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Saturday, December 31, 2016

Your New Year's Transformation: Corrective Posture and Exercise Therapy

Your New Year's Transformation
Corrective Posture and Exercise Therapy
Ashley Osier
MA, HHE, CPS, CSMT, CAMT


I was thrilled to have completed my program in corrective posture therapy last year. It confirmed much of what I learned in working with a posture therapist years ago to rehab my own back injury and completely supports the therapeutic micro stretching and fitness method I created over the years. The program presented scientific research and studies on the benefit of corrective exercise to rehab injuries, correct postural discrepancies, reduce pain symptoms, and prevent future injuries from occurring. Studies now show that long held postural discrepancies are impacting people's ability to prevent falls in the shower, effectively squat down and get up from the toilet, walk quickly to the door in an emergency, or hold a phone to make an emergency phone call. To put it plainly, our mortality rates are being affected by our inability to perform basic activities of daily living! This is not good folks, but it is a great wake up call to make these life changing transformations for the young and old…now. 

So let's talk about it more!

Becoming more aware of how we hold and use our body makes it more possible to age better, rehab from injuries more successfully, and prevent injuries and excessive joint wear and tear. Being more aware is not the only piece of the puzzle, which is why corrective exercise is so important in keeping the postural corrections in place for the long haul. The following photos and information provide just a few examples of how corrective posture and exercise therapy can change your life.






The stretch above may look simple, but for someone who has longstanding postural discrepancies it can be  quite painful. You can see how rounded his spine is even though he is trying very hard to stretch his arms above his head and straighten his back. This rounded posture does not happen overnight and structurally changes one's entire body mechanics, function, demands and comfort when awake and asleep, resiliency, and aging process. A rounded upper back has nothing to do with age. I have seen children with the same structure discrepancy. Hopefully parents will become more aware of how their children are holding their body and encourage subtle corrections early on to prevent extreme postural changes.

Let's look at another client in the same position. She is almost 20 years older than the client above, but she does not have any roundedness in her shoulders. However, just a year and a half ago, she was unable to lift her left arm more than three inches away from her body and was diagnosed with frozen shoulder. By combining corrective postural work, corrective exercise, and therapeutic bodywork, she not only has full use of both of her arms, but her structure is more balanced, flexible and strong. We are extremely pleased with her successful outcome and she is now excited about getting more fit.




Let's look at the photo below. Can you see any postural discrepancies? If we start at the top we can see that his head is arched back, which narrows the spacing between the vertebrae in the cervical spine and pushes his throat forward. The angle of his ears reflect the excessive arch in his neck from pushing is head forward for so many years.  His shoulders are unable to relax toward the floor, which has been greatly reinforced by longstanding poor posture. His rounded shoulders are key players in his shortened pectoral muscles which, if not stretched, will tighten further, pull his shoulders forward more, weaken his upper back muscles, and reinforce more postural discrepancies.




Practicing simple corrective exercises as in the photo below can make someone with advanced postural discrepancies sore. So staying practical with expectations and setting a timer with an alarm, for example, is useful in making sure you get the time needed each day to work on changing structural imbalances. A simple routine of 3-5 minutes upon waking and going to bed can be useful for many people. Others who are more severe will need to practice corrective exercises throughout the day to reprogram the muscle memory to hold the corrections. Applying corrective exercises at home, on the road, and at work is quite practical. Cars with high head rests for those who travel everyday can also be useful for regular practice. Workstations can easily be transformed by raising a computer, positioning the computer to be directly in front of you, using a stand/sit desk, and having a swivel chair with a high enough back to rest the head are all practical solutions. I will often encourage clients to integrate the Point Release™ Technique in their postural corrective work whenever they are traveling or working.  You can read more about that here.



The Grid Assessment






The grid assessment is truly eyeopening and I am sure you will agree by the end of this posting. The testing grid is made up of 2 inch squares that are evenly distributed above, below and on either side of darker and thicker marker lines. Clients stand in each direction so that they are in line with the center line and after photos are taken, they are able to add up and subtract the squares.  In each calculation, clients can verify where they are straight, rotated, tight, weak, and tilted. Then a corrective assessment in front of the grid with photos allows clients to feel what muscles will be needed to correct the imbalances and the photos will help them to clearly see that these corrective micro exercises actually change their discrepancies. Assessments are done standing, seated, and in corrective postures, exercises and stretches so that clients can see their progress and note where they need to continue working to achieve their goals. Post assessment stretches and exercises are given to reeducate the muscles and hold the structure in a new and corrective way.



Let's see how this actually works...










Here is a client seated without the grid. He looks to be sitting straight, but you can probably tell that his head is too far forward. Our goal is to align our ears with our shoulders, right? So we can verify that his head is a bit forward without having the grid behind him.


What happens when he stands in front of the grid?

                                          Before                                                 Initial Correction



What do you notice? With a small correction, he is slightly taller. You wouldn't have thought his chest was so collapsed in the seated position if you didn't have the grid or the corrected photo would you? When he uses his core muscles, engages his diaphragm and corrects his shoulders, his spine completely transforms.  You can tell by counting the squares at the low, mid and upper back sections. His hands are more at his sides than toward the front, which strengthens his upper back in the correct muscular engagement. His head is lengthened and slightly pulled back so you can see his nose slightly pulled back and even to the line as opposed to forward and below the line. His head is not as forward as in his seated photo, which is good because the seated photo was taken over a year ago. Without the grid assessment, these minor corrections are impossible to see and remember to maintain. Now he gets to keep these photos to remind him of what to do each day.









Let's look at this client of mine without the postural grid. Even without it you can see her neck and shoulder postural discrepancies. Her right shoulder is dropped, her left shoulder is raised. Her right hand is more forward on her leg, which reflects the forward rotation of her right shoulder. When we have more rotation in one shoulder than the other, it often creates a chest/rib rotation, which then affects rotation in the spine and weakens our back muscles over time. Now let's see what happens when we put her up against the grid.




Can you see how the squares behind her more clearly reveal what the postural discrepancies are and where in her body has the most challenges? The grid really shows the rotations in her neck, upper and middle back and even in her hips. Her feet are even, so it is not a matter of readjusting her feet. She is truly standing in what she thinks is straight. Though we can see her right arm more forward on her leg in the seated position above, we see how advanced the rotation is against the grid. After three car accidents, corrective work will take time and patience.

It is important to mention that working with clients who are in pain requires a conservative approach until pain symptoms decrease and are stable. I saw a personal trainer one time working with a 60+ client who told him she was on anti-inflammatory medication for her pain. This was her response to him instructing her to lift 10 pound weights. He responded in a demeaning way and persuaded her to push herself even though she was in pain. I was hesitant to say something, but his instruction was simply too much for where she was at. He seemed thankful for my input and I am glad I spoke up. Though soreness from exercise and even corrective work can happen, there are certain kinds of pain that are not appropriate, therapeutic, or corrective.  Most personal training programs are not thorough enough in this area so be please be careful when working with a personal trainer. 

Seated Grid Assessments and Corrections


Photos taken in a seated position for those individuals who sit for many hours each day can give critical insights to much needed corrective work. Children of school and college age sit in their chairs one to seven hours each day with a five minute break in-between classes and a modest recess/lunch break. During lunch they often sit for another 20-30 minutes in seats that are likely unsupportive. Let's look at these seated photos in front of the grid. 

                                                        Before                                   Initial Correction

You can see the difference between the before and corrected photos. Many kids either sit back in their seat with their shoulders raised or they sit in a slumped position. Neither postures engage the core muscles or aid in corrective structural alignment. You can see the difference in his shoulders. He naturally has sloping shoulders (right is actually slightly lower than the left), but his default inclination is to sit back with raised shoulders. His corrected posture shifts his body to the edge of his chair, which naturally puts him into a relaxed but upright and mostly even posture. Squaring up the hips with the feet straight forward and flat on the floor provide for more stabilization all around. Even if he sits back in his chair, he can still sit with corrected posture comfortably throughout the day. This child is right handed, so he likely sits at his desk with his right shoulder forward and elbow resting on the desk to write. This repetitive action educates his muscles to hold his shoulder down more than the left. Awareness of how he holds his body and what actions he performs repetitively will help him to make corrections throughout his daily activities.


Post Assessment


After assessing postural discrepancies, clients are given exercises and stretches to gently begin stretching and strengthening in a way that lengthens tight muscles, strengthens supporting muscles and shifts the structure holding the discrepancies. Corrective exercises and stretches are similar to but initially unlike the regular exercises you may do with the help of a personal trainer.  As schools are becoming more educated, we are seeing specialized classes for personal trainers to take and implement in their work. However, a class is different from a specialized program. Working with a Certified Posture Therapist, will give you the most optimal outcome without risking injury, prolonged pain, or decrease of function in the future.

My client below has been working with me correctively for about seven months. He needs both hips and both knees replaced and had his first hip replaced in August. His structure has many discrepancies due to a number of issues in his hips and knees. Over time, he has  compensated structurally to offset the weaknesses and imbalances. Though he has had one hip replaced, he still needs to apply corrective stretching and exercises to begin the process of reeducating his muscles to hold a stronger and more resilient structure. One simple but truly difficult corrective exercise for him is to shift his chest to the left and hold it. You can see the changes from before and corrective photos how much more balanced he is from the waist up. And yet the amount of effort that is required to hold these corrections is a work out in and of itself. I had him tuck his shirt in so there was no way to cheat. His core is engaged as well as his upper back and neck muscles. His shoulders are more even to the solid blue line. He is even a little taller. 

                              Before                                                                      Applying Postural Corrections

Though there is more work to be done, he has done an excellent job given his structural circumstances. He deals with bone spurs in his hip and bone on bone pain in his knees. If he continues working correctively, he is going to be very happy with the final results. When all of the surgeries have been completed, he will be very fit and will not need much time for the the other areas to catch up. This is yet another benefit of applying corrective posture and exercise therapy when looking at having surgery. 

Corrective posture and exercise therapy takes time and is a building block model to future successes. As the muscles begin to remember to hold in the corrected posture, clients can move to the next step of corrective work and so on. More photos with grid assessments will be taken and other assessments to measure progress and successful outcomes.


Applying Corrective Techniques with the Grid Assessment


Here is another example but using corrective work to increase structural discrepancies in the hips. My client below has one hip that is tighter than the other which created problems with her low back. As we apply corrective stretches and exercises to her routine, she has become more able to practice advanced stretching techniques to open her hips. In order to see results, the grid is able to assess her progress and she can use the photos to reference her progress and to encourage her in her own practice at home. Though I have taken photos of each foot forward, I am presenting her tighter side, left hip, so you can see how the grid works with a corrective exercise and stretch. Can you see any improvement after three minutes of the sandbags being applied in the hip opening stretch? 

Count the squares where the top of her knees are at and notice how much flexibility she has gained after applying the corrective stretch. It is important to note that her after photo includes her engaging her core and glute muscles to open the knees and press them down to the floor. It takes an incredible amount of effort and concentration to hold this position for many people, but with practice, more strength and flexibility is gained.

                          Before                                                                              After Corrective Technique


Aided stretching techniques are quite useful to promote gains in flexibility. She really has to concentrate and breathe while she relaxes her body and releases her hips. She loved this application so much she bought her own sandbags and practices this at home.


Corrective Sandbag Technique


A well balanced structure is the foundation to all corrective posture and exercise therapy. Any exercise or stretch will not do if they increase postural discrepancies. I truly believe that corrective posture and exercise therapy is going to transform our fitness industry. Chronic pain and injuries in the aging population and in youth athletes is on the rise as is the use of over the counter pain relievers and prescription drugs. Stay tuned for more posts on corrective posture and exercise therapy, therapeutic stretching and pain management with the Point Release™ Technique, and the StretchFit™ Method. 

For more information or to schedule an appointment, you can contact me at ewsomatherapy@gmail.com. I would love to implement a posture program at the elementary school level as well as implementing something in a retirement or assisted living community.  So if you would be interested in partnering up in either of these two areas, please let me know. 

Have a blessed New Year and use the coming year to transform your life by increasing your awareness of how you hold and use your body. 

Joyfully,

Ashley


Instagram (@theposturespecialist)
eastwestsomatherapy.com




Ashley Osier is a holistic health educator and therapist, stress management therapist, corrective posture and exercise specialist, an acupressure and massage therapist, stretching, massage, acupressure, and self-acupressure instructor and creator of the Point Release™ Technique and StretchFit™ Method. She specializes in working with stress management, injury prevention and pain relief, therapeutic stretching for individuals and couples, and posture awareness. She also offers coaching in nutrition and support for women going through divorce. Appointments can be scheduled by contacting her at ewsomatherapy@gmail.com.



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