The majority of Americans are afflicted with poor posture. The stagnant nature of desk jobs increases the forward head and rounded shoulders that are indicative of poor sitting posture, and this phenomenon has been exacerbated with the recent work-from-home push combined with the increase in technology use – “text neck” is a thing! Even children and teenagers are beginning to notice pain in their necks, backs, and joints related to sitting in an improper position for long periods of time doing virtual classes. And women tend to have this problem due to their anatomy, especially if they are large chested. Poor posture is not just a problem in sitting either! Poor standing posture can include slouching, weight shifting onto one side more, locking out the knees to utilize the leg muscles less, and arching or rounding the back instead of activating the glute muscles.
I gave a few presentations on this topic months ago, but then set it aside until my husband requested that I give him some exercise ideas to help with his posture related pain. I figured the exercises I gave him would be beneficial to others as well! I hope you enjoy the video despite the distractions, it was a family event and my son was very vocal throughout. I review each exercise in the YouTube video below:
The most common symptoms of poor posture are tightness in the upper cervical (neck) region and the pecs (chest), and weakness in the shoulders/upper thoracic (upper back) and cervical flexors (front of neck). I tell my patients this is a criss-cross pattern: diagonal muscles are weak, and the opposite diagonal muscles are tight. This may not help everyone to understand, but for visual learners think of a side view of the upper body with an X through it. So we want to elongate/stretch the tight muscles and strengthen the weak muscles.
1.) Thoracic extension over foam roller: There should be a certain amount of curve in the thoracic spine, but when people have poor posture they fold forward and increase that curve too much which causes pain. To reverse this, lay over a foam roller* horizontally with it just below your shoulder blades. Place your hands behind your head and bring your elbows close together. Slowly lower over the foam roller in a reverse crunch, until your back is extended. Repeat 20 times.
*you can get a foam roller at any sporting goods store, but the cheapest one I’ve found is at Five Below in their exercise section.
2.) Modified fish pose: This puts your thoracic spine in a similar position to the above exercise. Recline on your elbows, arch your low back, and lean your head back. Option to do this for 5 sec 20x or 10 sec 10x, try both and see what works best for you!
3.) Pec stretch on foam roller: This chest opener feels amazing! Lay with your spine vertical on the foam roller and open your arms wide. Try to find the place where you feel the most stretch in your pecs – move your arms up and down and bend or straighten your elbows until you find your sweet spot and stay there. Option to add weights in your hands to get a better stretch. You can either do this for 20 sec 5x, or just hold this position for 2-3 minutes.
4.) Rows: These are targeting your weak shoulder girdle. The video uses theraband but you can do these unweighted or even with light hand weights. Keeping elbows close to your body, pull your shoulders and elbows back like you’re trying to pinch a pencil between your shoulder blades. Repeat 20 times. The video demo shows rows at 3 different levels, which targets the 3 sections of the upper traps to strengthen.
5.) Upper cervical flexion: Laying on your back, bring your chin toward your chest while trying to only move the very top of your neck. Use your eyes to look down to activate those upper cervical muscles. This will be a good stretch on the muscles at the base of your skull, that are constantly being activated too much with a forward head position. Repeat 20x.
6.) Deep cervical flexor strengthening: These muscles on the front of your neck are almost never engaged and definitely weak. We use our superficial flexor muscles a lot to nod, but our deep flexor muscles get overlooked. To strengthen them, lay down and press the back of your head into the table. If you feel like you gave yourself a double chin, you’re doing it right! Hold for 10 seconds and then relax for 10 seconds, and repeat 10x.
As with all exercises, listen to your body. Don’t go past the point of pain, and if a prescribed amount of exercise feels like too much then do what you can and build up to it. Take breaks and let your muscles rest between sets and between exercises. Because your body isn’t used to these motions they will feel like a lot of work, even though you’re just using your body weight. You may be sore the next day or two!
I hope these exercises can help others who are struggling with pain related to poor posture, to start to help you return to a good alignment and to maintain that alignment while sitting and standing! As always, feel free to reach out with any questions about the above post or clarification on exercises.
Yes, you read that right – a towel. Not weights, not stretchy bands, not a treadmill or stationary bike, not the large exercise balls (while they all have their place). Much like Hitchhiker’s Guide to the Galaxy, I feel as a physical therapist that a towel is a versatile item that can be used in a variety of ways when performing exercises. Sometimes all the fancy bells and whistles in a gym can be confusing and overwhelming when exercising anyway, so let’s get back to basics. Here are some ways that I recommend a towel can be used while exercising.
These just skim the surface, the options are endless with a creative mind and the proper size of towel! A towel is one of the cornerstone items that I use with my patients. It’s something that everyone has in their house too, which makes carrying exercises over into a home exercise program easy. So next time you’re by the pool or getting out of the shower, think about the item you’re using as more than a drying tool – it can be used for exercise too!
First, a little explanation. Lateral epicondylitis, also known as tennis elbow, is inflammation at the lateral epicondyle of the elbow that causes pain in that distinct location as well as radiating into the forearm. Where is the lateral epicondyle, you may ask? Well turn your hand palm up, find your elbow, and look for the knobby spot on the outside of the arm. If you have sharp pain there, you may have lateral epicondylitis.
But why does tennis get all the credit for causing this pain? It’s true that tennis is a sport with repetitive movements that can cause this inflammation, but more often than not it’s other movement. Any kind of repetitive motion that can cause it! A lot of people with jobs that involve repetitive lifting (packaging, working on a line, etc) are succeptible to lateral epicondylitis. This is not only an athletic injury – thus my proposal of “activity elbow”. It’s more inclusive!
If you feel like you may have pain in the region that I described and are guilty of performing a lot of repetitive upper extremity movement, watch the above YouTube video to see demonstrations of some exercises that may help. Here are some more in-depth descriptions of the recommended exercises:
One thing that is super important with lateral epicondylitis is to rest it. The inflammation was caused in the first place because of overuse, so this is your body’s warning shot to take it easy. If possible, take a break from the activity that caused it to flare up in the first place. If this isn’t an option, think of ways or talk to your physical therapist or medical professional about ways you can modify your activity to decrease the stress on that elbow. It’s amazing how a small change in the way you move can yield big results. PTs are pretty obsessed with body mechanics for exactly this reason.
We do all these exercises and more at my clinic in Troy, Michigan! Feel free to reach out with any questions, future blog suggestions, or to schedule an appointment to reduce your pain!
I believe that the pelvis is the center of the body. This means that a slight alteration in the position of the pelvis can cause pain in the hips, knees, back, ankles, etc. So this is why I check the majority of my adult patients to see if their pelvis is even on both sides – ESPECIALLY my patients with low back and hip pain!
In my YouTube video, I walk through how to correct for a pelvic rotation. This means that one side is turned slightly either forward or backward. Muscle energy is using a patient’s own muscles to isometrically contract (i.e. contract without moving) and pull the bony structures back into their proper place.
I call this my PT magic trick. It’s a quick fix that can alleviate a lot of pain! I used to do it at parties and family gatherings frequently and people always leave with pleasant results.
I always recommend that a physical therapist or trained professional initially checks a patient’s pelvis and does the correction. This allows them to see if the pelvis is indeed rotated or if there is something else going on. A pelvic rotation presents with one leg being higher (“shorter”) than the other at both the medial malleolus of the ankle and the ASIS at the hip. Other reasons for one leg to appear shorter than the other could be:
However, if you have been to a PT and are consistently rotated on one side it’s nice to know the steps to perform a modified muscle energy at home. This is especially important in our current climate with more Telehealth therapy being prevalent, and some physical therapy clinics being closed altogether. This way people can perform the isometric contraction without the hand hold and get some relief.
The most important thing to do to maintain proper pelvic alignment after getting a muscle energy technique performed on you is to do exercises that stabilize your core and hip region without doing too much shifting onto one leg or the other. Your muscles are used to stabilizing your pelvis in a wrong position, and for 48-72 hours they are “tightening up in the correct position”. This is the most important time to maintain equal weightbearing on both legs. For this reason, avoid activities that involve standing on one leg for long periods of time. These include running, excessive stair climbing if you can help it, or jumping. Gravitate toward exercises such as bridges and planks where equal weight is being placed in both legs and the low core is being strengthened.
Above all else, listen to your body! I have a lot of patients that know when their pelvis is in proper alignment and when it isn’t.
This is the third part of my 3 part series about baby strengthening. I plan to also do a video and blog post in the future about strategies for starting to walk, but after I do a few adult related exercise videos. 🙂
The expected age range that babies start sitting is 4-6 months, although this window of time can vary. Babies start by sitting with their hands supporting them and their legs in a ring position, and then begin to sit with less and less support. I often see babies who are starting to develop their lumbar extensor muscles pushing back while sitting and falling over backwards, so keep an eye out for that! I like to keep my body or a soft pillow behind baby at all times, and counteract this extension by placing my thumbs and index fingers around baby’s pelvis. This allows me to counteract their extension by putting them in pelvic anterior rotation if necessary.
Sitting strengthening exercises are similar to core strengthening exercises, but more specific to this activity. Here are some of the activities I discuss in the above YouTube video:
For more great exercise ideas to help with sitting, check out my core strengthening YouTube video and blog post.
This is a good follow-up for my previous blog post about core strengthening activities for babies, as this is often the goal of working on core strength – mobility! We want our babies to be able to move in the most efficient way possible! I plan to make this a 3-part series on baby strengthening, with my next blog post being about sitting balance activities. A lot of the exercises overlap and can be used interchangeably.
In the YouTube video, I start by discussing the difference between creeping and crawling. We, as a society, use the word crawling to describe the hands and knees position that you may think of when you think of baby mobility. However, this is a misnomer. Crawling is actually used in the PT world to describe an army crawl (think your typical military movie with privates crawling through the mud under barbed wire). This means being low to the ground and doing a sliding shuffle, without lifting the belly from the ground. Creeping is actually what we want to see babies doing for the most efficient movement, and this is what you would think of as a classic hands and knees movement. Creeping is great for building core strength and coordination in preparation for walking. I often see proud parents who tell me their babies skipped the creeping stage and went straight to walking, and this makes me nervous. I want to see a baby creep because it develops the coordination and crossbody strategies that are used in the future, as well as building up appropriate abdominal strength. However I know it’s difficult to control a baby that is determined to move on to the next gross motor milestone. My only recommendation is to not encourage walking with your baby until creeping has been fully mastered.
With that being said, what are some good exercises to work on maintaining hands and knees position (or quadruped in the PT world) and facilitate creeping?
As I mentioned in the YouTube video, when I work with kids I like to give them positive reinforcement for their actions 70% of the time. When practicing creeping, this means that 7/10 times you practice with baby you allow them to reach their desired goal (be it a toy, or a parent, etc). This may mean helping them along if they’re struggling. Positive reinforcement allows baby to want to continue to try this movement.
Above all, have fun with it! It’s a learning experience for you as much as for baby. I hope this information helps, and look out for my next blog post about sitting balance activities.
I’ve had a few moms approach me about working on core strengthening with their babies recently, so I felt that it could be beneficial to many parents out there and warranted a blog post. Check out my YouTube video for specific exercises with a demo baby.
When babies are going through their gross motor milestones, core strength becomes more and more important. They begin to develop it early with tummy time, and then start to engage even more muscles when they move to prop sitting and ring sitting. The true test comes when they push into hands and knees and start incorporating the coordination involved with creeping (creeping the correct PT term for what parents call crawling, this may be featured in a future blog post).
But what if baby does not stay in tummy time? Lots of babies dislike tummy time, and you may often hear, “just push through it, it’s good for them!” However some babies learn quickly to roll from belly to back and it is difficult to maintain this position. Also, babies who have reflux or GERD can be severely uncomfortable in tummy time. So I’ve listed some activities in the YouTube video to make tummy time more comfortable, as well as activities to strengthen baby’s core in preparation for sitting that don’t require being on their stomach.
I hope these ideas can help parents to try some new strengthening ideas with their little ones! If you have questions or would like to make exercise modification suggestions, feel free to contact me. I expand and modify my exercises to fit each baby’s specific needs at my physical therapy clinic in Troy Michigan. And be on the lookout for more blog posts and YouTube demonstration videos in the near future!
Tara Schwark and I dive into the topic of constipation (in babies and adults), as well as some techniques and dietary changes to alleviate this common issue.
I never believed in the power of massage or stretching. What benefit do I feel if I do a 1 hour session of yoga? I might feel lose for a few minutes, but the next day, life goes on.
Real Physical Therapy is a different level.
While a yoga session stretches the entire body (poorly), my physical therapist sees what’s wrong with me, thinks about what stretches, exercises, and massages would make the problem go away.
Originally I thought stretches were holistic solutions, until my physical therapist stretched my pecs in a way I never would have dreamed up. The length of time and pressure were perfect. I melted and have increased flexibility and posture since. From that single session I learned a way to do this while I sit at a desk. Every trick my physical therapist teaches me makes me feel incredible. I never knew I could feel that good.
My relationship with my physical therapist has let me discover two life changing items:
This is a crowd pleaser,
You know those painful spots on your back? This is your tool to massage them until they are gone. Keep applying pressure until they are gone. Its perfect.
A massage has nothing on your bodyweight. For large sections of tight muscle, working on it with a foam roller will make it melt away. Using my bodyweight to apply pressures for 20-30 seconds on various parts of my upper and lower back has caused me to shake violently as my muscles melted. Incredible sensation.
Step 1 is to take it seriously and care. If you want to feel good, you need to put the resources into learning how to solve your problems. That means both learning the PT, investing in the time to get it completed, and doing the exercises at home.
It feels incredible. My posture has changed forever. And I love “Mandy’s Stick”.
Dr. Melissa Eiben of Pure Health Center in Troy MI partners with me in this video to explain some of the benefits and uses for kinesiotaping, and we do a few demonstrations!