Posture, habits part 1

You do not rise to the level of your goals. You fall to the level of your systems.

-James Clear

The beginning of the year is a time for many of us to think about resolutions or starting over in some way. Has that been part of your recent experience? I confess that I have never done well with resolutions, I start with big goals and loads of enthusiasm and quickly lose focus. This year has been different because I didn’t make resolutions; I had gradually been building a foundation for change with small habits throughout last year. It is fun to look back and see how a year of showing up for myself with tiny changes has built some sustainable shifts in my wellness. I am healthier as a result, and it is rewarding that I can share some of what I have learned with you both in the office and in this blog.

One often overlooked aspect of habit formation is the importance of understanding why you might choose to develop a specific habit. Mindfully returning to the task of taking care of yourself over and over is hard work. Being able to logically and emotionally plug into the reasons behind a habit can be very helpful when it is time to show up and do the work. I could write a whole post about the specifics of how to develop habits, but instead I will refer you back to Atomic Habits by James Clear as recommended in a previous post.

I’m going to try to give you some “whys” behind some of the healthy habits that you might choose. I have plans to discuss posture/body mechanics, exercise, breathing, mindfulness, sleep and nutrition. If you would like to hear about other topics, please reach out and ask me to cover them.

This post will focus on how you move (or don’t move) your body during daily activities. Daily tasks often require sustained postures or repetitive motions. Soft tissue imbalances can develop in your body in response, and your body starts to move differently as a result. This is not usually a painful or obvious process because your brain adapts to the changes in the soft tissues and the lack of movement and you just keep going (don’t get me going on the brain, what a miracle…). But then the weekend comes, and you decide to use your body differently by landscaping your yard/going rowing/holding your grandchild/cooking a big meal/sleeping in an unfamiliar bed. You have a soft tissue imbalance and a brain that has not been practicing movement, and sometimes that leads to an injury.

Here’s a common example: Many of us use computers or phones for a large part of our day. Our shoulders are rounded, our arms are turned in and in front of us, we might be looking down and we’re often sitting with our mid and low backs rounded. There is nothing inherently bad or dangerous about any of that, our bodies can do those things and it’s usually ok to do all the things that your body was designed to do. But when those activities and postures make up a large part of your day, your body adapts to that demand. Muscles in the fronts of your shoulders shorten, and muscles in the backs of your shoulders are stretched and weak. The joints of your thoracic spine get a little stuck in that rounded position. The ligaments in your spine stretch a tiny bit over time with the rounded posture, leading to muscular overload and fatigue in your mid back allowing your wings to creep forward. The heroic rotator cuff muscles are working overtime because it is their job to keep your shoulder joint in balance (centrated) when you use your shoulder, but as they fatigue your humerus slides up a little in the shoulder joint which gradually irritates the tendon of one of the rotator cuff muscles. The weekend comes, and you decide to plant those bulbs that have been sitting on the porch. By Monday, you have sharp pain in the top of your shoulder and you are diagnosed with rotator cuff tendonitis. That is an accurate partial diagnosis, but the underlying condition (painless dysfunction) is the process described above. The cool thing is that you can choose to make simple changes to fix all of it. Obviously, if you have a specific tissue injury like tendonitis, it is more complicated because that tissue also just needs time (and potentially help) to heal. But all the strategies that I will cover below probably still apply.

Disclaimer: The rest of this post will cover some general concepts that address what is happening in most bodies. Obviously, this is not advice that is specifically tailored to your unique situation or injury history. Please take what works for you, discard what doesn’t, and work as a team with your clinicians. Also, I want to acknowledge that the information that I am sharing comes from the work of many practitioners and scientists who dedicated their professional lives to understanding the human body. I don’t always remember where I learned something, but I can assure you that there are no truly original ideas in this blog! Like I tell my son, no matter how smart you think you are, there is always someone in the room smarter than you.

Here are some (not original) ideas that might help you:

1)     Let’s talk about flexibility and stretching muscles. Most of us know if we are naturally “stiff” or “bendy”. Often people who are bendy like to stretch because it feels good to do something that their body is naturally inclined to do. Stretching is neither good nor bad, it’s just a tool that is sometimes useful. Rule of thumb: If you are naturally bendy, you will probably benefit more from strengthening rather than stretching. If you tend to be stiffer, stretching may have more benefit for you (but strengthening is good for almost everyone).

2)     There are common patterns of muscle tightness that develop with typical postural stress. The most well-known of these are probably Upper Crossed and Lower Crossed syndromes, as originally described by Dr. Vladimir Janda. If you want to stretch, try to concentrate on stretching specific muscles with the most potential benefit. For many people, this could include pectorals, upper trapezius, levator scapula, latissimus dorsi, hip flexors and adductors and calf muscles.

3)      A more general concept that applies to people who are either stiff or bendy is mobility. If we relate flexibility to muscles, mobility is related to joints. And there is a predictable pattern of joints that tend to lose mobility in the human body (this is called the Joint-by-Joint theory as described by Gray Cook). Simple mobility exercises incorporated into your workouts or into your daily routine will help to normalize movement and reduce the effects of postural stress on your joints. Joints that are likely to benefit most from mobility work include ankles, hips, SI joints, the mid back and the upper neck. Joints most likely to benefit from stability (strength) work include the lumbar spine, shoulder blades, the lower neck and feet. Please reach out if you want help developing your mobility or strength programs.

4)     When you stay in one posture at or near your end range for more than 20 minutes, the ligaments holding one bone to the next start to temporarily lengthen ever so slightly (this is called creep, isn’t that funny?), adding to the muscular work required to sustain that position. Over time, this is what helps to create muscular imbalances. The game-changer is that changing position frequently stops this from happening. It is that easy, just set an alert on your phone and move your body every 20 min. Simple postural exercises (like Bruegger’s Postural Relief Position) are tools designed to help you to reverse these effects. Let me know if you’d like a handout with this exercise.

This seems like basic stuff, right? That’s because it is basic. But the magic is in owning the basics and having them connect you both logically and emotionally to your ultimate goals. First try to connect with the internal feeling of having your body feel strong and balanced when you do the things that you want to do. Then formulate your action step(s). That’s going to look different for each of you. If you’re just starting or returning to exercise, you might just add a reminder on your phone to do a postural exercise once an hour during focused activities. If you’re a regular on the bike or in the gym, you may want to add a short, focused mobility program to your workouts. If you love the flexibility from your hot yoga class, add some planks or dead bugs other simple strength exercises before class. Two keys to developing your new habits will be pairing them with something that you already do and keeping them so easy that it requires little to no willpower to complete them. When I started my change last year, I wanted to return to swinging kettlebells. I was very familiar with this tool and had a history of some epic workouts with them. But I was re-starting from scratch, so I put a small kettlebell in a room in the house that I have to go in, and my only goal was 10 swings a day. My entire strength program that I do 3-4 days a week started with 10 swings a day in the living room. I hope that inspires you to start very small and build the postural habits that are just right for you this year. I would love to help if you have questions or would like some support.