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)!
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.
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.
Minimal or barefoot shoes have become increasingly popular in the last few years because of their health benefits. Vibram claims their shoes will strengthen muscles in the feet and lower legs, improve range of motion, stimulate neural function, eliminate heel lift to align the spine, and allow the body to move naturally. Under the right conditions, minimal shoes can absolutely facilitate these changes; however, most of us don’t have feet that are healthy enough for these shoes without some training.
Being barefoot is natural, but our feet don’t function naturally anymore. Two main factors in our modern environment have led to feet that are severely lacking in muscle strength, joint mobility and neurological connection:
- Shoes that have stiff, supportive soles and positive heels
- The lack of natural surfaces in our environment.
The lawsuit against Vibram Five Fingers has been all over the news and social media the last few days. I’m not going to get into it, but you can read the details and an analysis by Katy Bowman here if you are interested. The problem is not that Vibrams (or any minimal/barefoot shoe) are dangerous; the problem is that our feet are deconditioned, and we fail to properly train them before jumping into a minimal shoe. Wearing a “supportive” shoe your whole life and then one day putting on Vibrams to go for a hike is like wearing a full body cast your whole life and then trying to do a cross fit workout. You the lack strength, mobility and neurological connections necessary, and you are going to get hurt. A principle of any good exercise program is a gradual, appropriate increase in the demand you place on the tissues.
My friend and fellow Restorative Exercise™ Specialist, Jennifer Gleeson Blue, put it this way, “You know how you don’t take someone on the brink of death-by-hypothermia and submerge them in a hot bath? It’s the same with minimal shoes. Your feet are on the brink of death-by-stability-shoe. But step one isn’t a five finger shoe.”
5 Steps to Transition to a Minimal Shoe:
1) Stop wearing positive heeled shoes. Switch to flat shoes and make sure they are wide enough for your toes to wiggle and spread. If you can tolerate it, try a shoe that has a more flexible sole. Even some athletic shoes have a heel that is slightly higher than the toes, so look closely!
2) Stretch your calves. Wearing positive heeled shoes causes the calves to become short and tight. We need to restore length to the calves to allow us to safely transition to a flat or minimal shoe.
3) Work on toe and foot mobility. Do these stretches to release muscle tension, improve circulation and neurological connection, and decrease pain.
4) Spend time barefoot around the house and backyard. Try out a variety of surfaces. This allows your feet to start getting reacquainted with FEELING things when you walk around.
NOTE: This transition may take weeks, months, or even years depending on the current health of your feet. Steps 1-4 are important for EVERYONE regardless of whether you intend to wear minimal shoes or not. If your foot has undergone significant damage from a lifetime of ill-use, surgery, or injury, minimal shoes may not be appropriate for you. That’s ok. You can still receive huge benefits from the above steps.
5) Start with short distances and natural surfaces in your minimal/barefoot shoes. Once you are ready to start wearing your new shoes, start with small distances. Slowly increase your walking mileage before you even think about running. (Although I don’t really I recommend running in minimal shoes.) Start with natural surfaces such as grass, mulch, or dirt to start training your feet. Concrete and asphalt are unnaturally hard surfaces and may cause you pain and injury. (I can wear my vibrams all day on natural surfaces, but I can only last about a mile on concrete.) As you increase strength and mobility, you can increase your mileage and try a greater variety of surfaces.
We just got back from a week in the Great Smoky Mountains. It was BEAUTIFUL! I was inspired by “Screen Free Week” to take a tech break while we were there. I used my iPhone only as a phone, camera and map/GPS, and I stayed off Facebook, email, Instagram, etc. It was a great decision for the health of my body and mind. I highly recommend it!
These are pictures from a 5 mile hike up and over a ridge, down into a valley with a waterfall, and back. You can see (in the first picture) how rocky and uneven the ground was. The trail was covered in pebbles, rocks, tree roots, mud, moss…. and my feet, legs, and hips felt great (tired, but great) the whole way and even better the next day! Had I done this hike in Vibrams 2 years ago, I probably wouldn’t have made it all the way, and I definitely would have been in serious pain. I’ve been “training” my feet for 4 years now, so they could handle the workout. Wearing minimal shoes can be a very healthy and enjoyable experience, but you have to do the prep work!
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.
I’ve had many friends, family members and clients complain of sciatica lately, so I wanted to write a post for them. I wanted to start out by showing you the anatomy of the piriformis muscle and sciatic nerve. You can see how a tight piriformis would agrivate the sciatic nerve. It’s relatively rare, but in some people, the nerve actually goes RIGHT THROUGH THE MIDDLE of the muscle. You can see the variations in anatomy in the images below.