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, Habits, Pelvic Health, Pictures of Exercises

How I Made it Through a Move Without Back Pain

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:

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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:

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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.

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Bolster up the head and shoulders and let the ribs and spine relax towards the floor. Make sure the bolster isn’t under the ribs, pushing them up towards the ceiling. Breathe here for 5 min.
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Place a block under the pelvis (not the low back) and let the pelvis and spine relax towards the floor. Breathe here for 5 min.

 

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.

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.

Pelvic Health, Pregnancy

Sneeze Pee

Sneeze pee.  If we are honest, most of us will admit that this has happened once or twice….you laugh, sneeze, cough,  jump, or some other high pressure activity….and you pee yourself.  Just a little.  (Or a lot.) It’s VERY common, which has led many of us to believe that it’s NORMAL. We accept it as an inevitable part of aging or something that happens once we’ve had children.  Incontinence is prevalent among women who have never given birth and in men as well.   I experienced sneeze pee in my early twenties before I found Restorative Exercise™.  (I’m happy to report that it’s now resolved.)  I’ve been talking about urinary incontinence, but you can have fecal incontinence too.  I came across this ad in a magazine last week.

butteryfly

NOT OK!!

The message I have for you today is this: incontinence is not a natural part of human function, and you have the power to change it.

Here are 3 things you can do right now to start improving it:

1) Stop doing kegels.  A too tight pelvic floor is at the root of incontinence (and other pelvic floor disorders), and kegels will make this worse.  Kegels may help in a short term way, but they are a band aid and don’t address the root cause.  You can read why here.

2) Instead of kegels, start squatting.  Squatting uses the gluts.  Strong gluts pull posterior (back) on the sacrum, which in turn pulls on the pelvic floor, stretching it out to its proper length.   It’s good to note that we are often too tight and weak to squat without some preparation.  Try these prep exercises to start increasing mobility as you practice squatting.  You don’t have to go into a deep, full squat to reap the benefits.  Keep your shins vertical (see below) to help you use the gluts and hamstrings (on the back of the thigh) instead of the quads (on the front).  Hold onto a door knob or pole  if you feel like you are going to fall over backwards.

RTsquat

3) Exercises are great, but you will see changes MUCH faster if you change your habits too. Read Fast Fixes for Pelvic Floor Disorder to learn some simple  lifestyle changes you can make.

If you are dealing with incontinence or any other pelvic floor disorder (and live in Middle Tennessee), you may want to attend the Pelvic Floor Workshop at Blooma Nashville this Saturday, September 19.  This class will use a combination of lecture and exercise to help women understand the mechanical causes of pain and disease and give them practical tools for change.  Participants will learn corrective exercises and lifestyle modifications to heal and prevent common ailments.

This class is for any woman who has experienced (or would like to prevent):

Pelvic organ prolapse

Incontinence

Menstrual cramps

Sexual dysfunction

Hip, knee, back and pelvic pain

High blood pressure

SI joint pain

Edema, swelling

A cesarean section (a pelvis that was “too small” or a baby that was stuck/breach/posterior)

Pelvic floor trauma

 

If you can’t make the workshop, consider a private session. We can work together to get rid these painful and embarrassing issues!

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:

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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.

 

 

Culture, Habits, Health

Good Posture, Brought to you by McCall’s Magazine

When my husband was working on his undergraduate degree in history, he had an assignment to write about the 1940’s using the school’s archives of McCall’s magazine.  He wrote about how the ads exploited the emotions of war wives and the homecoming of soldiers in order to sell things like silverware and soap.

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This one’s my favorite. It reads: “Happy New Year – I’m Your Dad!”

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While he was sifting through the archives, he found this gem: the “Do’s” and “Don’ts” of good posture according to McCall’s Magazine. Knowing that it would make my day, he snapped a quick picture.

Here is what they say and my thoughts as I was reading them.IMG_0210

(Top. How to Stand.) Don’t: “Stand like this, you look ten years older! Your tummy is pushed out, back rounded, head and neck outthrust like a turtle’s”.  Could they have picked less flattering imagery? Do: “Stand tall, feet straight ahead, tummy pulled in, buttock muscles tucked under, shoulders erect, head and neck held high.” I will grant them, the picture on the left is really sad looking….and the one on the right looks much better.  Feet straight ahead-yay! Pulling your tummy in and tucking your butt under?  Not so much. It looks good, but she’s on the fast track to back pain and sneeze pee.

(Bottom. How to walk.) Don’t: “Lead from your chin in walking! Abdomen sags; body slumps for it is used in disjointed sections, big muscles out of balance.” …..I don’t even know what any of this means. Do: “Start walking from a good standing posture with a spring in your step. Weight of body should be even over both legs and feet.” Why do I need a spring in my step?

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(Top. How to climb stairs.) Don’t: “Carry your weight from lower back or cramp middle muscles in climbing stairs. You tire if you don’t use leg, thigh muscles.”  What? How do you climb stairs without using your legs?  Do: “Climb stairs correctly. Lift weight by strong leg, thigh muscles. Body slightly forward, erect, as in good standing posture.” (Sigh)

(Bottom. How to carry bundles.) Don’t: “Use your hips for a shelf to carry bundles, books; this causes curvatures. You look lopsided— ” Oh, I totally do that, carry the laundry basket on my hips… Wait! It got cut off?!  Lopsided…and what?  Man, I bet it was good. Do: “Carry bundles with shoulders and hips even. Spine straight, use muscles of back, abdomen, arms.” That’s actually not bad….but what came after “lopsided”?

Well done Husband, well done.

Besides the obvious entertainment factor, why am I sharing this? I think it has some good reminders for us.

1)    Beware of where you get your health information.  There is a whole generation of ladies with pelvic floor disorders because they read to tuck their pelvis and pull in their tummy in McCall’s magazine. Ok, that’s dramatic. It’s not all their fault; McCall’s was simply reflecting the popular belief of the culture. But you get my point?  The same thing happens today.  Just because SHAPE magazine or Oprah told you to do 3 sets of 50 kegels everyday, doesn’t mean it’s a good idea. (It’s not a good idea, by the way. Read why here.)  No one is trying to mislead you or sabotage your health, but sometimes information you read is based on popular culture instead of science.  (Or it starts out as science and then becomes misunderstood/misinterpreted and turns into something scary.) The point is, question what you read/hear. Always ask “WHY”, especially if you are going to make a decision about your health based on the info.

2)    “Good posture” is decided by the culture and has nothing to do with health.  Just because it looks good, doesn’t mean it’s good for you. Read more about the difference between posture and alignment here.

3)    Did you notice the vague and subjective language?  Shoulders erect, lead from your chin, good standing posture, big muscles out of balance, don’t cramp your middle muscles…. When you read these, did you think “What exactly does that MEAN!?”.  Recommendations for good posture are often subjective. There is a lot of room for interpretation and misunderstanding.  When it comes to your health, don’t be afraid to ask for clarification!