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.
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!
So this is happening….
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.
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.
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!