Changing Strategies of Posture and Movement
Different ways, or strategies, for transferring loads through our body are available and in health we have a number to choose from. The strategy we use for the task at hand is often based on our body's structure, the load we are about to handle, the movement we are about to make and how predictable the situation is. Three common non-optimal strategies for transferring loads through the low back, pelvis and hip are:
How do you know which one, if any, you are? Perhaps your physiotherapist has told you. If not, consider the following.
Are You a Butt-Gripper?
Do you subconsciously tighten your butt either on one or both sides of your pelvis all day? Take a photo of your buttocks in either your underwear or some tight exercise pants and compare your buttock to the picture on the right. This picture is of a bilateral butt gripper. Note the drawing in of the fabric at the bottom of the pelvis, sometimes you will even see the fabric go up the cleft of the bum, sure signs that you are using a non-optimal strategy for transferring loads through your pelvis and that you are a butt gripper. You can also test yourself by feeling the shape of your buttock. Stand up for a few minutes and place your hands on the sides of your hips just behind the bones. Do you feel a big divot under your hand? Can you relax your buttock muscles and does this change the shape/divot any further? Once you become aware of this clenching or gripping habit you will begin to notice how often during the day you use this strategy.
You are not alone. Butt gripping is a common strategy seen in men with athletic histories (hockey players, soccer players) dancers who live in turn out and is also commonly seen in mothers. The consequences of butt-gripping are that this strategy:
1. forces the head of your femur forward in the hip socket and stresses the tissues of your groin potentially leading to groin pain or pain around the pubic symphysis
2. restricts the movements of your hip joints, particularly for flexion movements and thus impacts how you bend forward and how you squat (move in and out of a chair). The figure on the left below is of an optimal squat. The breast bone is lined up over the pubic bone, the hips, knees and ankle fold such that the line of gravity is directly through the center of the knees and feet and the spine is maintained in a neutral position. On right, is the same fellow being a butt-gripper. Note how his bum is tucked under, the distance from his breast bone and pubic bone is shortened, his neck is extended and his back is rounded (flexed). His knees are forward of his feet - not a great position for power or for mobility, yet this is often how people move to sit into a chair.
Watch this short video clip of a butt-gripping strategy and the postural and movement corrections necessary to perform an optimal squat. It's not perfect but it's certainly better than it started!
Sit Training for the Butt Gripper
People who grip just one side of their buttock/hip when they squat will often sit with their pelvis twisted. The twisted pelvis sets up a twisted spine and blocks the ability to freely rotate your chest while sitting. People who grip both sides of their buttock/hip when they squat will often end up sitting on the posterior aspect of their pelvis. Note the difference in the lumbopelvic alignment between this posture of sitting and the optimal posture of sitting.
Watch the following video clip (our heads are cut off to protect the client's privacy) to see how the butt-gripping strategy is corrected through teaching an optimal squat to sitting and some key points to consider while sitting if you are a butt gripper.
Are you a Back-Gripper?
Do you subconsciously lift your chest to correct your posture all day?
Take a photo of your posture from the side and compare to the picture on the right. This picture is of a bilateral back gripper. Note the forward tilt of her pelvis and the long curve of her spine. There is lots of work being doing by the long back muscles here this posture is often associated with multiple trigger points in the erector spinae muscles. Back-grippers love massages and love to stretch into flexion, however it only gives them temporary relief because as soon as they stand again, they fall back into the back-gripping posture.
You too are not alone. Back gripping is a common strategy seen in dancers, gymnasts and others who have tried to "sit up tall", be bigger, stick out their chests etc. It is the military stance. The consequences of sustained back-gripping are that this strategy:
1. forces the joints of your spine together potentially causes a mid or low back ache, especially when you stand for prolonged periods of time
2. restricts the ability of your spinal joints to bend forward, lengthens your anterior core muscles which makes them less powerful.
In the photo below on the left is our same fellow back-gripper. Note how his back arches and the distance from his breast bone and pubic bone is lengthened, his neck is overly extended as is the rest of his back. His knees are over of his feet, however a large part of his mass is behind his center of gravity and this excessively loads not only his back but his knee joints. Again, this is not a great position for power or for mobility, yet this is often how people collapse or fall into a chair. The photo on the right is of a real back-gripper, not someone just pretending! Note how strong her back muscles look compared to her abdominals.
Back-grippers need to practice a functional squat as well. Instead of focusing on release the hip joints, they need to think about maintaining the distance between the xyphoid and the pubic bone (i.e. not letting this distance increase and their back "hinge". If this is you, practice your squats with a broomstick down your back to help you maintain the neutral spine posture as you direct your hips down and back as if to sit in a chair.
Are you a Chest-Gripper?
Do you subconsciously squeeze your chest or upper abdomen in an attempt to flatten your lower abdomen all day?
Take a photo of your posture from the side and compare to the picture on the right and below. This picture is of an extreme chest-gripper. In more subtle ones you just see a narrowing of the chest and two long lines running vertically down the abdomen.
Note the protrusion of her lower tummy and the apparent intra-abdominal pressure. Excessive activation of the external oblique muscle (superficial abdominal) has been found in women with stress incontinence and you can see why. Prolonged use of this strategy and the excessive increase in intra-abdominal pressure it creates would be hard for the bladder and uterine support system to handle for long.
If you look like this, put your hands on either side of your chest and take a breath. Chances are, your lower chest doesn't expand but rather only expands in your upper chest.
You too are not alone. Chest-gripping is a common strategy seen in a lot of postpartum women attempting to regain a flat tummy as well in athletes who have done tons of situps and oblique abdominal curl-ups (situps with rotation). The long term consequences are that this strategy:
1. compresses the joints of your rib cage thereby restricting rotation and extension of your trunk - this is really bad for your golf or tennis swing
2. restricts the ability of your rib cage to expand and can potentially lead to disordered breathing and a whole host of symptoms that go along with that - see Capnometry Assessment and Training for disordered breathing
3. significantly increases your intra-abdominal pressure putting your pelvic organs at risk for prolapse and for stress urinary incontinence.
Learning to breathe properly is essential for the chest gripper. In a supine supported position (lying on your back with your knees and hips bent) put your hands on either sides of your rib cage. Think about relaxing the muscles of the upper abdomen and breathe into your hands slowly expanding your lower rib cage like an umbrella ? all the way around. Move this practice to sitting and then to standing. DON?T try to flatten your abdominal wall by drawing your navel to spine - this only tightens these superficial abdominals more, relax the chest, relax your upper belly and find your cue for the deep stability system - see lumbopelvic core muscle training practice.
MORE PRACTICE TIPS AND VIDEO CLIPS TO COME OVER THE NEXT FEW MONTHS - COME VISIT US AGAIN AND SEE WHAT NEW TIPS WE HAVE ADDED FOR YOUR POSTURE AND MOVEMENT PRACTICE!
