Posture Part II: Strategies for Improvement

On a previous blog post titled Posture: Does it Matter?, we discussed some of the nuances of posture, breaking down “good” and “bad” posture related to both psychosocial and biomechanical/physiology principles, how the dynamic nature of posture might be more aptly named as acture, and what factors could potentially influence a downward spiral into inefficient postural tendencies.

With a more clear idea of what posture is and is not, we can now discuss some practical ways to improve our posture from the inside out as well as the outside in.

Many of us with postural issues require hands on, neuromuscular training facilitated by a professional to help to relearn efficient movement patterns from the ground up. However, there are also regular strategies that all of us can bring into our daily lives to help enhance our postural awareness, comfort, and prevent issues arising from our habitual posturing.

Change Positions, Move Often

We have the wonderful ability to choose what posture is best for us in any given situation. Sometimes being in more of a flexed position will be desirable, sometimes being more upright will be desirable. Consider cycling between three or four shapes throughout the day rather than always trying to find one “correct” position. What works for us in one moment will not be the best choice in another, and what works best for one person will not be the same as what is best for a different individual. When a specific posture is desired for a prolonged period of time, consider what will allow for the greatest sense of comfort, ease, and support. Notice what your ease of movement is when you are turning and reaching for things, trying to find a position where you can have more freedom of motion. Generally speaking, the most efficient posture will be an upright carriage in which the bones of our spine are stacked, so each bone is able to receive support from the bone that is beneath it.

Another strategy is to move more often throughout the day, establishing a system of movement breaks, stretches and short walks throughout the day. By dynamically changing the length, tension, and blood flow into a variety of tissues, it is less likely that any particular area will get sore, tired and overworked, and less likely that habitual postures will become an issue over time. See our Movement Snacks blog for some ideas on how to bring small movement breaks into the rhythm of your daily routine. A regular, well-rounded fitness routine will also help, which might include a blend of activities that promote cardiorespiratory and musculoskeletal health (e.g. aerobics, strength-training, yoga). Additionally, here are some gentle yoga stretches that you could do throughout the work day-

Consider putting up sticky note reminders to move, stretch, walk around, and change positions throughout the day.

Tips for Finding Effortless Sitting Posture

The following description includes some tips for sitting ergonomics to help support an upright carriage. While most people find these strategies to be helpful and comfortable, keep in mind that one size does not fit all.

• Feet flat on the ground

• A chair with some degree of firmness, with hips at least as high as knees.

• Back support behind low to mid back. A partially deflated children’s ball, folded towel or blanket, or any other object that is comfortable can provide this support

• Head on top of rib cage, rather than significantly protruding forward. Vision and size of text on the screen can play into a forward head tendency, so check that you can see the screen well without craning your head forward. 

• It may be helpful for your screen to be directly forward of eye level, rather than higher or lower.

Enhance body awareness

If we are not aware of our body position, we have much less ability to change it. To further enhance your ability to feel and sense your posture and choose efficient options, consider regularly practicing embodied practices such as yoga, qi-gong, tai chi, body scans, and Feldenkrais lessons, which will help improve postural awareness. Becoming familiar with some “landmarks” of our body can be helpful, such as awareness of where on our pelvic bones we are sitting, where on our feet we are standing, where our chest bone, nose, and eyes are oriented towards. Some lessons that may be helpful for posture that most Wellness Station clients will be familiar with are the pelvic clock, easy turning, and shoulder elevators. Here is an example of the pelvic clock lesson to help you bring a better sense of ease and awareness into your sitting posture. 

To become more aware of your standing posture and ability, use a protruding corner in your house or a door frame to feel the back of your body. Stand against the corner or the edge of a door frame with knees slightly bent, feet slightly in front. First, get a general sense of how much of you can make effortless contact with the edge from the back of your pelvis to the back of your head. Then, tuck your pelvis under so your low back makes contact with the edge. Keep your low back in contact with the edge, as you try to bring your mid and upper back in contact with the edge. Roll your upper back up and down the edge a few times, keeping your low back in firm contact. How much of your upper back can easily contact the edge? Bra strap level? Top of shoulder blades? Regularly checking this can give you a sense of your posture and any changes over time that might be occurring in your ease of effortless stacking.

Ask your Wellness Station practitioner to provide you with additional lessons to help enhance your senses with consideration of your individual needs, limitations, and goals.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. Image address:

https://centr.org/images/article/Back_exercises-2.jpg

Reversals: What and Why?

Reversibility is the ability to stop, start, and change the direction of a motion at any point in time.

According to Moshe Feldenkrais, the ability to perform reversals is a key indicator of well-organized, refined movement. When performing a movement, consider your ability to turn around and go the other direction, pause, or do something else. When our reversibility is impaired, it indicates a lack of freedom to change our minds or to respond to changing circumstances. This can be evident in certain functional movements: can we sit down in a chair or get on the floor slow and controlled, or is there a plop? When attempting to change the direction of a movement (e.g. pelvic clock circles), are we able to find a flow or is there jerkiness and incoordination? Can we walk backwards? 

Reversibility is not just a movement, but a state of existence.

Our ability to be spontaneous, go with the flow, adapt, maintain presence and freedom of choice. An ability to perform reversals indicates that we are not moving on autopilot, but have a keen sense of what and how we are doing something in the present moment. When we reverse, we are traveling the same territory but from a flipped perspective. In the muscular system, what primarily for a particular muscle or muscles has been a concentric action (muscle shortening under tension) will become an eccentric action (muscle lengthening under tension). As mentioned above, “sit to stand” is a concentric action, and “standing to sitting” is an eccentric action. When we purposefully choose to reverse, it provokes the cognitive process of attentiveness, comparing and contrasting. This is one of the key requirements for learning.

When we use movement to enhance our learning, the quality of our lives can expand.

As we go through life, there may be a gradual tendency towards settling into our habitual patterns, and an associated loss of spontaneity, functional mobility, and options for how we move and engage with ourselves and the world around us. We may not be able to respond as quickly to the demands of the situation, like needing to step back quickly to avoid an oncoming vehicle while crossing the street. Or we may lose the agility required to turn around when we forgot our keys, and instead of taking one step backwards, we may need to take several small steps to turn ourselves around. The person who has difficulty with these reversals is much more vulnerable to falling when they do have to turn around quickly. Practicing reversals helps us learn more about how we move, and can expand our movement repertoire so we have more options available to us. We certainly do not want our only option to be able to plop down into a chair each time, rather than gracefully descending in any way we choose. Reversals are a key requirement for developing and improving balance, agility, neuromuscular control, and eccentric strength. In fact, dynamic balancing is essentially reversals in action.

Practicing reversals

Walking backwards

Walking backwards is a task that may have originally been easy, but perhaps can become impaired over time. If unsteadiness is present, perform this practice next to the kitchen counter or back of the sofa to have something to hold on to as needed.

Simply start by walking forwards slowly, paying attention to how your body moves, how the feet make contact with the ground, etc. Then, reverse it. Walk backwards, comparing and contrasting this experience to walking forwards. 

Check out this article that dives into the health benefits of walking backwards.

Focus on the eccentric

Bring attention to the lowering component of a movement, whether this is in strength training or daily life.

A simple example is to practice standing up from a chair, paying attention to how you do this. Then, try to sit down the same way in reverse, challenging yourself to lower down slowly. Compare and contrast the process of standing and sitting in terms of the mechanics of the movement as well as the sensory experience.

If strength training is part of your routine, pay attention to the lowering movement such as the descent into a squat, the lower of the weight during a bicep curl, or the lowering of your chest towards the ground during a push up. Try to refine the control of the movement, with the ability to slow it down, pause it at any moment, or reverse the movement at any point in time. Also, in a safe manner, practice some reversals quickly, because sometimes that is what life demands!

Yoga Transitions

If yoga is part of your routine, tune in to the transition between two poses.

A simple example is cat and cow, which involves reversing between spinal flexion and extension. Tune in to the exact moment of transition, and explore reversing the movement at different speeds, and at different phases of the motion (e.g. can you do the cat cow in slow motion, and switch between cat and cow through variety of ranges, rather than going all the way into the full expression of cat pose before transitioning into cow?)

This can be applied to any transition in yoga (or life off the mat). Get creative with it- pick any two yoga poses, and explore a variety of transitions between the two shapes.

Explore Your Own

Enhance your sense of spontaneity and exploration by bringing reversals into your daily life.

Perhaps make up a dance move. Practice the move again and again. Then, try reversing the move, as if someone recorded you and played it in rewind. Or, take an everyday task. Reaching for a glass. Can you pause as you reach, and reverse it? Repeat this, reversing the movement at various stages of the reach.

Notice if this brings any greater sense of awareness of your movement and ability to choose different options for how to reach for something. And notice how much more confident you will be crossing a street when an unexpected vehicle requires you to take a very quick step backwards.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. http://kinesophics.ca/reversibility/ 

2. https://www.movementandcreativity.com/blog/podcast/2021/2/7/on-reversibility-the-ability-to-stop-start-or-change-direction-at-any-moment 

3. https://www.eatingwell.com/article/8013593/health-benefits-of-walking-backward/

Walking Your Way to Better Health

It’s no secret that walking is good for you.

A natural and low impact activity that helps us connect more deeply to ourselves, others, and the world around us. Walking has been shown time and time again to boast some magnificent health benefits. The benefits tend to rise and peak around 10,000 steps per day, but any amount of walking is infinitely better than none. Research studies have demonstrated that regular walking can reduce the risk of heart disease, cancer, dementia, hypertension, and much more. It can also boost mood and mental health, bone density, balance, and aerobic fitness. Walking is great for your brain! Especially when done in new places, walking can promote neuroplasticity, bringing about remodeling in the white matter of our brain. This remodeling can improve memory, spatial awareness, and other higher level cognitive functions. When you combine a regular walking practice with a healthful diet rich in plants, social engagement, high quality sleep, and living true to your ikigai, you have found the fountain of youth.

If walking is so great for us, why aren’t we doing more of it? Many people may face significant barriers when it comes to walking. Some barriers may be environmental. Perhaps not living close to any safe walking areas, but rather an inner city with spotty side walks and heavy traffic. Or, perhaps it’s the weather. Many of us become Goldilocks when it comes to the temperature. Maybe it’s simply a lack of motivation. “I don’t feel like it.” “I don’t have the time.” Most commonly in physical therapy, the barriers are pain, as well as balance or mobility issues. Regardless of the barriers, it is important to become aware of them and address them accordingly.

For many of the barriers, it can be helpful to shift away from an “all or nothing” mindset. Many people feel like if they are going to walk, it has to be a long walk, and it has to be every day. Otherwise, what’s the point? The barriers become too great and instead, we end up not walking at all. A better strategy would be to find the middle ground between the all or nothing. How can I walk today? Can I sneak in five minutes after eating lunch and before my next meeting? Can I park farther away and take the stairs? Can I walk while I talk on the phone or listen to my audiobook? Perhaps if a long daily walk is daunting, set small realistic goals instead.

No matter how short the walk is, finding consistency in a routine is far more important than the actual distance walked. Perfect is the enemy of good.

Significant barriers to a regular walking practice as mentioned previously are challenges with pain, mobility and balance. At the Wellness Station, we can work together to figure out ways to get you walking without being limited by these challenges. Some factors to consider might be frequency and duration of walks, as well as implementing more rest breaks into walking. Or perhaps a mobility device can help take stress off certain joints or improve the ability to maintain balance while walking. Activity modifications can help decrease the barriers to a regular walking practice to help us get moving more regularly and with greater confidence.

Oftentimes, the movement patterns that we have developed can actually be limiting factors to the quality of our gait, which can contribute to pain and dysfunction. We learned how to walk once- we can learn some new ways! Relearning new motor patterns might start with a simple awareness practice.

Consider the following practice, perhaps walking around inside:

As you walk, pay attention to your footstep. Some things to be aware of are… “How do my feet make contact with the ground?” “What is my foot print like on each foot?” “How heavy or light is my step?” “How long is my step length?” “How wide is my step from right to left?” This awareness can be applied to many other aspects of the gait cycle and body parts which may include attention to the knees, pelvis, hips, spine, rib cage, shoulders, and head.

After becoming aware of the way in which you are walking, it is time to explore some changes. There are infinite ways to bring about changes into the mechanics of gait. Here are some examples:

• Slow walking. Simply change the speed of your walking to notice what it is like to walk in slow motion

• Walking in different directions. What is it like to walk backwards, or from side to side?

• Strut like you mean it. Introduce a fluid glide in your hips as you walk, and allow your arms to swing with your opposite leg. 

As you explore some variations in your walking, it is important to not play “fix it” with your body. There is no “right” or “wrong” way to walk, simply more options. As body detectives, throughout the therapeutic experience it is our job to find options that are more comfortable, thereby allowing us to sustain a healthy and active lifestyle. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. https://www.cnn.com/2022/09/12/health/walking-cancer-heart-early-death-wellness/index.html

2. https://www.nytimes.com/2021/07/14/well/move/exercise-walking-brain-memory.html 

What Does It Mean to “Explore Movement”?

The concept of “exploring movement” is extremely important for anyone pursuing therapy at the Wellness Station to understand. In a client interaction, I often make the suggestion for the client to explore a particular movement. This is sometimes met with confusion. What does it mean to explore? Am I doing the movement right or wrong? How many repetitions should I do? What next? By asking questions such as these, it is clear that the fundamental nature of the therapy we are providing is not yet understood. By understanding and applying movement exploration in the clinic and during home practice, clients will have a much higher likelihood of experiencing positive outcomes throughout the therapeutic experience and beyond. 

Exercise vs Movement Exploration

Many people who have not experienced the Feldenkrais Method or other somatic movement practices may have difficulty distinguishing between traditional exercise and movement exploration. Exercise is a broad term, and of course movement exploration could be considered a form of physical exercise. However, exercise has become more of a societal construct that implies hard work, high effort, rigid rules of what is “right” and “wrong”, and even a “no pain no gain” mentality in certain circles. While traditional exercise can play a crucial role in sustaining health and fitness, the manner in which many people exercise can actually contribute to various issues. Falling out of love with movement, because exercise starts to be related to effort and discomfort. Repetitive strain injuries from overdoing certain movements without incorporating variations. Triggering pain and inflammation in arthritic joints. Sometimes, the way exercise is performed is like trying to fit a square peg into a round hole. 

Movement exploration is a process that involves learning, attentiveness, and body awareness.

This is how we naturally learn to move, starting from infancy. It is the parent’s job to provide a safe environment, external props, and opportunities to explore, and the child begins to learn and develop in their own unique way. Child researcher and Feldenkrais Practitioner Esther Thelen demonstrated with her research that no two children move through the developmental stages identically, but in their own individual way based on the dynamic interaction between person, task, and environment (known as Dynamic Systems Theory). (1) Us adults are really not all that different from our younger counterparts, especially when it comes to how we learn to move. Approaching movement with curiosity and a sense of exploration recognizes that every person, task, and environment is unique, and therefore movement should be an individualized experience. Exploring movement allows people to recognize the unique characteristics of their own self, and develop various options that could be more helpful than the “right” way to do a movement that is taught through traditional exercises.

The fundamental difference between traditional exercise and movement exploration is that the former is goal-oriented, and the latter is process-oriented. (2)

It is not just about the destination, it is about the journey itself! Traditional exercise tends to be close-ended (one path leading to one desired result), whereas movement exploration is open-ended (multiple possible paths with no specific desired result, although positive results will still occur). By paying attention to the process of movement without only being concerned with the end result, we can learn to be mindful and attentive to our bodies. This helps to facilitate the learning process, which creates a virtuous cycle in which we begin to get to know our own selves with greater precision. 

A real-life example is hiking. Say you are to engage in a three mile hike to the top of a mountain, sprinkled in gorgeous wildflowers, waterfalls, and various paths to the top that will culminate in a panoramic view of glaciers and rocky peaks. In doing this hike, one might reflect on their intentions. Is the intention to walk three miles to get your “steps” for the day, burn 500 calories, and to check the box that you got to the top? If so, the journey itself does not matter. Might as well get on a treadmill for exercise, then drive to the top of the mountain later on. If the intention is to explore, then the journey itself is where the value lies. What feelings emerge as you soak your senses in the variable landscapes? What can you learn from fellow hikers along the way? What new discoveries will occur if an alternative path is taken? What is the qualia of the panoramic peak after engaging in such a journey? It should be noted that the two intentions are not mutually exclusive. One can value the benefits of the exercise (supporting muscle strength, cardiorespiratory fitness, healthy body composition, etc.) while also valuing the experience itself. 

Clinical Example: Spine like a chain vs bridging

To distinguish traditional exercise from movement exploration in the clinic, consider the example of the bridging exercise, often referred to as “spine like a chain” in Feldenkrais contexts. Even the language can distinguish some of the differences between the two methods. To “bridge” implies an end result, a goal-oriented approach. The goal is to lift your hips up into a bridge. On the other hand, calling it “spine like a chain” implies a process-oriented approach, in which attention is paid to the actual process of moving the spine one vertebrae at a time towards and away from the floor. 

Bridging (Traditional Exercise Context)

Lying on your back, bend your knees so your feet are close to your bottom. Now, engage your glutes to push your hips up towards the ceiling. Hold. Lower back down. Perform three sets of 10 repetitions.

---

Spine like a Chain (Movement Exploration Context)

Lying on your back, bring your legs up into a bent position, paying attention to where your feet are relative to each other, and relative to your bottom. Press through your feet to observe how your body responds. Notice your tailbone will start to lift. Then release this pressure, lightening the feet, to notice how the body responds. Repeat, with more force pressing through your feet, and notice what starts to lift away from the ground next. Moving throughout your comfortable range, practice peeling one vertebrae at a time from the ground until a comfortable height is reached. Hold this position if desired to sense the stability of your muscles. Lower down in reverse order, one vertebrae at a time until the tailbone is back down. Repeat, resting often. Any variations are encouraged, such as changing where the feet are placed or what range you are moving in. Explore this movement until you are no longer feeling engaged, or your body asks for something different.

---

Although the latter might be more wordy and perhaps confusing to some, it is a process-oriented approach that leaves space for the person to explore and discover. While the end-result of strengthening the core and hip muscles might be the same for the two options, the exploratory approach is more apt to facilitate additional benefits such as improved motor control, spinal mobility, and a refined ability to be present with oneself in order to sense and respond to the needs of the body throughout each moment in time. If one can approach traditional exercises through an exploratory lens, the greatest benefits can occur with a deeper enjoyment of the process and a lower likelihood of reinforcing strain-inducing movement patterns.

Challenge: How might one turn spine like a chain into a unilateral exercise? See the last blog “The Importance of Unilateral Exercises” for more on this topic.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Sources:

1. https://www.canchild.ca/en/resources/36-dynamic-systems-theory-a-framework-for-exploring-readiness-to-change-in-children-with-cerebral-palsy 

2. https://trans4move.com/blog/2018/6/15/movement-exploration-vs-exercise 

3. https://drlexgonzales.com/wp-content/uploads/2021/09/Blog_Segmental-Bridge-300x225.png 

The Importance of Unilateral Exercises

Most movements can be divided into two categories: unilateral or bilateral. Unilateral exercises are asymmetrical, in which one side of the body (e.g. one leg) is performing an action that the other side does not. Bilateral exercises are more symmetrical, in which both sides of the body are doing roughly the same thing. Both types of exercises are important and functional, but unilateral exercises will facilitate certain benefits that cannot be obtained from bilateral exercises alone. Some examples of unilateral exercises are: reverse lunge, single-leg bridge, single-arm overhead press, split squats, and single-leg deadlift. Examples of bilateral exercises include a squat, deadlift, barbell overhead press, push up, and bridge. In real life, we engage in both types of movements extremely often.

But, because life is rarely symmetrical, unilateral exercises tend to be more relevant to daily life.

Standing on one leg to pull your pants on. Reaching for the glass on the top shelf. Walking. Running.

Bilateral and unilateral exercises both serve a crucial role in functional fitness. While more force and power can be created with bilateral exercises, unilateral exercises require greater balance and stability. They can bring awareness to compensations and imbalances between sides of the body that can easily be overlooked during bilateral movements.(1)

For example, if one has weakness in the left leg characterized by a difficulty in distributing and generating forces, maintaining balance, or moving through a functional range of motion under load, a unilateral exercise will make this extremely clear. If one only ever did regular, bilateral squats, the right leg would continue to overwork, perpetuating a compensatory pattern that could contribute to issues down the road. While we should not expect that our two sides should be equal in their ability, it is helpful to be aware of our unique characteristics and engage in movements that will provide a stimulus for positive adaptations to occur. 

It is important to recognize that with most unilateral, “single leg” exercises, both of your legs continue to carry out an important job. Put simple, one is the mover, and one is the stabilizer. Contrary to what might be evident visually, it is the leg that is not moving that actually has the more difficult job. One leg is weight-bearing, and one leg is non weight-bearing (or bearing less weight than the other leg). The leg that is holding our weight is responsible for maintaining our balance and control of the movement, while the other leg is free to move through space. Consider walking. At each moment in time, one leg is holding your weight, foot on the ground, allowing you to move your other leg forward. By becoming more aware of where we are holding our weight, and which leg is free to move, we can refine our coordination, balance, and efficiency of movement. 

Mime Walking Example

Mime walking is a standing movement lesson that almost all Wellness Station clients learn early on. Many of us begin to have difficulty gliding our pelvis to shift our weight, which can be evident from a forward-flexed posture, short step length, and difficulty standing on one leg. This lesson helps to bring about greater elegance and ease to walking by teaching awareness of weight shifting from one leg to the other. The basic idea is to glide the pelvis to one side (e.g. right) so one leg holds your weight while the other leg lightens up, and then repeat on the other side. Once this concept is learned and felt in the body, countless variations and progressions can emerge that will translate into improved function and ease of walking.

Single Leg Stand to Reverse Lunge

To further progress mime walking, we can apply this motion into a single leg stand. We become aware that one leg is holding us up and controlling our movement and stability, while the other leg is free to move through space. Applying this into a single leg stand to reverse lunge flow is a dynamic way to improve balance, strength, and awareness of our differences from side to side. 

If lacking in steadiness and ease, gently hold on to a support surface with a hand (put your hands in the kitchen sink!), or don’t move the non weight-bearing leg through such a large range. 
If more challenge is desired, move in slow motion, increase the range of motion of the non weight-bearing leg, and/or hold a dumbbell.

Sit to Stands and Squats: Unilateral Bias

A basic squat or sit to stand movement can be changed to have a unilateral focus by holding more weight through one leg intentionally. Coming up onto the tip toes of one foot is a way to do this. 

If lacking in steadiness and ease, use a higher chair, and/or don’t come up as high onto the tip toes (keep more of the non weight-bearing foot grounded). Or, hold on to the kitchen sink as you do this motion. 

If more challenge is desired, use a lower chair or squat through a deeper range, move in slow motion especially on the way down, hold a dumbbell at the chest, or even practice hovering the tip toes off the ground. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Sources: 1 https://www.self.com/gallery/single-leg-exercises