“The health of the whole person can be traced to the health of their central nervous system.” -Dr Steve Judson
Chiropractic is based on the big ideas that the brain controls the body and the body can heal itself. Chiropractic looks to remove the interference between the brain-body connection to allow this to happen better.
There is no secret movement or stretch that is going to improve your mobility. Improvement comes from consistent action - getting into good positions throughout the day, every day! Working on movement and mobility while at the gym for 30-60 minutes per day a few times a week won't undue the sedentary or static lifestyle many of us have in the other 23 hours each day.
There are four different positions that I highly encourage you to get into on a daily basis and finding ways to incorporate them into your day.
1) Arms overhead - just get your arms up overhead. Stand in a door frame and put your hands up and stretch and move. Do this for 1-2 minutes at a time to open up your chest and lats.
2) Deep squat - this one may take a little bit of time to get into. A lot of us have mobility limitations which will cause us to point our feet out or our heels will pop off the ground. Hold onto something sturdy and sit back into a squat. Feet should be about shoulder width apart, maybe a little wider, feet point forward. The goal is to get your butt down close to your ankles.
3) Half-kneeling - kneeling on one knee with your opposite foot in front of you. Do this on both sides.
4) Tall kneeling - kneeling on both knees. Put a towel or pillow under your knees if you need to.
All of these movements can be done at your desk and at home. These four movements are key to improving your hips, lower back and shoulders. Sitting destroys our hips and causes a lack of mobility. Stuart McGill, a low back pain researcher, says when the hips stop moving, the back starts moving. The spine is meant to maintain a rigid shape while loaded all the way through movement. McGill has shown the best way to hurt your back is to move into flexion when its loaded.
I hear "I need to start doing yoga" on a weekly basis. Yoga is very beneficial, but again, it won't undue the hours of poor positioning you are putting your body through on a daily basis. Find ways to get into better positions throughout your day to improve your hip mobility and stability. Start now with the 4 positions mentioned above.
Sitting is the new smoking - a slogan that you have probably heard before. There are countless books on how being sedentary is wreaking havoc on our health. So we go into work and ask for a standing desk so we no longer have to sit. However, this is not going to be an end all solution. There are things that need to happen to make sure this is good for us, because standing like a statue all day at our desk is just as bad as sitting.
The standing desk has benefits because they create a more movement rich environment (provided you move while standing). I have a standing desk at the office with a stool, Topo anti-fatigue mat and foam roller. These tools allow me to get my body into different positions during the day. I use the stool to allow me to rest whenever I need it - it allows me to sit without closing up my hips too much. The Topo-mat is an anti-fatigue mat with different terrain shapes on it so it keeps me moving and allows me to use the different shapes to stretch my lower legs. The foam roller is used to place one foot (at a time) on it and roll it back and forth to keep my legs moving and in different positions. When standing at the desk, we want to keep our shoulders back and down and relaxed. Our elbows should be down at our sides. Our pelvis should be tucked under our lower back - to do this squeeze/fire your glutes - this naturally tucks your pelvis - fire your glutes about 20% of max to keep a stable base. Continually change stances, limiting standing on one leg or shifting to just one hip.
If you don't have a standing desk, there are positions you can get into on your chair to create movement and put your body in constantly varied positions (see video below). Transitioning between sitting and standing is best - especially if you can continue to move in both positions.
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"Where you think it is, it ain't"
The psoas muscles (also known as the hip flexors) can be a tricky beasts. The psoas originates on the bodies and transverse processes of the lumbar spine and inserts on the lesser trochanter of the femur. The psoas flexes the hip, may laterally rotate the hip, flexes the trunk, tilts the pelvis forward and assists to laterally flex the lumbar spine.
Sitting puts our hips in a flexed position and our trunk flexed with the seat supporting our legs and our lower back typically in a rounded position. With the seat doing the work for us, there is no need for the psoas muscles to fire. The psoas muscles go to sleep when they are no longer needed. When they are not firing they tend to lock up to create stability. When we stand, move and lift and our psoas muscles are asleep, other muscles with compensate. Your lumbar erectors with become tight and overactive, as well as your quads. Over time this can cause lower back pain. So the first thing we do is to try to roll out the lumbar erectors with the foam roller thinking this is what the problem is. Doing this may create a short term fix but does nothing to fix the initial cause.
Creating a plan to wake up the psoas muscles is a must. So what is that plan? We need to release the psoas muscles and activate them. Releasing the psoas is NOT very comfortable. There are a few ways to do this. A soft ball, a kettle bell, a rolling pin (or something similar) can be used to shove into your gut to release them. I typically start 1-2" out from the belly button and start to apply pressure lightly. The psoas run from the bottom of the sternum to the inside of the thigh bones in an inverted V formation. You can move up an down in the gut but be gentle, as you want to be able to breathe during this process. I like putting a softball on a box and slowly draping myself over the ball - with the ball placed 1-2" next to my belly button. You can also lay on the kettle bell or lay on your back with the kettle bell placed on top of you. (There are pictures below.) We will want to release the psoas muscles for 3-5 minutes per side.
Next we want to activate the psoas muscles. We can do this a few different ways as well. Just pick one that suits you best. The first way is to stand up with your back against the wall and raise one leg to or above hip level, with your foot and ankle relaxed, and hold it there. The goal is to hold it there for a minute. If your leg starts to shake, take a rest. We don't want other muscles to compensate. We can do the same thing laying on our back, but we will want to push down on the knee with our hands and actively push up on the hands with the knee and hold for 5-10 seconds at a time. The last way can be done at your seat. Place your hands on top of your knee and apply pressure down with your hands as you actively pull your knee up.
Weak or inhibited psoas muscles can be a huge reason for lower back pain and it is often overlooked. Check your psoas today or come into the office to have them checked if you are experiencing lower back pain.
In this image, you can see the psoas attaches to the front on the lumbar spine and travels down to the upper leg.
In this release, I places a kettle bell (or ball) on the table and am slowly and gently laying on top of it with the kettle bell places 1-2 inches next to my belly button.
This is an alternative setup. I am laying the kettle bell on top on me - 1-2 inches outside of my belly button.
Another alternative set up. I am laying on the handle of the kettle bell and gently sinking into it.
This is the activation exercise. After releasing the psoas, I will do this exercise to activate it. I bring my knee up to or above hip level, I will press down on my knee with both hands while resisting the pressure with my leg. Hold for 5 seconds and do this 5 times per side.
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Building upon last weeks post, the foot is very important in terms of movement and function of the body. If we lose functionality in the feet, we will develop compensation issues further up the chain. The feet are the body's foundation - if the foundation is broken, movement patterns and stability breakdown. Similar to a house, if there is a foundation problem, we will eventually see cracks in the walls.
There are a lot of fancy, complicated exercises and mobility techniques to help improve the feet. In reality, it takes just takes time, consistency and a commitment to improve your feet. Take your shoes (and socks) off as much as possible to get a feel for the ground, improve your proprioception and patterning. Make sure you point your feet (pretty) straight forward. This may feel strange if you have been moving with your feet point out. If this is hard, it may be a hip issue (which I will cover next week).
Something basic you can work on is called the foot tripod. It is a way of evenly distributing your weight in your feet. There are 3 points per foot. The first point is the center of the calcaneus or the heel. The second point is the head of the 5th metatarsal or the spot where the small toes attaches to the foot. The third point is the head of the 1st metatarsal or the spot where the big toe attaches to the foot. A balance between these three points gives the foot stability and it is thought that arches of each foot functions optimally when the tripod position is maintained. When the head of the first metatarsal is unstable, it is heard to maintain the tripod position and we tend to lose position and function of the arches in the feet. Other possible issues come from tight or weak foot, calf and hip muscles.
Learning the foot tripod can be difficult at first, especially if you have a flat foot or a loss of arch. Do this with shoes and socks OFF. Start by focusing on your heel and the 5th metatarsal points. Next lift your toes up and start to shift onto the big toe point - this makes it a bit easier to feel the big toe point.
Next week, we will cover the hip and its relationship with the foot.
In the gym, in the office and everywhere in between I see faults with our foundation (the feet). Whether it is squatting, deadlifting, rowing, walking, running or any other movement - I see common faults or issues that can be corrected. What I most commonly hear is "I was born with flat feet" or "I need orthotics." In reality, flat feet are developed - they are an effect of feet that don't function properly, feet with stiff or non-working tissues, hips with a poor connection to the feet or all of the above.
These issues can be fixed - the problem is that most people don't want to fix them, don't know that they can be fixed or don't know how to go about fixing them. Most doctors will cover the issues with a "band-aid" such as orthotics, rest, or medication. These things may mask the pain or symptoms but won't fix the problem(s). Faults in the feet will cause poor squatting/deadlifting/movement patterns and mechanics, foot pain, knee pain, hip pain and other possible symptoms.
We were designed to have strong feet, however, shoes, sitting and lack of motion have destroyed our connection with the ground, causing weak feet and masked proprioception - which means we don't feel the ground. Our shoes and orthotics mask our movement faults and restrict normal motion in our feet. Our feet are meant to be a primary shock absorber - a reason why we have so many bones and joints in our feet and ankles.
Go barefoot as much as possible - provided there is no pain. If pain is present, start mobilizing your feet 5-10 minutes per day to create feet that actually move and that you can control (without using your hands) - meaning you can spread and close your toes using your mind!
Mobilizations for your feet (videos below):
- Walk barefoot on different types of surfaces (start with soft ones first like grass, carpet or sand)
- Lax ball under the ball of your foot and pump to open the forefoot.
- Heel walks - to deal with tight calves/posterior tibialis/ankles
- Foot scrunches
- Foot torque
- Assisted Foot Twist
Some points to look at:
- Calluses on the inside of the big toes - indicates feet turning out when walking
- A curved achilles (have someone take a picture of your ankles from behind - your achilles should be straight)
- No arch
- Inability to spread your toes (without using your hands)
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"You become a the sum of your actions, and as you do, what flows from that - your impulses - reflect the actions you've taken."
Squatting is a movement we shouldn't take for granted. Think about how many times you sit down and stand up. If you squat with poor or lazy mechanics everyday for years, it shouldn't be much of a surprise that your knees and back light up with pain. Poor squat mechanics and poor or restricted range of motion can lead to back, hip, knee and ankle pain.
Faults in the squat typically come from poor range of motion in the hips and ankle. I often see the toes losing contact with the ground, the ankles and knees caving in, the knees jutting forward, and a rounding or hyperextension in the lower back.
Successful lifts start with the relationship you create between you, the bar and the floor. The air squat is no different. We want to create a solid foundation with our feet by keeping our feet screwed into the ground, keeping the toes in contact with the ground. Just as we don't want to loosen or lose our grip on a bar/dumbbell/kettlebell when bench pressing or shoulder pressing, we don't want to loosen or lose our grip on the ground with our feet.
Screwing our feet into the ground should be one of the first things we do when setting up for a squat. This creates torque and tension in the hips and legs and creates stability. We need this stability - starting with the foundation - to dial in our mechanics.
Our muscles can act as a shock absorber, as in running, or they can act as a powerful stiff spring, as in squatting. A spring works best when there is no slack in it. Imagine trying to fire a sling shot with slack in the band. You won't get and power out of the sling shot. If you create tension all the way back when firing it, you will get a ton of power from it. This is what needs to happen in the squat - keeping tension all the way to the bottom then back up.
- Feet shoulder width apart, pointing straight forward - can be pointed out slightly - no more than 10-15 degrees.
- Screw your feet into the ground as if you were going to spread the floor apart with your toes - this will instantly create torque and tension in your hips to create stability. You will feel your toes dig into the ground and your arches rise. We also want our mass centered over the middle of our feet.
- Squeeze your glutes and brace your trunk.
- Reach your hamstrings back and tilt your torso forward (Hip Hinge: see below) to load your hamstrings and glutes.
- Keep your shins as vertical as possible and actively drive your knees out laterally.
- As you lower yourself into the bottom position, there should be no slack - you should feel tension in your legs and hips the whole time.
- Your spine should not change positions throughout the movement - it should remain stiff and stable without rounding or hyperextending.
- Dropping into the squat, we would like to get our hips to knee level, but this may or may not be possible yet.
- Coming out of the bottom position, we just reverse the movement.
- Keep your trunk tight, spine neutral, knees out and feet screwed into the ground.
*Hip Hinge: maximal hip bend, minimal knee bend. The hip hinge is, in general, any flexion or extension starting at the hips that involves a posterior weight shift. With the hip hinge, you maintain a neutral spine and bend at the hips, not the low back - this creates tension in the hamstrings. This pattern relieves stress off of the lumbar spine and can prevent a whole host of injuries.
The deadlift is one of the most common and crucial movements in life. It is (should be) performed each time we pick something up from the ground. However, very few people understand how to do it correctly.
I test this movement, a long with a few others, in the office to get a sense of how a client moves and to asses any movement faults. So many people round their backs when they pick something up from the ground which will eventually lead to lower back pain. I think of bending a paper clip over and over until it breaks. This example is what happens to our lower back if we continually round our lower back when we pick something up from the ground (deadlift). Our back does not break in half like the paper clip, but it does break down and can eventually lead to lower back pain.
In the deadlift, we need to know how to brace our trunk, create torque and never sacrifice form for range of motion. Sacrificing form for range of motion is the fault I see the most.
The deadlift shares the same load order sequence and universal laws as the squat --> brace the trunk, create torque, load the hips and hamstrings, keep the shins vertical and distribute weight over the center of the feet.
The set up: my feet are shoulder width apart. My trunk is braces and my hamstrings are loaded - meaning my butt is back like I'm going to sit in a chair which creates tension in my hamstrings. My hands hang straight below my shoulders and my shins are vertical.
As I begin the lift, my spinal position does not change. We want to keep the weight as close to us as we can.
As we stand up, squeeze your flutes as you extend your hips. Don't lean back or shrug your shoulders at the top.
To lower the weight, simply reverse the order of the movement. Keep your trunk braced, back flat, head neutral, load your hips and hamstrings by sending your butt back and maintain as much tension in the system as possible.
Squatting is a foundational movement that most adults have lost the ability to perform. A big reason people end up needing to be cared for later in life is the loss of strength, power and mobility in the hips. Most of us will bend forward in the spine to pick something up off the ground instead of hip hinging and squatting. Over time this can be detrimental to our spines and can create long term issues. We should be squatting and deadlifting throughout the day to create healthy patterns. Most people will say "my squat is terrible" but will not spend time on fixing it until there is a big enough problem present - back pain, degenerative disc disease, bulging discs, etc. Test your squat today and get to work now!
To test your squat, stand with your feet about shoulder width apart and your toes pointed straight ahead or slightly turned out. Sit back and down like there is a chair behind you, make sure your knees stay in line or slightly outside of your feet. Try to get your upper leg parallel with the floor, keeping your shins fairly vertical and your heels on the floor.
The main things you want to accomplish are 1)maintaining control of your spine the entire movement 2)break at the hips first 3)keep your shins fairly vertical 4)keep your knees in line or outside your feet as you descend 5)can you get close to or beyond parallel (hip below knee). Number 5 is the least important if you are just trying this or starting out. You can put a chair/box/ottoman behind you (as pictured) to use as a target to get your hips back and down and help focus on the first 4 steps. Get the pattern down! Don't go lower until you can master them. Be patient!
feet about shoulder width apart, toes pointing straight forward or slightly outward (no more than 15 degrees)
breaking at the hips first - push the hips back
shins vertical, knees tracking over the toes, tension in the hamstrings