Issue link: https://www.massageandbodyworkdigital.com/i/918051
A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 73 IMPROPER FOOTWEAR Wearing shoes with an elevated heel forces the body's center of gravity forward of its normal position. As the center of gravity moves forward, the body senses that it is off balance and takes immediate action to prevent what it perceives as falling forward. In this case, the body's response is to ramp up activation of the erector spinae and the cervical paraspinalis. As a result of this activation, the neck is pulled into extension, thus moving the head into a balanced position over the trunk and keeping us upright. 5 While this adaptive position does accomplish the short-term goal of allowing us to operate while in these types shoes, the long-term effects are all too often undesirable effects, like pain, up and down the kinetic chain. KNOWLEDGE INTO PRACTICE Knowing the four main ingredients for postural problems is one thing, but putting that knowledge into practice requires four key components. 1. Recognition. It is important to recognize several factors when dealing with this type of client. First and foremost, we need to understand that the position they are in is not normal. If the position is not normal, how could they possibly feel normal (i.e., pain-free) or function normally? 2. Response. Look at the sum picture of all the input. Understand that the position the client is in didn't happen spontaneously. In all likelihood, this position developed slowly, over time, in response to something (or perhaps, many things) that the client is (or was) doing. The important part here is understanding that the output—in this case, the client's posture—is a reflection of what's being put into the system. Therefore, if we can change the input into the system, we can change the system's output (the response). With each leap in technological advancement, dating back to the late 18th century, we have seen a significant reduction in physical activity levels. We have now reached a point where only 1 in 3 children are physically active every day and only 1 in 3 adults receive the recommended amount of physical activity each week. 2 Over one-fourth of the population has no physical activity whatsoever outside of their "normal job-related activities." 3 The word here is atrophy—muscles and body processes that are not used will not be maintained; they will shrivel up and disappear. TOO MUCH SITTING Research shows that people are sitting for as much as 15 hours a day. Furthermore, we spend 60 percent of our time engaged in sedentary pursuits. This establishes poor postural habits and weakens the muscles that hold us upright. Like anything we do repeatedly, we adapt to it so we can do the activity more efficiently (i.e., with less energy expenditure). Repetitively sitting for long periods of time conditions our bodies for sitting and necessarily deconditions our bodies for standing and moving. SMARTPHONE/TABLET/ COMPUTER USE Americans spend nearly 11 hours a day in front of screens. 4 Much of this time is spent looking down. Placing the neck in a flexed position when looking down increases the functional weight of the head by as much as 60 pounds. Exerting that extra force on the body for over 10 hours a day adds up very quickly. We are now seeing children as young as 10 years old with postural problems reminiscent of people in their 60s from just a few generations past. 3. Stack the Deck. Know the odds that you are up against. If the client engages in some activity for 7–8 hours a day, seven days a week, their body is going to alter its shape to adapt to performing that activity more efficiently. How effective is 60 minutes of bodywork going to be if the pattern we are working on has been engrained over thousands of hours and many years? 4. Force Multipliers. To have any chance of permanently resolving problems stemming from a postural issue, we must take advantage of every opportunity to enhance the in-office work we do with our clients between visits. One of the easiest and most effective ways to do this is with targeted exercises that can be performed daily by the client. For example, one of the most common findings on palpation in a client with FHP (think anyone complaining of chronic neck or upper-back pain) is short, mechanically advantaged extensor muscles in the suboccipital region. The client would no doubt benefit significantly if we were to release and lengthen these muscles during their session. GETTING THE CLIENT ON BOARD We could enhance the effect of our work significantly by teaching the client a chin tuck (see "Chin Tuck Exercise," page 72). This simple exercise can be used to prevent the upper cervical extensors from shortening by engaging and strengthening the deep neck flexors. The chin tuck has several unique ways of helping us help our clients. First, it can be used as a tool to increase the client's awareness of their abnormal head position. Second, it has the ability to increase the strength and endurance of the deep neck flexors, while at the same time actively stretching the suboccipitals (and scalenes). Third, this exercise takes advantage of the principle of reciprocal