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

One of the goals of Mayer Wellness, LLC is to help people design a life where they can reduce, eliminate and manage their pain to create a satisfying life. So, it is important to me that I teach my clients self-care. As all therapists know, what the client does between appointments is far more critical in making progress than the appointment itself. Receiving bodywork regularly is a wonderful part of a wellness routine. However, good movement habits and regular self-care is a must to keep pain and stiffness at bay.

I know from personal experience that my old shoulder injury will rear its ugly head if I don’t keep up my regular stretching and exercise routine. My regular activities include lots of shoulder movement, but when I’m at the computer more, I know I can’t skimp on my routine or I will pay for it. Most of the time some light stretching and weight bearing through the shoulders with some yoga keeps my shoulder in check. However, when it decides to flare up, I need more. That is when I turn to my self-care tools.

I have always been a lover of gadgets. Kitchen gadgets, yard gadgets, technology, and of course self-care gadgets. There are many tools on the market now. A search on amazon.com for self-care products resulted in over 8000 products. How do you choose?! One option is just to keep purchasing them, trying them out for a while, and see what you feel. This is what I have done over the years. I don’t believe I’ve ever returned an item. Not because they were all effective. Far from it. I didn’t feel right returning something after using it for a couple weeks, which I think is a fair trial period. So, I kept them and let them pile up.

After a couple decades of buying and trying I’ve landed on several self-care products, I can’t live without. I’m sharing this because I’m hoping to save you time, energy and expense. And, help you with your own self-care. I use many of the products in my workshops and with my clients. I don’t sell any of them in my practice, but I have often been asked. I’ve considered it, but the retail business is entirely different from the therapy business, and I’m just not ready to go there yet.

Becuase I have been asked so many times if I sell the product or where they can be purchased, I created is a page on my website dedicated to the products I use in workshops, with clients, and recommend for self-care.  You can continue reading of just go right to my Recommdended Products page and poke around.

Amazon.com has a wonderful program (Amazon Affiliates) that actually pays me a small (very, very small) portion of any sale from a link to my website. So, full disclosure: If you buy something I recommend after clicking on my site link to amazon.com, I profit. It does support my private practice, so I very much appreciate it!

Another thought before I begin unveiling my favorites is gift giving. Those that know me, know I’m weirdly crazy practical. Many years ago for Christmas, I gave everyone in my family and extended family a TheraCane. If you are not sure what this is, it is a self-care tool shaped like a cane with handles that helps you get at the knots in your back. Everyone was a little confused at first now knowing what it was. After a few lessons, they loved it. It ended up being one of those gifts that kept on giving. So, if you need a present for someone you care about, you are sure to find something on my list. Unfortunately, we all have pain or stiffness now and then so if you are practical like me, then these products make great gifts. And, no, the TheraCane is no longer on my favorites list, but I may pull it out on an infrequent occasion.  Here is a link if you do want to check it out. Thera Cane Massager (Black)

You can choose to keep reading or I show and explain the tools in this video.

I am never without my number one favorite tool, the therapy ball. They literally travel with me everywhere. I have used them in the car, hotel rooms, planes, my office, during meetings. I have lent them out and given them as gifts. They are versatile and get can into tight spots almost anywhere in the body. Therapy balls are the primary tool I use in my workshops. There are many tips and tricks to getting in those areas deep in the hip shoulders you can never quite seem to hit.

The best therapy balls are dense but have some give when you press into them. They also have a “sticky” opposed to a slippery surface, so they do not easily slip away from you when you lean into them. Using balls that are too hard is not safe for many people and can damage tissues. Balls that are too soft such as tennis balls are not as effective and more difficult to use. It is also best to find a set of therapy balls that come in a pair and includes a bag or pouch to be used together or individually. This offers more options in your stretching routine.

The Acupoint ball is my personal favorite and the size and density I use in my Myofascial Stretching Workshop. It is excellent for most people, especially women, as they are slightly smaller than other therapy balls (about 2.5 inches). A smaller ball easily gets in between muscles to reach deeper into the fascial system.

On my Recommended Products page, I have a link to a slightly larger set of therapy balls, a set of therapy balls of various sizes for targeting smaller areas, and a larger four-inch ball for the abdominal area. Yes, I own them all and use them all. They are all wonderful when used correctly.

You can use the therapy balls alone, but to really increase the effectiveness it is helpful to have a yoga strap and a set of yoga blocks. You can substitute a book for the block and a scarf for the strap, but the right tools make a significant difference.

A yoga strap is an excellent adjunct to your yoga practice or your myofascial stretching routine. Yoga beginners who are just diving into improving their flexibility appreciate the extra reach they get from using a strap. In your myofascial stretching routine, a strap allows you to move your extremities in an unlimited amount of directions to change the angle of your pressure with the therapy balls. While you can use a belt or a scarf, yoga straps come in different lengths and provide more options. My favorite yoga strap, the Therapist Choice Stretch Strap, has elastic loops you can slip your hands through to decrease the amount of grip needed to hold the strap. This allows you to relax your body more as you stretch. The downside of this strap is that it cannot be made into a circle for bound poses in more traditional yoga practices.

You may also choose a traditional yoga D-ring strap. This brand comes in lots of colors and lengths (6, 8 or 10 feet). Why different lengths? The longer your legs or the reach of your arms, the longer your strap should be. A very tall person might want the longest strap length to provide the most options for using the strap. A shorter person may do just fine with a shorter strap. I have an 8-foot strap which serves me well. I’m 5’7″. The D-ring also allows the strap to be made into a circle for binding or securing the body in certain positions.

Yoga blocks are essential for someone just starting yoga. Blocks allow you to ease into poses and support you when you can’t quite reach the floor or need extra space when moving through many poses. Blocks can also dramatically increase the effectiveness of your myofascial stretching practice when using the therapy balls. Yoga blocks come in different sizes and densities. Depending on your intention for use and your experience you may choose different blocks.

If you are purchasing blocks to use with your therapy balls, it is a great idea to have a set with two different sizes of blocks. This provides options with how far you can lift or tilt your body areas to angle into the therapy balls. The link on my Product Recommendation page offers a 3 inch and a 4-inch wide block.

If you are purchasing blocks to support you as you ease into a yoga practice, I recommend a broader 4-inch set of blocks. This width is often more stable and comfortable on your hands as you lean into them. If you want an even greater sense of stability with your blocks, choose a cork option. They are heavier but offer some give when leaning into them. I love my cork blocks. They are pricier, but when I’m doing a lot of sun salutations, they are helpful to provide a little extra room and stability with pulling my legs through from down dog. The brand I recommend offers both foam (in lots of pretty colors) and cork options in a 3 or 4-inch block set at a reasonable price.

One of my most used props in my toolkit is the half-roll. The calf stretch is the hands-down most crucial stretch you can do for keeping your fascial system relaxed and open. While you can use a rolled yoga mat or a book to do the calf stretch, having a half-roll is convenient and can be used for many other stretches or balance exercises. It also looks nice if you want to use it at your standing work-station (which I highly recommend). I keep one at work and one at home. I often use it while in the kitchen prepping supper.

I’m generally not a fan of foam rollers and almost never recommend them to my clients or use them in my workshops. However, many people do use them. If you do roll, I suggest you use a roller with texture. Smooth rollers may press into the tissues and loosen tight areas, but they smash everything else in the process. I recommend you roll to locate tight spots then press and hold to release them. A roller with texture gets in between the tissues and provides points of pressure deeper than a smooth roller can.

The hand-held single ball roller is excellent for when you don’t have time to get down on the floor and use a therapy ball. Using them in the car or at work is excellent. It is also an easy way to help out a loved one when they ask you to rub their shoulders. It feels great, and they make lovely gifts.

When you need to get in a little deeper a roller with two handles can really do the trick. This tool is pricey but by far the best hand-held roller. Great to use when a loved one asks for some TLC.

Many of us have pain and tension in our necks periodically. Getting into those muscles is tricky. Massaging and lengthening them is helpful and feels good. I own and use the following two products when my neck needs some TLC.

The Cranio Cradle gently presses into the muscles at the base of the skull.  It can also be used in the upper and lower back area. It is soft and flexible, but sturdy enough to support the weight of your body. You can also change the angles for your best stretch. It can be used anywhere you can lay down.

This neck hammock is easy to set up and provides a very gentle stretch. It is also suprisingly comfortable with little cushion in the neck and ear areas. You can control the amont of stretch by moving your body further from the connection to the wall/door.  The connectors are sturdy elastic so you feel well supported. Using a hammock can help train your neck to relax. To up the effectiveness while in the hammock, meditate.

While all these tools are great, there is nothing like an expert practitioner to help you find the tight areas and teach you how to use them to their maximum effectiveness. You can also purchase gift certificates for a workshop, a stretching consultation or a one on one myofascial session by contacting me directly.

How you think about your body shapes you.  Our bodies are not inherently weak with a need for protection.  They are inherently strong with a need for movement.

This blog post isn’t about loving yourself in the way you might think, although that is important.  I will not ask you to stand in front of a mirror and repeat how much you love yourself or your body.  But, I am going to ask you to reflect on how you think about your body and movement, and how you refer to your body.

I hear many people, not just my clients, but also friends, relatives, and people I run into at the store talk about how their bodies are failing them or how they need to be careful of their delicate neck, back, etc.  They reference their bad leg or their bad shoulder.  They refer to their bodies as weak, failing, old, bad, injured, frail, broken, fragile, hurt, delicate, deteriorating, etc. They refer to the damaged or painful area as “my bad leg” or “the bad side of my neck.”  It isn’t really their fault.  The media uses this language, but the biggest culprit is the retail system.  Skillful marketing tells us to protect our fragile necks with this new pillow, our aching back with this mattress, or buy these shoe inserts to protect your deteriorating feet. Our healthcare system even uses this language, but it is slowly shifting to person first language. Person first language shifts a statement about a person to place the person first and the issue second and removes labels such as victim.  Rather than stroke victim, we say a person who had a stroke.  A person shouldn’t be defined by or labeled as their illness, injury or disability. We shouldn’t define ourselves or our body parts by our illness, injury disability or pain.

I will make gentle suggestions that they try to be kinder to themselves.  It is ok to say, “the arm that hurts,” but it would be even better to refer to it as my left arm or my right knee. I might even get really over the top with some clients and encourage them to use language such as “the area that needs more love today.”  Words matter.  We should be as gentle and patient with ourselves as we would be with a small child.  On the other hand, we should also have high yet realistic expectations of ourselves and our bodies.  We should expect them to function well if we are treating them well.

I am asked very frequently about the best pillow to protect their fragile neck, the best mattress to protect their bad back or the best shoes to protect their injured feet. My response is never a product.  My clients are rarely prepared for the long-winded answer they receive. I usually begin with the statement that your (insert body part here which may be the neck, back, feet, etc.) should be flexible and strong.  If it were, you wouldn’t need to protect it with (insert product here which may be a pillow, mattress or shoe insert). You may want the (insert product) now, but if you work on increasing the strength and flexibility of your (insert body part), you won’t want or need it.

Our bodies do a heck of a lot for us.  We need to refer to our bodies kindly and feed them with not just kind words and thoughts but also proper nutrition and hydration. We also need to feed our bodies a variety of movement.

Our bodies are meant to move.  Our bodies are designed for an amazing amount of motion.  Our shoulders, hips, knees, neck, etc. can move through ranges of motion that support all sorts of activity.  We are made to be able to reach above our head by extending our arms and lifting up on our toes.  We can squat to the ground by bending our feet, ankles, knees, and hips.  We can twist our spine in diagonal patterns to reach across our bodies.

However, for most of us, this tremendous range goes unused for hours, days, weeks or even months.  But, we fully expect that when we do decide we need to reach way over our heads for the rarely used serving bowl, or stoop down and look under the couch for the dog toy everything will work as expected. Unfortunately, when we do need to move into these extremes our bodies protest, and something often goes awry.

Keep reading because I am not going to ask you to add a regular exercise program of CrossFit or gymnastics to start moving and strengthening all your joints. But, I am going to suggest that you become more aware of how you are moving (or NOT moving) your body each day. I’m also going to suggest that you have realistic expectations of your body.

Take a few moments and think about the last time you reached over your head.  Can you identify at least one instance of reaching high enough you had to lift your hands over your head in the past 24 hours?  The past week? Recent modern history? Just kidding.  This may include placing your coffee on the roof of your car while you opened the door and tossed in your handbag or reaching for your heavy sweater on the top shelf of the closet since the weather has turned chilly.  Or, maybe it was several times in the yoga class you attended twice last month.  In any case, for many of us, it is not a regular part of our day.  So, the fantastic mobility of our shoulders goes unused and begins to take on the shape of what we are doing most of the time.  How many times did you reach out in front of you to type on a computer or check your phone?  How many times did you reach forward to prepare food or steer your car?  This has become the predominant motion of our shoulders.  As a result, they become stuck in this position. The shoulder blades spread across and up the back and the humerus, or upper arm bones, rotate forward. When stuck in this position, the mechanics of this joint are completely thrown off.  If you look in the mirror and see one or both arms hanging in front of your hips and you see mostly the back of your hands, your shoulder joint is probably stuck in this unnatural position.  The fascia thickens to support the joint in this position and support the activities you do most of the time.  But, when you need to reach the sweater on the top shelf, you feel the pinch and the tweak in the joint.

This same story can be told about the hips, the feet, the spine or the neck.  Our typical day to day movements are minimal, but our expectations of these muscles and joints are high when we need them.  I’m not just speaking to people with the so-called sedentary lifestyle.  Many people in our culture with the 8 to 5 desk jockey jobs do go to the gym and get in the recommended 3-4 times per week, 30 minutes of moderate exercise. But, what type of exercise?  Much of gym-based exercise is very linear, repetitive and limited in range of motion: treadmill, elliptical, bicycle, stair climber, rower. These machines keep our bodies moving in a limited range, not even close to the variety we have available to us and occasionally need to use.

So, what can you do?  Reflect on your daily ranges of motion.  When are you reaching?  When can you squat? Can you set up your life, so you ask your body to make these motions daily or even multiple times per day?  Here are some simple ideas.

Place your coffee cups and towels on a high shelf.  Then you’ll have to reach above your head at least twice each morning.  Put the toothpaste and your pajamas in a lower drawer.  Then you will need to squat at least twice each evening.  Think about how you can integrate a twist into your day.  Can you reach across your body to reach for the soap in the shower every day?  Maybe use your left hand to adjust the rearview mirror before you back out of the garage.  Notice your patterns and mix it up.  Ask more of your body but keep it simple and part of daily life. 

I have a chin up bar in the doorway between my kitchen and dining room.  While I am pretty far from being able to do a chin up, I stretch or hang on the bar several times a day. I use my arms a lot during the day doing sometimes intense pushes and pulls.  It is great for me, but I also need to move the joint in other ranges as well. The bar keeps my shoulders limber and strong in all directions.

If you are a person who has the opportunity to move all day as part of your job, you are fortunate.  This movement will keep you healthy.  My only caution is that you be sure you are moving in proper alignment and using your body in the manner in which it was designed.  If you move a lot but still have aches and pains, check your alignment. Small changes can make a huge difference. If you are the person who sits during most of the workday, can you organize your space for more reaching and squatting throughout the day? Small changes can make a big difference.

Again. Our bodies are not inherently weak with a need for protection.  They are inherently strong with a need for movement.

Side note: As an occupational therapist, I understand there are many people who do have illnesses or injuries that have left them disabled and make the suggestions I have in this blog entirely more difficult.  My basic suggestion stands that we should all, regardless of our ability or disability challenge ourselves daily to maintain as much motion and health as we have available to us. This suggestions also extends into mental challenges, but that is another blog. Namaste.

 

Maybe you have noticed this tagline on my website. Perhaps not. I thought long and hard about a motto, slogan or catchphrase for my business and this is the result. I did not put it through a rigorous focus group evaluation process, so I’m not sure if the public understands what I mean. Hence, my next blog post.

What does it mean?

Break the cycle. This portion of the phrase is referring to the pain cycle. Over the past 27 years, I have seen many clients and completed countless ergonomic evaluations.

I was almost always called in to do an ergonomic evaluation because someone was experiencing pain. Unfortunately, it was quite rare that I was asked to complete an assessment to prevent a problem, but that is the way our healthcare system works. As I would talk with the person and evaluate how they use their equipment, I could get a clear sense of how much their work equipment and work habits have contributed to the pain they are experiencing. I could also get a pretty good feel for how willing they were to change their work habits. All this information, combined with years of experience helped me make a recommendation on whether they should seek out additional therapy or not.

For many people, a few tweaks of their workstation set-up and some changes in their posture, they are good to go. Their pain should settle down quickly. These are the folks that notice a pattern between their work and their pain and aren’t afraid to speak up. They notice they hurt while working, and they feel better over the weekend or while on vacation. They also notice this pattern early in the process and don’t just wait to see if it goes away. It might be their neck, back or hands that hurt. It doesn’t matter much where the pain is located. These people probably don’t need any therapeutic intervention such as occupational or physical therapy. Improved work habits will settle things down.

The next group is similar, but perhaps they need more changes to their workstation or work habits. They have also let things go longer. This may be because they didn’t want to make a fuss at work or they are just too busy to make the time for an evaluation. They are generally very fast paced folks who are a little more ingrained in their work habits. These folks will likely struggle a bit more to make the necessary habit changes which will, in turn, take more time for the pain to subside. I will often give them a little more support by offering some stretches they can do to help them to break the pain cycle.

Then there are those folks that have been experiencing pain for many months or even years. They may have also seen their physician and been prescribed pain medications or a splint. Their work habits may not have even been on their radar screen as a cause of the pain. Or, maybe it did, but they didn’t know they had the option to change. These folks need more help and support breaking the cycle. In addition to recommending changes to their habit and workstation, I also suggest they seek out therapy. The pain they are experiencing will probably not go away with changes in the work they do, at least not for a long time. Breaking the cycle takes more. Seeking out help from an occupational or physical therapist will help break the cycle and support hem through making changes at work.

I actually see all four categories of people in my practice now. People who are seeking myofascial release to prevent pain and primarily want to be sure their bodies are functioning optimally do occassionally find their way to Mayer Wellness, LLC. These folks are rare, but there is a shift happening. More people are thinking preventatively. It does take time, energy and resources but it is possible to design your life to focus on prevention.

The majority of my clients fall into the other categories. They are experiencing pain somewhere in their body and want help breaking the cycle. I may be their first stop in this process, or I may be one more therapy in a long line of traditional treatments, alternative medicines, and medications. There are so many people with pain and almost as many options for managing it. Most of the people that end up in my office are seeking not just to break the pain cycle but also figure out why the pain is there in the first place.

Although I hate to admit it, my skills are limited (tongue in cheek). My skills and my scope of practice are certainly limited. I can’t diagnose medical conditions. What I can do is help people work backwards through old injuries and surgeries, evaluate their posture and body alignment, evaluate their holding and body tensing patterns, evaluate their habits of movement during work, leisure and exercise, evaluate their stress and how they manage it, and finally evaluate the tension in their muscular and fascial system. Through this process, we connect the dots and create a hypothesis about where the pain may stem from. From there we begin to redesign their life.

The redesign process may be limited to reducing the tension in their tissues through myofascial release (MFR) techniques. For others, the redesign process may mean changing postural habits. Others may need a lifestyle make-over adding new methods for stretching their bodies or managing stress. For one client it was as simple as changing the way she sat on the couch with her family in the evening to watch movies. This simple redesign and a few MFR sessions broke her cycle of back pain and had her back on track.

Many people don’t know they have control and options beyond medication to manage and even eliminate their pain. And, these people aren’t unaware because they aren’t intelligent. While working at Creighton University and providing ergonomic evaluations, I helped heads of departments, physicians, attorneys and even exercise science faculty sort out their ergonomics and get rid of their pain. These folks most certainly have plenty of smarts. What they don’t have is my skill set. They have their own area of expertise. The attorney I helped undoubtedly wouldn’t expect me to be able to represent myself in court (should the need arise). I call on her to help me with that aspect of life.

Sometimes my clients, past and present, feel “dumb” that they didn’t recognize their poor posture or a movement habit I point out. I remind them of their own area of expertise, and they aren’t expected to know it all. They have me. And, when the time comes that I need something in their area of experise, I may call on them. In fact, I have. I have served technology professionals, physicians, nurses, physician’s assistants, architects, engineers, massage therapists, teachers, spiritual directors, teachers, moms, grandmas, plumbers, receptionists, delivery drivers, coders, executives, business owners, marketing professionals, caregivers, students, office managers, therapists, security professionals, athletes, stylists, dog walkers, optometrists, and many more.

Each person brings a perspective that consists only partially of their professional knowledge. Every individual has a set of beliefs about what it means to be healthy and well and what will help them achieve it. I learn so much from hearing their ideas and perspectives on wellness. Most are very open to my recommendations and whole-heartedly implement them to the best of their ability. The clients I am blessed to work with are very enthusiastic about simple lifestyle redesign ideas that will empower them to take control over their pain. It is exciting when they report back… wow, I feel better.

So my goal and the goal of Mayer Wellness, LLC is to help people…

Break the cycle.

And…

Redesign life.

Pillows are a frequent topic brought up by clients who see me for myofascial release (MFR).  They are often concerned if the pillow they are using is helping or hurting their bodies, specifically their neck.  Most of my clients also report they have been on a never-ending quest for the perfect pillow that will relieve their stiffness and pain.  They have tried endless pillows of varying thicknesses, fillings and price points.  They often end up purchasing an expensive pillow with dips and curves that hold their head in perfect alignment.  When it doesn’t relieve their discomfort, they are then concerned if they purchased it in the correct size.  Should they have bought the small when they chose the medium???  I frequently hear they paid so much for it, they feel the need to keep using it anyway.

A quick search on Amazon of “pillows for sleeping” resulted in over 8000 results. The most expensive pillow I could find on amazon.com was $906.00. Don’t believe me? Do a search.  The least expensive was on sale for $8.84. Pillows are big business.

There were many pillows with a full five-star review.  There are pillows directed at all ages and many different problems from allergies to migraines.  There was even a pillow for infants if you want to get started early on a stiff neck. Now, granted, I know there are some issues people have where a pillow can be very helpful and even necessary.  So, I’m not saying everyone should toss their pillow.  I’m not saying anyone should throw out their pillow.  My goal with this post is to get you thinking about your neck, how stiff the muslces and fascia are in your neck, and what you are trying to accomplish with a pillow.

The goal of most people is to get a good night’s rest and to wake up ready to greet the day feeling great and full of energy. That is certainly mine.  I will admit that I too have gone on the quest for the perfect pillow, but I never found it.  I did find a pillow I really liked after I modified it by removing about a third of the stuffing. Even then, it didn’t take away the stiffness I often felt and the occasional headache I’d have in the morning. But, it was better than anything else I’d tried, so I stuck with it until…

I was listening to a podcast by one of my favorite author and podcaster, Katy Bowman.  She mentioned that she had weaned herself off a pillow in 18 months.  Katy is very into natural movement and also has no living room furniture.  She explained how we didn’t evolve with pillows and not using one leads to more natural movements at night.  Katy reported how she gradually went from a very thick pillow to a much thinner pillow then eventually a folded towel.  At the time of the podcast, she was using an old t-shirt when she wanted something under her head. It sounded risky and uncomfortable, but I love Katy Bowman, so I thought I’d give it a try. It made sense to me from a natural movement perspective and a myofascial perspective.  It took me two weeks.

What?!  Two weeks?! How did you do it, Amy?  Well, let me tell you.  I have one of those 10” x 10” bean bags you can warm up in the microwave.  I have been warming it up for years and taking it to bed with me.  I find it very soothing regardless of the season.  I will put it where I have a little ache or pain or just let it sit on my chest and soothe me to sleep. Occasionally I’ll put it under my neck if it feels stiff.  When I decided to try not using my pillow, I put that under my neck curve while laying on my back and quickly fell asleep. The problem came when I rolled onto my side.  That just wasn’t going to work.  I had my regular pillow nearby and switched to it when I turned to my side.  That pattern continued until one night I rolled to my side, switched to my regular pillow then moved back on my back with my regular pillow and then woke with a blazing headache. It felt like my regular pillow was pushing my head forward and it was. So, the next night I decided to stick with the bean bag when I rolled to my side.  I wadded it up as much as I could and eventually fell asleep.  When I turned to my back again, it was right there for my neck curve.  I’m a very active sleeper and will sometimes roll to my stomach as well.  Nothing works well now for that position so, I use nothing.  …and it works well.  I still use my little bean bag most nights, but many nights I prefer it on a shoulder or elbow if I have a little ache or pain, so I have nothing under my head or neck.  And, it works just fine.

So, the big question… how is my neck? Is it less stiff?  Do I have fewer headaches? The answer to both is yes.  The reason I decided to try this experiment is that it made sense to me.  I am a big believer that our bodies need to be both flexible and strong, and that includes the neck.  For some reason, we are taught that our neck is so much more fragile than the rest of our body.  We need to be super careful with it. Well it if is weak, tight and out of alignment, that is true. It is more likely to cause problems and be very painful when it is tight.  If we are placing it carefully on a pillow for 6 to 8 hours each night, no matter how perfect the alignment we are creating an even stiffer neck.  We are training it to prefer one position.  That is not good.  During the day many of us go to work and end up looking a screen much of the day again, keeping our necks in one primary position.  Again, not good. The problem comes when we ask our neck to suddenly turn and look over our shoulder when we hear the dog tipping over the plant or our friendly co-worker sneaks up behind us with a surprise “boo.”  We’re not flexible enough to handle these “extreme” motions.  Extreme is in quotes because they are actually normal motions but not to a neck that is very stiff.

According to Katy Bowman, biomechanist, academic and author of Move Your DNA and Alignment Matters, when you laterally flex your neck or let your ear drop to your shoulder, they should touch.  When I Googled the normal neck range of motion, I found 45 degrees to be the most common, but I did see 60 degrees. In our culture, it is so typical to lack range that we now expect less from our bodies.  No, I can’t touch my ear to my shoulder unless I shrug my shoulder up. I’m working on it. The motion should be measured with the shoulder at rest and in its normal alignment.  If you are not sure if your shoulders are in alignment, check your clavicles or collar bones. They should be level or parallel to the ground.  If they aren’t or one is level, and one isn’t, you’ve got some tightness to work on.

Another common neck problem is the head forward position.  If you stand most people next to a plumb line, the ear will not be in line with the ankle as it should.  The ear will likely be much further forward.  There are many reasons for this common posture, but one is our use of thick pillows.  Big fluffy thick pillows are a symbol of luxury, and they look beautiful on the bed, but they are not great for our necks. They push the head forward and limit head movement at night.  Again, our bodies need lots of movement and positions to be strong, flexible and healthy.

When sleeping with a tiny pillow or no pillow your head and neck will move more.  They will not only move more, but they will also stay in different positions longer allowing the muscles, joints, and fascia to lengthen.  In addition to lengthening, you also have gentle compression forces into your shoulders when you are sleeping on your side.  Your tissues respond best to long slow stretches and why not get them when you are sleeping?  When your neck tissues are suppler, they will have better blood and lymph flow to your neck, head, and brain.  It will take more tension away from your thyroid, your vocal chords, your ears and your jaw.

It definitely takes time and effort to make lasting change in your body but making an effort to have greater neck flexibility and strength can make a huge difference in your health and well-being.  This may be from changing your sleeping habits or changing your movement habits, either way, it is worth it. If you can’t seem to make the change, get some help.  A neck that is chronically stiff may mean your fascia is tight.  If you’ve tried regular massage and haven’t had lasting change, try myofascial release.  The gentle sustained pressure will open the fascia, increase blood flow and make it easier to loosen the muscles.  This combined with regular neck movement through its full range of motion both at night and during the day will keep your neck well. 

 

Sleep well!

 

Should I have a stand-up workstation?  I get this question ALL the time.   My answer… it depends.  Side note: My first-year students at Creighton really dislike that answer, but it is soooo true. Humans are pretty darn complicated. The students eventually get it and use the same phrase when explaining how occupational therapy works to their clients, families, and their own students.

What does it depend on? Your alignment, my friend.  And, your understanding of what your body needs related to movement. So, it depends on your knowledge of ideal body alignment combined with the body’s need for movement. This blog is NOT about treadmill workstations.  Although there is some research that says they may be good for you, most of us either can’t afford them, or our cubicle is way too small.

Why do you need proper alignment?  If you take a body that is not in proper alignment, then move it from sitting to standing, you add a host of additional forces on that body.  Imagine toes that point outward and ankles that turn inward?  Then the knees almost face one another and are slightly bent or hyperextended.  Maybe one of each! Of course, we must add the butt tuck.  Think this alignment is uncommon?  Nope.  I see it quite regularly in my practice and places like the grocery store. Yes.  I’m looking.  I can’t help it.

When a body is out of alignment and then asked to perform daily tasks such as standing at a desk for hours at a time or walking the dog, we experience forces our bodies were not designed to handle on a regular basis. Now is when your fascia steps in and saves the day, sort of. When your fascial system detects trouble, such as repeated forces on a misaligned joint, it will tighten up to protect the joint. Thank you, fascial system, for helping me function even though I’m out of alignment!  Yeah!  But, there is a cost.  Your fascia is connected from head to toe and fingertips to fingertips. When it is tight in one area, it affects the entire system. You may not even feel anything unusual in your misaligned ankle, but you have a tugging sensation in your lower rib cage.  This is how fascia works. It really is all connected.

This person may seek treatment for pain in the rib cage.  Traditional therapy and logical thinking based on our current textbooks would lead you to treat the rib cage. First, we must make sure they have seen the appropriate health professional to rule out any medical causes such as a tumor, of course.  With so much research coming out on the fascial system, we must look beyond the rib cage.  We can start at the ribs and probably make them feel a lot better very quickly.  But, they’ll be back.  Why?  We haven’t addressed alignment and the tightness around the misaligned ankle.  So, no one gets out of my office without a clear understanding of where they can improve their alignment and how.

So, back to the stand-up workstation. If you are going to sit or stand at your workstation for many hours per day, you must understand and practice proper alignment.  But, a huge but, you can’t stay static in that perfect alignment all day long.  You must consider your best alignment posture your home base. Hang out there.  Learn to feel comfortable there but vary from it regularly.  The more comfortable you are in proper alignment, the safer you will be in other positions. I suggest exploring as many different positions as possible that you can get away with at your workplace.  If you have a door that closes and people don’t come to visit you often, that can be a lot of positions.  But, if you greet the public all day long in a professional work environment, you are likely to be pretty limited if you want to keep your job.

Even if you are limited, there are some easy things to do to keep moving but first let’s discuss ideal body alignment in a stand-up workstation. Your feet should be pointing straight ahead. Reach down and find the long bones in your feet.  Point the middle ones straight ahead. Now place them directly under your hip bones.  Feel the bones.  Most people overestimate the width of their hips. If you feel pigeon-toed in this position, you have work to do.

While we’re working with the feet, let’s discuss shoes.  Choose the lowest heeled shoes possible.  This applies to men and women.  A heel, any heel, will tip you forward.  You will compensate all the way up the chain of joints in your body.  The compensation may be small, but we are talking about a lot of time.  Small misalignments over long periods of time can cause problems.  Let’s skip up to the knees. If we get them in proper alignment, we’ll likely pull the ankles right along.  Make sure your knees are pointed in the same direction as your feet, straight ahead.  For some people, this takes a lot of effort and coordinating muscles they haven’t used in a long time.  You must use the muscles in your thighs and hips to pull them into alignment.

Next, check your hips and your pelvic tilt. Finding the correct angle can be challenging to do yourself if you have been out of alignment for a long time.  Most people tuck their tailbone.  Reach around and feel your low back. You should feel a gentle curve in your spine.  Your tailbone should angle away from you, not under you. Before we move up any further, shift your weight to your heels.  Stack your knees and hips over your heels.  Avoid putting too much pressure in the front of your foot for too long.  The large bone in the heel can bear this pressure.  The smaller bones in the front cannot.

Now that your weight is in the heels stack your shoulders on top of your hips, knees, and ankles.  Pull your head back, too.  Your ears should be over your shoulders. Be careful that you are not just tilting your ribcage back.  Keep your ribs still and bring your head back.   Next, reach and feel the base of your skull.  Tip your chin until your eyes are level with this point.  If you are straining about now, think like you must look weird or feel like you might lose your balance backward, you have more work to do.  

Finally, the shoulders and arms. In sitting or standing, they tend to be the source of quite a bit of trouble.  To get them in best alignment I’m going to walk you through a few movements.  First, be sure the rest of your body is in best alignment from your feet to your head. Gently squeeze your shoulder blades together and keep them as far down away from your ears as you can. Turn your palms up, bend your elbows to about 90 degrees.  Keep your elbows at your side and rotate your shoulders, so your hands are out to the sides. You are now externally rotating your shoulders. Feel that position in your shoulder joints.  See if you can maintain as much of that feeling as possible and while keeping your elbows close to your side, slowly move your hands as if you are going to type on a keyboard. That my friends is proper arm alignment.  As you slowly release the effort of holding your shoulder in that perfect position, notice where your shoulders gravitate.  If they round forward, you have more work to do. If you found this confusing, you can watch my short video on the shoulder alignment stretch.

As we said earlier, this alignment is your home base.  Vary from it regularly.  Step away from your desk and sneak in a brisk walk with a lot of arm swing as often as you can even if it is just to the water cooler and back.  Stretch your arms above your head and rotate your wrists.  If you can paint the bubble without attracting too much attention, paint it as often as you can.  If you are not sure what that means, see my short video. Painting the bubble is easy to do if you are reading from your monitor.  It feels amazing.

Have something under your desk to step one foot on occasionally. Use a yoga block, an old book or binder or a fancy ergonomic footrest. I like to have something I can move around easily so I can either step on it or use it to stretch my calves. I have another video on calf stretching that is great to do while at your standing workstation or any other time of day.  Stretching your calves qualifies as movement at your workstation.  Do it!  Shift your weight, slouch a little, cross your ankles. It is all good as long as you’ve worked on proper alignment enough that it comes naturally to you and feels as comfortable as any other position you can contort your body into.  If you can achieve and hold proper alignment easily, get going on that stand-up desk. They are awesome.  If you can’t figure out or easily hold proper alignment, get some help.  Your investment in proper alignment will serve you well beyond your stand-up workstation time.

Mayer Wellness, LLC Introduction to Alignment Workshop Series