Are Your Clavicles Where They Should Be For Pain Free Movement?

New eBook Based on the Myofascial Self-Care Workshop

My eBook A Beginner’s Guide to Myofascial Self-Care: How to Relieve Pain, Tension, and Stiffness Naturally and Start Feeling Better in Just Minutes is now available in two formats.

If you’ve been to the workshop and want a reminder of all the great releases plus many more, this is it!  It is 80+ pages of instructions with pictures. Over 400 people have attended this live workshop over the past 3 years and loved it. I frequently get the comment, “why don’t people know about this!?”. I’ve been percolating this for many year and I’m so pleased to offer this information to the world in the form of a video based class and a book.

Or do you have a friend or family member you wish you could bring to the workshop, but they are unable to get here?  This ebook or the video-based workshop is the answer.

The Kindle version is available on my Amazon author page. 
Or as a downloadable PDF on my Teachable site. You can find the video based class here too.

A special thanks to The Freckled Lexicologist (aka my daughter) for all the editing support. And, my clients who inspire me daily to continue to improve.

You Can’t Heal if You Don’t Breathe

A settled nervous system is a prerequisite to healing. -Resmaa Menakem MSW, LICSW

I recently participated in a book club. A new friend invited me because she was aware of the work I do and we had recently had a conversation on how to create yoga classes that are trauma sensitive. The book was My Grandmother’s Hands by Resmaa Menakem, MSW, LICSW.

Affiliate alert:

The book takes a look at how trauma is held in the body and not just influences our behavior but often overrides our thinking and in turn our actions. The book focus on race issues in our culture and the cultures of our ancestors. Despite having studied quite a bit about body based therapies, breathing, and the nervous system, this book brought many “wows”, “interesting!” and “I never looked at it that way” from me. I think it is an important book and everyone can benefit from reading it.

When I meet a new client, one of the first things I check is how they breathe. Are they using their diaphragm? Not just to settle down or sing, but ALL THE TIME. It is our most natural way to breathe. Our body has a built in efficient way to breath but we don’t use it for many reasons. I always tell my clients, if you get nothing else from me, please breathe with your diaphragm ALL THE TIME.

One of the first videos I created was about diaphragmatic breathing. Even though, it was a early effort, I keep it up because it is important. Please take the time to view it. Three and a half minutes.

I tell my clients that they must breathe with their diaphragm when I’m working on them. I am able to do sooooo much better work for them when they are breathing correctly which in turn relaxes their nervous system and their entire body. We practice it until they can feel it and do it on their own. Surprisingly many people find it quite challenging. During myofascial release work, it makes a huge difference in the outcome.

Regardless of what you are healing from, learn to settle your nervous system. It is the first step to healing.

Quick Posture Check: Number One Change You Can Make Immediately

Use a yoga strap or a belt that has a buckle that will hold the strap taught. Place the strap right over your hip joint.  Lift your foot off the ground by lifting your knee to help you find the right spot.  Adjust the length of the strap so it doesn’t touch the ground. Look in a mirror to see where the strap falls. 

If your strap is falling forward from your ankle as in the photo on the left, you are leaning too far forward and likely putting weight in the forward part of your foot. This is not good posture.  
Our bodies are designed to stack up like a building. One story is stacked directly on top of the next.  Our knee joint should be stacked over the ankle joint.  The hip joint should be stacked over the knee and ankle. 

Back up your hips until you see the buckle line up with your ankle as in the photo on the right. You may feel like you are to topple backwards.  With practice, this sensation will go away.  Start by feeling the weight of your body in your heels. 

This small change can make a world of difference in your experience of pain and tension immediately, and over time. This is how you are designed to stand. This small change will help with pain in the feet, calves, hips, low back, and neck. Seems like a pretty hefty promise, I know.

Leaning forward is like holding a bowling ball with your arms outstretched.

Consider this, leaning your body forward is like holding a bowling ball with your arms outstretched. It takes a lot of work. If you are going to hold something for a long time, you hold it as close to your body as you can or even put it on your shoulder. Leaning forward constantly is asking your body to do a lot of extra work.

Another quick check can be done by looking at the side seam of your pants.  Is is vertical or does it angle forward?  Try to make your seam vertical. 

The next step is stacking the shoulders over the ankle, then the ear over the shoulder. 
You don’t have to be in perfect posture all the time, but this simple posture should feel as comfortable as any other posture.  If it doesn’t, your muscles are out of balance and your fascia is doing overtime to support your body. Poor posture plays a role in tension and pain. Stack your body up well!

If you can’t seem to change your posture, get help.  Take a stretching workshop or get one on one myofascial release. This softens your body and makes better posture more achievable and comfortable.  

It’s your move!

Tweaky Low Back? Try this stretch.

This stretch is an old favorite, just like the sweatpants I have on in the photos. I’ve suggesting this stretch to several clients and friends lately so I thought I’d add it here. 

Firstly, most adults do not like to get down on the floor.  There are many benefits to getting on the floor and it is the safest place to exercise. You can’t fall down! Look at the act of getting on the floor as part of your exercise. It makes so much of your body move it ways it needs to in order to stay healthy. Here’s another pro tip.  Keep a mat set up somewhere in your home so you always have an easy and clean place to get on the floor. Keep a chair next to it so you can use it to get up if necessary. 

This stretch opens the space between the ribs and the hips.  The big quadratus luborum muscle, as well as many other muscles and the surrounding fascia are being stretched.  Follow the link for a picture of the anatomy if you like. This stretch will help to take the tension out of this space and take the pressure off the spine and associated nerves. This can help to relieve that stiff and tweaky feeling in the low back. 

Here’s how. Pay attention to the details. They matter!

  • Stretch the side that has more symptoms first. If the symptoms are equal, start with either side. Always do both sides. Sit as shown in the first photo.
  • Come down onto the elbow as shown. While keeping your lower hip in place on the floor, roll your top hip toward your head so that your hips are stacked vertically as shown by the green arrow. You may not be able to completely stack them until you reduce the tension as you practice the stretch.
  • Slowly straighten your lower leg. Press the heel away from you as shown in photo 3.
  • Bring the top knee forward and towards the floor. Pay attention to how this affects the sensation you feel. If it is too intense, back off. Allow the shoulder to gently move up toward the ear. This will add slightly more stretch to the ribcage.
  • Move your top arm and shoulder forward or back to determine where you feel the best stretch in your body.
  • Hold the stretch for 10 to 20 slow breaths.
  • Repeat on the other side. Always do both sides. Hold the side that is more symptomatic slightly longer.
  • Advanced option: To reach even deeper into the side body is to place a ball or half-roll between your body and the floor. The ball should be placed between the lower rib and the hip. Follow the myofascial principles when using this technique.

Want to learn more, feel great, and have a body you can rely on to do what you want to be able to do? Join the unlimited classes to begin creating a resilient body or make an appointment to learn more if you are not sure where to start. Make an appointment.
It’s your move!

Have you tripped on nothing lately? Check your ankle mobility with this easy test.

Have you ever had one of those embarrassing moments when you tripped on seemingly nothing?  It may have been a slight change in the sidewalk or grade of the parking lot.  You look around to see if anyone saw your stumble and then look down at the ground like it is the ground’s fault. Or worse, yet, you actually did fall. It is NOT the ground’s fault. It may be your ankles. Check the basic mobility of your ankles with this simple test.

Why should you do this test? When was the last time you challenged the mobility of your ankles? If you sit or stand in place most of the day, frequently wear heels (even many athletic shoes have a slight heel), walk primarily on flat surfaces, and rarely take the stairs, then you are asking your ankles to do very little for you. As a result, they stop moving in all the wonderful ways an ankle is intended to move.

One of the most important ways the ankle needs to move for us is by helping to lift the front of the foot up. This motion can be lost from weakness in the muscles in the front of the calf, tension in the back of the calf, or stiffness in the front or sides of the ankle.  Or, it could be all three.

Lifting the front of the foot up is important for walking. This motion becomes even more important for walking on uneven surfaces, hills, and stairs. If you noticed that you have caught your toe on an uneven sidewalk or when going up the stairs, do this test and see if your ankles are lacking mobility.

Ankle Mobility Test

  1. Make a fist with the tip of your thumb poking away from your hand and place it next to the wall, as shown in the photo above. If you can’t do this yourself, measure your fist or ask a friend to help you. 
  2. Place the big toe of your left foot next to the edge of your fist, as shown.  
  3. Keeping your left foot in place and keeping your heel on the floor, try to touch your knee to the wall. You can allow the other leg to be in whatever position you feel will help you. 
  4. Repeat with the right foot. 


As you can see, our model is able to touch her left knee to the wall.  It took a little effort, but she was able to touch.  The right knee would not touch.  She admitted that she has caught that foot on uneven surfaces and has started feeling she needs to watch where she’s walking more.  She reported she injured the right ankle a while back.  Can she correct this?  Yes, with a little focused stretching.  Attention to this issue will help to prevent a fall as she ages!

A Note on Falls

There are many potential reasons for tripping and falling beyond ankle mobility including vision issues, vestibular issues, sensory issues and weakness in other areas of the body. When falls there are really two primary areas to consider. One is the initial loss of balance, which could be due to any of the issues listed above, and two, our ability to catch ourselves when we stumble. The mobility and strength of the lower body, namely the ankle, is significant in helping to catch us when we stumble.

Falls and Fascia

A very significant finding in myofascial research in the past year is that the retinaculum or the strap of tissue across the top of the ankle is one of the most highly innervated structures in the body. If you’d like to learn more about fascia research, check out the book Fascia, Function, and Medical Applications by David Lesondak and Angeli Maun Akey. This structure gives us sooooo much information on where our body is in space (proprioception) which helps us know where our feet are and therefore keep our balance. The more mobile our ankles are, the more information we can get from them. This information coordinates with vision, sensation, etc. to keep us upright and safe.

Your Results

If you are able to touch both knees to the wall easily, awesome!  Your ankles are probably in good shape. But, you may still have a weakness issue if you are not easily able to lift your toes. If it takes some effort to touch your knee to the wall, or you are unable to touch your knee to the wall, you have some work to do.  The good news is that you can change this (unless you have metal rods or screws limiting your motion).  It will take some effort, but our bodies are very moldable, even into our 60s, 70s, 80s, and beyond. 

You have options to make change. Myofascial release can help the tissues become more mobile and all the wonderful layers of fascia, ligaments, tendons and muscles glide freely. You can also learn to stretch your ankles along with all the other parts of your body that help support your function and keep you safe (um, all of your body).

Want to learn more, feel great, and have a body you can rely on to do what you want to be able to do?  I’m starting natural movement classes again in October. The first 30 minutes of class will be focused on beginners so anyone at any age can join. More info here.  

Not sure where to start or need a personalized program? Make an appointment for a New Client: Natural Movement Consultation.  If you’re already a client, make a one-hour appointment.  

It’s your move!

I’ve Fallen and I Can’t Get Up!

This was a line made famous by a commercial for senior alert necklaces over a decade ago. According to the CDC our risk of falls is continuing to rise and by 2030 we’ll have 7 fall related deaths per HOUR if the trend continues.If you are in your 50s and up or have loved ones in their 50s and up, you MUST read this.

I chose this as my article this month because in the past two weeks I worked with two clients, both in their 80s and very active. They walk, exercise, mow the lawn and lead fun productive lives. Both fell unexpectedly and could not get up. It was a scary several hour ordeal of being on the ground until help arrived. They were amazed and confused because once someone helped them to a chair they could instantly stand up and walk. WHY?

First let’s address the falls themselves. The circumstances were quite typical and could send any of us off balance: a wet floor and wet grass. Why do seniors fall more than younger folks in these instances? Having good joint range of motion and the muscle strength to react quickly are extremely important. If we’re not continually challenging ourselves with activities or exercise that helps to maintain these as well as challenging our balance, we put ourselves at risk. Often, we don’t know it is gone until we need it. However, this is NOT enough.

Over time, lots of sitting can reduce the range of motion and strength in our lower body.

Let’s examine why someone who can mow their entire lawn with a push mower can’t get up from the ground. He has plenty of strength but only within a small range of motion of his hip joints. He has functional hip and leg strength from a sitting position to a standing position (meaning it isn’t great, but he can get up) and great strength in a walking range of motion (meaning he can walk a long time comfortably). He has poor or no strength at a greater range of motion than a seated position such as what it takes to get up from a low chair/couch or the floor.

How does this loss happen without us even realizing it? We sit and sit and sit. All this sitting leads to loss of motion and strength. This leads to poor postural habits and tight fascia. It creates a downward spiral of problems with balance and overall health. To make matters worse, when older adults start to have trouble getting up from chairs we buy them lift chairs, raised toilets and install grab bars. Now they can get up independently. Yeah! These tools are fine, but we avoid the underlying problem. We cannot just apply these band-aides. We must address the greater issue of loss of motion! How do we do this?

Progressive exercise for increasing leg range of motion and strength.

Here are some ideas. In the photos you see Dwight and Pam (both provided their permission to share their photos). It is important not to just dive into a big exercise routine. It is important to grade the movements in a safe progression for each person. Occupational therapists (OT) are trained to expertly grade activities to the individual based on their skills and health history. OTs also put exercise in context, so the developing skills directly apply to the desired activity.
I’ll explain the photos and add some detail.

In the first photo, Dwight is positioned in a chair that is lower than he typically sits in at home. When trying to rise, he cannot get himself up without the assistance of his arms pulling him up. This was surprising to him. My suggestion was that he position a chair about this height at his kitchen sink and practice getting up and down slowly without “plopping”. Plopping happens when there is not quite enough strength throughout the full motion to control the lowering motion into the chair. At the lower end, strength gives out and we plop into the chair. I instructed him to use less and less assistance from his arms as his legs gain strength in this new range of motion.

In photo number two, I asked Dwight to change his leg position in the chair. Dropping one leg back begins to mimic the position he’ll eventually need to get up from the floor. He found this position even more challenging. He should start with assistance from his arms and gradually reduce this assistance as he gains strength in this new range of motion.

In the third photo we see Pam, who admits getting up from the floor is not easy for her and anyone who has seen Pam for a massage knows she is STRONG! Pam is positioned in a low stool with the split stance. Dwight isn’t ready for this position, but it is what he’ll transition to next. Pam is using her arms to assist as she moves through the lowest part of the motion. She reduces her arm pull as she finds the strength in her legs. The stool provides a sense of safety while practicing challenging movements and provides a safe place to land and rest if she fatigues too quickly.

The next phase (photo four) is switching to a lower target. Lower the knee to touch the target and come back up. The target might be three pillows or the stool at first, then gradually lower the target as strength throughout the range builds. You may also notice Pam is doing the movement at a door. This is another good option for grading the support. Starting at the kitchen sink provides excellent stability and support. A door offers support but not as much stability.

In the fifth photo, you see Pam touching her knee all the way to the floor. Excellent! She’s built enough strength to get down and back up again. However, she’s not done yet.
In photo five she is learning not to rely on any external support to get up. This increases stability and balance in this lower range of motion. You may not fall in a place where you will have an external support to assist you in getting up. Continue to do the exercise in a place where support is available if needed. You should do the movements until your muscles fatigue or you will not get stronger.

In the final photo, we see Pam’s foot. As we age, we also tend to lose range of motion in our feet ankles and calves. This is NOT simply due to aging. It is due to lack of use. When adults have foot pain, we are often offered immobilization as an option to protect them. This creates a spiral of decreased motion and strength. Our feet must also be strong and flexible and are a key element to being able to get up and down easily as well as maintain our balance in an upright position. My other client who was very active but couldn’t get up was completely lacking in this motion which prevented her from being able to get up from the floor. She’s currently working on this skill. Pam’s motion is excellent! Yeah Pam!

Finally, we have not addressed going from the position of being completely flat on the floor. This is another important progression I’ll address in another article. Just remember that if you fall, you are not guaranteed to fall in a place that will be easy to wiggle out of. Many falls happen in the bathroom where you might be on your back, front or side with very little room to maneuver. It is important to have strength available at all ranges of motion to get yourself safe.

The key points: • Get up and down regularly as part of your exercise plan at every age. If you have hip or back pain, you may be lacking in strength and motion. This is an early sign! • Grade your exercise with the help of an expert if you are very weak or have other health conditions. • Don’t forget your feet, ankles and calves. • Provide older adults with assistive devices as needed but don’t be fooled that they are the answer to the problem. Your loved one is still at risk if they can’t get up. Connect them with a health professional that can get them moving safely. • Create a body that is prepared to get up from any position.

Dwight’s next challenge!

UPDATE! At his last wellness session, Dwight reported he was able to do about 15 get ups from the chair without the use of his hands and was ready for the next challenge. In the photo you can see that we’ve given him a bolster as a target to futher increase his range of motion. He could not get to the bolster without using his hands to lower himself down and pull himself up. However, this was true with his last challenge of getting up from the chair with split stance. He was able to improve with significantly in just a few weeks! We’ll see how he does with this challenge. His plan is to do the exercise at his kitchen sink with a couple pillows as his target. The pillows will also keep him safe if he does need to rest. The goals is to use less and less arm strength as the legs gain strength in this range of motion. Go Dwight!

Need help getting started?  Make an appointment for a New Client: Natural Movement Evaluation and Consultation.  Or Join a MovNat class on Schedulicity.

Practical Meditation Tips to Get Started Right Now

Many of our lives have been turned upside down resulting in high levels of stress.  It is unclear when our lives will be back to “normal” and this uncertainty results in even more stress. All this stress results in a physical outcome as tension builds in our muslces and fascia. Meditation is a well researched option for effectively reducing stress and anxiety.  So why aren’t we all meditating?  
Many people don’t meditate because they don’t really understand how to do it and they get crazy frustrated when they can’t empty their mind or achieve the appropriate cross-legged posture.  The good news is that you don’t have to do either of those things.  The bad news is that is does take some effort but if you really understand the basics, it can be quite enjoyable and helpful.  The other good news is that it doesn’t just help with stress and anxiety. Meditation can improve focus, improve your mood, give you more energy and help you be more creative.  Those are some great reasons to meditate. 
The true purpose of meditation is two-fold. In the moment, meditation shifts the brain and body into a more relaxed and calm state resulting in an immediate positive change in physiology. Over time, meditation can change your brain and help you respond to stressful situations in a more positive manner.

Photo by Kelvin Valerio on Pexels.com

Here are some practical tips to get started. 
First, you can meditate anywhere and in any position.  You can sit on a pillow cross legged or you can spread out on your lazy boy recliner, what truly matters is what is happening in your head.  As you get started, if your body is more comfortable, you will be less distracted.  You can even meditate standing in line at the grocery store!  Again, what is happening inside is what is most important. 
You can meditate for very short periods of time and get positive outcomes. Even just a few minutes can begin to shift your physiology and start you on the path to shifting your brain. Start with just a couple minutes at a time and slowly add a minute here and there as you gain skill and confidence. Also, time of day doesn’t matter.  Fit it in anywhere you can as you get started.  There are no rules.

Well, there are rules in some styles of meditation and there are many styles out there.  Once you get going you may want to explore what is out there and go down a more specific meditation path, but for now let’s just get over the hurdle of getting started. In ALL meditation styles there are several common ingredients and I’ll cover them all briefly here. I have a video you can watch that explains them as well.  

1. Breathe.  Learn to breath with your diaphragm.  Learn to breathe deeply and slowly.  This one skill can help you make profound shifts in your health and well-being.  The video above also covers diaphragmatic breathing.  You ALWAYS have your breath available as a focus point  Breath well and bring your attention to it often. 
2. Focus.  Your brain must have something to focus on.  We are wired for awareness.  Emptying the mind completely is nearly impossible.  The goals is to bring your attention to the breath, an object or a sensation depending on your choice of meditation style. You can be aware of other thoughts and sensations.  The goal is to learn to let them go and keep returning your attention where you want it and not get pulled down the rabbit hole of your wandering thoughts. 
3. Judgement .  Just let it go.  As thoughts enter your mind or as you notice sensations during meditation, do not judge them as good or bad. Experience them and let them go.  You will find yourself not only judging what is happening externally such as the sound of someone firing up their lawn mover just as you decide to try some meditation, but also internally.  You will get frustrated with yourself when you can’t control those pesky thoughts about what you’ll have for dinner later. Do not judge yourself and your ability to meditate. Rather congratulate yourself each time you notice your attention has wandered and you have decided to bring it back to your object of focus.  Treat yourself gently in the process of learning much like you’d teach a puppy or small child a new skill.  You are gentle, patient and encouraging with them, be so with yourself. This is probably the number one issue most of us struggle with when practicing meditation. 
4. Calm. Learn to soften your body.  Learning to spot tension in your body and continually let it go will help you be more comfortable as you meditate. Soon, this will cross over into daily life. 
5. Mindfulness.  Keep your attention in the present.  Stress and anxiety are typically past or future oriented.  We can’t change the past and can plan appropriately for the future but can’t control it.  Staying in the present is generally much less stressful.  Use your five senses (sight, sound, touch, smell and taste) to pull your mind in to the present. 
6. Process. Let go of any outcomes you are trying to achieve and simply focus on the process of meditation.  It is called a meditation practice.  Practice regularly and focus on the process of continually bringing your mind back to the object of focus.  In a five minute meditation you may have to do this fifty times.  That is OK.  Next time it might only be thirty or it might be fifty-one. If you stick with it, it will get easier.  

There are many strategies you can use to help yourself let go of those pesky intrusive thoughts that will continue to interrupt your meditation process.  I will share those in the next post.  For now, you may want to watch the introductory videoPractical Meditation.  This will also introduce you to a simple meditation.  My follow up video cleverly titled Practical Meditation #2 will introduce you to a few other styles of both sitting and standing meditations.  Happy meditating! 

Are your clavicles where they should be for pain free movement?

woman-red-and-pink-off-shoulder-dress-standing-near-wall-3195986-2We commonly refer to clavicles as collar bones. The clavicle bones are the two long thin bones beneath your shoulders on the front of your body. You can easily feel them with your fingertips. The clavicles connect the sternum (breastbone) to each scapula (shoulder blade). They are far more important than you might think. Five muscles (pectoralis major, sternocleidomastoid, subclavius, deltoid and trapezius) attach to each clavicle supporting complex three-dimensional motion. The clavicles and the attached muscles supply the support and motion required for complex shoulder and arm function. If one or both of your clavicles are not in proper alignment, your shoulders and arms are likely unable to achieve their full range of motion. This misalignment is very likely to lead to an injury or pain that seems to come out of nowhere.

 

Why might one or both clavicles be out of alignment? This is most likely due to tight muscles or fascia. Tightness is often a result of past injuries, repetitive awkward movements, chronic poor posture, or a combination. So, how do you know if you are at risk? Look in a mirror or have someone take a photo of you with your clavicles in full view. If your clavicles don’t appear to be horizontal or near parallel with the ground, you likely have some tightness pulling your clavicles out of alignment. The more angled one or more clavicle is, the more out of alignment it is. It is far more common for the slope of the clavicle to be lower toward the center of your body and higher on the shoulder side. You may also have one or both clavicles out of alignment from front to back as well. If your shoulders are slouched the shoulder end of the clavicle may be farther forward than the other side.

In the photo above, the model has very horizontal well-aligned clavicles.  The model below has very angled clavicles.  This position may indicate an imbalance of tension in her muscles and fascia.  The third model at the end of this article has her shoulders pulled up and forward creating both a slope and a forward position of the clavicle.  This is a very unhealthy position.  Hopefully this was just a pose for the camera and not a permanent position of her clavicles!  

woman-wearing-black-off-shoulder-dress-3257052-2

Another clue when you look in the mirror is noticing where your arms hang in relation to your body. When everything is in good alignment, the tip of your middle finger should be able to feel the side seam of your pants. (This may also be affected by lower body alignment but we’ll stick with the clavicles for now.) If your arms are hanging forward from your body, the muscles and fascia around your clavicles are probably very tight.

 

Here’s what can you do if your clavicles are not in the best possible alignment. Notice what muscles you need to engage to exaggerate the angle of your clavicles. The upper trapezius muscles pull the shoulder end of the clavicle up and the pectoralis pulls it forward. Lengthening these two muscles is a great place to start. You can start by doing the shoulder stretch on my website.  mayerwellness.com/stretch-and-mobilize-your-fascia They key to stretching with the intent to address tightness in the fascia is to go slow , be gentle, and hold the stretch for at least a minute or two.

Taking your muscles and joints through their full range of motion on a regular basis is another way to keep your body healthy. This helps to maintain range of motion, muscle balance, and good blood supply to the area of the body you are moving. A wonderful simple and fun exercise you can do anywhere is the Paint the Bubble exercise. Look for it on my website. mayerwellness.com/stretch-and-mobilize-your-fascia This will take your shoulders through their full range of motion. Notice how your shoulders feel before and after this exercise. You will be amazed that you can actually feel a difference!

woman-sitting-on-bench-near-plants-1605178-2

 

 

 

Now go look in the mirror and check out your clavicles!

Adult Tummy Time: Why you should be doing it every day.

We’ve all heard babies should have time on their tummies. Tummy time is not about their    bellies. It is about their back and helps them develop a spine strong enough to help them lift their heads, sit up and prepare to stand and walk. Imagine a toddler trying to walk with their spine and hips still in the fetal position. The prone or tummy position stretches out the front of the body and strengthens the hips and back. This creates the strength and balance necessary for continued development and healthy alignment. If you’ve been around babies who are just starting tummy time, you know that it isn’t always welcome at first. But, as the baby gets stronger, it becomes another fun way of exploring and interacting with their environment. Adults need tummy time too, but for entirely different reasons. 

When I recommend tummy time to my teen and adult clients, I often get “the look.” That “what you talkin’ about Willis?” face. I laugh, then explain. 

Adults (let’s include kids and teen in this conversation too) rarely spend time laying on their stomachs. Some health professionals also recommend not sleeping on your stomach, which in my opinion, only makes sense when there is a medical issue, injury, or significantly limited range of motion in the neck. For many of us, it is just fine and actually a good idea. It promotes neck range of motion and helps us get back what we lose during the day from looking forward constantly. Sleeping positions could take up another entire article. If you are interested, you may want to check out my blog on pillows.

Back to getting prone during the day…

Our culture is set up so that we are almost always sitting. Toileting, eating, working, driving, relaxing, etc. all involve chairs of varying structure and   comfort. Chairs didn’t become common until the 16th century. Since then, we’ve kept making them more and more cozy and   comfortable. Our bodies have become very accustomed to chair sitting. Chair sitting isn’t necessarily bad, but most of us are using them irresponsibly. We collapse into the chair, letting the chair do the work of keeping us upright. We allow our tailbones to tuck under and our head to sink forward. What does this look like? The fetal position!

The fetal position.

Our bodies become sticky in the positions we are in most, especially if we don’t move them regularly through a full range of motion in different planes (think yoga, tai chi, dancing or similar). Add up the hours you sit in a day. For many of us that will be 12 plus hours. Ouch! Not only does our fascia thicken and tighten with lack of movement. This habitual positioning creates muscle imbalances. Some are far longer than they are intended to be, and others are short. Both are probably tight. What to do? The good news is that our bodies are very resilient.

To get on the path to tummy time, the first thing you should know is proper pelvic positioning. There are a variety of landmarks, but this is probably the easiest for most people to find. Stand sideways in a mirror. Feel the bones that stick out the furthest in front on both sides of your hips. These are known as the anterior superior iliac spine or ASIS. Now, find the pubic bone. Put your fingers just under your belly button. Press in and slide down until you feel a bone. That is the top of your pubic bone, which is also part of your pelvis. These three bony landmarks are all connected. Now try this movement that will remind you of The Rocky Horror Picture Show. Tilt your hips, so the pubic bone is further forward than the ASIS landmarks. Now try tipping the ASIS points back and your pubic bone forward. The goal is to line them up in the same plane as shown in the picture. This is the position where your lower back is the strongest. It is also the best position for diaphragmatic breathing and pelvic floor function!  This position also  allows the upper body to stack up in best alignment. So if you can’t get rid of your neck or shoulder pain, check your hips!

You may be able to feel the landmarks better if you get on the floor on your tummy. A floor is best to try this. A bed is too soft and will skew your results. Make sure to have your chest and shoulders close to the floor also. Can you feel those three points touching the floor? If not, reach your hand to feel the landmarks.  What isn’t touching? Can you tilt your pelvis back and forth to get there? If you can’t your fascia, muscles or joints are probably sticky. Don’t force it. Instead, stay there and see if your body will slowly adjust. Give it time. It may take a few minutes or a few months. But moving toward proper pelvic alignment is a huge step to better overall health and less pain. If you have trouble achieving this position with gravity helping you, you will have a tough time working against gravity while standing. 

If this is too hard, start on the bed, but move to the floor when you can. You can take your tummy time further by adding a ball to stretch your abdominal fascia and muscles. See more in my video Belly Stretch.

While in tummy time, you probably won’t have anyone entertaining you or cheering you on like you may have had as a baby during tummy time. But you can entertain yourself. Read, play a game, listen to a book or music, watch the news or some Netflix or better yet, meditate. Get your family and friends doing it too!

If you need help finding proper alignment and deciding how to get there, make an appointment. I’m happy to help!

Ice or Heat? Which is best for pain?

This is a common question with a complicated answer.

I taught at Creighton University for 20 years.  Before my students asked almost any question, they already knew the  answer I would give them. It became a running joke.  The answer to almost every question about how to treat an injury or a diagnosis is…

…it depends.

A good healthcare practitioner (Western or Eastern medicine) knows they are not treating a diagnosis or an injury.  They are treating a person. We are all very similar, but we are all extremely different. There are no clear answers.  There is good solid research out there for many issues we face, but what we have is really a drop in the bucket.  And, the answers often change as new knowledge is always emerging.

Dr. Gabe Mirkin coined R.I.C.E. in 1978. This stands for rest, ice, compression and elevation. It has been a commonly accepted practice for treating injuries but there has never been great evidence to support it.  It has also led to many common misconceptions about what to do for all types of pain.

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In this short article, Dr. Mirkin discusses how icing or cooling actually delays recovery. Our natural response to injury is inflammation.  It is a natural part of the healing process.  Icing constricts blood vessels and prevents healing. However, he does say that icing may help prevent pain, but we should only do it for short ten minute periods immediately following an injury.

The Cochran Library provides us with a systematic review of heat and cold for low back pain. There is moderate evidence for heat and very little evidence for cold.

What about the R. or the rest in the R.I.C.E. protocol? The NIH provides a fact sheet on low back pain. There is strong  evidence that you should not stop moving. You should move gently within a safe range of motion respecting your body’s pain limits.  This movement pumps the muscles pulling healing blood deep into the tissues.  This pumping also mobilizes the lymph which is critical for healing. If you are not sure how much you should move based on your injury, talk to your healthcare practitioner.

What should YOU do?

  • Discuss your options with your healthcare provider. There may be other variables you should consider when deciding how to treat your pain. For example, if you have a condition that decreases your ability to feel, it may not be safe to use either heat or cold.
  • If you are not experiencing an acute injury, the evidence points to heat. But, heat doesn’t mean hot.  Gentle warmth is best.blaze-bonfire-burn-672636
  • Everyone is different. Even though the evidence might point to heat, if you are in pain and ice enables you to decrease your pain enough to move and complete your daily tasks, ice may be the better option for you.  Life keeps on going despite our pain but use it sparingly.  Keep in mind that cold decreases your ability to feel so move with caution after using cold.
  • If your goal is to move or stretch your muscles and fascia, the evidence points to warmth.
  • You can do both. Alternate heat and cold.
  • Remember that both should be used with caution. Don’t put either directly on the skin. Place a layer between the modality and your skin such as a bath towel.
  • The American Chronic Pain Association provides a Resource Guide addresses many options including heat and cold.