Have you ever picked up your toddler and your baby at the same time and tweaked your back? Pulled yourself out of bed and hurt your shoulder? Ran down the stairs quickly and hurt your knees? Made yourself a sandwich and twisted your wrist? As crazy as it sounds, any number of trivial circumstances, like these, could cause you to injure yourself. Unfortunately, many of these injuries have underlying causes and in most cases, these events serve as the proverbial straw that broke the camel’s back.
In the case of problems with your neck, upper back, shoulders, and arms, the underlying causes are often your shoulder blades rounding up over your rib cage. This rounding, aka bad posture, causes your head to shift forward and the normal curve of your neck to straighten. (For every one inch that your head shifts forward the weight of the head increases by 10 lbs. This shift sets up the body for a deformity called a dowager’s hump later in life.) The purpose of the curve in your neck is to provide support to the head by creating a spring. The supportive spring keeps pressure off your muscles and more importantly the nerves that come out of your neck. These nerves, not only go to structures on the face, neck and vital organs but also go down your arms to the tips of your fingers. Thus, making you predisposed to an injury.
What are some reasons these injuries may occur?
The issue is the scapula is not stabilized. That may seem easy enough to fix, but how do we do this when everything in our lifestyles’ dictates the opposite? A 2018 survey of some 5,900 adults found that nearly 26 percent sit for more than eight hours a day, 45 percent don't get any moderate or vigorous exercise during the week, and about 11 percent sit more than eight hours a day and are physically inactive.
You may have heard that sitting is the new smoking. Posture while sitting is critical and it’s important that you use the back of your chair when you sit. Sitting forward in your seat causes your lower back and then your shoulders to round and the aforementioned circumstance to happen. Not only does poor posture put an excessive amount of force on the neck and upper back, but it also decreases the range of motion of your shoulder joint. This change in range of motion consequently causes the motion in the elbow and wrist to change like a series of dominoes. This compensation can set your body up for a situation where the proverbial straw can break the camel’s (meaning you) back.
As an example, tendonitis in the elbow may require adjusting, active release technique, cryotherapy, rest, splinting, stretching, ultrasound and any other number of modalities to reduce the pain, swelling and spasms, but if the normal motion of the joint isn’t restored by removing the compensatory movement, you’ll find the injury becomes a weak point: something that happens again and again and again. All the solutions are merely a patch fix. How does a black piece of tape over the check engine light, fix the engine? Additionally, although the joint or it’s related structures do suffer damage, if the underlying cause never gets addressed, the problem will be ongoing eventually leading to an injury that’s chronic in nature.
So, what’s the solution Dr. Eric? I thought you’d never ask!
Rehabilitative exercises are a very effective way to prevent injury when performed daily. You may have heard that practice makes perfect. The physiological term for that is called neuroplasticity. Your nervous system controls and coordinates every cell, tissue, and organ in your body. Your muscles are no exception. One nerve is connected to thousands of other nerves, which in turn is connected to thousands of other nerves. The more times a nerve fires to a nerve next to increases the likelihood of it firing to that nerve because it physically forms more connections to the nerves they most frequently fire to. This is how a habit forms. Brian Tracy once said, “good habits are tough to form, but they’re easy to live with.” It takes on average 90 days of repetition for a habit to form. Correcting what may be many years of dysfunctional programming.
In the case of your posture, the protocol is to stretch the muscles that typically round your shoulders forward and strengthen the ones that pull your shoulder blades together and down.
The two largest muscle groups that round your shoulders are both the pecs and the lats. When you stretch a muscle, the stretch should be uncomfortable but not painful. You want to hold the muscle in its contracted state for ten seconds. After ten seconds, the body will start to contract the muscle in order to prevent it from tearing. This is called the stretch reflex. You want to stretch the muscles for three sets of ten seconds twice daily.
The child’s pose stretch is great for stretching out the lats. The pecs require a modification to be the most productive. There are two contributions to the pectoralis muscle. One comes off the clavicle and one the sternum. The contribution that comes off the sternum is much more substantial and deserves the majority of your focus in a stretch. In order to isolate the sternal portion of your pec, raise your straightened arm to forty-five degrees so that your arms are in a “Y” configuration like in the song YMCA. Find a corner of a room, place your hands on each wall and leading with your chest with your arms straight, lean toward the corner of the room.
Next, you want to strengthen your scapular stabilizers. The rhythm of the movement should be one-one-two. That means one second on exertion, a one-second hold and a two-second return to the starting position. Upon return to the starting position, there should be no pause or rest to immediately start the motion of the next repetition. You want to complete ten to twenty repetitions per set, performing at least one set per day. You want to perform each set so that the last two to three repetitions are difficult for you: if there not, additional sets and increased difficulty of movement is necessary.
I have found the Foundation Training exercises by Dr. Eric Goodman to be extremely helpful for both core and scapular stabilization. I like performing the exercises as a warm-up to my regular routine. The exercises can be found on youtube individually or you can see me performing all 10 exercises on my website at the following address: https://www.spartachiro.com/exercise-videos/.
The key to avoiding injuries is the old boy scout motto of “be prepared.” An ounce of prevention is worth a pound of cure. Following the routines described above in combination with staying hydrated and avoid sitting as much as possible will keep you in top shape to stay healthy and pick up that toddler and baby at the same time without hurting your back. Also, don’t forget to come and see me for regular adjustments. They prevent more than just injury and keep the entire family happy and healthy!
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