Back Pain, Culture, Habits, Pelvic Health, Sitting

This One’s for the Guys

“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.

man on ball

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.

man stretch

 

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:

  1. 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.
  2. Try these movement breaks for the office.
  3. 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.
  4.  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.
Back Pain, Pelvic Health, Pictures of Exercises, Sitting

Movement Breaks for the Office (part 1)


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.IMG_2484

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

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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.

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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.

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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.

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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.

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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.

Feet, Hip/Leg Pain, Lymph, Pictures of Exercises, Sitting

Make Fists With Your Toes

We are flying back to California for Christmas today. If your trip is like ours, you drive about an hour to the airport, sit on the plane for another couple hours (in our case about 4 ½), then ride in a car another hour or (or 3 depending on Los Angeles traffic) to your destination. If you’re like me, that last hour in the car feels like an eternity.

You don’t have much of a choice when it comes to sitting in the car or on the plane. The time you spend in the airport? You have a choice how you spend that time. When your plane is delayed, and you have 4 hours to kill at the airport, you have lots of time to move around before you are confined to your seat. I try to move around as much as possible (and sit as little as possible) while waiting for my flight. This is how we did it today:

1.   I like to check my bag, so that I have more freedom to walk around. (I love that you don’t have to pay to check bags on Southwest, so I try to fly them when possible.) When I’m not schlepping a bag around, I am more inclined to take the stairs instead of the escalator and move more in general while at the airport.

2.   I recommend a bag or backpack that stays on securely without needing to use your hands or scrunch your shoulder up to your ear to keep it on. This also allows you to swing your arms freely while walking and keep your upper body less tense. Letting the arms swing while walking is great for moving lymph (as is walking itself) which helps your immune system. (More on this here.) 

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3.   These are some stretches I like to do at the airport that don’t involve getting down on the floor. Your hips, legs, and spine will thank you!

Yes, the airport is strangely empty 2 days before Christmas.

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Standing Hamstring Stretch: Prop your foot up on something, flexing the toes towards the shin. Try to straighten the standing leg and back up your pelvis.
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Thoracic Stretch: Place your hands on a wall, roll the elbows in towards each other so the elbow “pits” point up towards the ceiling and elbows point towards the floor. Drop the chest towards the floor as you hinge forward from the hips.
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Lunge: Keep the front knee over the shin as you drop the hips towards the ground. Keep the torso over the hips. This stretches the hip flexors (front of the back leg) and is quiet a bit of work for the other leg muscles at the same time.
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Wide Leg Wall Glide: Stand with your legs wide and feet about 6 inches from a wall. Hinge forward from the hips, untucking the pelvis.
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Then glide the pelvis back and forth. You will feel your backside sliding along the wall. Keep the knees straight ( and quads relaxed if you can). This stretches lots of nooks and crannies in the hips.

 

4.   When you have A TON of time, you can sample local craft beers with Lucy, the bartender from Croatia, see pictures of her hometown, and dream about going there. One thing I love about bar counters (or bar height tables) is that you can stand while other people sit, and it’s not awkward at all. After learning about Croatia, you can take your beer to go, walk around the airport, and browse the bookstore. Apparently there are no “open container” rules at Nashville International Airport.

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5.   Once you are on the plane and captive to your seat, you can still get in a little movement. Debbie at Positively Aligned demonstrates some options here. And of course, there’s always John McClane’s seat mate’s advice, “make fists with your toes”. (A reference to Die Hard, one of my husband’s favorite Christmas movies; although, I would argue it has very little to do with Christmas. It doesn’t have the same “get in the Christmas spirit” affect as It’s a Wonderful Life or Christmas Vacation.) Nevertheless, try it, it really does feel amazing. Swelling of the feet and lower legs is a huge problem for a lot of people when they fly, and any movement helps the circulation to the area. Getting up mid flight to walk up and down the aisles is helpful as well. I try to get an aisle seat, so I can take as many “bathroom” (aka walking) breaks as I want.

Whether you are traveling or not, I wish you a very merry, healthy and movement filled Christmas!

(For My Husband: “Ho Ho Ho, now I have a machine gun!”)

Habits, Hip/Leg Pain, Pictures of Exercises, Sitting

. . .but what about when I DO sit?

I’m always telling my clients about the health benefits of sitting less, and the question that usually follows is something like this: “…but what about when I DO sit? What’s the best way?”  I know that you aren’t going to spend the ENTIRE day standing and walking (and I would not advise that you do so).  At some point, you will have a lunch date or drive in your car or sit down because you are tired. And that’s ok.  It’s not that sitting is inherently bad and standing is inherently good.  The problem comes when we remain in one position almost constantly (whether it’s sitting, standing, or anything else). Moving your body through many different positions throughout the day is the best way to keep all the tissues healthy.  

When you do sit, here are some things to think about.

  1. Sit for short periods of time, and don’t sit in the same position for hours on end.

    neutral pelvis
    When sitting with a neutral pelvis, the ASIS and Pubic Symphysis are stacked vertically. You will have your natural lumbar curve (called lordosis).
  2. Sit with a neutral pelvis. You know when a little kid sits on your lap and their “butt bones” dig into your thigh? Those are called the ischial tuberosities (or sitz bones), and you want to sit up on those rather than on your sacrum (tailbone). See picture on the right. (Thanks to Susanne at Kangaroo Fitness for the great photo.)
  3. Sit in a variety of positions.  I like to sit on the floor and put my food/computer/bills/etc on the coffee table.  If your hips are really tight (like mine), try sitting with your hips elevated to help get your pelvis neutral.  These are some of my favorites:

IMG_1533 IMG_1528 IMG_1525 IMG_1526 IMG_1527 IMG_1524

Turns out it’s really hard to take side view photos of yourself.  Not exactly high quality, but you get the idea.

When we sit, we tend to always sit with 90 degrees of hip and knee flexion (think sitting in a chair).  Note: Sitting on an exercise ball may add instability, but it’s still sitting with 90 degrees at the hip and knee.  Mixing up your positions will stretch the muscles of your legs and increase the mobility of your hip and knee joints.  This way you can work on your health while you do the other things you need to do. Increase circulation while you answer emails. Decrease hip pain while you eat lunch.  Improve your pelvic floor health while you play a game with your kids.  If you’re like me, you probably have tight hips, but you don’t have 5 extra hours everyday to stretch them.  This is a simple (but not easy) way merge your “I need to fix my hips” time with your “I have a million things to do” time.

For more ideas, you can see pictures of resting postures from around the world here.

 

 

Back Pain, Habits, Health, Hip/Leg Pain, Sitting, Standing

More Exercise Isn’t The Answer

WHAT?!

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.)

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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!

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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.

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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.
Hip/Leg Pain, Pictures of Exercises, Sitting

Road Trip Relief

So this is happening….

Screen shot 2013-08-03 at 8.32.53 PM

Which means I’m spending A LOT of time sitting in the car. You all know how I feel about sitting. You know when you’ve been in the car a long time and your butt or legs start to go numb? If you’ve never experienced this, trust me, it’s the worst. Pain, numbness, and tingling are all signs that something is awry. It’s your body’s way of getting your attention, “Hey, look over here, things are not right!”.  It’s like a fire alarm going off. When you are on a road trip or just spend a lot of time driving, you can do these 2 exercises to help lessen the negative effects of excessive sitting.

SQUATS: These are a great way to stretch AND strengthen the gluts and hamstrings. As muscles contract and relax, they draw blood into the area. This increase in circulation helps decrease swelling, numbness, and pain. To do a proper squat, 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 access your gluts and hamstrings. You can lower yourself as close to the ground as you can without letting the tailbone tuck under and the knees come forward.  Holding onto a pole, tree, or another person will help your get your hips all the way back. Gradually try to use less arms and more gluts/hamstrings to hold you up.

RTsquat
Keeping the tailbone up (see the lumbar curve?) allows you to use your gluts/hamstrings.
RTsquat2
Not like this! See how the tailbone has tucked under and the low back has lost its curve?

I’m just going to put this out there. I’ve never been more grateful for my ability to squat than in the last 2,000 miles. The better you become at squatting, the easier time you will have “hovering” at those rest stop bathrooms. Let’s be honest ladies, it’s a skill we all need.

“Number 4” Stretch: You can do it seated as well, but when you’ve been sitting for the last 2,000 miles, who wants to spend another minute seated?! This is my favorite road trip stretch because it stretches your tight gluts and piriformis (one of the deep muscles of the hip) and helps restore blood flow to the gluteal area.  This is also a great stretch for sciatic pain. There are a lot of great stretches for these muscles, but this one is awesome because you don’t have to sit or lay down on anything gross at the rest stop. Back your hips up like you are doing a one legged squat. Untuck the pelvis and lift the tailbone up. Cross one ankle over the opposite knee, KEEPING THE PELVIS UNTUCKED. When you get good at it, you can let go of your hands to test your balance and build strength.

RT#4-2
Pelvis untucked, standing knee is over the ankle.
RT#4
Not like this! Tailbone tucked under, standing knee is coming forward of the ankle.

 

Whether you are sitting all day in a car or in the office, take 5 minutes every hour to run through these 2 exercises.  Hold for a minute each, then repeat. You will feel so much better at the end of the day!

Back Pain, Sitting

Homemade Desks & Hedgehogs

If you read Sitting is the New Smoking, you know that sitting less is one of the best things you can do for your health. Transitioning to a standing work station at home or the office is a great way to start. It doesn’t have to be anything fancy. You can stack a plastic crate or box on your desk and put your computer on top. For a larger (and more sturdy) workspace, find a cheap coffee table or end table at a garage sale. Cut the legs if necessary to make it the appropriate height. My friend Josh recently made the switch to a standing desk. *

Here is his desk:

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And his hedgehog:

urchin

(Yes, this is his actual pet hedgehog, Urchin. Be honest, you love him, right?)

And his story :

“Going from a sitting desk to a standing desk was possibly the best workplace decision I’ve made–you know, apart from doing valuable work alongside awesome people. Before making the switch, I read claims that it was healthier, built better posture, burned calories, and increased focus. It sounded a little too good to be true, but I figured any one of those benefits alone was worth it. Right off the bat, there was a noticeable difference in my energy level and ability to focus. After a few days of soreness from standing for so long, I noticed the pain in my upper back (from hunching over the desk) had dissipated. Moreover, standing all the time seemed to reduce soreness in my lower back–I assume because it was being strengthened. Perhaps the best part of all, though, was the variety of new ways I could now fidget while working; balancing on one foot, putting my leg up on the desk, doing the frustration dance, and pacing like an absent-minded scientist were all so much easier when I was already standing! All in all, I think standing desks are a win.”

Sounds great, right?

At first, standing most of the day may be difficult because your muscles aren’t used to working all day; however, the benefits far out way the effort! 

Here are 5 tips for transitioning to a standing work station:

1) Know where your pelvis belongs. Try this: Let your pelvis shift forward, so you can feel more pressure in the front of your feet. Now BACK IT UP until you feel more pressure in your heels. That’s where you want it. Feel the difference? It gives you less foot & back pain, stronger bones, healthier pelvic floor, and longer, stronger posterior (ones on the back side) leg muscles.  More details on this and a good visual here.

2) Ditch the heels! I know they are pretty, and they make your legs look awesome; but when you wear them, you can’t get your pelvis where it belongs, and you don’t get any of the benefits of #1. In fact, you get the opposite (more pain, osteoporosis, weak pelvic floor, and tighter muscles). Even a small heel throws off your alignment. Stick to flats. Save the heels for special occasions.

3) You might feel like #1 is really hard. If you have been sitting your whole life, the hamstrings are tight, weak, and not used to holding you up for hours at a time. Do this stretch several times a day to stretch the hamstrings and calves.

Try to lift the tailbone, keeping that little curve in the low back.
Slightly elevate the ball of the foot. Hinge forward from the hips without bending the knees. Try to lift the tailbone, keeping that little curve in the low back.
The tension in the hamstrings and calves pulls the pelvis into a tucked position. You might look like this in the beginning.
The tension in the hamstrings and calves pulls the pelvis into a tucked position and causes the spine to round. You might look like this in the beginning.

Work up to holding the stretch for 1 minute.

4) Take breaks. You will probably get sore & tired in the beginning. You don’t have to stand the whole day. If you alternated between sitting and standing every 30 minutes, you would cut your sitting time by 50%. The point is to move your body through a variety of positions throughout the day. Take a stretch break. Walk a lap around the office. Go get a drink or a snack. I type at my kitchen bar counter, and when I get tired, I pull up a bar stool and sit for 5 minutes.

5) While doing #4, enjoy this clip from The Office.

*A special THANK YOU to Josh & Urchin for their contributions to this post!