Building Proper Posture

Recently I injured my shoulder by exercising poor judgement at the gym. One thing led to another, and I found myself at the mercy of a physical therapist. On my first visit, she explained that shoulder injuries are always treated by first addressing posture deficiencies. . . regardless of age, she hesitantly added. I reminded her that I had sustained my injury exhibiting super-human strength at the gym, not because I was old. She had no reply.

Proper Posture Devolves Over Time

Athletes suffer from the SAID Principle, or Specific Adaptation to Imposed Demands. Any given sport will produce adaptations specific to the activity performed. If you’re a figure skater, you’d adapt to the specific strength demands required for figure skating. For runners to develop the endurance for long distances, we must train by running long distances. Adaptations occur in the muscles and systems that are stressed by that activity.

With repetitive movement (or non-movement such as prolonged sitting), the muscle and soft tissue remodel to become stronger in the direction of stress. This is good as it relates to our sport, but long term repetition can create muscular imbalances that slowly devolve into poor posture. As posture deteriorates, joint movements become restricted allowing muscles to weaken. The joints then try to compensate causing pain, stiffness and loss of mobility.

A quick review of exercises that improve posture yields a variety of core strengthening exercises. Most athletes rely on a strong core, and we already spend a fair amount of time on the effort. However, good posture is not only derived from a strong core, but also from the neck, shoulders and hips. Although my strengthening exercises were effectively targeting the core, they were not targeting these other areas that are also essential to good posture.

The Crossed Syndrome

Photo: Triathlon-Hacks

A cyclist‘s position on the bike causes tightening of some muscles while the opposing muscles lengthen and become weak resulting in upper crossed and lower crossed syndrome. Both have negative effects on posture and efficiency for cyclists.

Pinterest Photo Origin Unknown

Upper Crossed Syndrome occurs when the back muscles of the neck and shoulders (upper trapezius, and levator scapula) become extremely overactive and strained. The muscles in the front of the chest (the major and minor pectoral is muscles) become shortened and tight. Potential injuries include headaches, biceps tendonitis, rotator cuff impingement and thoracic outlet syndrome.

With Lower Crossed Syndrome the gluteals (gluteus maximus, gluteus medius, gluteus minimus) and abdominal muscles become weak or inhibited, and the hip flexors (rectus femoris and iliopsoas) and lumbar erector spinae become tight. Injuries can include hamstring strains, anterior knee pain and low back pain.

One-sided rotational sports (such as tennis, golf, hockey, baseball…) can also cause this type of muscle imbalance, although all athletes are at risk of injury from muscle imbalances regardless of the cause.

Uncovering Posture-Enhancing Movements

Over these past few months of recovery, I’ve formulated a routine that stretches and strengthens those muscles that cause our posture to devolve over time while also targeting the core muscles that are normally part of a runner’s strengthening regimen. The goal was to create a sequence that was easy to remember, could be completed in about 10 minutes, and wouldn’t require equipment.

There’s dozens of exercises that target the neck, shoulders, core and hips, so it’s easy to add or substitute other exercises to more intensely target one area or another. This basic routine provides a good starting point, however, as to the types of exercises you would want to include in a personalized program.

This program hasn’t completely replaced my regular strengthening program, but it’s been an effective way to build core strength in a way that also helps support proper posture. The 10 movements include:

  1. Standing Half Forward Bend
  2. Camel Pose
  3. Child’s Pose
  4. Classic Plank
  5. Side Plank – Left
  6. Push-Up
  7. Side Plank – Right
  8. SpiderMan Stretch w/T-Spine Rotation
  9. Up Dog
  10. Child’s Pose
Disclaimer: If you are just beginning an exercise program, you’re dealing with a back, neck or shoulder issue, suffer from high or low blood pressure or have other health issues, please consult your physician or a physical therapist before performing this or any other exercise regimen.
Hold each position for 30-60 seconds, for 5-10 breaths, or as long as you can. Perform 1-3 complete sets.

1. STANDING HALF FORWARD BEND

Courtesy: Pinterest

Uttanasana: Sanskrit word combination: ‘ut’ means Intense, ‘tan’ means Stretch, and ‘asana’ refers to Posture.

Primary muscles involved: stretches the hamstrings and low back.

Tips: Keep feet shoulder width apart and parallel. Bend at the hips (not the waist). Beginners should bend the knees if necessary, but don’t worry if you can’t touch the ground. Go as far as you can. Don’t forget to breathe.

Variation: STANDING FORWARD FOLD WITH HAND CLASP

Courtesy blog.myfitnesspal.com

This pose stretches your hamstrings and low back, while the hand clasp opens the chest and shoulders. Keep a soft bend in your knees and use a strap or towel to make the pose more accessible. If you can, keep your torso long and your knees even.

2. CAMEL POSE

Courtesy: yogabycandace.com

Primary muscles involved: Shoulders, Chest, Core, Hip Flexors

Tips: Keep the legs vertical, and push the hips in the forward direction. Bend the head and the spine backward without straining, and don’t allow the shoulders to extend past the feet. Relax the muscles and breathe normally.

Variation: an easier variation of this pose is to position the palms on the lower back while slightly bending the head and spine backward. Relax the muscles and breathe normally.

3. CHILD’S POSE

A relaxation and resting pose that normalizes circulation, and gently stretches the hips, thighs, ankles and spine. Leave the arms stretched out in front, or rest palms beside your feet.

4. CLASSIC PLANK

Courtesy: lifehack.org

Primary muscles involved: biceps, neck, and shoulders

Secondary muscles involved: arms, biceps, core, thighs and gluteus.

Tips: Keep your torso straight and rigid, the body in a straight line from ears to toes with no sagging or bending. This is the neutral spine position. Ensure your shoulders are down, not creeping up toward your ears. Your heels should be over the balls of your feet.

Variation: TALL PLANK

Courtesy: wikihow

5. SIDE PLANK – LEFT

Courtesy: bodybuilding-wizard

Lean on your left elbow and forearm in a side-lying position, with your shoulders and hips parallel to the floor. Raise your hips until your body forms a straight line from your ankles to your shoulders. Brace your core by contracting your abs forcefully as if you were about to be punched in the gut. Place your right hand on the hip. Hold the position without letting your hips drop.

Primary muscles involved: deep abdominal muscles (obliques, transverse abdominis), quadratus lumborum (muscle in the lower back)

Secondary muscles involved: erector spinae, adductors, gluteus medius, gluteus minimus.

Variation: SIDE PLANK ON HAND

Courtesy: bodybuilding-wizard

6. PUSH-UP (perform up to 30 reps, or as many as you can)

Courtesy: healthline.com

The New York Times says, As a symbol of health and wellness, nothing surpasses the simple push-up. The push-up is the ultimate barometer of fitness.

Starting from the tall plank position, keep the pelvis tucked in and the neck neutral with palms directly under the shoulders. Keep the back flat while lowering the body by bending the elbows until the chest barely grazes the floor. Extend the elbows and repeat as many reps as possible.

Primary muscles involved: chest muscles/pectorals, shoulders/deltoids, back of your arms/triceps, abdominals, the “wing” muscles directly under your armpit, called the serratus anterior.

Variations: bend your legs at the knees to make the pushup easier. If necessary, start out doing the exercise against the wall instead of the floor or from the edge of the kitchen counter.

To make the pushup harder, adjust the position of the hands either wider or more narrow, use the fingertips instead of the palms, or place your feet on a high surface such as a bench to increase resistance.

Advanced: The Hundred Pushups Training Program (a 6-week program)

7. SIDE PLANK – RIGHT

Courtesy: plankexerciseroutine

8. SPIDER-MAN STRETCH W/T-SPINE ROTATION (perform 10 reps each side, or as desired)

Courtesy: skimble.com

According to the renowned strength coach Mike Boyle, the Spider-Man is extraordinary because performing it to one side simultaneously develops mobility in both hips. The movement requires you to tilt your pelvis backward, which prevents your back from arching and forces you to stretch the opposite side’s hip flexors, Boyle says.

Take a long lunge forward. Place fingertips or palms on the ground in line with the front foot. Make sure the knee is on the outside of the arms, not between them. Keep back knee off the ground. Look up and create a neutral spine. Step through and repeat with other leg. After attaining a neutral spine, lift the outside arm towards the sky. Watch your hand as your lift the arm.Attempt to create a straight line between your arms.

9. UP DOG

Courtesy: yogabycandace

Stretches the chest and abdominal muscles while strengthening the shoulders, triceps, forearms, and low back.

The palms should be aligned under the shoulders, the shoulder blades engaged and pulling the shoulders down and away from the ears, the chest open, and the eyes looking forward.

Only the palms of your hands and the tops of your feet should be touching the floor. Push strongly into both.

Primary muscles involved: Chest, shoulders, abdominals, triceps, forearms, low back

10. End with CHILD POSE

Read More:

Yoga For Runners, Darebee.com

8 Neck and Shoulder Stretches to Relieve Pain: Work and play both stress the neck and shoulders. Here’s how to recover; OutsideOnline

5 exercises to correct lower cross syndrome in cyclists, Canadian Cycling Magazine

The Anatomy of a Runner

Some athletes have left an indelible mark – they are so spectacularly talented it simply boggles the mind.

Michael Jordan comes to mind. I was lucky enough to have watched him play at the United Center in Chicago some years ago. He was mesmerizing. And I’m just old enough to remember Walter Payton running across the field for a touchdown, like art in motion. . . the same as watching Michael Phelps swim, or Shalane Flanagan’s stride. The examples are endless, but what is it that makes these athletes successful? The magic question.

It would be easy enough to blame it on genetics, but I would offer up Misty Copeland – the first African American woman to be named principal dancer with the legendary American Ballet Theatre. Whatever your ballet stereotypes, Copeland probably doesn’t fit them. She’s been told she shouldn’t wear a tutu – she doesn’t have the right legs, her muscles are too big.

IMG_2882Emil Zátopek was the first runner to break the 29-minute barrier in the 10,000 meters, and the instigator of interval training. Even as he trained to become an Olympian, he wore work boots instead of running shoes, and moved his torso in a way that many criticized as inefficient. His tortured facial expressions prompted one sports columnist to remark that he “ran like a man with a noose around his neck.”

He is the only athlete to win the 5,000 and 10,000 meter races, as well as the marathon (a race he had never run) in one Olympic Games.

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What many of our favorite athletes have in common is that they were unlikely candidates for their sport. They move funny, have unorthodox body types, suffered devastating setbacks, started their sport late in life. . . or didn’t burn out despite starting too early. We all have more in common than we thought.

I hold my elbows too far out when I run. It probably makes me slower. Maybe you kick one leg out at the back of your stride, over-pronate, or carry your hips off-center. Does it matter? If we review the most unorthodox athletes of all time and consider their accomplishments, I would have to suggest the answer is no, it doesn’t matter.

Does it cause injuries? Maybe.

IMG_2885.JPGMy first real issue was that my toes went numb when I ran. My husband and I tried everything – larger shoes, different socks, orthopedic inserts. Once we figured out the problem was Morton’s Neuroma, I was on a mission to discover a fix, which turned out to be as simple as taking one vitamin B-12 each day – for ten years and counting.

Whatever the injury/pain/issue, the anatomy behind the issue became as fascinating to me as the running itself.

Runners have hundreds of issues in common. We have a propensity for pulling the same muscles: the quad, hamstring and/or calf muscles. Then there are those dreaded black toenails (cut them short!).

Muscles that are the most prone to cramps are those that cross two joints. A weakened Tensor Fascia Latae can tug on the knee and vice versa. Gentle stretching may help the sore Achilles’ tendon and an out of sorts Plantar Fasciitis, but does very little to loosen a tightened ITB. If you have knee problems, it might be wise to strengthen the hip. A sore back? Strengthen the abs.

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Every athlete is different. Our execution varies from one to the other. What works for me may not work for you, and vice versa. One thing is certain, however, the anatomy behind our running that can (and eventually will) affect our running is shared by us all, and it spans from our brains to our little toe.

A better understanding of our anatomy may be the secret sauce in the never-ending quest to remain injury free – something else we all have in common, whether you’re a runner, walker, dancer, gardener, or mom lifting baby.

(Reader Alert: consider this the prologue of another Fartlek series of posts: The Anatomy of a Runner.)

Next up:  The Anatomy of a Runner:  it’s all about that bass.

Does Running Cause Knee Problems and Eventual Arthritis?

A couple of weeks ago in class we debated whether running causes knee problems. Everyone seems to believe if you run for too many years, you will eventually have bad knees, arthritis or both.

Approximately one third of serious runners will incur an injury in a given year, and approximately one third of the injuries will involve the knee. Biomechanical studies on running reveal the tremendous cyclic forces to which the knee is subjected and show that forces of up to 300% body weight can occur even during normal walking, and this may rise to 550% during running.

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I read a fascinating study that measured the changes in the cartilage volumes in the tibia, patella and medial and lateral meniscus (the cartilaginous tissues that provide structural integrity to the knee) after the extreme dynamic loading that occurs in long-distance runners. It also examined the rate of recovery from the alterations occurring at the knee joint due to loading during distance running.

In short, although there were significant changes after a 5, 10 and 20 km run, the conclusion on the basis of the study was that the cartilage is able to adapt well to the loads caused by running and that the articular structures were found to recover rapidly so that exercise could be continued after a short rest without reservation.

Our bodies seem to have been designed to withstand the pressure of running. The affected tissue is not only adaptable but regenerative, rebuilding itself within a short period of time. This study revealed that after 1 hour of rest no significant reduction of cartilage volume was measured for the patella, the tibia or the lateral and medial meniscus.

The best evidence that running does not lead to pain and eventual arthritis comes from an ongoing study of the Fifty Plus Runners Association. The study was launched in 1984 when all the runners were at least 50, and updated every five years or so since. Many of the runners are now in their 60s, 70s, or older.

The newest update to this study was published last September in Arthritis Research & Therapy. It compared the runners, who averaged about 26 miles a week, to a matched set of controls, who averaged about two miles a week.

The study’s major conclusion: The runners experienced “about 25 percent less musculoskeletal pain” than the control group. That’s a major check mark in my book for staying active.

Runners will eventually get injured.
Runners will eventually get injured.

The most enjoyable reading I found on the topic came from Paul Ingraham, a science writer and runner who suffered from a severe case of ITBS and subsequently studied knee injuries for several years.

imageHe writes, “Both kinds of runner’s knee are repetitive strain injuries. Humans are indeed born to run in many ways, but we’re certainly not indestructible…”

He identifies two common “runner’s knee” conditions: pain on the side (iliotibial band syndrome, or ITBS), pain on the front (patellofemoral pain syndrome, or PFPS) and provides a checklist of symptoms to help you identify the cause of your pain. It’s fun and informative reading.

Every source seems to agree on several things we can do to help prevent long term damage to our knees due to injury and/or prevent the onset of osteoarthritis regardless of our chosen sport (ITBS in particular also affects cyclists and hikers).

Avoid Carrying Extra Weight: Increased body weight, which adds stress to lower body joints, is a well established factor in the development of osteoarthritis. Your knees, which carry the brunt of your weight, are particularly at risk. For every pound you gain, you add 4 pounds of pressure on your knees and six times the pressure on your hips.

Recent research suggests that excess body fat produces chemicals that travel throughout the body and cause joint damage, which would mean obesity plays a systemic, not just a mechanical, role in osteoarthritis onset.

Avoid Overuse/Injury: While running itself doesn’t increase the risk of osteoarthritis, running injuries can–especially when you delay treatment or rush recovery. If an injury is not properly cared for, the non-healing of it can cause the degenerative process of arthritis to start in the joints.

Train smart: don’t ramp up too quickly, don’t train if you’re Injured.

Be Strong: Studies show that weakness of the muscles surrounding the knee is associated with osteoarthritis, especially in women, and makes the pain and stiffness worse after onset. Strengthening exercises for thigh muscles are important in reducing the risk.