Everyone wants a strong core and knows that it’s important. What most people don’t realize is that having “6-pack” or a flat stomach, doesn’t necessarily equal strong. When I say “a strong core”, I’m talking about muscles that can do their job. The abdominal muscles are meant to decompress the spine, support the organs, provide movement, lower the pressure in the abdominal aorta, help you breathe/cough/vomit, and more. When you have muscles that function properly, you might also end up with a smaller waistline; however, a flat, fit, toned abdomen does not necessarily mean it’s strong and healthy. Plenty of very fit people have diastasis recti, hernias, digestive trouble, and pelvic floor issues. If you are after a strong and functional core, here are a few things you can do to start heading in the right direction. These things can help minimize back pain, decrease your chances of developing diastasis recti, and recover healthy core function, whether you are pregnant, postpartum, or neither.
1) Drop your ribs. The rib cage should be stacked right over the pelvis (see photo), not lifted or jutting forward. Read this post for a detailed description. This one small thing can have a huge impact on your core strength. The abdominal muscles attach on the rib cage. If you are constantly lifting them or jutting them forward, you are undermining their ability to function.
2) Release your belly. Constantly holding tension in your belly also undermines abdominal strength. This can come in the form of habitually sucking in your stomach or constantly bracing/tensing your abdominal muscles. For starters, just get on your hands and knees and try to let your belly relax towards the floor. Allow the tailbone to move up towards the ceiling. Notice any desire to pull your belly back up. Let it relax more. This article talks about why relaxing your belly is so hard. And this one gets into the difference between sucking in your stomach and activating your TVA.
3) Practice #1 & 2 in everyday life. Once you’ve learned how to drop your ribs and release the tension in your abdomen, start bringing these new habits into everyday life. Pay attention to them when you walk, stand, sit, drive your car, work on the computer, or hold your baby. This is a really great post on ways to move better in everyday life to heal diastasis recti. <— IF YOU HAVE DR, READ THIS POST!!
Dropping your ribs and releasing your belly is a great place to start. Doing those two things will relieve back pain, improve digestion, and increase the activity of your abdominal muscles. Your abdominal muscles can work reflexively (automatically) now that you’ve eliminated habits that were interfering with this process. They can now respond appropriately when you move and will become stronger.
4) Move more in everyday life. I’m going to repeat that: Your abdominal muscles can work reflexively (automatically) now that you’ve eliminated habits that were interfering with this process. They can now respond appropriately when you move and will become stronger. The real gains in strength come when you take your new found alignment and start moving more. Sitting with your ribs aligned and belly relaxed has its benefits, but your abdominals won’t be very active in this position because there is no need for it when you are sitting still. They are responding appropriately to your position. When you stand up, they should contract more. When you start walking, even more. If you walk carrying a baby or a grocery bag, even more.
After my daughter was born, I had a two finger gap both at my belly button and above it . In those first 3 month postpartum, I walked, stretched and paid attention to my alignment during everyday life; I didn’t do any “core exercises.” The gap above my belly button closed completely, and at my belly button it’s down to 1 finger. (Most experts consider a gap 1 finger width or less to be normal.) I did this intentionally, as a sort of experiment, to see what would happen. Going up and down stairs, getting up and down off the floor, and doing everyday life while holding a 10lb baby is a lot of work. I wasn’t “working out”, but my muscles did a lot of work because I was moving. Honestly, I did a lot of laying around and resting too, especially in the first 6 weeks. I don’t have a flat stomach, and I still look 3 months pregnant. My core definitely isn’t as strong as I’d like it to be, but moving well and moving more was enough to close the gap and restore function in a relatively short period of time.
5) Take a class. I know I just got done saying that you don’t need to exercise, but practicing exercises that encourage reflexive core activity are helpful for regaining healthy core function. If you’ve had years of rib thrusting and sucking in the stomach, chances are you have some tension in the trunk and some muscles that aren’t “online”. Specific exercises to release tension and reconnect with those muscles can be necessary. Here are two options starting May 16th (next week)!
This is the one and only post written during my pregnancy. (I’m full term now, just waiting on baby to arrive.) Writing a blog or engaging in social media just hasn’t been a priority the last nine months. I’ve been spending less time online. I wanted to experience this pregnancy with less technology, fewer distractions and time wasters. For a variety of reasons, we made a conscious decision to keep our news off social media. Now I’m heading into my maternity leave, and I wanted to write a quick post. Short and sweet, just a few things I’ve learned about alignment and natural movement during the last nine months. These are all things that I knew on an intellectual level, but being pregnant has caused me to understand and appreciate them in a new way.
1) Keep moving, so that you can keep moving. This is probably the most important thing I did during this pregnancy. JUST KEEP MOVING. I’ve made this recommendation to my clients, but now I really understand how important it is. You are gaining weight gradually and your body is going through major changes over the course of almost a year. If you keep walking, squatting, going up and down the stairs, getting up and down off the floor, you will gradually gain the strength as your weight gradually increases, and you will be able to continue doing those things. Two of my goals for this pregnancy were to reach the end and still be able to get up and down off the floor and be able to hike at least 2 miles. I’m nearing the end, and let me tell you, I feel truly enormous, but it’s manageable. I can’t imagine how difficult it would be to get around if I hadn’t been moving all along. Last week we went for a hike– uphill, downhill, up and over boulders, through a partially dried up creek. At this stage of the game, I’m tired, I’m slowing down, and I stop for lots of pee breaks (good thing I’ve been practicing my squatting!). We went slow, about 3 miles in 2 hours, BUT I did it. Not only did I do it, I enjoyed it. I share this not to brag (my endurance certainly isn’t what I had hoped it would be!), but to encourage you that it’s possible to never reach the point where you are too big to move. Just keep moving.
2) Do what you can, then rest. There were days that I could walk about 10 minutes before I needed to have a snack and take a nap. You’re tired. I hear you, mamas. Sometimes it is a victory just to get out of bed and walk to the mailbox. When you can only muster the energy for a little movement, DO IT, then rest. Other days I felt up for a long walk, going to prenatal yoga class, and teaching a class. When you feel good, and you can challenge yourself, DO IT, then rest. Give yourself grace. Growing a baby is hard work. Release yourself from expectations. Your body is doing an amazing thing.
3) Don’t underestimate the importance of pelvis back, ribs down & feet straight. Seriously, this one small thing saved me from so much potential pain. I didn’t have any back pain during this pregnancy, and this is part of the reason why. I knew this was important before, but experiencing it while pregnant took it to a whole new level. In my classes, I demonstrate leaning your pelvis forward and thrusting your ribs (what NOT to do). It’s really common to assume this position in pregnancy because the extra weight in front tends to pull you forward, unless you know to stand differently. As I got bigger, demonstrating this became more and more uncomfortable. Even just being in this position for a few seconds feels awful. I actually had a hard time demonstrating for the pictures below because it feels that bad. You can learn more about this (and see better pictures of these various positions) in these posts about pelvis position, rib position, and how to stand when you are pregnant.
(Left to right: Ribs lifted, pelvis forward & feet turned out, pelvis back & ribs down.)
4) This stuff really works, AND ALSO sometimes you need additional support. By “this stuff” I mean practicing good alignment, moving more (and moving better), sitting less, the corrective exercises, and moving towards more natural movement. Don’t get me wrong– I’m tired, I wake up stiff and achey, and my fingers and toes are starting to get a little sausage-y. This pregnancy hasn’t been without it’s discomforts, but I’m nine months pregnant and I’m not totally miserable. For starters, I haven’t peed myself once. Yes, the baby head pressing on my bladder is causing unspeakable pressure. Yes, I pee more frequently than I did before. But I’ve never felt like I couldn’t control my bladder. I haven’t had any back pain, sciatica, pubic symphysis pain or hemorrhoids. One thing I did experience early on was SI joint instability and a tweaky feeling in my hip. Before I got pregnant, I knew that my right side was weaker and less stable, so it was no surprise when it started giving me trouble after gaining my first 10 lbs. I knew the exercises I needed to do to improve my pelvic stability, but it wasn’t getting better. Getting additional support from a PT was really helpful. She could manipulate the bones of my pelvis to help correct a rotation and tape my sacrum to give a little extra support until my muscles were strong enough to keep my pelvis stable and aligned on their own. Here’s the thing with the common pregnancy aches and pains: most of them come from issues that were there before you were pregnant (like mine did). Add the extra weight, the shift in hormones, and all the other changes that occur, and the “weakest link” presents itself. These issues aren’t “just part of pregnancy” that you have to live with; often there is something you can do to make it better. Seek out help! Try the things in this blog or find a Restorative Exercise Specialist near you. If you need additional support, see a chiropractor, PT, massage therapist, or another professional who can help.
“My husband/boyfriend/dad needs this stuff!”, I hear it all the time! So, in response, I’m teaching an Alignment for Guys workshop February 28th (details below). I work primarily with woman, but corrective exercises, alignment principles, and natural movement apply to men too. Other than our reproductive organs, men and women have the same basic anatomy & physiology. It’s nothing new, just worded differently, because it’s hard for a man to read something about pregnancy and vaginas and think “yes, I can see how this applies to me.”
My classes are full of women, and we talk a lot about pelvic floor issues–things like incontinence, painful periods, sciatica, etc. Today, let me be clear that men have alignment related pelvic floor issues too! Several sources estimate 95% of prostatitis (prostate inflammation) isn’t bacterial. Meaning there is inflammation that isn’t caused by an infection and can’t be treated with an antibiotic. In many cases, there is a mechanical/muscle tension component. In the year 2007, John Hopkins estimated over 18 million men in the US over the age of 20 suffer from ED. (I’d be willing to bet it’s higher now.)
Another thing I’d like to be clear on is this: the alignment principles aren’t just for pelvic floor issues. Problems with pelvic health and function are common, so I tend to talk about them a lot, but they are just one small piece. The tension and misalignment created by our modern life creates issues for every part of our body. Improving alignment can help rotator cuff problems, arthritis, plantarfasciitis, headaches, back pain, hernias, prostate issues, and high blood pressure, just to name a few. We like to blame these things on “getting old”, but all of these aliments can have mechanical causes. How you move (or don’t) can cause or exacerbate these common male issues.
Bear with me as I make an over generalization. Men are less likely than women to do activities like yoga, walking and stretching. I know this is a stereotype, but look around the yoga studio or the stretch class at your gym, and TELL ME this isn’t true. (Funny story about guys trying yoga here.) What I teach is different than than yoga, but the trend applies here too. When I used to teach “co-ed” classes, they were usually 80-90% women. When I teach at a certification week, it’s at least 95% women every time. Men are more likely to do activities that are about speed, strength, endurance…..things like weight lifting, running, sports, cycling…. None of these activities are bad, but when you combine short bouts of very intense workouts with longer periods of sedentary time, pain and injury are bound to follow, despite your best intentions. In order to continue doing the acitivites you enjoy, you need something to help fill in the gap between your sedentary time and your workout time. Exercise and sports have a lot of benefits, but we know now that they can’t undo hours of sitting each day. Our bodies have adapted to a lifetime of chairs, couches, cars and computers creating tension and misalignment. When we take these bodies to the gym and ask them to do challenging things, it’s like taking out a rusty, misaligned, uncalibrated machine that has been sitting in your garage for the last 20 years and expecting peak performance. Not going to happen. This is why even the most fit, athletic guy you know has pain and injuries.
I think there is a widespread belief that when it comes to exercise, the harder it is the better it is. The “easy” things like stretching and walking aren’t worth doing because they don’t make you sweat and don’t make you want to puke. If you want to remain active, pain free and have all your parts function well, you need to start doing some of the “easy” things. As you learn to move differently and move better while doing the “easy” things, you can start doing the more challenging things without injury and pain. If you come to one of my classes, you’ll find very quickly that the things that appear “easy” can be quite challenging.
If you (or the men in your life) are experiencing any of the above mentioned issues, feeling a bit achy or older than you should, here are some suggestions:
- If you are local: Join us for the Alignment for Guys Workshop on February 28th! This class will be an introduction to alignment for better health, mobility, and strength. We’ll identify and review exercises that address common aches and pain brought on by hours sitting in front of a computer or behind a steering wheel, overcorrecting a slouch with “military posture”, and “getting old.” Register and see details here.
- Try these movement breaks for the office.
- Read “Don’t Just Sit There” by Katy Bowman to figure out how to move more and still be productive at work. Another good resource is this list of ways to create a more active workstation.
- For male pelvic floor issues: David is a Restorative Exercise Specialist who works with men experiencing pelvic pain and dysfunction. This article has lots of resources too.
We recently moved to Nashville, and although this move was considerably easier than our last one, it still takes a toll. For most people moving and back pain go together. We’ve all been there: I think I can move that couch by myself….this box isn’t THAT heavy….I don’t need help…. Usually what follows next is a back spasm (and maybe some cursing) followed by days/weeks of pain. Even if you get off lucky and only have some mild soreness, it’s both uncomfortable and avoidable. Here’s how I got through the move without the typical back pain:
1) I used my HIPS. You’ve heard “lift with your legs, not with your back”, right? I’d like to revise that saying to “lift with your hips, not with your back”. I think a lot of people get into trouble when they THINK they are using their legs because their knees are bent. It’s true, some of the leg muscles are working when the knees are bent, but the position of the pelvis determines whether the big muscles on the back of the leg (gluts & hamstrings) can work here. The position of the pelvis also effects what is happening in our back (because they are attached). When our hips are tight, we tend to over use and abuse our spine and/or knees when bending over to pick something up. The pelvis will tuck, the low back will go into flexion (round) and the knees will move forward. In addition to being a vulnerable position for the spine and hard on the knees, it prevents a person from being able to effectively use the gluts and hamstrings to do the heavy lifting. A person who lifts like this might use some leg muscle but will also use their back:
Try this instead: Bend down like you are going to pick somethings up. Now, do it again, and pretend like you are squatting. Untuck your pelvis and back your butt WAY up until shins are vertical. This allows you to use the gluts and hamstrings (hips!) as well as save your back when you lift:
Now, you might be thinking “I don’t think I can get into that position, much less lift a box in that position.” Can you see how my knees are coming forward in the picture on the left? I can’t quite make it all the way to the ground with vertical shins, so I allow them to come forward, then on the way up, back my pelvis up as soon as possible, so I can use my hips to do the work. You might also notice that my pelvis is a little bit tucked. It’s not perfect, but it’s still enough to keep me from the full on back spasms of my past. I’ve been working on building the strength and mobility to be able to do this for years, and I still have a ways to go. It takes time. You’ll find some hip opening and squatting homework at the bottom of the page to help you get there.
2) I paid attention to my body’s warning signs and asked for help. What are the warning signs? I’m so glad you asked. All of these are signals that you are not strong enough to do what you are attempting to do. Stop and ask for help if you:
- Have to hold your breath, bear down, valsalva
- Leak urine (Yes, it’s common. No, it’s not ok.)
- Feel any downward pressure, straining or bulging in your pelivc floor or abdomen
- Experience back or pelvic pain (during or after)
By the way, if you experience these signs during a workout, the same guidelines apply. It’s your body’s way of telling you that you are not ready to do that particular activity. Continuing to do an activity that causes theses things to happen can make back, pelvic floor and core issues worse. There are steps you can take to gradually build strength without compromising spinal health or core/pelvic floor function. (See the suggestions below.)
3) I relaxed & released my psoas. If you try your best, but still have some pain at the end of the day, try these psoas releases. The psoas is a muscle that attaches on the spine (T12 & all lumbar vertebrae), goes through the abdomen, and attaches on the femur (thigh bone). It is often a culprit in low back and pelvic pain. During this move, some days I had mild soreness/stiffness in my back, but when I did these two releases, it was gone the next day instead of lingering or becoming worse. Notice I’m calling them RELEASES not EXERCISES. This is because all you have to do here is relax and let the tension release. There is nothing to do or force. If you want more, my colleague Susan demonstrates more psoas exercises on her blog.
Here are some ways to start gaining the strength and mobility you need to prevent injury:
- Get started at home with this easy series.
- Try an Alignment Snack (20-30 min online class). I like “All Around the Thighs” and “Frankie Says, Relax the Posas” for stretching all the muscles around the hips and addressing the psoas.
- Join me for Aligned & Fit on Mondays at 8:30 (starting 9/14) at Blooma Nashville Yoga. This class focuses on building functional strength– the kind of strength you need to do daily life. Play with your kids, lift heavy boxes, climb stairs, chase your dog, carry babies…. without peeing your pants or ending up in pain!
PS- This isn’t just for moving! Apply these principles to any heavy lifting or repetitive bending down you might do– lifting your kids, cleaning the house, lifting weights, loading the dishwasher, etc. to use your hips and save your back.
By now you’ve heard about the benefits of sitting less a time or two. Maybe you’ve created a standing desk or experimented with sitting on the floor in a variety of positions. Changing you position throughout the day (rather than sitting in one position ALL day) has improved your health in countless ways. Well done!
Here is series to help relieve the lower body tension caused by excessive sitting. These exercises can easily be done at the work– no need to change clothes, get all sweaty, or buy special equipment! The tension in the legs and hips can cause back/hip/leg pain, incontinence, prostate inflammation, pelvic pain, sciatica, poor circulation, muscle weakness and countless other ailments. For best results, do these at least 2-3 times during the day. It is best to do these exercises barefoot or in socks, as wearing shoes will interfere and make the exercise less effective. You can also combine these exercises with short walks around your office (or even outside of your building) every time you need to make a phone call. Even if it’s just for 5-10 minutes, moving instead of being stationary improves circulation and glucose regulation. Some say that sitting for too long increases your risk for developing type 2 diabetes by 91% even if you exercise regularly!
1) Double Calf Stretch: This is a great way to work on untucking the pelvis and stretch the calves and hamstrings. Roll up a towel or yoga mat. Place the balls of both feet on the towel with the heels on the floor. Place your hands on a chair and bend forward from the hips. Your feet should be pointing straight ahead. Let your hips back up so that there is more weight in your heels. Lift the tailbone up towards the ceiling without bending your knees.
2) #4 Stretch: This stretches the piriformis and is great for those suffering from sciatica. It can be done any time you are sitting or standing.
Seated: Sit on your “sitz bones” the edge of your seat. Cross your left ankle over your right knee without letting your pelvis tuck. Relax the left knee towards the floor without letting your pelvis shift to the side
Standing: Stand on your right leg and cross the left ankle over the right knee. Bend the right knee like you are sitting in a chair (like a 1 leg squat). Lift the tailbone towards the ceiling as you back the hips up. Hold onto a chair or wall for balance.
3) Wide Leg Wall Glide: To stretch the inner thighs, stand with your legs wide and feet about 6 inches from a wall. Hinge forward from the hips, tailbone to the ceiling. Then glide the pelvis right to leg along the wall. Keep your gluts against the wall and the knees straight (relax the quads if you can). The hands can rest on a chair for support. This can be done without a wall as well.
4) Pelvic List: Stand with the right foot on a step, phone book or block. Line up the outside edge of your foot with the edge of the step to straighten the foot. Slowly lower the left foot towards the ground (without bending the knee) and bring it back up using the muscles of the standing leg (not the muscles of the low back or waist). This exercise strengthens the muscles on the outside of the hip.
5) Door Knob Squats: These are a great way to simultaneously stretch and strengthen the gluts and hamstrings. The strength and mobility required to squat is essential for pelvic floor, hip and low back health. As you bend your knees, back up your hips as far as you can, untuck the pelvis and lift the tailbone. Keep the knees over the ankles (vertical shins) to both protect the knees and help you use your gluts and hamstrings. Holding onto a door knob will help you back your pelvis up.
For more “at work” exercises to address computer claw hands and shoulder tension, see Part 2.
I recommend Katy Bowman’s book, Don’t Just Sit There. It’s a comprehensive guide to sitting less and moving more, without compromising your productivity. Another good resource is this list of ways to create a more active workstation.
You are going to love this! These are some of my favorite exercises for relieving shoulder and upper back tension that accumulates during the day. We do so many things with our arms: computer work, driving, studying, carrying babies, breastfeeding, yard work…. add misalignment, old injuries, weak muscles and stress to the mix and you have a recipe for serious discomfort. If you experience shoulder & upper back pain and/or tension, you will love this routine. It only takes 10 minutes and you’ll feel great! (See additional resources at the bottom of this post as well.)
Minute 1: Rhomboid Push Up
The rhomboids are muscles on your upper back that connect the spine and the scapula (shoulder blades). When you have the habit of retracting your scapula (retraction=pulling the shoulders back like you are squeezing something between the shoulder blades) these muscles get tight and weak. I know that this position is often taught as “good posture”, but it is not good alignment. (Read about posture vs. alignment.) When you retract your scapula it looks good, but holding this position habitually is sabotaging your shoulder girdle and spinal health. These muscles help hold the spine upright, and when they are tight and weak, they can’t do their job, resulting in hyperkyphosis.
To restore the length of these muscles, try this. Start on your hands and knees. Roll the elbows in towards eachother so that the elbow points back towards your thighs and the elbow “pit” faces the same direction as your middle finger (see picture). Keep a slight bend in the elbow to keep from hyper extending.
Let the chest drop towards the floor and feel the scapula come together (retraction) WITHOUT BENDING YOUR ELBOWS ANYMORE THAN THEY ALREADY ARE. Then press the hands into the floor and push the shoulders blades wide (protraction). Keep the pelvis untucked. This is a VERY difficult motion to learn, so it may take some time to master. WATCH THIS VIDEO of my friend Susan demonstrating the rhomboid push up.
Minute 2: Floor Angels
First bolster you head and shoulders with some pillows or folded blankets. To stretch the chest and shoulders, move the arms slowly overhead like you are making a snow angel. Rotate the arms so that your palms face up towards the ceiling and your thumbs are closer to the floor than the pinkies. The hand will start out touching the floor, but will lift away from the floor as you move the arm overhead.
Keep the ribs relaxed down. Try not to let them pop up towards the ceiling like this:
Minutes 3-5: Tennis Ball “Reverse” Rhomboid Push Up
I got this AWESOME move from Jill Miller of Yoga Tune Up. Take two tennis balls or balls of similar size & density (I’m using yoga tune up balls here) and put them in a sock. Tie a knot in the sock to keep the balls in place. Lay on your back with the balls underneath your upper back, one on either side of the spine. Start at the top of your scapula.
Reach your arms up to the ceiling feeling the scapula spread wide, them relax and let them fall towards the floor. It’s the same motion as the rhomboid push up, just upside down. Do this for 1 minute, moving slowly. Then roll the balls down an inch or two, and repeat this motion for 1 minute. Repeat this process one more time. (We are doing 3 different positions here, but you can always do more.)
If you want more pressure, you can experiment with pressing your feet into the floor to lift your pelvis up into a small bridge.
Minutes 6-8: Tennis Ball Floor Angels
Move the balls back up to the first spot they were in (on either side of the spine near the top of the scapula). Repeat the same “snow angel” motion with your arms that you did in the Floor Angels for 1 minute. Roll the balls down an inch or two and repeat 1 minute. Roll the balls down again and repeat.
If you love this stuff as much as I do, you will want to check out Jill Miller’s new book The Roll Model. My husband gave it to me for Christmas this year, and I’m slowly working my way through it. She shows you how to roll away tension from head to toe. SO GOOD!
Minute 9: Rhomboid Push Up
Repeat slowly for 1 minute.
Minute 10: Floor Angels
Repeat slowly for 1 minute.
Want more for your shoulders?
1.) Read 3 things you need to know about your shoulder tension.
2.) Drop in for Upper Body Stretch & Strengthen class at Blooma Nashville.
3.) Try an Alignment Snack (20 min online classes). For upper body I love these: Everybody Needs a Little Shoulder Bolster, Rhomboid Madness, Can’t Get Enough of Shoulders & A Real Pain in the Neck.
Pregnancy is another place we see the difference between posture and alignment. You all know the common pregnancy posture: pelvis and belly pushed forward with hands resting on the low back. It’s normal to see this all around us, but it’s not good alignment. Ideally, you would stand the same whether you are pregnant or not. If you haven’t read the last few posts, start by reading “Alignment, is that like posture?” and “Stand up Straight!” to bring you up to speed.
When you are pregnant, you still want all your pieces stacked perpendicular to the ground. In fact, this may be even more important when you are pregnant. If you add 30 extra pounds to a frame that is unstable, you are going to notice pain or dysfunction at the “weakest link”. For example, maybe you stand with your pelvis thrusting forward and have occasional back pain. Then you get pregnant and have excruciating back pain. Is the pain cause by the pregnancy? No, it’s the result of putting extra weight on a skeleton that was already misaligned. Pregnancy magnifies whatever misalignment you had going into the pregnancy.
This is my dear friend Leanne about 38 weeks pregnant. She is such a good sport. (Fun fact- she actually went into labor an hour after I took these photos. On the left we have the typical pregnant posture. Imagine her hands on her lower back, belly pushing forward as she waddles along. (I say “imagine”, because Leanne worked so hard on her alignment during pregnancy that she never actually waddled.) Her pelvis is leaning forward and her torso is leaning back. Her pelvis is posteriorly tilted (aka, tailbone tucked under), and her feet turned out. On the right we have a beautifully stacked skeleton. Her ear, shoulder, hip, knee, ankle are all in a vertical line. She has a neutral pelvis with her rib cage stacked right on top and her feet straight.
Picture A: Typical Pregnancy Posture (Just say no.)
Picture B: Aligned and Pregnant (Gold star!)
A pregnant woman who stands like Picture A will likely have more back pain, but alignment affects more than whether or not she is in pain. I’d like you to notice two very important things: the shape of her belly and the shape of her rear end. It’s ok, I asked her permission to have a bunch of strangers (although, let’s be honest, not that many) analyzing her very pregnant figure. Can you see that both her belly and her backside are completely different shapes in the two different pictures? In the typical pregnancy posture (Picture A) her rear end is flattened out and looks smaller. Her belly is sort of pointing upwards. In the aligned picture, you can see her gluts look bigger (in a good way) and her belly is pointing straight ahead.
Looking at the shape of Leanne’s body is a subjective assessment, but it illustrates an important underlying concept: How you stand affects your pregnancy, labor and delivery in very real ways.
1) Better baby positioning in utero. You are the container in which your baby lives. When you change your shape, you change the shape of your baby’s container, and the baby will adjust accordingly. How you stand during pregnancy can help (Picture B!) the baby to be in an optimal position for delivery. More on this here.
2) Appropriate pelvic floor tension. Standing with the pelvis in a post tilt (tucked under, like Picture A) causes excessive tension in the pelvic floor and inactive gluts. You want your pelvic floor to be relaxed enough to let a baby pass through more easily. You also want your pelvic floor to be strong enough to hold up your organs and hold in your pee. You need strong gluteal muscles to achieve this not too tight/not too loose pelvic floor muscle length. When you stand like Picture B, your gluts are being used all day long to hold you up and move you around. They will become as strong as they need to be to support your pregnant body and balance out the pelvic floor.
3) Increased birth space. The strong gluts mentioned above will pull the sacrum posterior (back), increasing the birth space (who doesn’t want that?). In addition to changing how you stand, you can also START squatting and STOP doing kegels. For more on squatting and pelvic floor health, read what the Alignment Monkey has to say.
For an extra challenge, try this online class that has a lot of one leg squatting: A Balanced Approach to Hip Strength.
If you are pregnant, and live in Middle Tennessee, contact me to start your complete prenatal alignment program!
Have you ever been told to “stand up straight!”? This phrase has children everywhere grumbling as a well meaning adult lectures on the importance of good posture. In my opinion, it’s one of the most relevant examples of the difference between posture and alignment. The phrase has permeated the culture with its vague (subjective) recommendation for our spinal health and caused a lot of confusion. I have many clients who have spent years trying to get their back “straight” because of this misunderstanding and suffered greatly because of it. For all of you out there in the same boat, I hope this post helps you find some relief.
First of all, the spine isn’t supposed to be straight. It has curves like an “S”. I’m going to say it again: a healthy spine has curves. Specifically, notice the thoracic (mid back) curve. This is called kyphosis. The word kyphosis is often misused to mean “too much curve.” (Too much curve is called hyperkyphosis.) You want that kyphotic curve. It’s supposed to be there.
Most people translate “stand up straight” to equal “chest up, shoulders back.” This lifting of the chest/rib cage creates forces that distort the curve of the thoracic spine. If I asked you to stand up straight or show me your best posture, chances are it would look something like this:
(Again, ignore the “I Dream of Jeannie” arms. I’m just doing that so you can see the line that is coming up.)
Looks pretty good, right? In my last post, you learned how to align your pelvis. When you did this, you may have felt like you were going to fall over backwards or felt some discomfort in your back. If so, learning where your ribs belong will help. Let’s revisit the super awesome grid app.
The vertical line is lined up with the bottom of my rib cage. See how that line falls out in front of my pelvis? My “good posture” is lifting my rib cage and pushing it forward. Look at any skeleton in an anatomy text book, and you will see that the rib cage is supposed to be right over the pelvis. Put your finger tips on the most inferior, anterior part (the part that is lowest and towards the front) of your rib cage. Can you feel the pointy edges of your ribs sticking out? Now exaggerate your best posture. Are your ribs sticking out even more? Now relax and let the ribs drop down ALL THE WAY. (If you feel like you are slouching, you’re on the right track.) At this point you shouldn’t be able to feel any boney edges sticking out. They will be directly over your Anterior Superior Illiac Spine (ASIS: boney protrusions on the front of each side of your pelvis). If this description is confusing, or you have a hard time finding these boney markers, see how to test for rib thrusting against a wall.
I have one finger on my ASIS and one on my bottom rib, so you can see where they are. Now the rib cage is right over the pelvis, where it belongs.
Take a look at these side by side. On the left: Ribs are aligned, restoring thoracic kyphosis. (What you want.) On the right: Ribs are lifted and thrusted forward, distorting the thoracic curve. (A recipe for pain and degeneration.) Can you see the difference?
I know these two positions look similar, but the physiological effects of these two positions are very different. Remember, “good posture” looks good but is not necessarily healthy. The rib thrusting/chest lifted position distorts your spinal curves and puts excessive compression on the one or two vertebra that you are displacing. The vertebra that make up the spine stack on top of one another forming a protective housing for the spinal cord. When we lose or distort our spinal curves, the integrity of this protective structure is compromised, and the spinal cord and nerves that branch off are at risk for damage. Displacing the ribs also compromises the abdominals’ ability to do their jobs. One of these jobs is to properly support the spine and decompress the discs. Many people find huge relief from back pain when they stop thrusting their ribs. Another job of the abdominal muscles is to support the weight of a growing baby when you are pregnant. When these muscles are compromised, it can lead to diastasis recti (excessive spreading/separating of the abdominal wall).
When you get your ribs down (ALL THE WAY DOWN) you might (read: almost certainly will) find that you have hyperkyphosis and your head and shoulders are too far forward. Like this:
Don’t panic! I know, it’s alarming when you see how far forward your head is. The good news is you can make changes with some hard work. Resist the urge to lift your chest/ribs to “fix” this problem! It will look better in the short term but will not solve the problem. When the ribs are down in their aligned position, it reveals all the tension in the upper body that we typically hide by lifting the chest/ribs. Instead of hiding the problem, use the two exercises below to start correcting it.
First, elevate your head and shoulders and relax here until your ribs start to relax down towards the floor. You can let your arms rest on the ground by your sides. This helps relax a muscle called the psoas.
Next: After several minutes, add SLOW arm motions like you are making a snow angel without letting the ribs pop back up towards the ceiling. Rotate the arms so that your thumbs are closer to the floor than the pinkies. This will stretch the chest and shoulders.
Happy New Year!
I thought I’d start off 2014 by addressing one of the questions I was most commonly asked last year: “Alignment, is that like posture?”.
When I tell people that I teach alignment, what usually comes next is something like “Alignment, is that like posture?” or “Oh, I need that, I have terrible posture.” While they may sound like the same thing, alignment and posture are actually two different things. Posture is how something looks. Alignment is how something works. Posture is subjective and cultural. Alignment is objective and scientific.
“Good posture” means different things to different people. We decide that a particular posture is good if it creates a look that is seen as desirable. Certain postures might look good, but that doesn’t mean they are healthy. Different sports or activities require a particular posture to maximize performance or to create a certain aesthetic. (This usually occurs at the expense of tissue longevity. Look at all the best athletes and dancers. They are REALLY good at their sport, but their career is usually over by age 40.)
Whether it’s intentional or not, we often use our body position to say something about ourselves— a macho guy who puffs up chest to look tough, a tall kid who stands slouched over to appear shorter, a woman who sucks her stomach in to look thinner—you get the idea. Sometimes we adopt a particular posture for a good reason, such as coping with an injury or surgery, but continue the habit once the need is no longer there without even realizing it.
I’m writing this on an airplane, and one of my seatmates asked me what I’m writing about. We got to talking about posture and where the notion of good posture comes from. Seatmate #1 said her parents told her good posture meant standing up straight and holding your stomach in. Seatmate #2 said she spent time living in another country (I wish I could remember which one…. somewhere in Asia) and that the desired posture for women in that culture was a stooped over position because it showed humility. A woman who walked around with her head held high and “stood up straight” would not be respected. Subjective & cultural.
Optimal skeletal alignment is objective. It’s based on science—anatomy, physiology, biology and physics—rather than culture. It’s the orientation of all the parts that allows everything to work the way it is supposed to work with the least amount of damage. Think about the alignment of your car. You go to the mechanic, and they adjust the alignment. (No one ever took their car in to get the posture checked.) They make sure all the parts are in the proper position—not just to allow your car to run, but to help all the parts wear evenly, and ensure that the vehicle doesn’t sustain unnecessary wear and tear. The same is true for your body. When your musculoskeletal system is aligned, all your body systems can function properly, for as long as possible, with the least amount of unnecessary wear and tear.
This image is taken from the Restorative Exercise™ Specialist training manual. It shows the 25 points to consider when assessing skeletal alignment.
Here’s your first step to good alignment: Back up your pelvis.
First, let your pelvis shift forward. (Notice the picture on the left.) You will feel more pressure in the front of your feet than the heels. Now back your pelvis up until you feel more pressure in your heels. (Notice the picture on the right.) That’s where you want it. Your legs should be straight (no bent or locked knees) when you do this. Can you feel the difference?
Left: My pelvis is out over the front of my feet, and my upper body is actually behind my pelvis.
Right: My pelvis is stacked right over my ankles. There is a vertical line from ear, shoulder, hip, knee, ankle.
(Don’t let the “I Dream of Jeannie” arms confuse you…they aren’t part of it. I’m holding them up so they don’t block the view of my pelvis.)
NOW, check out the lines I can make with my super awesome (not at all nerdy) grid app. It’s much easier to see the differences when there are actual lines.
SO COOL, right? I’m not a very “techy” person, but I LOVE this app. Go by the objective alignment marker (a vertical line) rather than how it feels. If you go by what feels right (subjective), you will always go back to your old postural habits. To see the lines on yourself, you can hold a belt or strap at the center of your hip joint and watch where it falls. It’s helpful to do this in front of a mirror. You would want the weight bearing, structural beams of your house to be completely vertical (perpendicular to gravity), and it’s the same for your legs.
Just backing your pelvis up will reduce unnecessary damage to your feet, knees, hips, and spine. This position gives you stronger bones and better pelvic floor function. You will use more leg muscle which means a higher metabolism and better circulation– all this just by shifting your pelvis.
Whatever your health goals are for 2014– less pain, stronger muscles, better balance, fewer headaches– working on your alignment is the first step! In the next few weeks, I’ll be sharing more about the differences between posture and alignment and giving you simple, practical steps to make big improvements.
I know, I know. Hear me out.
You may have seen this article in Buinessweek that came out a few years ago titled Your Office Chair is Killing You. It focuses mainly on the way that sitting negatively affects the alignment of your spine, encouraging a “C” shape instead of the natural “S” curve, which leads to degenerative disks, neck/back pain, osteoporosis of the vertebra, bulging disks, high blood pressure and about a hundred other things. It also talks about the metabolic changes that occur after prolonged sitting, which increase our risks for obesity, diabetes, and heart disease.
Sitting in a chair all day make the muscles of the legs very tight, which causes hip/leg pain and significantly reduces the circulation to the lower body. Do your feet or legs get numb halfway through the work day? Now you know why! Tight muscles of the hips and leg are also a huge culprit in back pain because they can pull the spine out of alignment. When you are sitting, your muscles are pretty inactive, which significantly affects metabolic processes in your body.
We all know that it’s unhealthy to be sedentary, but here is the part that is often misunderstood.
“People need to understand that the qualitative mechanisms of sitting are completely different from walking or exercising,” says University of Missouri microbiologist Marc Hamilton. “Sitting too much is not the same as exercising too little. They do completely different things to the body.”
Did you catch that? Sitting too much is not the same as exercising too little. If you go to the gym everyday, you may consider yourself an active or fit person. What you need to understand is that an hour at the gym everyday is not enough to counteract the damage of sitting all day. That’s like eating a salad for dinner to make up for the fact that you smoked all day. It doesn’t work like that, right? No amount of kale is going to undo those cigarettes. The research shows we need to sit less, not just exercise more.
Take this quiz to find out how much you ACTUALLY sit each day. It’s very eye opening. The first time I did it, I was shocked!
If you are a student or have a desk job, sitting less requires some creativity. Read how to transition to a standing desk here.
This is my new desk that I made recently. It started out as a $19 baby changing table from the thrift store. Unfortunately, in my excitement, I forgot to take the “before” picture before I tore off the box part on top. (You know, those side pieces that keep the baby from rolling off.)
I attached a piece of plywood on top, painted it, and found some cute hardware in the clearance bin at Cost Plus World Market. A non traditional desk doesn’t have to be expensive or ugly!
I like to multi task by stretching my calves while I work. My dog likes to be RIGHT next to me all the time. Sometimes it ends up looking like this.
Just by standing up you will:
- Increase your metabolism & circulation
- Use more muscles during your day
- Reduce hip, leg & back pain
- Build bone density
- Decrease your risk for cardiovascular disease, obesity & diabetes
It’s not that standing is a magic pill, it’s just a simple way to start reducing the amount of time you are sitting in a chair. You can swap your chair sitting time for sitting on the floor in different positions and other types of movement. The goal is varied and regular movement throughout the day.
Here are a few ideas:
- Instead of meeting a friend for coffee, meet at a park and take a walk.
- Take the stairs instead of the elevator.
- Instead of sitting at a desk, try sitting on the floor while studying or working on the computer. Cycle through different sitting positions.
- Look for the furthest parking spot instead of the one closest to the store.
- Stretch while watching TV or reading rather than sitting on the couch.
- Read Don’t Just Sit There, by Katy Bowman for ways to get in more movement while you work.