Tag: back pain

How “Fixing Your Posture” Could be Causing Your Back Pain and What to Do About It

 

Earlier this year I made a post called 4 Tips to Get More Flexible Without Stretching, and the #1 item on the list was to improve your posture. This post offers a deeper dive into posture, how some “fixes” can actually create back pain, and a checklist with alternatives.

We all know that hunching over like a buzzard is not good for us. The “tech neck”, rounded back, forward-thrusted head, and drooping shoulders characteristic of our modern lifestyle is obviously problematic. But how do you fix it? What should you do instead?

The most common “fix” that I see is to thrust the chest forward, lift the chin, and pull the shoulders “down and back” like a proud peacock. While this posture may work for peacocks, it isn’t so great for human anatomy and can actually cause more chronic pain, especially in the mid and upper back.

This tutorial is a little step-by-step bottom-up checklist for getting your bones stacked up and your muscles gently but firmly engaged for relaxed, healthy, mobile posture.

It is important to note that “perfect” posture is not a requirement for health or the same for all bodies. There is tremendous variety in the way our bodies are formed so this might not be what is optimal for you. This is just a set of guidelines you can use to check in with your body if you are having back pain or if you notice that your posture is feeling weird.

Posture Checklist to Align Your Spine

1. Notice How your Posture is Now

The textbooks have some guidelines for correct posture that I take as a loose jumping-off point, understanding that all bodies are different. Look for the landmarks of your ear, your shoulder bone, bone on the outside of your hip (the greater trochantur of the femur), the middle of the knee, and the ankle bone and get them all lined up one on top of the other.

Noticing where you deviate from this vertical line can help you identify some postural corrections that might help with chronic pain or tightness.

2. Check Your Pelvic Bones

All of us have different sizes and shapes for our hips, butt and bellies that make our posture look different, and that is part of what keeps the world interesting! Instead, I like to assess pelvic position using the bones, since those tend to be more (but by no means completely) consistent.

The two hip bones in the front (the anterior superior illiac spine or ASIS for those who care) and the pubic bone make a downwards-facing triangle in the front of the hips. With some variation for anatomy, you want to make these boney landmarks flat and symmetrical with each other so that the pelvis isn’t tilted side-to-side or front-to-back.

This generally involves a gentle engagement of the muscles of the pelvic floor and the illiopsoas. I have a number of workouts on pelvic stability if this feels mysterious and inaccessible for you and you can see how this looks in the video below at 2:00 minutes.

3. Engage Your Meat Corset

The meat corset is my fond nickname for a triple-layered band of muscles that wraps around your waist like a corset made of you. The transverse abdominus, internal obliques, and external obliques are a vital set of postural muscles, and like all postural muscles they are ideally awake and responsive almost all the time.

You can feel your meat corset by putting your hands on your waist and coughing or laughing. For postural work these muscles only need to be awake and lightly engaged. The “suck in your gut” cue that I loathe does not encourage sustainable posture, and endless crunches aren’t going to help either. I find that breathwork can be a good entrée to building that healthy meat corset structure.

Again, check out some of my workouts for some meat corset strengthening ideas and see the visual at 2:50 in the video below.

 

3. Open The Shoulders Without Squishing the Shoulder Blades

Forward rounded shoulders are the scourge of modernity, with so many of us sitting hunched over keyboards, phones, steering wheels, gaming consoles, textbooks, food preparation, sewing machines, antique scrolls, you name it. As previously stated, the common “fix” of thrusting the chest forward, squeezing the shoulder blades together, and lifting the chin is suboptimal. It strains and compresses the muscles of the upper back in a way they will not enjoy long-term and can create ongoing back pain if you try to maintain it.

Those gimmicky postural aides that encourage squeezing your shoulder blades together are just going to create a host of new issues for you.

The trick with shoulder blades is actually to pull them apart, while externally rotating the shoulder socket. This will get your upper back engaged sustainably while opening up the front of the chest and shoulder, and stacking that shoulder joint over your hip.

For an exercise to help you find this tricky position, please check out the video embedded below. For this specific tutorial skip to 4:00.

 

4. Stack that Ear

The head and neck come last, stacking them comfortably over the nice foundation you just built along the rest of your spine.

Many of us have a forward thrust to our head, so that the ear habitually sits in front of the shoulder instead of over it (see previous list of reasons). This position makes the neck muscles have to work much, much harder to hold up that heavy coconut of a head.

My favorite quick exercise to start to bring that head back in line is to interlace the finger into a basket cupping the back of the head, elbows wide, and gently press the head and hands together, feeling the inspiration of the muscles in both the upper back and the front of the neck. The chin should not be lifted or dropped, but remain parallel to the floor.

For that tutorial, skip to 6:30 in the video below.

 

Now What? Why is Good Posture so Awkward?

The first time I ran through this checklist and tried to align my posture correctly I got mad. How the hell was I supposed to walk around like this? It felt foreign, difficult, and uncomfortable.

The good news is that perfect posture is not a requirement for a rich, full, happy life or even for pain-free mobility. Like so many other things in life it is pretty much always a work in progress, something you chip away at, check in on, and use as a tool when you need it. If your current posture doesn’t cause you problems and is working for you, you may not need to change it. If you start to have pain, then running this checklist may provide relief.

When I was really dedicated to improving my posture to address my hypermobile back and a lower back pain I set an alarm on my phone to go off every hour on the hour to remind me to run through the check list. After a while I didn’t need the checklist, my body just started to remember to do it.

My posture now definitely isn’t perfect, but it’s good enough that I don’t have back pain any more and I still run through the check list if I’m on my feet for a long time or feel like I need it. It’s change the way that I walk and run, and vastly improved my forward bending which was always pretty crappy.

I hope this checklist is useful for you too!

Happy Bendings,
Kristina

 

 

Step by Step Introduction to Back Bridge/Wheel Pose

Back Bridge, or Wheel Pose as it is called in yoga, is a beautiful foundational element of the back bender’s practice. There are so many benefits to this position in strengthening the entire back of the body while opening the hips, chest, and shoulders.

I also love Back Bridge because it requires your body to reconfigure itself and learn some new skills. So much of what you need to do to have a comfortable Back Bridge feels counter-intuitive. 

We are so used to a forward-facing orientation with our body. We push with the front of our body and pull with the back of our body. In Back Bridge we have to push with the back of our body, which is where so many new back-benders get stuck. If you try to push up into Back Bridge with the front of your body, it will feel pretty much impossible.

Here are two preparatory exercises that you can do, before you are upside down and bent over backwards, so that your body has some idea of where to engage and how to behave in Back Bridge. These are both isometric holds, which are very useful for re-training your nervous system to create new patterns of muscular contractions. I recommend holding each of these for about 30-60 seconds for 3 sets if you are new to Back Bridge or feeling stuck, prior to pushing up into Back Bridge.

For the visual learners, please check out the video at the end of this post.

 

Lower Back Bend Isometric Hold

This hold will look very familiar to most of you. It is a simple shoulder bridge, focused on the muscle groups that you will need in Back Bridge. Both knees are bent, hip width apart with feet parallel, and the heels are close to the butt (exact distance will vary but find something comfortable for you).

They key components of this hold are:

  • Start by pulling your heels and butt towards each other to fire the muscles in the backs of your legs
  • Extend your hip flexors by using the lower glutes to lift just the tailbone up off the floor, keeping the rest of the back flat
  • Make sure that the hip flexors stay in the lengthened position as you lift higher off he floor (for more info on why it’s important to lengthen the hip flexors to protect your lower back see this blog post on back pain in backbends)
  • For bonus points extend the arms up overhead and press them gently down into the floor while keeping the chest opened

Hold for 30-60 seconds, repeat 2-3 times

 

Upper Back Bend Isometric Hold

The upper body hold is often less familiar to the body, which makes it especially important. This hold does require a certain amount of wrist flexion, so if your wrists are tight I definitely recommend a good wrist warm-up and the addition of yoga blocks under your hands to help mitigate the pressure on your wrists (see the video at the end for a visual, the blocks come in at  4:03).

The key components of this hold are:

  • Place your palms flat on the floor or on the yoga blocks just above your shoulders, spread out your fingers to engage your wrist muscles, and make sure your fingers are pointing towards your shoulders not out to the sides
  • Forearms are parallel to each other, not opening out to the side like little wings, while the elbows reach back past the ends to upwardly rotate the shoulders and decrease pressure on the wrists
  • Keep your head and hips resting on the floor while just your upper back lifts, opening the chest towards the ceiling
  • The dream is to feel the engagement in your upper back, not your neck, chest, or shoulders. If you are not feeling your back muscles, keep your upper back on the floor and just work on pressing your hands down until you get acquainted with those back muscles

Hold for 30-60 seconds, repeat 2-3 times

 

Pushing Up Into Back Bridge

After doing these isometrics, you are ready to attempt pushing up into your Back Bridge! The push up happens in three stages.

  • First, start your lower body isometric hold.
  • Second, start your upper body isometric hold but this time continue to push up until your head starts to lift, pausing with the top of the head gently resting on the floor (make sure that most of your weight is in your hands, not pushing down into your delicate neck vertebrae).
  • Align your arms so that your forearms are parallel and re-engage those same back muscles you felt in your isometrics, then use them to push your arms straight.

Ideally, this should feel like a lot of work on the back side of your body while the front side of your body gets to open up. If it doesn’t feel that way, it’s ok! Keep working on your isometrics and the muscles will start to learn their new jobs.

Check out the video below for a visual guide to walk through the exercises, and happy Back Bendings!

Got a Bendy Back and Tight Hip Flexors? Try this Short Workout

Five years ago I wrote a blog post titled The Curse of the Bendy Lower Back that laid out many of the difficulties facing people with a naturally bendy lumbar spine. One of the most unpleasant consequences is shortened, weak, painful hip flexor muscles.

This phenomenon has been well documented. In 1979 Dr Vladimir Janda coined the term “Lower Crossed Syndrome” to describe the postural condition where the back arches and the pelvis tilts forward. This results from and further contributes to tight muscles in the lower back and the front of the hips, and lengthened muscles in the abdominals and glutes/hamstrings.

At the root of the problem is inefficiency. Our bodies are designed to move from a stacked spine where the S-curve rests directly on top of a vertical pelvis and very little muscle is required to hold us up. When our spine is not neatly stacked the muscles and connective tissue have to work much harder to hold us up, resulting in angry, resentful, tight muscles.

In the case of the bendy lower back, the spine pulls the pelvis into a forward tilt (and sometimes the pelvis pulls the spine). This makes the back muscles have to work very hard to hold up our upper bodies, and compresses our illiopsoas, the largest and deepest set of hip flexor muscles. It also aligns us in a way that makes it our quadriceps muscles over work and makes it harder to use our abdominal muscles and glutes. Left unchecked over time this creates chronic postural problems, tightness, and pain.

I’ve had a pretty severe case of Lower Crossed Syndrome for most of my life. I do exercises every day to counter its effects and it has decreased my back and hip pain and increased my hip mobility. I’ve also seen these exercises help other people with the same issues, so if you’re in the same boat, perhaps they will prove useful for you too!

The video below contains specific exercises that I find useful, but here are some guiding principals that can help you design your own workouts and adapt your current workouts to make sure that you aren’t reinforcing your imbalances.

1. Know Your Dominant Muscles and Try to De-emphasize Them

For many folks with bendy back issue, the quadriceps muscles are bossy as hell. When designing your exercises, find ways to reduce input from the quads in favor of the illiopsoas, glutes, hamstrings, and core muscles. Basically, anyone but the quads. It may mean going lighter with your effort in order to find those quieter, shyer muscles.

2. Just Because a Muscles is Tight Doesn’t Mean it’s Strong

The back and hip flexors do not want to lengthen. They may feel tight as a bridge cable, but that doesn’t mean those muscles are good at contracting either. Often those muscles are just stuck at one length, not getting shorter or longer. When that happens, I recommend working on contracting the muscles first, before trying to stretch them. It is easier to make a muscle contract than relax, and once you get them to contract they gain some confidence and are more amenable to relaxing and stretching.

3. Just Because a Muscle is Long Doesn’t Mean it’s Weak

Those glutes and abs may be stuck in a long position, but that doesn’t mean they aren’t strong in a long position. When I was doing backbends all day my abs were very strong, they just didn’t want to get shorter. The key to making sustainable change was to get away from the crunches that I was used to and find exercises that forced me to use my abs when they were in a shortened position, with my spine in forward flexion. This resulted in lots of shaking, and some sustainable improvement in my bendy back issue. Putting a squishy ball or pillow under the hips for ab work is a great way to start.

4. Changing Posture is a Daily Practice

Posture doesn’t change overnight. It’s likely you’ve had this posture imbalance for much of your life so doing exercises once in a while isn’t going to make a noticeable difference. Changing posture and maintaining that change means doing exercises to address the imbalance almost every day, possibly for the rest of your life. But hey, at least you’ll always have something to do.

For my fellow hyperlordotic (bendy lower back) friends, I hope that some of these tips and exercises are useful for you. I know many of you may be dealing with back and hip pain, and all I can say is that there is hope for relief with consistent dedication to this small, undramatic, exercises.

Happy Bendings!

 

Spinal Anatomy for Back Benders

Back bending is one of the most challenging areas of the flexibility arts. The spine is an extremely complex structure consisting of bones, cartilage, connective tissue, and tons of nerves. You are essentially bending your brain’s tail.

Back bending is also special because most of the flexibility gains come from shortening the muscles of your back. Most flexibility training focuses on lengthening muscles. That is why back bending feels so different than other types of stretching and why it requires a specialized, primarily active (strength-based) approach. For ideas on strength-based spinal mobility check out the Video Club series.

Back bending is intense! Moving those bones and nerves around can create all sorts of unexpected responses. Dizzyness, euphoria, nausea, headaches, intense emotion, muscle spasms, and exhaustion are all common responses to back bends. My coach used to say that one hour of backbending taxes the nervous system like eight hours of normal exercises.

And of course back bending can be dangerous. Overtraining risks the possibility of fractured vertebrae, herniated discs, pinched nerves, and chronic pain.

Lest I sound like a total downer, I still love to teach and practice back bending. I just have strong feelings about the need for education and safety around the pursuit of the back bend. So let’s start with understanding the basics of how the spine is constructed.

 

The Three Segments of the Spine

Outline of the Spinal Anatomy

The spine is made up of 24 boney chunks (vertebrae) that are hollow in the middle to allow the spinal cord to pass through. In between each vertebrae is a squishy disc to allow for movement and protection, and there are tough cords of ligaments that keep everything held together. To nerd out more deeply on the anatomy of the spine check out this good introductory article from the University of Maryland Medical Center.

Vertebrae change shape as they go up the spine. Based on that shape the spine can be divided into three different sections. Each section has a different kind of movement function.

Lumbar Spine

The Lumbar SpineThe lumbar spine starts at the sacrum, a flat shield-shaped bone that attaches to the pelvis. The five lumbar vertebrae (some people have six) are the largest of the three sections and naturally curve into a back bend shape. Some people have a lot of natural curve, some people have less.

The primary muscles supporting the lumbar spine are the illiopsoas, transverse abdominus, obliques, and the pelvic floor muscles. The muscles in the back that need to shorten for backbends are the multifidi, quadratus laborum, and the large muscles on either side of the spine that connect the spine and the ribs.

The shape of the lumbar vertebrae makes them more mobile going forwards and backwards although they also allow for twisting and side bending. Your lower back is part of the support system for your entire upper body, so it is important to keep it strong and mobile even if backbends aren’t your passion.

If back bends are your passion, beware over-using your lumbar spine. Because it has a natural back bend curve it’s easy to dump into your lower back, especially if you have a lot of natural curve and/or tight hips and upper back.

 

Thoracic Spine

The Thoracic SpineThe thoracic spine is the longest section of the spine, starting in the mid back and extending up to the base of the neck. The shape of the vertebrae differs considerably from the lumbar spine allowing for less mobility. The thoracic vertebrae are also the anchors for the ribcage, further limiting movement potential.

The muscles that support the thoracic spine in backbends are primarily upper back muscles including the lower and mid trapezius, the serratus anterior, and the rhomboids. The diaphragm is also involved in upper back bending and a tight diaphragm can limit upper back mobility.

The thoracic spine has a natural forward bend that is often exaggerated by modern posture. This is why learning how to find a backbend in the thoracic area is valuable even if you aren’t a back bender. And if you are a back bender it is extremely important to develop the muscles that reverse the natural curve of the thoracic spine to avoid over-using the lower back and neck.

The thoracic spine is very good at twisting, so one entry point it to work on twisting motions.

Cervical Spine

The cervical spine is in the neck, providing the bridge between the skull and torso. There are seven cervical vertebrae designed for maximal movement in all

Cervical Spine Illustration

directions: forward, back, tilting, and twisting. This is necessary for us to have the mobility we need but it does mean that back benders (and everyone else) need to take very good care of our necks.

Like the lumbar spine, the cervical spine also has a natural backbend shape. That makes the neck another vulnerable place for back benders. I often teach backbending without including the neck at all until some amount of thoracic bend is present to lessen the pressure on the cervical vertebrae. Strengthening the neck muscles is also essential, especially for those planning to practice chest stands (locust pose) or shoulder stands.

 

It is important to strengthen all of the neck muscles evenly because it is so mobile. Don’t just work the back bending range, work forward, tilt and twist with resistance. That head weighs about 11 lbs. It’s heavy!

 

 

Know Your Bend

Understanding the sections of the spine and how they work will aid you in improving the beauty and ease of your backbend and making sure that your back stays healthy and pain-free.

Pro Tip:
Take some photos of your backbend. Notice where you are bending: which areas of your spine are doing the work? If you notice that you are only bending in a few spots and other areas of the spine are not bending at all, or eve bending forwards, this is a good indication that you should focus your training on evening out that bend before going deeper into your flexibility.

Please watch the video below for you visual learners, and check out our video workouts and workshops for ideas on how to safely approach back bending.

Happy Bendings!

Improve Middle/Straddle Splits and Hip Stability: How to Do a Highly Effective Clamshell Exercise

 

I’ve often said that if I were stuck on a desert island and I could only bring one exercise, the humble clamshell would be a strong contender. This exercise is gold for targeting one of the most important and under-utilized muscle groups in our lower body: the deep butt.

The deep butt are six little muscles that run horizontally under the gluteus maximus, connecting the head of the femur to the pelvis at various points and angles. These muscles (the obdurator internus and externus, the gemellus superior and inferior, the quadratus femoris, and the famous piriformis) are external rotators and are vital to stabilizing your pelvis for positions like middle splits and straddles, as well as for life.

But the gold in clamshells is very much in the details. It’s so easy to swish through a set of clams utilizing non-targeted muscle groups like the obliques, the hip flexors, opposite butt muscles, and even the spinal extensors. The gluteal muscles (gluteus maximus, minimus, and medius) are working but not the primary targets here. The first time I figured out how to get all those other helpers to pipe down and really focus on the deep butt muscles I was shocked to find a tiny range of motion and shaking like I was hefting an olympic barbell. But it was just my thigh bone. So exciting!

How to Set Up for Success

Even Out Your Hip Bones: If you have a difference in the diameter of your waist and hips, which most people do, when you lie on your side your top hip will tip up towards your rib cage making your hips uneven. Use your waist muscles to lengthen that top hip out towards your heels until the top hip bone is directly above the bottom hip bone. This will make it harder for your obliques and back muscles to “help out”.

Slight Lean Forward: Very slightly rotate your pelvis forward as if you were considering rolling forward onto your belly. Lengthen your top knee out just past your bottom knee. Feel like that top leg is lengthening out of the hip socket. You are going to maintain this lengthened feeling and forward tilt throughout the exercise to minimize the participation of the gluteus minimus and medius and hip flexors.

Stack the Insteps of your Feet: Make sure that the feet are stacked one directly on top of the other with the insteps lined up and pressed together. That slight press down with the top foot is going to encourage the external rotators to be more enthusiastic.

Tips for Optimal Execution

Nothing Moves but the Knee: Try putting your top hand on your top hip. Don’t let that hip bone move at all. The only movement is the lifting and lowering of the thigh bone.

Bottom Leg Stays Relaxed: It is so tempting to push that bottom leg down to lift the top leg up, and some amount is inevitable. But really try to keep it as relaxed as possible.

Keep it Small: Most of us don’t have a huge range in our external rotation. If you are doing a giant movement where your knee points towards the ceiling every time you are likely bringing pelvic and spinal rotation into it and no longer isolating those deep butt muscles. Keep it small, keep it honest.

Feel the Burn: For most people this is not an isolation we do every day. Those deep butt muscles should be singing! You probably wont need more than 10-20 reps to get to shaky, crampy, maximum. Feel free to do multiple sets but when you get too tired to isolate, take a break.

For you visual learners check out the YouTube video below!

Pro Tip: The standard way to do this exercise is with the hips at about a 45 degree angle and the feet lined up with the hips but that isn’t the only way to do it. You can emphasize different muscles but doing the same set up with the knees tucked up towards the chest or in full extension with the feet back behind me like you were hanging upside down from a trapeze. These exercises are great for improving hip stability at every angle.