Home Posts tagged "bad posture" (Page 3)

Strategies for Correcting Bad Posture – Part 4

This wraps up a four part series on key points to consider and techniques to utilize for correcting bad posture.  In case you missed them, check out the previous three installments of this series: Strategies for Correcting Bad Posture - Part 1 Strategies for Correcting Bad Posture - Part 2 Strategies for Correcting Bad Posture - Part 3 We'll pick this up with tips 13-16. 13. Look further down the kinetic chain. I spent much of the last installment discussing the role of the thoracic spine and glenohumeral joint in distorting upper body posture.  However, the truth is that it goes much further down than this, in many cases, and isn't quite as predictable.  As the picture below shows, a posteriorly rotated pelvis (swayback posture - third from left)) can kick off a nasty thoracic kyphosis, but an excessively lordotic posture (second from left) can do the exact same thing; it really just comes down to where folks compensate.

In the swayback posture, we see more flexion-based back pain (in addition to the classic upper body injuries/conditions), whereas the lordotic posture kicks off extension-based back pain.  Stretching the hip flexors a ton will help the lordotic folks, but usually have minimal effect for the swayback folks.  So, you really have to assess the hips individually and contemplate how they impact what goes on further up.

Likewise, you can look even further down the chain.  Overpronation at the foot and ankle kicks on excessive tibial and femoral internal rotation, which encourages more anterior pelvic tilt - which goes hand-in-hand with a lordotic posture.  Further up, we may compensate for this lordosis by getting more kyphotic to reposition our center of mass and remain "functional" and looking straight ahead.

14. Get ergonomic...conservatively.

While some ergonomic adjustments to your work station can be extremely valuable, simple modifications often yield the quickest and most profound results.  I've known folks who have gotten symptomatic relief by going to a standing or kneeling desk to get away from extended periods of time in hip flexion - and by getting the computer screen up to eye level.

Likewise, I always remind people that the best posture is the one that is constantly changing.  So, regardless of how "correct' your posture may be, it should always be a transient thing.

15. Use 1-arm pressing and pulling variations.

This recommendation will be appreciated by those of you who have checked out my new product, Show and Go: High Performance Training to Look, Feel, and Move Better.

If you're doing the program, chance are that you've noticed that there are quite a few unilateral upper body strength exercises - often one in each upper body training session.  The reason is pretty simple; you train thoracic rotation and scapular protraction/retraction on each and every rep.

If we are doing thoracic mobility work and lower trap/serratus anterior activation drills in our warm-ups, this is a perfect opportunity to create stability within that new ROM and solidify the neural patterns we've hoping to establish (and get an added core training benefit). You simply can't get this with bilateral exercise, particularly in a supine (bench presses) or prone (chest-supported rows) position.

16. Add range of motion - not just load - to your weight training program.

This note is one that anyone with a decent power of observation could make.  Walk in to any gym, and notice the people with the absolute worse posture as they go through their workout routines.  What do they do?

They move as little as possible on every single rep.  They squat high, don't go anywhere near the chest on bench presses, or just make up "strength exercises" that amount to violent spasms.  And that's just the ignorant folks.

Among advanced lifters, you'll see a lot of folks with terrible shoulder mobility and posture sticking with board presses and floor presses (which are certainly justified in limited volumes at specific training times), and doing rows with crazy heavy weights that force them to substitute forward head posture in place of anything even remotely close to scapular retraction.

In short, these folks keep working to add load, when they really should be maintaining or even lowering the load while adding range of motion to their weight training programs.

Wrap-up

Hopefully, this series brought to light some concepts that you can put into action right away.  Down the road, I may "reincarnate" this series as I think up some more strategies - or based on reader feedback.  Are there other areas you'd like covered?  If so, post in the comments section and there may be a Part 5 afterall!

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Strategies for Correcting Bad Posture: Part 3

This is the third installment of my Correcting Bad Posture series.  In case you missed the first two installments, you can check them out here: Strategies for Correcting Bad Posture: Part 1 Strategies for Correcting Bad Posture: Part 2 Today, we pick up with tip #9... 9. It's not just the strength exercises you perform; it's how you perform them. Often, people think that they just need to pick a bunch of "posture correction" exercises and they'll magically be fixed.  Unfortunately, it's not that simple, as making corrections takes time, patience, consistency, and perfect technique.  As an example, check out the following video of what some bad rows often look like in someone with a short pec minor, which pulls the coracoid process down and makes it tough to posteriorly tilt and retract the scapula.  The first substitution pattern you'll see (first three reps) is forward head posture replacing scapular retraction, and the second one (reps 4-6) is humeral (hyper)extension replacing scapular retraction.

Ideally, the chin/neck/head should remain in neutral and the scapula should retract and depress in sync with humeral movement.

Of course, these problems don't just occur with rowing motions; they may be seen with everything from deadlifts, to push-ups, to chin-ups.  So, be cognizant of how you're doing these strength exercises; you may just be making bad posture worse!

10. Get regular soft tissue work. I don't care whether it's a focal modality like Active Release, a mid-range modality like Graston Technique, or a more diffuse approach like general massage; just make sure that you get some sort of soft tissue work!  A foam roller is a good start and something that you can use between more targeted treatments with a qualified professional.  A lot of people really think that they are "breaking up scar tissue" with these modalities, and they certainly might be, but the truth is that I think more of the benefits come from altering fluid balance in the tissues, stimulating the autonomic nervous system, and "turning on" the sensory receptors in the fascia.

For more thoughts along these lines, check out my recap of a Thomas Myers presentation: The Fascial Knock on Distance Running for Pitchers.

11. Recognize that lower body postural improvements will be a lot more stubborn than upper body postural improvements. Most of this series has been dedicated to improving upper body postural distortions (forward head posture and kyphosis).  The truth is that they are always intimately linked (as the next installment will show) - however, in the upper body, bad posture "comes around" a bit sooner.  Why?

We don't walk on our hands (well, at least not the majority of the time).

Joking aside, though, the fact that we bear weight on our lower body and core means that it's going to take a ton of time to see changes in anterior pelvic tilt and overpronation, as we're talking about fundamentally changing the people have walked for decades by attempting to reposition their center of gravity.  That's not easy.

So why, then, do a lot of people get relief with "corrective exercises" aimed at bad posture?  Very simply, they're creating better stability in the range of motion they already have; an example would be strengthening the anterior core (with prone bridges, rollouts, etc.) in someone who has a big anterior pelvic tilt and lordosis.  You're only realigning the pelvis and spine temporarily, but you're giving them enough time and stability near their end range to give them some transient changes.  The same would be true of targeted mobility and soft tissue work; it acutely changes ROM and tissue density to make movement easier.

Long-term success, of course, comes when you are consistent with these initiatives and don't allow yourself to fall into bad posture habits in your daily life.  In fact, I have actually joked that we could probably improve posture the quickest if we just had people lie down between training sessions!

12. Add "fillers" to your weight training program. Mobility drills aimed at correcting bad posture are often viewed as boring, and in today's busy world, they are often the first thing removed when people need to get in and out of the gym quickly.  To keep folks from skipping these important exercises, I recommend they include them as "fillers."  Maybe you do a set each of ankle and thoracic spine mobility drills between each set of deadlifts (or any strength exercise, for that matter) - because you'd be resting for a couple of minutes and doing nothing, anyway.  These little additions go a long way in the big picture as long as you're consistent with them.

I'll be back next week with Part 4 of the Correcting Bad Posture series.

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Strategies for Correcting Bad Posture – Part 2

Today, we move forward with more strategies for correcting bad posture. In case you missed it, be sure to check out Strategies for Correcting Bad Posture: Part 1.  We pick up with tip #5... 5. Don't overlook a lack of glenohumeral (shoulder) joint internal rotation. When it comes to bad posture, everyone thinks that the glenohumeral joint is only a "player" when it's stuck in internal rotation; that is, the ball - or humeral head - is rotated too far forward on the socket - or glenoid fossa - meaning that the individual just doesn't have adequate external rotation.  And, this is often true - especially in non-athletic populations. However, you'll also very commonly see poor posture folks who present with big glenohumeral internal rotation deficits (GIRD), particularly on the right side (for very legitimate reasons that go well beyond the scope of this article).  This is much more common in athletes, particularly overhead throwers (read more: Static Posture Assessment Mistakes).  When the posterior rotator cuff is stiff/short and there is an internal rotation deficit, we have to substitute excessive scapular protraction (winging) or thoracic flexion/rotation each time we reach for something. So, for many folks, posterior shoulder mobility and soft tissue work is an important inclusion in cleaning things up in terms of appearance, function, and shoulder health.  If - and only if - you've been assessed and it's been determined that you have an internal rotation deficit that compromises your total motion at the glenohumeral joint, you can integrate some gentle sleeper stretches (scapula stabilized!) to get a bit more ROM in the posterior cuff.

6. Don't overlook a lack of glenohumeral (shoulder) joint flexion. The shoulder is a tremendously mobile joint, so we need to appreciate what goes on outside the transverse plane as well. In particular, I see shoulder flexion limitations as a big problem. These limitations may come from the lat, teres major, long head of the triceps, or inferior capsule.  Another overlooked cause can be posterior cuff restrictions; it's not uncommon to see both GIRD and major shoulder flexion limitations on the same side.  As the picture below shows, the infraspinatus and teres minor run almost vertically when the arm is abducted a mere 90 degrees - which means that they're struggling to lengthen fully to allow full shoulder flexion (and abduction, for that matter).

These restrictions that can contribute to both faulty compensation patterns in certain positions, as well as overall bad posture chronically.  Let's have a look at what these issues look like in the real world. First, in someone with a shoulder flexion limitation, you'd first want to check them in the supine position, with the knees flexed and back flat (to avoid substituting lumbar extension for shoulder flexion).  Ideally, the arms should rest flat on the table - so this would be a "not-so-hot" result (especially since the arms "fall" to the sides a bit instead of staying in "attempted flexion"):

Next, let's take this same shoulder flexion limitation, and look at what would happen actively.  In the first three reps of the video below, take note of the position of our subject's head at the start and finish of each rep; you'll see that as he "runs out" of shoulder flexion, he substitutes forward head posture.  On the next three reps, after I cue him to keep his cervical spine in a more neutral posture, he has to arch his back excessively (lumbar hyperextension) to complete the movement.

Now, imagine taking this walking disaster (only kidding; I had Dave fake it for the video, as he's actually a finely tuned trained killing machine who can't be stopped by conventional weapons - and he's single, ladies) taking up overhead pressing, Olympic lifting, or just reaching for a glass on the top shelf.  Then, imagine him doing those tasks over and over again. Obviously, the posture will get worse as he reinforces these compensation schemes - but something is going to surely break down along the way; it's just a question of whether it's his low back, shoulder, or neck!

Correcting these issues is easier said than done; as I noted, there are several structures that could be the limiting factor.  However, for those looking for a relatively universal stretch they can use to get a bit of everything, I like the wall lat stretch with stabilization, one piece of a comprehensive (but not excessive and boring) static stretching program included in Show and Go.

7. Don't ignore the thoracic spine. The previous two examples focused exclusively on the glenohumeral joint, but the truth is that it is tremendously dependent on thoracic spine positioning.  Ask any physical therapist, and they'll tell you that if they can get the thoracic spine moving, they can instantly improve glenohumeral joint range-of-motion without even touching the shoulder (this is incredibly valuable with folks who may have stiff glenohumeral joints that can't be mobilized aggressively following shoulder surgery; they need ROM in any way possible).  And, truthfully, you can substitute a lack of thoracic spine extension for the shoulder flexion problems and compensation schemes above, and a lack of thoracic spine rotation can work in much the same way as a GIRD (substitute excessive scapular protraction with reaching tasks).

If you ever want to quickly check to see what limiting thoracic extension does to someone's upper body posture, just put them in supine position and push the sternum/rib cage down - which will bring the thoracic spine into flexion. Watch what happens to the position of his chin, and the size of the "gap" between his neck and the table:

Now, just consider what kind of "yank" this puts on the sternocleidomastoid chronically...

...and you'll understand why a lack of thoracic spine mobility can give people enough neck pain and tension headaches to make Lindsay Lohan's hangovers look like a walk in the park.  And this doesn't even consider what's going on with scalenes, suboccipitals, levator scapulae, subclavius, and a host of other muscles that are royally pissed off!  Also, think about all those folks in your gym doing hours and hours of crunches (especially while tugging on the neck).  Ouch.

For that reason, we need to get our thoracic spine moving - and more specifically, we need to get it moving in both extension and rotation.  I've mentioned in the past that the side-lying extension-rotation is one of my favorites (assuming no symptoms); remember that the overwhelming majority of the range-of-motion is coming from the upper back, not just the shoulder:

Here's another we're using quite a bit nowadays in our folks who have good internal rotation (which we want to keep!):

8. Watch your daily habits and get up more frequently. I'm at 1,140 words for this post right now - plus several pictures and videos.  In other words, some of you might have been hunched over your computer screens trying to figure out what I'm saying for over 20 minutes now - and that's when "creep" starts to set in an postural changes become more and more harmful (both aesthetically and functionally).

With that in mind, make a point of getting up more frequently throughout the day if you have to be sitting a ton.  Likewise, "shuffle" or "fidget" in your chair; as Dr. Stuart McGill once said, "The best posture is the one that is constantly changing."  Now, shouldn't you get up and walk around for a few minutes?

I'll be back soon with Part 3 of this series, but in the meantime, I'd encourage you to check out Show and Go: High Performance Training to Look, Feel, and Move Better, a comprehensive program that includes many of the principles I have outlined in this series.

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Strategies for Correcting Bad Posture: Part 1

This week, I'll feature several strategies for correcting bad posture; you should be able to insert these into your weight training programs quickly and easily for immediate results. Here we go...

1. Train more frequently.

Obviously, in many cases, those with bad posture often simply don't exercise enough, so any motion is good motion.  However, this also applies to regular exercisers who hit the gym 3-4 times per week as well.  Why?

Well, I do a lot of my "corrective" work in my warm-up programming - and the more often you train, the more often you'll have to do your foam rolling and mobility warm-ups.  So, breaking your training program up into smaller components on more frequent days might be the best way to force yourself to do the things that you need the most to correct bad posture.

2. Use daily mobility circuits.

Along the same lines as the "increase training frequency" recommendation, it'll never hurt to repeat your mobility warm-ups during your daily life. If you are someone who is really in need of drastic changes, do your warm-ups twice a day, seven days a week (on top of any static stretching you do).

3. Strengthen the deep neck flexors.

When you get stuck in a forward head posture, the deep neck flexors (muscles on the anterior portion of your neck) really shut down as the sternocleidomastoid, suboccipitals, levator scapulae, scalenes, and upper traps get dense, fibrotic, and nasty.

You can start off by simply doing chin tucks against the wall (put the back of your head up against a wall, then make a double chin without the back of your head losing contact with the wall). Then, you can progress to quadruped chin tucks, a drill I learned from Dr. William Brady.  In this drill, you'll work against gravity as you pull your head into a more neutral cervical spine posture.  Most people will butcher this on their first try by going into hyperextension as they get to the "top" of the movement.

When you get the technique down, you'll actually notice some crazy soreness along the anterior aspect of your neck in the days that following. We usually go with sets of 5-6 reps and a 2-3 second hold at the top of each rep.

4. Go with a 2:1 pulling-to-pushing ratio.

This is a recommendation you see quite a bit, but nobody really talks about how to "smoothly" apply it to a weight training program.  Here are a few approaches I've used in the past:

a. Simply add an extra pulling exercise on the end of a day's session.

b. Pair a bilateral pulling exercise with a unilateral pressing exercise - and do "halves" on each pressing set.  In other words, if I was doing 6x6 chest-supported rows (CSR) with 3x6/side 1-arm incline DB presses (IDP), here's how I'd set it up: CSR, IDP-right, CSR, IDP-left, CSR, IDP-right, CSR, IDP-left, CSR, IDP-right, CSR, IDP-left.

c. Make the pulling exercises in your program the A1, B1, and C1 options, with the pressing as the A2, B2, C2.  And, simply have an extra set of each of the pulling exercises - meaning you just don't return to the pressing exercise for a last set.  This might work out as more of a 3:2 pulling-to-pushing ratio, but you can always tack an extra set or two on at the end to make it work.

I'll be back soon with more strategies for correcting bad posture, but in the meantime, I'd encourage you to check out Optimal Shoulder Performance at www.ShoulderPerformance.com, as this resource features loads of postural correction strategies to complement the ones featured in this series.

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