Thursday, October 26, 2017

What's posture got to do with it? Everything!

Does our posture affect what happens when we exercise?
This is the first in a multi part series, today we will discuss the detrimental effects of postural faults in the upper body and next time we will address the lower body. In exercise as well as in normal day to day movement, there is a complex interaction between how we move and how much we move.  Most commonly how well or poorly we move is reflected in our capacity to move.  If we move well we can move a lot, and conversely if we move with altered movement patterns, it can be less efficient, detrimental and many times pathological.

Postural faults are not your fault..well not entirely.

One of the most common thing we see in our office is poor posture, but why?  Believe it or not, it's the way we have evolved vs. our current environment.  Over 30,000 years of recorded history, man has been active.  Farming for vegetables, chasing or hunting for prey, it was not easy or sedentary type existence. Fast forward to the 21st century and we no longer need to hoe the field or track migratory prey over long distances. Our bodies were designed to move and perform tasks crucial to survival. Those tasks formed a balanced frame because the tasks were diverse.  Not so much anymore.. For those who want to know more about primitive patterns, how we analyze it and how we get back to healthy movement click here for a power point presentation I created for fitness professionals.

We live in a flexion based society and most of us contribute to it in almost every aspect.. even when we weight train. 

It's no secret that we as a society have become not only complacent but we're also stuck in the seated position for much too long. We spend more and more time at the work desk, and even more in the car and when all that is over we go to the gym and sit in all of these Precor and Hammer strength machines some more. All of this concentrates the work that we do in the front of our bodies; overdeveloping the front half, and making it dominant.  The result is your posture collapsing forward.  In essence we are feeding the poor posture with something we are told is good for us.  Exercise is good for us, but much more so when it's done correctly and not reinforcing postural faults.

Don't worry Doc, I train back day too..
I'm ashamed to say I fell victim to this one too way back when, most think that training your lats with pulling type exercise will balance your posture, but it does not. The Latissimus doesn't balance out the chest/pecs the middle and lower trapezius and rhomboids do. This thought process contributes to this Upper Crossed Syndrome which is widespread and an underlying factor in so many musculo-skeletal issues.
The chest has taken over and pulled the shoulders forward

A healthy balance or the muscles that move us forward and backwards in the upper body

The Lats(back) has taken over and rotated the shoulders in

Take into account the previous discussed predisposition (the front of us taking over) and we quickly see that our workouts can be contributing to a myriad of pathological processes including but not limited to;

  • Arthritis in the neck (cervical degeneration)
  • Pinched nerve in the shoulder (thoracic outlet syndrome)
  • Pinched nerve in the neck(cervical radiculitis) 
  • Tendinitis in the biceps
  • Shoulder Bursitis(sub-acromial bursitis)
  • Shoulder impingement 
  • Rotator cuff syndrome or tear
  • Upper back spasms(thoralgia)
  • Headaches
As a matter of fact, you don't even need to exercise for the above problems to occur if you have the rounded shoulder syndrome. This is why it's important to have good movement patterns before starting any exercise program. If we can begin with correct fundamental movement exercises, you need to be able to perform these movements (without bad mechanics) before you start an exercise program.  These movements are;
  • Upper body push(push up, plank)
  • Upper body pull(TRX pull up, pull up)
  • Squat
  • Hip hinge or Deadlift
  • Lunge
  • Twist (rotation or anti-rotation)
Many feel like these exercises are too hard, or they have bad knees etc., but the truth is that a good fitness professional knows how to scale these exercises to make them possible for everyone. I wrote a terrific post about exercises that incorporate may of these movements here.

Balance; the key to so many things
You're not pulling this off without some good shoulder stabilizers
The head needs to be balance on top of the shoulders or the muscles that support it will become tight, it's like balancing a 10 lb bowling ball on top of the body. If you don't have the right leverage it gets ugly..FAST  The same holds true for the shoulder, the shoulder blade provides platform of the shoulder.  If that base cannot hold it's stability it's difficult and dangerous to try and lift objects without overwhelming the stabilizing muscles. It's those instances where you start to see the rotator cuff tears AC joint separations and bursitis. 

You want the gym? You can't handle the gym!

For as big as the fitness industry is, there is very little cohesion and even less standardization.  There are commonly competing ideologies and ideals (crossfit vs. NSCA), and there is no central authoritarian agency, no standards of progressing .  The truth is that we learned or were taught these fundamental movements in our youth(primitive patterns), however we may not of mastered them or we have forgotten them.  In fitness there is very little "vetting". We go out and perform exercises because the trainer said so or we see everyone else doing them, seldom asking why?  The truth is that there is a process that you need to follow that will dramatically increase the chances of a successful exercise routine.  You need to be able to pass movements benchmarks before graduating to the next level. After all, your routine is worthless if you are too injured to perform it and studies show that most exercise enthusiast will not return following a major injury. Tune in next time when we discuss the lower body imbalances and the pitfalls associated with them before we start on what needs to be done to prevent these types of problems.

Today we provided principles, so you can adapt your own protocols, don't hesitate to contact us with questions. 
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Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at and feel free to like us at our facebook page.

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