POSTURE and Back Health

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POSTURE and Back Health

• Presented by
• Maureen Hagan
• BScPT (Physiotherapist), BA PE
• ACE, Can-Fit-Pro Certified
• 2006 IDEA Fitness Instructor
• 1998 Program Director of the Year

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Session Objectives

• Learn How To
• Evaluate postural alignment and its role in back
  health.
• Assess static and dynamic postural alignment.
• Identify common postural imbalances and design
  exercises that address common muscle imbalances
  associated with postural dysfunction.
• Design and implement a 30 minute Better Backs
  training session with little to no equipment.

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Defining Posture

• It is your power foundation- a stacked framework
  from your feet through your legs, hips, spine and
  shoulders to your head. Lee Parore (Power
  Posture).

• The neutral position from which all movement
  arises or the keyboard on which your brain
  orchestrates movement.

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Defining Neutral Spine

• Alignment that optimizes the spines natural
  curves, with each part adding to whole body
  movement.

• Posture or position of greatest efficiency,
  around your center of gravity, with muscles on
  all sides, exerting pull.
• A balanced lumbar curve the position in which
  the lumbar spine and the pelvis are best aligned
  to receive the weight of the trunk with minimal
  joint stress.
• When lumbar curve is balanced you transfer forces
  between your upper and lower body with ease.

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The role of POSTURE in Back Health

• Powerful movements depend on every part of the
  spine being strong.
• The spine coordinates whole body power via proper
  execution of movements or exercises.
• Perfect posture pays dividends- by reducing
  stress/loads which leads to tension in the
  antigravity musculature, degeneration of weight
  bearing structures, less efficient movement,
  misalignment and risk for injury.

• More specifically
• Cervical spine gives your head freedom of
  movement,
• Thoracic allows rotation of your torso,
• Lumbar spines provides stability,
• Sacrum provides the base for your spine to sit
  on.
• Sacroiliac joints act as a pivotal axes allowing
  movement integration between your legs, pelvis
  and spine.

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Factors that influence Posture

• Aging- your body gradually loses its capacity to
  absorb and transfer forces however its not aging
  that influences posture as does
• Inactivity/sedentary living/reluctance to
  exercise -leads to loss of natural movement flow,
• Poor postural habits -eventually becomes your
  structure,
• Biomechanical compensation ? muscle imbalance,
  adaptive shortening, muscle weakness
  instability within the core,
• Body composition increases load, stresses on
  spinal structure, leads to spinal deviation,
• Workspace ergonomics,
• Poor movement technique/execution/training ,
• Injury -leads to reduced loading capacity or
  elasticity,
• Others
• Posture is the single most common cause of
  painful soft tissue syndromes affecting the body!

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A Better Core Equals a Better Back

• Your core musclescomprised of the abdominal and
  back muscles- act like that of a corset to hold
  everything in or support and stabilize your
  lumbar spine.
• The result is a slimmer shape, and more
  importantly, a spine that is supported against
  strain, pain and injury.
• The core corset also functions to move the
  trunk in all directionsflexion (forward and
  laterally/sideways), extension and
  rotation/twisting.
• These core muscles must remain strong throughout
  our lives to allow us to continue to move the way
  our bodies are meant to as well as help balance
  on one leg.
• To build a functionally strong backa better back
  for life you must first address posture in the
  context of fitness

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Posture and the Scope of Practice

• Fitness professionals should limit their
  observations and assessments to general
  screenings.
• Specific posture and muscle dysfunction work is
  limited to addressing strength and flexibility
  exercise and muscle re-education that will help
  offset poor postural habits both in sitting and
  while moving.
• Diagnosing and prescribing corrective exercise
  may be seen as outside the fitness professionals
  scope of practice.

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Kyphosis (with forward head and rounded
shoulders)
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Lordosis
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Flat Back
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Sway Back
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Postural Analysis Assessment includes

• Static Postural Assessment
• Dynamic Postural Assessment
• Gait analysis
• Flexibility assessment
• Muscle testing
• Once postural alignment is assessed the focus
  should be on teaching and training Neutral
  Spine

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Static Postural Assessment

• Standing on both feet front, side and rear views
  
• Standing on one leg
• Sitting supported and unsupported
• Kneeling
• Supine
• Sleeping

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Dynamic Postural Assessment

• Performing
• A push- up
• A squat- with arms in front, lifting overhead
• A lunge
• Walking
• Lifting

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Review of Dr Stuart McGills Research and Program
Ultimate Back Fitness and Performance

• 5 Stage Program
• 1. Develop corrective patterns build basic
  patterns through to complex activity specific
  patterns
• 2. Build whole body and joint stability
• 3. Increase endurance
• 4. Build strength and stamina
• 5. Develop speed, power and agility.

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Update on Back PainProgramming

• Do
• Encourage daily exercise for spinal stability and
  mobility even with individuals who have a healthy
  back,
• Include cardiovascular training into back
  exercise programsthey are ideal for preventing
  and managing back pain,
• Carefully evaluate and select exercise
  dosagelight weight/load and greater repetition
  for enhancing endurance strength,
• Focus and encourage quality of movement versus
  quantity and,
• Increase range of motion to achieve and maintain
  neutral spine or ideal posture.
• Brace vs. Hollowing technique.

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Update on Back PainProgramming

• Dont
• Impose high loads (of resistance) in an attempt
  to gain strength
• Avoid traditional curl ups that encourage
  flattening the lower spine (lumbar region) into
  the floor by modifying the exercise as described
  below or selecting alternative ways to target
  abdominals,
• Exercise into positions or with loads that
  produce or increase pain (even in programs that
  advocate benefits ie yoga, Pilates),
• Perform range of motion exercises early morning
  if you suffer low back pain because disk
  hydration is at its greatest and compressive
  forces on the disks will be increased,
• Exceed the capacity or tolerance of the
  individual reduce the number of sessions to 2-3
  brief sessions per day vs longer sessions at a
  time,
• Stop exercising altogether but instead modify
  activity and,
• Diagnose or prescribe therapeutic or
  rehabilitative exercise.

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Strengthen the Weak for Integrated Power

• STANDING WITH STAB BALL AT THORACIC SPINE- CHIN
  GLIDES AND SCAPULAR RETRACTIONS
• SQUATS with progression (WALL SQUAT WITH
  STABILITY BALL, FRONT BODY SQUATS)
• SEATED ROW/LAT PULLS/SUPINE PULLOVERS/PRONE
  SHOULDER FLEXION (neutral spine)
• DEADLIFTS
• 4 POINT KNEELING OR PRONE ALTERNATE ARM AND LEG
  LIFT
• V-SIT with variations
• SIDE LYING DOUBLE LEG LIFT/STANDING HIP ABDUCTION
  (with variations)
• SIDE LYING/SITTING LATERAL TRUNCK FLEXION
• PRONE PLANK/HOVER (with scapular stability)
• HIP BRIDGE (SUPINE, SIDE) with variations
• MODIFIED ABDOMINAL CURL UP with focus on
  maintaining neutral spine (balloon) and
  progressions (SUPINE CROSS CRAWL/AB CYCLE)
• PRONE BACK EXTENSION (both lumbar and thoracic
  regions)
• PRONE EXT PRESS UP
• SEATED/STANDING SHOULDER PRESS
• Emphasis is on leveling and stabilizing the
  scapulae pelvis.

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Stretch the tight for whole body mobility

• SUPINE/STANDING STRAIGHT LEG HAMSTRING stretch-
  with neutral spine
• PRONE QUADRICEP stretch (with hip extension and
  adduction)
• LOW LUNGE with lateral body opposing
  stretch(psoas muscle)
• PRONE EXTENSION PRESS UP
• SUPINE SPINAL ROTATION with alternate upper body
  rotation
• SUPINE INNER THIGH STRETCH (at the wall)
• FIGURE 4 STRETCH (standing or floor)
• SEATED OR STANDING ANTERIOR SHOULDER/CHEST (WITH
  EXTERNAL ROTATION) stretch
• CALF stretch
• SITTING LATERAL FLEXION (against wall with hands
  behind head)
• STANDING ITB/QUADRATUS LUMBORUM
• FIGURE 8 STRETCH (upper body)
• Stretch big to small, breathe and
  maintain for 30-60 seconds

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Performance Power Points

• Bend and Lift Power-bend your knees, pull navel
  in, maintain your lumbar curve, hold your breath
  and push with your legs to initiate lifting.
• Twisting- allow your hips to steer, rotate
  through your hips, engage your abdominals, twist
  between your shoulder blades and move your eyes.
• Leg Power- push the ground with your feet, keep
  your knees aligned and engage your abdominals and
  your butt.
• Pushing Power- keep your elbows in front of your
  shoulders, your tongue on the roof of your mouth,
  engage your abdominals and push with legs.
• Learn correct movement in a slow and meaningful
  manner, then add rhythm and speed.
• Train specifically for movement that you wish to
  become more powerful in performing (increase by
  20).

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Checklist for Aligning the Spine and Building a
Better Back1. Set the feet/foundation2.
Secure the pelvis3. Stabilize the scapulae4.
Position the head Everything links. Posture
can be structural (how you were born) or
functional (how you cope with your body weight or
have adapted over time). Dr Michael Colgan
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Power Posture

• Integration Push Test
• Its all about Whole Body Integration/Movement
  springing and flowing from your power center.

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References and Resources

• Eisenman, Rachel, MS Posture 101. ACE Certified
  News, February-March, 2007
• Hagan, Maureen, FIT-iology- the Study of Fitness
  In Action, Volumes I (Lessons 9 10) I
  (Lesson 24) Volumes Publishing. Go to
  www.mohagan.com
• Florence Peterson Kendall Muscle Testing and
  Function 4th Edition- Williams Wilkins 1993
• McGill, Stuart, Low Back Disorders-Evidence
  Based Prevention and Rehabilitation, Human
  Kinetics
• McGill, Stuart, Ultimate Back Fitness and
  Performance, 3rd Edition, Human Kinetics
• Parore, Lee, Power Posture- The Foundation of
  Strength, Apple Publishing
• www.nasm.org for BodyMap to assist postural/body
  assessments

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Your speaker...

• IDEA Fitness Instructor of the Year 2006
• IDEA International Program Director of the
  Year1998
• Vice President- Operations, GoodLife Fitness
  Clubs, Canada
• Director of Education-Can-Fit-Pro (Canadian
  Fitness Professionals)
• Licensed Physiotherapist
• adidas sponsored athlete
• Author of FIT-iology-the study of fitness in
  action,
• Volumes I II
• Professional Speaker with Canadian Association of
  Professional Speakers
• Website www.mohagan.com
• Email mo_at_goodlifefitness.com
• Or defyaging_at_golden.net