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Monday, July 1, 2013

Posture Problems and How to Correct Them

Balance in Motion, Santa Barbara Massage Therapy - Fix bad Posture
From Ask the Trainer


Static and Dynamic Posture

Static Posture

When someone mentions posture, you probably immediately think of static posture. Static posture is the alignment of your body while you are still. More importantly, static posture refers to the length-tension relationships of your muscles and the corresponding alignment of your joints. You may first notice posture problems when you or someone else observes obvious issues with your static posture.

Dynamic Posture

Dynamic posture is the alignment of your body during movement. The length-tension relationships between working and opposing muscles are especially important to dynamic posture. Poor dynamic posture can influence static posture and vice versa. Since many exercises are repetitive movements, it is important to keep your dynamic posture in mind.

Posture Problems You May Not Know About Can Lead to Injury

If you have imbalanced length-tension relationships and improper dynamic posture during movement, the constant tug-of-war between muscles can prematurely age your joints and possibly lead to muscle, joint, tendon, and ligament injuries. These types of muscle imbalances are called postural distortion patterns.
There are many problems associated with poor posture which have negative long term effects on your body and health. These problems with your posture will not only impact how you feel, but how your body looks. If you continue to exercise with poor posture you will recruit the wrong muscles and build your body disproportionately.
Massage therapists are devoted to fixing muscular injuries, some of which are due to posture problems. Orthopedic surgeons physically repair any musculoskeletal overuse or traumatic injuries, some which are also due to posture problems.

Massage Therapists Take a Preventative and Corrective Stance to Fix Your Posture Problems Before They Lead to Injury


What Causes the Common Posture Problems?

Balance in Motion, Santa Barbara Massage Therapy - cumulative injury cycle

Muscle Imbalances Due Sedentary Lifestyles are a Primary Cause of Posture Problems

The cumulative injury cycle illustrates how muscle imbalances originate. First, there is a trauma, which can result from repetitive motion with poor dynamic posture or poor static posture.
The trauma causes inflammation, causing your muscles to spasm and develop knots or adhesions.
The adhesions decrease the functionality of your muscles, which your brain cannot control properly. The inability of your nervous system to maintain proper postural alignment causes muscle imbalances.
If you do not correct your muscular imbalances the cycle will repeat over and over again and get progressively worse.

If You Ask Professionals from Different Fields, You May Get Different Answers

A chiropractor may tell you that your spine is out of alignment and that causes posture problems. A podiatrist (foot doctor) may tell you your whole body is out of alignment because of a ill-fitting pair of shoes or flat feet.
A psychologist may even tell you that your bad posture is due to depression. My point is that there are many different ways to look at posture problems, and there may be many ways to solve them.
You don’t have to be a personal trainer, doctor, or massage therapist to see that muscle imbalances are likely the cause of your posture problems.

What are Some Common Specific Muscle Imbalances ?

Balance in Motion, Santa Barbara Massage Therapy - seated posture problems
The most common muscle imbalances are caused by a sedentary lifestyle. When you are seated for a large percentage of time, you can a characteristic pattern of certain muscles becoming tight or shortened.
If a muscle sits in a shortened position for a prolonged period if time, it will become tight, which really means it will become shorter than it is meant to be.
When a muscle is shorter than the optimal length, it not only affects the opposing muscle, but can have repercussions on the entire musculoskeletal system. Here are some common muscles which cause the most posture problems.

Balance in Motion, Santa Barbara Massage Therapy - tight hip flexors posture problem

Tight Hip Flexors

Tight hip flexors are a major cause of many posture problems. The human body is meant to be upright most of the time, not seated in a computer chair or on the couch.
When subjected to long hours in a seated position, the hip flexors become shortened. When the hip flexors are shortened, they cause the pelvis to rotate anteriorly, or tilt downward in front.
You can easily see the repercussions of anterior pelvic tilt on skeletal alignment. The lumbar spine becomes excessively arched and the thoracic spine develops a kyphotic (rounded/hunch back) alignment. Forward head posture can be another downstream result of anterior pelvic tilt.
Tight hip flexors can take over the work meant for the abdominal muscles, making it almost impossible to get benefit from many abdominal exercises.
Tight hip flexors cause the primary hip extensor, the gluteus maximus, to become lengthened and weak. This is because of the agonist-antagonist relationship between the glutes and hip flexors.
When the primary hip extensors become weak the synergist (helper) muscle also takes over, causing further problems. In this case, the hamstrings may take over work intended for the glutes, and become injured due to excessive strain.

Tight Hamstrings

You can probably feel the difference in length of your hamstrings when you sit down. When you stand, the muscles are lengthened. Sitting even with good posture (above) shortens your hamstrings. If you sit for prolonged periods of time, you will be prone to chronic hamstring tightness.
There are a few posture problems associated with tight hamstrings. If the hip flexors (above) are tight, the glutes will weaken and the hamstrings will become your primary hip extensor. The hamstrings are supposed to be the synergist, but become the prime mover. This is called synergistic dominance, and it increases the chances of injury.
It is easy to see why synergistic dominance increases the chances of injury. The gluteus maximus the largest muscle in the body. If the gluteus maximus cannot extend the hip, the hamstrings, which are not as powerful as the glutes, are forced to do more work than they are designed for. Hamstring tightness can also make you prone to hamstring strains, pulls, and sciatica.

Weak & Lengthened Upper Middle Back

Balance in Motion, Santa Barbara Massage Therapy - protracted shoulders posture problems
Forward shoulders is another muscle imbalance which causes posture problems which are repercussions of the sedentary lifestyle. Also called upper-crossed syndrome, forward shoulder posture is prevalent among those who are inactive, especially if your job requires long hours sitting at a desk in front of a computer.
You can also develop forward shoulders posture from poor exercise selection. If you perform too many pushing exercises (bench press, shoulder press, push-ups) while neglecting back exercises, or perform pushing exercises improperly, you can develop this muscle imbalance.

Are There Any Muscle Imbalances Which Are More Prevalent in Men Than Women ?

Many muscle imbalances develop because of common daily postures. Since men and women have different mannerisms, certain posture problems are more common in one sex, but may still occur in both.
Three Common Muscle Imbalances and Associated Posture Problems Which Primarily Occur in Either Sex:
  • Tight Piriformis
  • Tight Adductors
  • Tight Calves

Balance in Motion, Santa Barbara Massage Therapy - bad posture can cause neck pain
How Can You Prevent and Correct Posture Problems Due to Muscle Imbalances?

The Most Important Step of Prevention and Correction is Detection Get to the Core of the Problem

Corrective Flexibility Can Help You Restore Your Body’s Balance

What Are Some Corrective Flexibility Exercises to Combat Muscle Imbalance and Posture Problems?

The Best Approach to Corrective Flexibility is to Use Multiple Types of Flexibility Training. (For specific exercises see the end of this article.)

Self-Myofascial Release

Self-myofascial release (SMFR) sounds a lot more complicated than it is. Myo- is the prefix meaning muscle. Fascia is the tissue which surrounds your muscles. Repeated muscular contraction can cause you to develop adhesions or spots of muscle tension. You will be releasing the tension of your muscles by essentially giving yourself a deep tissue massage.

Static Stretching
Balance in Motion, Santa Barbara Massage Therapy - piriformis posture problem
The piriformis is a deep butt muscle which is the most powerful external rotator of the hip. A tight piriformis is more common in men than women because men tend to sit with their legs spread apart.
A tight piriformis can lead to problems with the knees and also piriformis syndrome. Piriformis syndrome is is when the piriformis irritates the sciatic nerve and causes a deep shooting pain from the buttocks down the back of the leg. This is commonly referred to as sciatica.
The adductor complex is the group of muscles which squeeze your thighs together. Since women often sit with crossed legs the adductor muscles commonly develop excessive tension.
Tight adductors can cause the femur (upper leg bone) to become internally rotated. A likely result of this imbalance is knee pain, since the joints of the knee will no longer line up properly. Tight adductors can be demonstrated by a knock-kneed appearance. This indicator of adductor tightness is especially evident in the bottom of a squat when the hips are almost fully flexed.
Women who wear high heels are prone to tight lower leg muscles including the gastrocnemius, soleus, and peroneals. The tightness in these muscles is demonstrated by flattened and externally rotated feet. Tight calves can also be a leading cause in plantar fasciitis and other painful foot and ankle problems.
It may be obvious to you if you have pronounced posture problem. If it is not obvious, it is a good idea to see a specialist such as a Massage Therapist, chiropractor, or exercise physiologist. There are a several tests which a professional can use to diagnose specific posture problems.
There are telltale signs which a professional such as an orthopedic massage therapist looks for during functional movements that show your posture problems. You may also be able to observe your own movement in a mirror. Once you know which of your muscles needs to be strengthened or loosened up you can move on to the next step.
You can not get a strong core by sitting at a desk all day. The muscles which are closest to your body’s center of gravity have to be strong for a fully effective workout. If you perform core exercises, you will teach your body to maintain proper dynamic postural alignment for during all of your exercises. You will also improve your static posture.
Since the hip flexors and glutes are at the core of the lumbo-pelvic hip complex you must have the proper length-tension relationship between them. In most people, the hip flexors are tight and the glutes are weak. Therefore, strengthening the glutes is a key aspect of correcting posture problems.
The very best way to strengthen your glutes is by performing multi-joint leg exercises. You just have to be sure to contract the correct muscle, in this case, the glutes.
If you have muscles which are chronically tight, corrective flexibility takes a direct approach. Muscles which are tight due to chronic posture such as sitting all day at a desk take time to correct. Just like weight loss, what happens over weeks, months and even years is not easily reversible. Be patient and diligent, and you will see results with time.
Once you know your correctable structural posture problems, you can follow a corrective flexibility program. Each corrective flexibility exercise should be specific to your situation. Since this takes time, you should perform these corrective flexibility exercises daily if possible.
Here are two different ways in which you can begin to correct your muscle imbalances and posture problems.
foam roller
You can get myofascial release and trigger point therapy from a massage therapist, and you can also do it yourself in between massages.  The best way to perform self-myofascial release is with a foam roller (left), massage ball, medicine ball or even a hard ball such as a tennis or golf ball.
Place the tight body part on the foam roller. The most important thing to remember is to relax the muscle to which you are applying pressure. Apply pressure to the entire length of the muscle with the foam roller. Even though it is just a piece of foam, as you move up and down the muscle you will notice some spots hurt very badly. The muscles have accumulated hypertonicity, which you can think of as tension. Apply pressure to the most tender spots for 20-30 seconds each.
Self-myofascial release is not for everyone. You may feel like it does nothing for you. If you feel this way, make sure you do it 100% correctly before you abandon it. Each progressive time you perform SMFR on a muscle, you will notice less tension as the tender spots go away over time. It takes longer for some muscles than others.
You can perform SMFR before or after a workout. You should focus your SMFR on the muscles which are the root of your muscle imbalances and posture problems. Perform a session on the foam roll before your static stretching.
Static stretching is the classic stretching technique you learned from your high school P.E. teacher. You can correct posture problems most efficiently with a combination of SMFR and static stretching. Static stretching is rather simple. Hold your body in the position of “slight discomfort” for at least 20 seconds. For the best stretches, check out our Pinterest board!

Here are some corrective exercises to get you started:


Corrective Exercise #1: Foam Roller for Gluteals
Self myofascial massage techniques performed with a foam roller are very popular in the corrective-exercise setting. The more we spend our days sitting, the less we extend our hips as nature intended. Consequently, the posterior hip and gluteal musculature gets used incorrectly--some muscles are overworked, while others atrophy. Using a foam roller on the gluteal complex can rejuvenate this area and keep it healthier.
How to Do It: Sit on the foam roller with one ankle balanced on the opposite knee. Roll weight onto the buttock that’s on the same side of the body as the lifted leg and apply pressure to any sore spots in that buttock. Have clients perform this exercise once per day for 1-2 minutes each side.
Corrective Exercise #2: Hip Flexor Stretch (With Rotation)
Hip flexor stretches are particularly important in corrective-exercise programs because of the excessive amount of time we spend sitting down in hip flexion. Stretching the hip flexors can reduce the forward pull on the lumbar spine, thus reducing the possibility of excessive lumbar lordosis (a common cause of back pain).
How to Do It: Kneel on one knee with the other foot in front for balance. Tuck the pelvis under, using the gluteal muscles and abdominals to assist with the movement. Raise the arm on the same side as the kneeling leg to increase the stretch. Hug yourself around the shoulders, and rotate the torso over the front leg. Hold the stretch for about 30 seconds and repeat 6-8 times. Ask clients to do at least one set per day on each side.
Corrective Exercise #3: Single-Leg Squat 
Body-mind programs emphasize balance, coordination and weight transfer to correct movement deviations. Science has helped us better understand the body’s systems and the degree to which muscles need to coordinate with one another to facilitate balance and weight transfer. A good example of this is seen in the single-leg squat.
As we descend into a single-leg squat, the gluteal muscles of the standing leg work eccentrically to slow down both hip and leg motion. As we begin to rise out of the squat, the glutes extend the hips in order to return the body to an upright position. At the same time, as we lower into the squat, weight is transferred forward in the foot and ankle, and as we stand up, weight settles back into the heel. It is imperative that you understand the coordination and timing of this movement so you can help clients learn to transfer weight properly—as is necessary, for example, when walking. 
          
How to Do It: Stand on one leg and squat down by bending at the ankle, knee and hips. Slow the foot motion down with the muscles of the foot and calf, and the hip motion down by engaging the gluteal muscles. Extend the hips and raise the arch of the foot back to its neutral position as you return to the starting point. Clients should perform 1-10 repetitions, 1-5 times per week, depending on the goal.

1 comment:

Jacob Bastomski said...

This post is so amazing and informative. Patients who suffer from chronic or occasional pain often times want to learn why and how their problem came about.

Chiropractic Neurologist Dr. Jacob Bastomski