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Triathlon Success: Hamstring And Glute Togetherness

To keep a triathlete healthy and resilient, the hamstrings and gluteal muscles must work together as a team.   The athlete fires the gluteals and hamstrings simultaneously to stabilize the pelvis and produce force through the lower leg.  When you run, bicycle, or swim, these muscles work at a team to produce efficient propulsion and reduce stress on the lumbar spine and knee.  A triathalon is the ultimate long duration physical endeavor.  Triathletes need hamstrings and gluteal muscles that can stay on and strong for a long time.

Most fitness programs do not properly train the muscle of the posterior chain.  Fitness center exercise generally involves training the hamstrings as knee flexors on some type of “leg curl” machine.  Gluteal training rarely occurs past neutral hip extension, with little effort on improving overall hip range of motion.  Any type of seated gluteal training is inappropriate for an athlete.

The term physical therapists and strength coaches use for butt muscles that are non- responsive is “gluteal amnesia”.  Our sedentary lifestyle involves very little of the glute recruiting sprinting, deep squatting, and climbing that activates the gluteal muscles.  We mistreat our gluteal muscles with hours of compressive sitting and little in the way of full range hip movement.  Many fitness clients and most physical therapy patients need some remedial gluteal training.  Give these three drills a place in your triathalon training program.

Single Leg Bridges

Lay supine with the arms braced against the floor to stabilize the upper body.   Bend the knees and place the feet flat on the ground.  Lift the right leg up off the ground.  Using the muscles in the back of the left leg, lift the hips up off the ground.  Push up through the heel of the left foot and drive the left hip into full extension.  Hold at the top for three seconds and then lower in a controlled manner.  Perform ten repetitions on each leg.  Common mistakes are allowing the pelvis to tilt and not fully extending the hip.  Hamstring cramping is an indication that you are not using the glutes enough and need to focus on creating a better mind to butt connection.

Goblet Squat

The squat movement pattern is a skill that is easier to teach if you add some load.  You can use either a dumbbell or a kettlebell for this exercise.  It has been my experience that the exercise is easier to learn with a kettlebell.  Hold a kettlebell by the horns, with the elbows down, and the kettlebell close to the chest.  Keep the chest proud and pull the abdominal muscles tight.  You may have to experiment with foot placement as everyone has different hips.  The position you would place the feet if you were going to jump is a good starting point.  Initiate the squat by pushing back the hips.  Keep the torso tall and descend.  Let your pelvis fall between the hips. The elbow should drop down between the knees.  Nothing will inhibit your progress more than thinking about how you are moving during goblet squats.  Keep your brain quiet and get in some repetitions.  Effort has amazing capacity to improve motor control.   Perform ten repetitions.

Mini Band Monster Walk

Your will need a mini resistance band–a nine inch loop of resistance band, (two dollars from performbetter.com).  Most fitness clients will do well with a green or yellow mini band.  Place the mini band loop around both legs just above the ankles.  Assume an athletic stance with the feet straight ahead, knees bent, and hips flexed.  The band should be held taught throughout the exercise.  Imagine your feet are standing on railroad tracks.  Walk forward for ten steps on each side, keeping the feet over the railroad tracks.  Walk backward for five repetitions on each leg.  Try to keep the hips and shoulders level throughout the exercise.

Once you have mastered all three exercises, build your gluteal and hamstring performance by traveling through the program for two or three trips.

  1. single leg bridges  R and L x 10
  2. goblet squats x 10
  3. mini band monster walk x 10 each leg

View video of the exercises here: https://youtu.be/QeteeLPF4AU

Kat Wood, DPT, ATC

Triathlon Success: Core Connection

In the fitness world core stability training has gained a solid foothold and more people are getting away from spinal damaging resisted twisting machines and the ever present sit up gizmo.  Most people know how to perform a “plank” exercise and have added this drill to their fitness routines.  Learning how to properly brace the core stabilizers and perform a sustained plank type isometric exercise will resolve back pain, improve the hip to shoulder girdle connection, and make you a better movement machine.  The problem is most people never advance beyond the basic plank exercise.  Triathletes need significant anti-rotation and anti-extension core strength and endurance.  I have three drills that will help keep you strong and resilient in your quest to complete you first tri.    Read the directions and give these activities a place in your fitness program.

Alternate Single Arm Planks

Position the body in a toes and elbows plank, but separate the legs so the feet are wider than the shoulders.  Lift one arm up at a 45 degree angle in relation to your body and hold for five seconds.  Lower the arm back down and try the other arm.

If you are unable to perform the alternate arm plank on the floor, regress the exercise by placing the hands on a bench in a push ups position.  Lift one arm up at a 45 degree angle in relation to your body and hold for five seconds.  Lower the arm back down and try the other arm.  How many and much?  Perform three to five repetitions on each arm.  Work up to longer hold times instead of more repetitions.  Five repetitions on each arm with a ten second hold is a good goal.

Pallof Press

You need a cable machine or resistance tubing set at mid torso level.   Position your body at a 90 degree angle in relation to the pull of the cable.  Assume an athletic posture with the feet at least shoulder width apart and the spine neutral.  Push the hips back a little and keep a slight bend in the ankles and knees.  You should look like a tennis player preparing to return an opponent’s serve.  Use a strong overlap grip on the handle and set the hands in the middle of the chest.  Brace the midsection and hips and move the handle out in front of the body and then back to the chest.  Select a resistance level that permits execution of all repetitions without losing the set up posture.  If one side is more difficult, start the exercise on that side.  Perform fifteen repetitions on each side.

Many of us have terrible respiratory patterns.  We are unable to fully inhale and exhale when under any physical stress.  The Pallof Press can be used to improve respiratory control.  Use the same set up and press the cable out.  Hold the cable with the arm fully extended while inhaling for four seconds and exhaling for six seconds.  Bring the arms back in and then repeat.  Perform four of five inhale / exhale respiration repetitions on each side.

View the video here: View Video

 Michael S. O’Hara, PT, OCS, CSCS

Triathlon Success: Hip Flexor Function

Two of the most important muscles for efficient running and a pain free set of knees are not visible in the mirror.  Most people have never heard the names of these muscles.  Located deep inside the body, covered by innards and all too often, layers of mesenteric fat, these muscles labor unloved and forgotten.  Triathletes interested in optimal performance and a body that remains injury free should give some attention to the iliacus and psoas muscles.

Anatomy

Five muscles flex the hip–bring your femur forward.  Three of the hip flexors attach to the front of your pelvis and run down the front and sides of your thigh.  They are the sartorius, tensor fascia latae, and the rectus femoris.  Two of the muscles attach to your spine and posterior pelvis and travel across all of the lumbar vertebrae, the sacroiliac joint, and the front of the hip joint.  They are the iliacus and psoas muscles.  The sartorius, tensor fascia latae, and the rectus femoris can lift your femur to parallel, 90 degrees hip flexion, and no further.  The iliacus and psoas are responsible for lifting the hip above parallel.  Many people have very weak iliacus and psoas muscles and are unable to flex the hip above 90 degrees.

Multi Joint Control

“Hip flexor” is a very simplistic description of the function of the iliacus and psoas muscles.  The iliacus and psoas flex the hip, but they also rotate the hip, stabilize the pelvic girdle / lumbar spine, decelerate hip extension and co-contract with a team of muscles to hold us upright.  Properly functioning iliacus and psoas muscles keep the pelvis stable when you walk or run and this mitigates stress on the knees and lower back.  When the iliacus and psoas muscles are weak, the pelvis tilts forward and backward.  This rotates the femur in and out and twists the knee.  Your knee joint likes to bend back and forth and dislikes any extra rotation.  Extra knee rotation wears out the back of the kneecap (patella) and places stress on the supportive cartilage (medial and lateral meniscus) of the knee.  A triathlete with a wobbly pelvis places significantly more stress on their lumbar spine.

Triathalon Considerations

Riding a bike shortens and neurologically anesthetizes the iliacus and psoas muscles.  A tight psoas muscle compresses the lumbar vertebrae together and increases pressure in the lumbar discs.  Athletes with “quad strains” often have pain in the sartorius and rectus femoris muscles that has been brought on by overuse of these muscle as they compensate for a weak iliacus and psoas muscles.  Tight and inhibited iliacus and psoas muscles are responsible for the wobbly gait pattern you frequently see as the triathlete transitions from the bike to the run.  Two drills that will improve the function of the iliacus and psoas muscles are listed below.  Read the directions and watch the video.

Standing Hip Flexor Isometric

The Standing Hip Flexor Isometric drill functions as both an evaluation and a method of restoring iliacus and psoas function.  If you struggle with this exercise, you need to spend some time and effort on improving the performance of your iliacus and psoas.  Listed below is a description of the exercise and several activity regressions and progressions.

You need a box or exercise bench.  The taller you are, the higher the bench.  Six feet tall, try a bench that is 24 inches high.  Five foot, four inches, try a twelve inch box.  A mirror for visual feedback is helpful.  Stand with the right foot on the bench and the left foot on the floor.  Hold a pvc pipe, broomstick, or golf club overhead.  Brace the abdominal muscles to keep a tall spinal position and tight lordosis (inward curve) in your lower back.  Lift the right foot off the bench by pulling the thigh up with the muscles in front of the hip.  Hold the foot off the bench in a solid and stable position for five seconds and then lower.  Do not let the position of the spine change.  Do not bend the left knee or tilt the pelvis.  The only joint that moves is the right hip.  Athletes should be able to lift and hold the right knee 30 degrees above waist level.  Start with sets of three repetitions and alternate sides.  As you get stronger, increase the duration that you hold the foot up to ten  seconds.  If one side is weaker than the other, perform more repetitions or an extra set on that side.

Bench Assisted Hip Flexor Stretch

This drill will improve hip extension range of motion and enhance mobility in all of the hip flexor muscles.  Bicyclists often have very flexed lumbar spines and limited lumbar and/or hip extension.  This mobility exercise is the antidote for the physical restrictions created by too much time in the saddle.

You will need an exercise bench or a padded chair that is 12 to 16 inches tall.  Place a cushion or Airex pad directly in front of the bench.  Set up with the left foot on the floor in front of the Airex pad and aligned with the left hip.  Place the right knee on the Airex pad and the front of the right foot up on the bench.  Stay tall through the spine and hold the position for twenty to thirty seconds.  For many people this will be enough stretch.  If you are able take the arms overhead.  Work further into the movement by bending the front knee and moving forward.  Repeat on the other side.

Video of these exercises can be found here: View Video

 Michael S. O’Hara, PT, OCS, CSCS

Triathlon Success: Foot Fitness

Foot and ankle injuries are the number one problem in the sport of triathalon.  The thousands of spins on the bike, impacts on the run, and kicks with the swim can take a toll.  Some preventative training can help speed tissue recovery in your feet and safeguard the ankles.

The foot and ankle are made up of twenty-six bones that are controlled by an elaborate combination of intrinsic and extrinsic foot muscles.  A web of fascia interconnected to the muscles creates a dynamic sling that gives our foot form and acts as a spring to propel   the body through space.  Our feet evolved to guide us over an ever-changing environment of varying surface with minimal support from footwear.  Modern footwear, deconditioning, and prior injuries can all take a toll on the functional mobility and strength of the foot and ankle.  Preventative exercise activities can go a long way to prevent painful injuries in the lower leg and foot.  Watch the video and give these activities a try.

Foot Wave

You can perform this exercise throughout the day and it will help keep your feet healthy and strong.  Point the foot (plantarflex the ankle) and flex all of the toes.  Draw the foot up (dorsiflex the ankle) and keep the toes flexed.  Extend the toes while keeping the foot pulled upward.  Point the foot downward while keeping the toes extended.  Keep the foot pointed and flex the toes.  Move through this exercise in a steady and deliberate fashion.  Take time to feel the muscles activate and stretch in the foot and lower leg.  Repeat the “foot wave” for five to ten repetitions.

Short Foot Drill

The muscles on the bottom of the foot are called the foot intrinsics.  The foot intrinsics function in a manner similar to the core muscles of the torso.  Their job is to brace the foot so it can transfer forces through a stabilized series of boney arches.  Weak or slow to respond foot intrinsic muscles impede the foot’s capacity to decelerate forces.  The short foot drill will improve foot intrinsic muscle performance.

To perform the short foot drill on the right foot, place the right foot flat on the ground and place the left foot back.  Bend the right knee about 20 degrees and lift the left heel off the ground so more weight is on your right foot.  Lift and spread the toes of the right foot.  Lower the toes back to the ground and grip the floor with the big toe.  Contract the muscles on the bottom of the foot.  You should feel a lifting of the foot arches.  Tighten the muscles of the right leg from the calf to the hip and lift the pelvic floor.  Hold this tension in the foot and leg for ten seconds and then release.  Perform five repetitions.

Soft Tissue Mobilization

Treat the soft tissue structures of the ankle and foot with a consistent program of massage.  Three or four times a week, take five minutes and perform some massage stick work to the muscles of the lower leg.  Find a tennis ball and roll out the plantar aspect of the foot.  Deep soft tissue work helps improve circulation, prevents aberrant scar tissue formation, and promotes tissue elasticity.

Cryotherapy

Age brings lower leg arthritic changes and circulatory deficiencies.  These can create pooling of inflammatory byproducts in the feet and ankles created by a week of triathalon training activity.  Cooling the feet and ankles in an ice bath can help break the chemical cycle of inflammation and enhance recovery.  At the end of a training day, fill up a bucket with water and lots of ice.  I like to get most of my lower leg under the water.  Try fifteen to twenty minutes every other day.

Watch our Foot Fitness video for demonstration of these exercises: View Foot Fitness Video

Kat Wood, DPT, ATC

In the April 2018 issue, Mike O’Hara discusses the benefits of the farmer’s walk exercise. Jeff Tirrell tells you how to reduce injury to your ligaments and tendons, and tips are given for getting back out into the garden.

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Spring Trap

Preventing Gardener’s Trauma

After a long, snowy Michigan winter, the first warm and sunny day, we charge outside and clean up the yard.  The months snow bound in the house have made the gardeners eager to start the spring clean up and prepare for the summer to come.  Most of us will spend the winter in a fairly sedentary physical state and with no physical preparation to launch into hours of challenging outdoor work activity.  Every year at our clinics, we treat patients with gardening and yard work induced injuries that could have been prevented with some modifications of activity and preventative exercise.  These are my four hints to help safeguard my gardener friends from an unintended trip to the doctor’s office.

#1: Set a Time Limit.

Most of the patients we see with gardener trauma report that they worked “all afternoon” in the yard.  It is not uncommon to hear patients report they were bending, pushing, or pulling for five or six hours.  Use some caution and limit the duration of your weeding, raking, and shoveling.  Set a time limit of two hours and then stop–the garden will be their tomorrow and you will be less likely to have to undergo a springtime MRI.

#2: Use Proper Ergonomics.

Many gardening tasks place your body in challenging positions.  Ergonomic experts go to great lengths to eliminate forward trunk flexion and sustained knee flexion from industrial work settings.  Pulling weeds and cleaning out flowerbeds combines both of these positions and can create mechanical back and knee pain.  Avoid being in the “hands and knees” position for extended periods of time by changing positions frequently.  Use knee pads to reduce compressive forces on the knee joints and purchase gardening tools with extended handles so that you need not bend as far or as often.

#3: Avoid Lifting Heavy Objects.

After a sedentary winter spent indoors watching television and knitting, the last thing you should attempt is to hoist the 40 lb. bag of fertilizer into the back of the wheelbarrow. Lifting injuries increase dramatically with loads greater than 25 pounds.  Lifting any object from the floor to standing is risky, and carrying unstable loads that can shift around increases stress on the body.  Divide heavy loads into smaller portions and avoid lifting directly off the floor.  Get a bigger, stronger, and fitter neighbor or family member to help with heavy lifting tasks.

#4: Prepare For Battle.

Gardening and yard work are challenging tasks that should be met with a degree of preparation.  If you want to work for five hours in the garden and remain pain free, you must train your body for that level of activity.  I have selected three simple exercises you can do to get yourself ready for action in the yard.  Simple modification of ergonomics, limitations on work duration, and preparatory exercise can prevent a summer of pain.

Getting Ready To Toil In The Soil.

These three exercises can help you avoid injury and make your spring gardening safer and more productive.  Ideally you will perform these drills three times a week for two or three weeks before getting outside and working.

Hip Flexor Stretches

This stretch elongates the large muscle that runs across the front of the hip and attaches to the spine.  This region tends to tighten with prolonged sitting and can restrict hip and spinal motion.  Place one knee up on a cushioned chair and the other foot slightly forward on the floor.  Keep the spine tall and bend the front knee to stretch the hip flexor muscles.  Hold for five to ten seconds and repeat five times.  Perform the stretch on the other side.

Four Point Fold Ups

If you are going to spend time on all fours, it is a good idea to train your body for this task.  Assume a four-point position, knees under the hips and hands under the shoulders.  Keep the hands stationary and drop the hips back toward the heels.  Go back to the point you feel a stretch and hold–do not stretch into pain.  You may feel this in your hips, shoulders, lower back, or upper back.  Hold for five to ten seconds and repeat five times.

Bodyweight Squats

Gardening and yard work involves a lot of squatting.  Being able to safely squat allows you to lift with better body mechanics.  Simple bodyweight squats will strengthen the legs and trunk in preparation for these tasks.  Place your feet at least shoulder width apart.  Check the foot width with a full length mirror– most people squat with the feet too close together.   Keep the heels flat on the floor and squat down by pushing the hips back.  Work on maintaining balance and control during the motion.  Practicing this movement pattern will also improve your flexibility.  Perform a series of ten repetitions and then rest and perform another set of ten.

Michael O’Hara, PT, OCS, CSCS

In the February issue of our newsletter, Mike O’Hara discusses ways to improve hip mobility and strength.  Read Jeff Tirrell’s article on why dairy products may actually be good for you.  Having back pain doesn’t mean you can’t have a fitness program.

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The Coldest of Shoulders

Understanding and Not Understanding Adhesive Capsulitis

Marilyn first noticed the right shoulder pain when she was sleeping on her right side.  Over the next month, the pain became more frequent and more intense.  Her shoulder ached in the morning and after any repetitive activity.  Marilyn tried medications and ice, but the pain persisted.  After eight weeks, the pain decreased, but her shoulder movement had become restricted.  Her shoulder became so tight that she developed difficulty with activities of daily living such as fixing her hair, dressing, and bathing.  Marilyn had developed a “frozen shoulder” and the frustrating thing was that she had no idea why it had happened.

No one fully understands why a frozen shoulder develops.  For some reason, the envelope of tissue that surrounds the glenohumeral joint–the joint capsule, shortens and develops thickened adhesions or scar tissue.  The medical term is “Adhesive Capsulitis”.  This tissue restriction limits the ability of the humeral head (upper arm bone) to rotate and glide properly so your shoulder becomes tight and painful.

Most of the time, a frozen shoulder occurs with no associated injury or activity.  Frozen shoulder most commonly affects patients between the ages of 40 and 60 years old.  It is far more common in women than men.  Individuals with diabetes are at far greater risk.  If you have undergone a surgery or sustained a trauma to the shoulder, you can develop a frozen shoulder.  This is especially true if you have held the joint immobile for a period of time.  Several studies have linked Parkinson’s disease, thyroid problems, and heart disease to a greater incidence of frozen shoulder.  Patients that develop a frozen shoulder are more prone to getting it in the opposite shoulder.  Despite all of this knowledge, we continue to see many frozen shoulder patients that have none of these predisposing factors.

I would add another condition to the commonly mentioned predisposing risk factors for frozen shoulder.  In my career as a physical therapist, it has been a rarity to find a frozen shoulder patient who was strong.  From grip strength in the hand to the muscles that hold the shoulder blade on the rib cage, these patients are usually weaker than their same age and sex peers.  The strength in the unaffected arm is often as limited as the arm with the frozen shoulder.  My belief is that the most common risk factor for developing a frozen shoulder is upper body weakness.  The glenohumeral joint is a fairly unstable joint that relies on the integrity of the muscles to kept it free from trauma.  If the shoulder muscles are unable to properly control the joint, then excessive stress is transmitted to the joint capsule and an inflammatory response ensues that scars and tightens the capsule.

Physical therapy for a frozen shoulder consists of manual therapy to stretch out the shortened joint capsule and a program of exercise to restores shoulder range of motion, coordination, and strength.  Most of the time, we get the patient when the shoulder is at its tightest point and recovery takes six to ten weeks.  As with so many conditions, the patients that get to therapy earlier or before the shoulder is fully frozen do better with therapy.

In many ways, Marilyn is the typical frozen shoulder patient.  She is the correct, age, sex, and fitness level.  Further medical work up revealed that she was prediabetic and in need of some ongoing medical attention.  Marilyn was a model physical therapy patient and her shoulder function was restored with six weeks of physical therapy.

Michael S. O’Hara, PT, OCS, CSCS

In the January 2018 issue, Mike O’Hara focuses on strengthening your hamstrings.  Exercises to make your hamstrings stronger, not longer are given along with video demonstration.  Jeff Tirrell tells us how to make incremental changes in our diets to see positive changes, and the spotlight is on Fenton Fitness member, Robin Forstat–a nationally ranked power lifter.
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snapshot-1-11-9-2016-12-58-pmThe New York Times recently reprinted an article by Jane Brody entitled “Posture Affects Standing, and Not Just the Physical Kind.” In the article, Ms. Brody talks about how poor posture creates problems across multiple areas of physical function. The respiratory, digestive, emotional, and neurological systems are all impacted by postural restrictions. You are even more likely to be a victim of crime if you have a slumped over posture. So how do you develop better posture?

Get Up Out of the Chair
Ergonomic chairs, elevated monitors, slanting keyboards, and lumbar supports are fine, but nothing works as well as standing up and walking around every fifteen minutes. Office modifications, while well-intentioned and generally a good idea, cannot compete with endless hours of desk sitting. In order to fight against the postural stress that creates pain, we need to get up and move. Everyone wants an exact number, so I suggest that after fifteen minutes of sitting, you stand up and walk/stretch for three minutes. The best advice is to get a standing desk and completely eliminate working in a seated position.

Perform Posture Correction Exercises Every Day
If you want to abolish the neural and connective tissue restrictions created by postural flaws, you need to work on it every day of the week. Two or three visits to the gym will not be enough. You need lots of repetitions over a long period of time to reverse the changes created by hours slumped over the desk or strapped in a seatbelt. Specific exercises that wake up your nervous system, strengthen your postural muscles, and reverse tissue shortening are required. It should take you no more than 90 seconds to complete one or two of the exercises listed below. Set a timer, enlist the help of your coworkers, and work at these exercises every day. See the exercise suggestions and video presented at the end of this article.

“This Feels Weird”
For most Postural Stress Disorder (PSD) patients, standing upright and sitting tall will feel abnormal. Their body positioning neural feedback mechanisms have been damaged by years of improper loading. Feeling better with a more upright and stable posture will take between six weeks and six months to achieve. Very often, “other sensations” go away fairly quickly– Migraine and sinus headache episodes are less frequent. That torn rotator cuff no longer creates shoulder pain. The arthritis in your hip is less problematic. The plantar fasciitis pain in your foot resolves. The pain symptoms caused by poor posture are far more widespread than most people realize.

You May Have To Avoid Certain Activities
Your gym program and recreational activities can make your posture worse. When you exercise, avoid movements or activities that pull your head and spine further into a forward bent position. The rowing machine and the exercise bike are often poor choices. If you have postural problems, do not perform sit ups, crunches, or any other repeated or sustained spinal flexion. Avoid exercises that shorten the muscles in the front of the shoulders such as bench pressing and flys. Most PSD sufferers sit too much, so refrain from any fitness activity performed in a seated position. The most important thing a good fitness coach can do for clients is put them on the path to postural integrity.

How Long Will it Take to See Changes?
Most physical therapy patients report that the exercises get easier and they feel better after three weeks. Postural correction is a long-term project and clients continue to see results twelve months after starting on a consistent program of postural retraining.

So What Do I Do?

Chin Tucks
The forward head posture of the average computer operator creates all kinds of adaptive tissue changes in front and in back of the neck. Some daily chin tucks can mitigate the damage. Stand at attention, pull your shoulder blades back, and push your chest forward. For many of you, this is going to be challenging. Place you finger tips on your chin and gently push your head straight back. Visualize your head being pulled upward by an imaginary string attached to the crown of your head. Hold for two counts and then release. Perform ten repetitions.

Doorway Stretch
Office workers perform so many tasks with the arms forward and head down that they develop restrictions in the muscles in the front part of the shoulders and chest. Use a doorway stretch to reverse this adaptive shortening. Stand up with the elbows placed at shoulder level against the doorjamb. Step one foot forward through a doorway. Hold a gentle stretch for ten seconds and then lower the arms and rest. Perform two or three ten second stretches.

Overhead Back Bend
The sustained forward bent sitting posture tightens the front of the shoulders, inhibits thoracic spine extension, and can mess up your respiration. You can reverse all of these with some overhead back bends. Stand with the feet shoulder width apart. Reach the arms over your head and bend backward. Allow your hips to come forward and lean back into your heels. Breathe in through your nose and let your stomach rise. Breathe out through your mouth and let the abdomen fall. Perform three or four deep abdominal breaths while holding the arms overhead.

Standing Tubing Rows
Prolonged sitting weakens the upper back and shoulder retractor muscles. Standing tubing rows strengthens these muscles. Purchase an all-purpose band ($25.00) from performbetter.com and set it up in a door at work. Grasp the handles and stand tall with the arms extended and tension on the bands. Contract the muscles between the shoulder blades and pull the handles toward your body in a rowing motion. Hold the elbows back for two counts and then return to the starting position. Keep your neck relaxed during the exercise. Perform eight to fifteen repetitions.

View video of these exercises: https://youtu.be/KktwMew5Wks

Read the NY Times article here: http://well.blogs.nytimes.com/2015/12/28/posture-affects-standing-and-not-just-the-physical-kind/

-Michael S. O’Hara, P.T., OCS, CSCS

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