its not your hamstrings or glutes that are really working, its the quads- which, as we mentioned, are already shortened. 

One thing I haven't mentioned so far is whether or not you sit with your legs crossed. I did, for quite some time, before working out (during training to be a massage therapist) that this wasn't such a good idea. It's led to me having one weak hip flexor (the psoas muscle) on the left and one which is too tense on the right – the leg that crossed. The good news is that with some strengthening work on the weak muscle I can rebalance this out fairly easily – oh, and I now keep both my feet flat on the floor when desk-bound!

It's common with head forward posture for the gravity shift to cause your upper back to curve backwards and your the hips to tilt – one thing is compensating for the other (we've said elsewhere that everything is linked and connected), and you end up out of shape, quite literally, feeling a little wonky and perhaps not being 100% comfortable but not really knowing what is not quite right.

The risk to your health because of poor posture are not only muscular aches and pains, but headaches, compression of the spine, dysfunctional muscles and postural imbalances. These can lead to all sorts of other health issues which you won't instantly connect with poor posture, such as breathing disorders.

How can you make things better? Find out if your employer will carry out a desk assessment, most places do these days because it's a serious health and safety consideration for them. Get one booked in. Your screen needs to be positioned so that you look straight at it without your chin dipping (ideally your chin should be parallel to the ground) – this will help you keep your ears positioned over your shoulders and the gravitational forces from your head going straight down. Shoulders should be positioned directly over your hips and spine in a neutral position. Your chair needs to be the correct height and if needed use a foot rest. Your telephone should be within easy reach and if you're on the phone a fair bit get your employer to invest in a headset – hands free calling significantly reduces neck and shoulder strain. Consider moving your mouse to the opposite hand for a few hours every few days – you'll get used to it quicker than you think.

To start with this will all feel a little weird. It's bound to because you've been sitting incorrectly for some time now. But please persist. Any imbalances which have worked there way into your body over months, maybe years, will take a decent amount of time to work their way out.

My final comment refers back to where this all began - restricted movements. You can change your job but for most it isn't a practical solution. So we have to make do with what we have. What you can do is to get up and move. Do as cats do every time they move or get up – Stretch! 

Most important is to move and keep your body fluid. I highly recommend a book called “Stretching” by Bob Anderson – he provides a simple easy to follow guide to stretches for various sports and daily activities, and I note the latest edition has a section on Computer Stretches!

Pregnancy: postural changes

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It goes without saying that your body undergoes dramatic changes during pregnancy. One of those changes is your posture. But don't go thinking it will happen overnight because it doesn't, the changes are gradual and creep on you as you gain weight and your body adjusts to the various developments of pregnancy. Because of the weight you will gain your body experiences more aches and pains than it usually would. It's a given, but what you do about it could help provide relief, I'll return to that later.

As your abdomen and breasts enlarge your centre of gravity changes and your body does its best to hold you upright. The extra weight tends to pull you forwards and downwards (it's like that moment when you're starting to lean forward and pick something up), this affects the pelvis by tipping it forward and in turn leads to increased curve in your lower back (the lumbar region). Hey presto – you've got lower back ache!  You may also get sciatica as a result of the pelvis tilting forwards (anterior tilt) - causing compression of the sciatic nerve.

Try this now - stand up - tilt your pelvis so your bum sticks out, your abdomen pokes forwards - can you feel the subtle shift in your centre of gravity? Feel how the curve of your lower back has become exaggerated. You might notice your toes need to grip on the floor a little harder? Now imagine how all of these changes will increase and intensify as pregnancy progresses.  Men too should try this, so they can get a sense of what the woman goes through.

As a knock on effect of the pelvic shift and increased lumbar curve, muscles and joints higher up the spine and around your shoulder blades (thoracic area) and your neck (cervical area) will be put under increasing strain and before you know it you could end up with back ache higher up, maybe neck ache, stiffness, headaches and maybe sinus problems. A further effect of the increased lumbar curve (and breast enlargement) is that your shoulders tend to round forwards and your head and chin poke forwards. As we've said elsewhere, everything is linked and connected. Everything affects you elsewhere in your body. If one thing changes in your posture it will affect other areas of your body.

Lower down in your body your knees may have a tendency to lock backwards as they try to stabilise your body position, and your feet are constantly being challenged as the weight moves forwards and your toes take the strain.

Breathing changes in pregnancy too, firstly because of the internal organs, including lungs, being squashed and repositioned as your baby grows. But also the diaphragm (the major muscle involved in breathing and which separates the abdominal and thoraxic cavities) is also being repositioned. The diaphragm attaches in many places, including the upper two or three lower back (lumbar) vertebrae. As we've already mentioned, the lumbar curve becomes exagerated in pregnancy, and this will clearly affect how the diaphragm works and lead to a decrease in lung capacity. You would notice this as shortness of breath.

Returning to the spine, because of the change in the spinal curves the ligaments that hold your vertebrae and other joints together are subjected to additional strain – it's not just the muscles. If you've not already heard of relaxin then you need to know about it. This is a hormone which causes joint laxity because of how it acts on ligaments. In certain parts of the body during pregnancy this is very useful – such as the birth canal which needs to accommodate your baby during birth – the pelvis needs some flexibility to cope. However, relaxin doesn't just affect ligaments and joints which need some flexibility for birth – it affects all ligaments and therefore all joints. One effect can be the onset of symphysis pubis dysfunction (SPD), defined in the Illustrated Dictionary of Midwifery (Winson & McDonald, 2005) as “excessive softening of the cartilage with softening of the pubic bones and destabilisation of the joint”. Note the word excessive; not every woman who gets pregnant is affected by SPD. So it's good that your pelvis becomes more flexible, but you need to bear in mind that your pelvic bones may not be aligned, and that you may need to adjust the way you lift items or walk, particularly up/down stairs. Thinking about feet again, they're at risk of collapsing arches as the ligaments become lax and strain under the extra weight you're carrying.

When bones become misaligned the muscles will have to adjust in some way. That could be either by lengthening or shortening. Neither of these are great, but the good news is that tension in muscles caused by short muscles can be helped with focussed massage. In SPD the gluts (bum muscles) and lateral rotators (small and deep muscles in your bum) are often found to be short as the pelvis starts to open up and expand slightly. Shortness in these muscles can also be linked to sciatic pain.

As a consequence of the realigning of the pelvis, extra weight-bearing and postural adjustments, some muscles can also become weak through what could be termed overuse or by being strained. Fluid retention is also common during pregnancy, and this too can cause strain on joints. A common complaint in the wrists is carpal tunnel syndrome, where the nerve (medial nerve if you're interested) that goes to your thumb and some of your fingers is literally compressed in a tunnel of bone at the wrist. You might experience numbness or tingling, pain or loss of function. With this syndrome caused by fluid retention, lymphatic drainage massage can help disperse the accumulated fluids and ease the pain.

What can you do to help alleviate pain and discomfort caused by postural changes during pregnancy? Pilates or yoga are excellent for keeping your posture in the correct alignment. A specialist pregnancy class is invaluable because the instructor will have the knowledge about correct alignment of your posture, and know how to instruct you towards the optimal posture for your individual pregnancy. Swimming is also good because the water takes your weight – see my post on this in May here. Finally, it goes without saying, that massage is immensely beneficial for soothing the aches and pains that do crop up. The therapist can identify shortened tight muscles which need relaxing. If you have water retention then lymphatic drainage techniques can be employed with the aim of improving your circulation and reducing the swelling. By easing muscle tension and reducing swelling there should be a reduction in joint stress, particularly important for those weight-bearing joints like knees and pelvis which are subject to ever increasing pressure as pregnancy progresses.

I hope you are now more aware of the way your posture may change during pregnancy (and afterwards, as your body will need time to readjust back to its normal posture after giving birth), and that I've given you a few ideas how to have a more comfortable time. I always think it is better to know what may be coming and have the knowledge to deal with it. Let me know if you have any other suggestions or want to share your experiences.