Performance, productivity and……….Posture?

productivity

The newest most powerful productivity hack could be standing right in front of you, quite literally! Our posture plays much more of a role than first thought and the science is clearly telling us why.

Task orientated people will agree they are most productive in the mornings. You’ve had a good night’s sleep, feel refreshed and the mind is clear to tackle the day ahead. In fact many of the world’s top entrepreneurs and business leaders advise scheduling key priority tasks in the mornings.

But where does the drive and productivity go by the afternoon and is there a way of bucking this trend of decreased efficiency?

Well the good news one simple free solution could change the way we work forever.

Lack of movement and prolonged sitting have a global effect on our health, much more than just causing muscle tightness and an aching low back. So much so that Dr. Camelia Davtyan, clinical professor and director of women’s health at the UCLA,  stated that “Sitting is the new smoking”.

So let us have a look at what sitting does to our body and more importantly our brain. A study conducted by Harvard University looked at the effect of a slouched sitting posture compared to a expansive upright posture (standing, shoulders back and chest out). The results were fascinating. Slouched sitting postures promoted feelings of inferiority, sadness and depression whilst expansive postures increased feelings of confidence and leadership abilities. The standing postures actually altered participant’s hormone levels by decreasing the stress hormone Cortisol and increasing levels of Testosterone. So something as simple as standing tall and pushing your chest out can change the chemistry in the brain. This theory known as Embodied Cognition explains how the mind body relationship is a two way street. The emotional experiences have a direct influence on the function of body and visa-versa the postures we adopt have a direct influence on our mood, concentration and productivity.

The lack of movement associated with prolonged sitting also plays a role in our brains stimulation. Nobel prize winning neurobiologist Roger Sperry discovered that 90% of the stimulation of the brain comes from movement of the spine. Prolonged sitting in a slouched position reduces this stimulation drastically. Conversely walking and gentle stretching stimulates the brain. Making movement a regular part of our day is is key to keeping productive.

Poor posture and slouching also has effects on our breathing. Over time prolonged sitting causes us to adopt a shallow breathing pattern resulting in a reduced oxygen intake. Common signs of this are feeling tired and sluggish mid afternoon and yawning in the middle of the day.

The running theme in all these studies is prolonged sitting decreases how well our brain and body functions. It’s like trying to drive a sports car with the handbrake on. So what small daily disciplines can we implement to take the handbrake off and tap into increased productivity and tangible results?

Here are my top five productivity hacks for ultimate performance and consistent productivity.

  • Implement the 30 for 30 rule – Move for 30 seconds every 30 minutes as an absolute minimum. Break your day into 30 minute chunks. Set a reminder and get up and move for 30 seconds. This movement stimulates and wakes the brain.
  • Stand for attention! Where possible work standing up. If holding a team meeting or taking a lengthy call do these standing. This reduces the postural fatigue making it less likely you will slouch when you sit down.
  • Chest up and out. Whenever you walk through a doorway raise your sternum by 2 cm. This small change in posture increases lung volume and releases hormones which increase confidence.
  • Utilise your lunch time. Changing your environment and moving for 20-30 minutes will make you more productive than if you worked straight through your lunch. The movement stimulates the brain, the new environment takes your mind off work preventing mental fatigue.
  • Box Breathe. When feeling tired or stressed close your eyes and breathe deeply from the diaphragm. Breathe in for 4 seconds, hold for 4 seconds, breathe out for 4 seconds and hold for a final 4 seconds before repeating 4 times. This not only increases oxygen uptake which will perk you up but also reduces the release of stress hormones.

As Jeff Olsen famously said “The following are easy to do and easy not to do”. These productivity hacks need to be replicated daily for tangible results. Don’t keep these a secret. Share them with your colleagues and enjoy improved posture, productivity and performance.

 

Reduce Back Stiffness with this Simple Daily Stretch

Woman Suffering From Back Pain

Waking with low back stiffness is common place amongst office workers and the elderly. Its often a sign the back muscles have been overworked from the day before. Thats right! The back muscles get overworked from merely sitting all day.

To prevent this stiffness building, which can lead to dysfunction, back spasms and possible injury including disc swelling we must gently warm the spinal muscles up before weight-bearing.

This simple movement is great at safely improving the movement of the spine to ready you for the day ahead.

 

For more detailed exercises specific for you email us at chiroexercises@gmail.com and we will let you know of a great chiropractor near you.

Have a burning question you want us to answer? Leave a comment and we’ll get back to you.

Txt neck – What’s really going on ;)

text neck

As a chiropractor I see people with all sorts of aches and pains but one trend I have noticed is neck pain and associated problems like headaches, migraines and jaw pain on the rise over the past few years.

Often ‘poor posture’ is the generalised cause but I feel a more specific cause is right under our noses, quite literally – smart phones.

So what’s really the problem with cell phones?

Firstly it’s important to understand how the neck and spine works to best appreciate how the use of phones is damaging our health.

The spine has a number of curves that act like a suspension system, evenly distributing weight and forces without overloading one area of the spine. The neck more specifically has a gentle ‘C’ shaped curve which keeps the head upright, eyes parallel and distributes the weight of the head through the spine.

The neck vertebra are unique in their structure. Their small thin structure allows for fast, intricate and accurate movements. The further down the spine the bones become wider and thicker, dealing with the increase load that is placed on them. Think of the neck as a formula 1 car, nimble, fast and delicate. The low back vertebra are more the off road 4×4 car, sturdy and hard wearing.

The problem comes with sitting and working with things in front of us. Over time we start to slouch with the head creeping forward, which undoes the natural curves of the spine. This places huge stress on the small neck joints, which in turn causes the surrounding muscles to get tight and stiff. With every inch the neck moves forward more weight and stress is being placed on the neck vertebra. Like holding a bowling ball close to the body and then further away, the work load increases even though the weight doesn’t. We are now effectively asking the formula 1 car to go off road, not a good idea.

Over the past few years a lot of money and research has gone into ergonomics, how we should be sitting, moving and lifting. No doubt driven by fear of future litigation when it becomes apartment that the deterioration of a generation’s health may be driven by the sedentary work postures we adopt. We now know how to set up our desk station and car seat to maintain good healthy posture. But is it possible to have good posture when looking at our phone?

There are two ways to tackle this problem. Firstly look at how we use our phones and secondly how much we use our phones.

Often we hold our phone below eye level causing the head to tilt forward, past the neutral position, the danger zone. Ideally we would keep the head in neutral whilst looking at our phone but this would result in people walking around with their phone out at eye level and I don’t see that catching on very soon. The potential for technology in eye wear is a real solution to this problem but until then we need to look at the amount of time we are on the phone. Looking down for short periods of time is very safe for the neck, in fact that’s what the neck is designed to do but prolonged (over 10 minutes) bending of the neck (looking down) is what causes the muscles and joints to over stretch. Limiting use to short bursts is ideal. If you love to catch up on social media at night then try lying on your back when looking at the phone. The solution however may be as simple of not using your phone as much as we are. Not a popular option but often the simplest solution is the best one.

In the meantime here are some great stretches to help alleviate the tightness that comes from txt neck.
Stretches to help with the problem:

Rolled up towel:

Lying on the floor and placing a tightly rolled up towel under the neck for 2 minutes can help undo much of the stress from a forward head position. Great to do before bed.

rolled towel under neck

 

Movement:

Introduce movement every 20 minutes. This can be as simple as rolling your shoulders, going for a 30 second walk, standing or stretching.

Rules:

Have rules about phone use. Commuting to work – then listen to a pod cast and put your phone away. Try and refrain from looking at your phone whilst walking along the street.

phone rules

And most importantly seek professional advice from a Chiropractor, Physiotherapist or Osteopath if you are experiencing neck pain and headaches. Don’t reach for the pain killer, you’ll only delaying the inevitable.

hp-chiropractic

 

If you enjoyed this article please check out our archive for more like it. If you’d like more info please contact us via email at chiroexercises@gmail.com.au

4 Exercises to Transform Your Posture

super posture

Correct upright posture is not only essential for a healthy spine and body but crucial when making a first impression. Someone with a slouched forward drawn posture will automatically make you think they lack confidence, are passive and timid. Compare that with someone who stands tall with shoulder back and chest out, this portrays a strong confident individual. If you were having to pick between two similarly qualified candidates for a role in your organisation you’d most likely pick the one who exudes confidence.

Using good posture as a tool to portray confidence has been used by political candidates, sports professionals, musicians and those in authority for hundreds of years.

beyonce good posture

Beyonce with strong confident posture

So how can we all improve our posture? The following four simple exercises will help combat the effects of prolonged sitting which is the main contributing factor of a slouched drawn forward posture.

  1. Stretch the tight chest muscles
Stretch through a doorway,

Stretch through a doorway,

Hold for 30 seconds and repeat 3 times throughout the day

2. Strength the weak mid back muscles

Step 1

Step 1: Tall with chest raised and shoulders back.

 

Step 2 -squeezing shoulder blades together

Step 2 -squeezing shoulder blades together

 

Using a theraband and standing with good upright posture open the arms out whilst squeezing the shoulder blades together. Aim for 3 sets of 12 repetitions. If you don’t have a theraband a light 1-2kg weight will suffice

 

3. Stretch the tight hip flexors

 

Hip Flexor stretch

Hip Flexor stretch

Hold for 30 seconds and do 3 times on each leg

4. Switch your Glutes back on.

Glute bridge

Glute bridge

Before raising your buttocks off the floor lightly engage (tense) your abdominal muscles then squeeze your buttocks together and lift. Aim for 3 sets of 12 reps

Making these part of your usual exercise routine and sticking to it is a great way to improve posture. Repetition and consistency, like most things with our health and fitness, will enable you to achieve great results, great posture and hopefully future success.

Would you like a complimentary postural assessment from a chiropractor near you? Enquire via email at chiroexercises@gmail.com

You are only as young as your spine.

floss

Without fail twice a day ,like most people, I spend 2 minutes brushing my teeth, it’s a social norm. It’s hygienic, stops bad breath and prevents our teeth decaying. We value our teeth so much that we will also go for a check-up with our dentist a couple of times a year just in case there is decay or damage we can’t see. And quite rightly so.

But what are we doing to prevent the same decay happening to our spine. After all the teeth and spine are both made of the same material, bone. If you compare the role of both it soon becomes apparent that our spine plays a much more important role in our survival than our teeth. If you had to live without one you wouldn’t get very far without your spine.

Functions of the spine

  • Houses and protects the spinal cord. Communicating signals from the brain to the rest of the body, without which we wouldn’t be able to function.
  • Maintains our frame: This gives us strength, mobility and durability.
  • It is an attachment point for our muscles and ribs.

So the problem arises from the lack of feedback regarding the health of our spine. Unlike our teeth, we cannot see the daily health of our spine. In fact, the scary truth is that the spine can slowly degenerate over many years with no signs or symptoms at all.

 
“But I don’t do anything strenuous enough to cause decay to my spine”.

Unfortunately this is a common misconception, the truth is the less activity you do the quicker your spine is affected by osteoarthritis (degeneration); a moving door hinge will rarely rust. Sitting at work is enough to speed up degeneration in the spine. I have seen numerous people in their mid-20’s and 30’s who present to me with mild to moderate back pain that they attribute to posture and sitting at work. When we look at their spine on X-ray I am shocked at the rate of degeneration. Their spine is that of a 50-60 year old, all because they weren’t looking after themselves. Osteoarthritis of the spine cannot be reversed. Treatment and maintenance can help prevent progression of the degeneration but once you’ve got it, you’re stuck with it.

Rarely though, I am pleasantly surprised and see elderly people who have looked after their spine and have little degeneration and great movement, they are also healthy and happy. So what’s their secret? Consciously or sub consciously they all follow these four key principles

  1. Move often and move safely. Sitting for longer than 20 minutes causes undue stress on the spine. Get up and move as much as you can. Take part in regular exercise; this can be walking, yoga, pilates or going to the gym but move frequently!
  2. Don’t ignore your core. Your core brings strength to your spine. You need it like you need the tyres on your car.
  3. Eat well. A balanced healthy diet is needed for the health of all the cells in the body, including the bone cells. Smoking, excessive drinking and sugary foods deteriorate the health of bone making it easier for them to degenerate irreversibly.
  4. Get a regular check up with a chiropractor. Chiropractors specialise in the function of the spine and nervous system. This is our bread and butter, like a dentist is with teeth. Get a check-up regularly throughout the year to keep you at your best

Doing all the above regularly can make the difference between keeping mobile and having great quality of life into your later years versus being immobile, in pain and house bound. As a dentist once said “you only need to floss the teeth you wish to keep”, so go and floss your spine daily by doing these 4 healthy habits.

 

Written by Dr Callum Forrest MChiro, DC

For more information on how to keep your spine healthy or for the details of a great Chiropractor near you email us at: chiroexercises@gmail.com

New Year, New Strategy

strategy

It’s that time of year again. The post-Christmas / New Year’s blues have truly set in, your email inbox is overflowing, the work is stacking up and to make things worse you’ve made a new year’s resolution to lose weight and get fit which is making you feel constantly hungry. It’s no surprise then that 90% of New Year’s resolutions are broken within the first month.

Well this is how I think we should approach our health for 2016. Pick one small change to your usual routine which is going to benefit your overall health, not 6. Because when the inevitable happens and you break one of your resolutions it won’t be long until the others come tumbling down.

Once you’ve implemented your health change for a month you should be comfortable with the routine you’ve put in place to maintain it. It shouldn’t feel like a chore or be an effort. Now pick another healthy action and add this into your routine. Again do it for a month, get used to it, and get comfortable with the routine. So you now have 2 health routines which you’ve consistently implemented into your life and it doesn’t feel like you’ve done much! If you keep doing this every month you will have made 12 significant health changes by the end of the year. If you had tried to action the same 12 health habits all at once in January it’s fair to say you would be in a worse situation come the end of the year than if you implement one at a time.

Here are 12 everyday actions for you to action to benefit your overall health.

  1. Hydration. Drinking enough water for your body type is one of the most underrated factors essential for good health. Almost every disease state will have chronic dehydration as one of the causative factors. To calculate how much water you should be drinking multiply 35ml per Kg of your body weight. During periods of hot weather or if you’re unwell you can increase this to 45ml per Kg. Now you know the amount for you invest in a drinks bottle. Buy one for work and one for home. Work out how many you need to drink to reach your goal. Little and often is so important. If you drink all your water when you get home in the evenings your body will flush it out.

    35ml x Body Weight (Kg)  = Your daily water intake (ml)

    35ml x Body Weight (Kg) = Your daily water intake (ml)

  2. Movement. Sitting for prolonged periods has been shown to have huge detrimental effects to your health including accelerating the rate of degenerative change (Osteoarthritis) to your spine which is irreversible. Make the effort to get up and move if you’ve been sitting for up to 20 minutes. You can download programmes for you PC which let you know when 20 minutes have passed with a reminder to get up and move. Why not get up and have a glass of water and kill 2 birds with one stone!offcie stretch
  3. Fresh Fibre with every meal. Eat some form of fresh, raw and uncooked vegetables and fruit at the beginning of each meal in your day. This will take minimal preparation and you will notice a difference to your energy levels within a week.fibre
  4. Stretch every morning. Whether you feel it or not certain muscles will get tight after sleep. To ready your body for the demands of the day do a simple Cat Camel stretch every morning to improve mobility and decrease chances of low back pain. Taking part in a yoga class regularly is a fantastic way to keep your body mobile and healthy.

    402d1_ab4d4a74292cf43c_cat-cow.xxxlarge

    Cat Camel stretch

  1. Educate yourself in an area of health you’re interested in. It can be fitness, nutrition, skin care, whatever you fancy but make the effort every day to educate yourself in an area you wouldn’t normally. The best way to do this is read 10 pages or listen to at least 15 mins of an audio book or pod cast in your selected topic every day. The latter can be done on the way to work, during your lunch break or whilst shopping at the supermarket. There are tonnes of fantastic pod casts out there, free to download on every health topic under the sun.podcast
  2. De-stress every day. Stress affects everyone but in different ways. Stress, whether it be at work, home, family etc. causes a cascade of chemicals to be released which if at consistently high levels are dangerous for our overall health. Free to down load 10 minute meditation Apps are great. If you find it hard getting off to sleep try then do in bed at night. Alternatively it can be done first thing in the morning.stress
  3. Reduce your coffee or tea- Caffeine should be limited as much as possible. Try and reduce your intake by 50%. It will be challenging for the first week but your body will quickly adapt and you will not rely on caffeine to keep you awake.coffee 2
  4. Invest in yourself: Get a check-up from a dentist and chiropractor. Prevention is the best medicine. If you wait until you have tooth ache or back pain the cost and time of treatment will be more than if you get a regular check-up.

    Prevention is the best medicine

    Prevention is the best medicine

  5. Make time for breakfast: This often comes down to a time management issue more so than anything else. A wholesome healthy breakfast eaten everyday will not only give you more energy throughout the day it will reduce your craving in-between which can lead to unnecessary snacking but it also it improves gut motility and absorption.breakfast
  6. Plan your evening meals: At the end of the day when we’re tired hungry and have nothing at home to eat is when we make poor meal choices with unhealthy quick to prepare meals often accompanied by over eating. Try and plan your meals for the week so you know what you need to get. Prepare the meals in advance. Make a batch and freeze where possible. Remember your fresh, raw and uncooked vegetables or fruit from number 3!

    Be prepared

    Be prepared

  7. Go for an hour power walk every week. You’ll be amazed at how much energy is needed to maintain a good paced power walk for a whole hour. Doing this on your own can also act as a great stress reliever and de-clutter the mind but getting a friend, partner or family member to go with you is great too. I advise doing this on a Sunday morning.power walk
  8. Minimise your use of laptop’s or tablets directly before bed. These electronic devises emit blue light which ssuppresses the production of the hormone melatonin. Melatonin controls the sleep and wake cycles. A reduction in melatonin at night is associated with sleeplessness. But melatonin suppression has far worse consequences than simply poor sleep it has also been shown to increase the risk of cancer, impair immune system function, and possibly lead to cardio metabolic consequences such as type 2 diabetes, metabolic syndrome, obesity, and heart disease. So instead of watching your favourite TV programme in bed or catching up on the news on your phone put them down and read something real like a book or magazine.No-sleep-laptop

 If you are serious about making these small easy to do changes to your lifestyle then make a note of each change to its corresponding month in your diary. Also get a friend, family member, work colleague on board as well. It will help you keep accountable to the positive changes you’re trying to make.

 Good Luck!

The Pain Game

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(c) Can Stock Photo Inc. / kikkerdirk

We’re led to believe that experiencing pain is a dangerous phenomenon and should be suppressed by any number of medication currently on the market. If you’ve got a headache take a headache pill, joint ache take a pill or rub pain relieving cream into the area etc.

Pills2.36491959

But what is the pain trying to tell us?
Pain is the way the body can communicate injury, infection and dysfunction to the conscious part of the brain. Is this something you really want to ignore? Unfortunately turning down the pain doesn’t address its cause but purely the symptoms. Its like disabling the fuel warning light in your car. It doesn’t address the fact you’re nearly out of petrol.

It’s therefore fair to say that PAIN IS NOT THE PROBLEM. It’s just an alert telling us there’s more going on.

But how accurate is pain as an indicator?
Although essential for our survival pain isn’t particularly good at telling us what the problem is, in fact at times it can be quite misleading. For example we have a huge amount of pain receptors in our mouth and lips. Biting your tongue can be extremely painful for a reasonably small amount of damage done while other people experience minimal pain after rolling their ankle which can cause significant damage to the ligaments.
With spinal dysfunction pain can also be quite misleading. Our spines are an incredibly strong, flexible structure which is comprised of a number of extremely versatile tissues. It is very difficult to damage a healthy functioning spine. Pain arising from the spine is often the last part of a bigger picture of dysfunction to arrive. Postural issues, prolonged sitting, incorrect lifting, previous injury etc can grumble in the background slowly disrupting these strong tissues causing us minimal to no pain. In fact slight stiffness might be our only conscious indicator. And then one morning we bend to put our shoes on, pick something up, twist awkwardly and ouch PAIN! When asked what caused the pain we attribute the putting on of our shoes when in fact it’s been building momentum over a long period, like a car rolling down a hill with no brakes. The putting on of the shoes was the final straw.

What separates chiropractic from other health modalities is we address the underlying cause of your problem and although we are compassionate about the pain you’re experiencing we know there’s more going on. In fact getting rid of your pain can often be the easy part, correcting its cause is where we stand head and shoulders above other practitioners.

hp-chiropractic

As mentioned earlier pain is the last thing to show itself with musculoskeletal conditions and is the first to go. Unfortunately that doesn’t mean the problem has gone and unless the underlying dysfunction is addressed a relapsing cycle of painful spells is likely to occur with no real progress being reached. You’ll be treading water. That’s not how we, as Chiropractors, work.

The Pain Game is a multi billion dollar industry.  Why? Because pain will always comes back if you don’t address its cause and masking pain may lead to further injury and the cycle starts all over again.

What’s your strategy to tackle pain? But more importantly what’s your strategy to address the cause?

Early morning exercises: The hidden danger to your back.

early morning run

Its important to say at the beginning of this article that the people who get up early before work or on their day off to exercise should be commended and this article is not meant to discourage. My aim is that it highlights a couple of easy to do actions which could prevent low back and disc injuries creeping in.

To fully understand the concerns with early morning exercise we need to review the anatomy and physiology of the spinal discs in the low back. The discs primary role is to aid the spine in distributing weight and force evenly through the body. It was often thought that their main role was shock absorption but this has since been dis-proven and they are now more accurately described as force distributors.

The discs are made of two types of tissue. A toughened rope like outer structure called the Annulus fibrosis and a softer toothpaste like inner structure called the Nucleus pulposus (see picture below). Over time poor posture, prolonged sitting and repetitive movements can cause small tears in the outer tougher Annulus. With repeated tears over time the inner Nucleus will migrate to the outside of the disc. It is at this point symptoms are felt as the disc presses on surrounding sensitive tissue and nerves.

05-6_Lumbar_disk

The discs absorb its nutrients and water when we are sleeping and non weight bearing. These nutrients are vital for the health and strength of the disc. Like a sponge filling with water the discs become saturated. On waking first thing in the morning the discs are at their fattest. We are actually slightly taller first thing in the morning compared to last thing at night. This though can be an issue when wanting to do strenuous exercise. When the discs are fully saturated more pressure and stress is exerted on the Annulus during compressive loading. This means that excessive stresses and strains through the disc could cause tearing of the outer fibres and/or bulging. Exercises like running, squats, dead lifts, lunges and jumping place large compressive loads on the spine and discs and therefore could cause problems. Morning sit ups are definitely not sensible, no matter what the Rocky training montages may suggest.

So should I completely avoid doing these exercises during my morning routine?

Definitely not. It is important though you take the time to prepare your body for the demands of these exercise. Spending the first 30-40 minutes of the morning weight bearing (standing and walking) allows the discs to adapt to the pressures and loads not experienced during sleep. This will actually remove some of the water from the disc but in doing so allowing it to be more strong and stable. Discs can also be put under huge stress from sitting so people who have a long commute to work or those to tend to sit down early on should take note. I advise my clients to have their breakfast standing if possible. This will help the disc adapt to the stress of weight bearing without stressing it enough to cause an annular tear. After weight bearing for the first 30-40 minutes a thorough warm up is needed. Don’t start with a weighted bar when doing squats or dead lifts. Use body weight and dynamic movements which increase in range as the warm up set progresses ie. Cat Camel.  If running, spend the first part fast walking slowly building to your running pace over 5 minutes.

402d1_ab4d4a74292cf43c_cat-cow.xxxlarge

Although swimming doesn’t put as much compression through the spine as the other exercises described I would still follow the advice just to be safe.

In conclusion early morning training is a great way to start the day and can give you an energy boost which is felt for the rest of the day but rolling out of bed chucking on the trainers and hitting the gym hard is not the way to do it. Give yourself time to adapt. Walk and move then spend time warming up with dynamic body weight exercises. It might meaning having to get up a little bit earlier but it could mean the difference between staying fit and healthy and having a disc injury resulting in time off work and exercise.

Standing desks : Fashionable or Functional?

Open plan office

I get asked the question weekly by my clients if they should ask work for a standing desk. So here are my thoughts on the new kid on the block that HR departments worldwide are investing plenty of money in.

Firstly the effects of prolonged sitting are well reported. As discussed my previous article Tight Hip Flexors: A catalyst for dysfunction, sitting has been dubbed the new smoking by Dr. Camelia Davtyan, clinical professor of medicine and director of women’s health at the UCLA Comprehensive Health Program. Its effects include heart and lung disease, Increase risk of a whole host of cancers and metabolic conditions like diabetes to name just a few.

So it seems that getting a standing desk is the obvious solution, right?

Well I would disagree with this quick fix approach. Sitting becomes dangerous when done for a prolonged period and the same is true for standing. Regular movement is the key preventative factor for the detrimental effects of sitting. From a musculoskeletal view point the spinal curves are designed to distribute weight and force evenly through the frame into the ground. Its is not effective at doing this when we sit. Tissue creep, the process where ligaments and disc tissue starts to change shape, is one of the detrimental repercussions of prolonged sitting. This can lead to disc derangement (bulging discs) and increase in degenerative changes to the lumbar spine (Osteo arthritis). Getting up and moving for 2 minutes after 20 minutes of sitting is enough to stave off the effects of tissue creep.

The same is true for those with standing desks. Standing for more than 20 minutes without movement can cause postural muscles to fatigue often leading to the adoption of compensatory postures ie: Placing more weight on one leg as seen below

standing posture

Here this person is placing the majority of their weight on their left leg. This will soon lead to fatigue of the Gluteus Medius and an increase ‘slant’ of the pelvis. This over time increases the force placed on the lumbar spine and left hip. Repeated daily over a long period will cause similar spinal dysfunction as seen with prolonged sitting. Add into the mix high heels which places increase stress on the low back curve, tightens the calf’s and over engages the lumbar muscles and this could cause spinal troubles quicker than sitting ever could.

So what’s the solution?

Being able to change from sitting to standing every 20 minutes in conjunction with 2 minutes of walking is, in my opinion, the ideal way to keep healthy whilst at work. You can improve this further by having a glass of water whilst you’re up. Some standing desks are able to raise and lower which is ideal but without the movement factor the so called health benefits are redundant.

But I can’t leave my desk every 20 minutes that’s ridiculous”…

Fair point but be prepared to have aches, pains and a decrease in overall health. When it comes to our health there aren’t many excuses that stand up to scrutiny. Make health the number one priority and the excuses quickly disappear. Here are some more tips to improving your health whilst at work:

  • Put the printer in the furthest corner of the office so you have to get up and move.
  • Set reminders every 20 minutes to remind you to move. Stand Up! The Work Break Timer app By Raised Square is free to download and a great tool.
  • Invest in a digital wrist bands which counts your daily steps. Take a note and have a target you aim to reach. Being accountable for our health has never been more easy, the only issue is we have to do it.

So in summary movement is the key to being healthy at work. There are no quick fixes to keeping a healthy spine and nervous system despite claims made by many ergonomic companies. Invest in making changes through routine rather than expensive solutions.

Thoracic Dysfunction – My clinical observations

evolution-man-computer

Whether the presenting complaint or a cog in the chain of dysfunction I have found a restricted hyperkyphotic thoracic spine a recurrent finding in patients of all ages. Seemingly caused by the repetitive demands of daily life i.e. sitting, driving, and poor posture, this is one of the most important areas to address with patients. This article will go into detail why I think this is the case and how I go about treating it.

The knock on effects of a restricted hyperkyphotic thoracic spine are numerous. Lets go through a few of them:

  • Increased degenerative changes to the thoracic, lumbar and cervical spine. The curves of the spine work as the body’s suspension system. Beautifully distributing load,weight and forces through the frame into the ground without over-loading one area. The thoracic spine is the middle link in this suspension chain. An increase kyphosis and reduced flexibility of the thoracic means that this load cannot be distributed evenly instead being focused on key linkages of the spine, namely: C/T junction, mid-lower thoracic spine and lower lumbar spine.

  • Altered respiratory function: Reduced thoracic mobility will in turn reduce rib motion and lung capacity. The accessory respiratory muscles become over activated (Sternocleidomastoid, Scalenes group and Pectoralis minor) and the primary respiratory muscle (diaphragm, intercostalis, upper abdominals) become tight. This is a hot topic for research with some links between chronic disease and increased kyphosis being found.

  • Reduced scapular and shoulder function. An increased kyphosis is often accompanied by tight anterior neck and chest muscles. The shoulders becomes drawn forward placing the scapulars in a chronically protracted position. The scapular stabilisers become weak and under-activated whilst the upper traps become over-activated. This position of the scapular shortens the rotator cuffs leading to trigger points, shoulder pain and possible knock on effects of sub acromial bursitis and rotator cuff tendinopathy.

  • Forward head position: The anterior position which the head tends to adopt with this presentation can often lead to headaches, reduced concentration, migraines and neck pain. This in itself can lead to reduced sleep quality and fatigue.

So the chronic effects of a forward drawn / slumped posture are much more than just low back or shoulder pain. Worryingly this is becoming more common in children who are picking up bad postural habits from sitting at school and having to carry a heavy backpack. Highlighting the importance of correct posture to kids and showing them how to effectively pack their back packs to reduce strain on the spine is tremendously important in the prevention of long term dysfunction.

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I like to use the following analogy to describe the issue with my patients.

The spine is influenced by muscles at the front and back to keep us upright. Like the guide wires of a tent these need to be pulling evenly for a balanced, stable platform. Prolonged sitting, slouching, working with laptops, carrying bags etc cause the front muscles to become tight, pulling the mid back and shoulders forward. This is the same as tightening the guide wires on one side of the tent only. As you can imagine this causes the spine to be unbalanced. The body tries its best to correct this by recruiting other muscles but adopting the troublesome postures everyday means it is in vein. Chiropractic can help re-establish the normal balance and movement to the spine and muscles. When you’re moving better and more balanced we will then look to strengthen the muscles which have become weak to get you more stable.

This can be elaborated or stripped back to suit the needs of your patient.

How do I tackle this postural epidemic.

Firstly its important to mention that this pattern of symptoms is not caused by the dysfunction of the thoracic spine alone. As I mentioned in my earlier article :Tight Hip Flexors: A Catalyst For Dysfunction, prolonged sitting causes shortening of the hip flexors which has numerous knock on effects. I have found that addressing this dysfunction in conjunction with the thoracic spine has great outcomes.

When treating patients with this presentation I focus on a few key areas.

  • Correct spinal restrictions / dysfunction with adjustments.

  • Release anterior tight muscles (Psoas, Pecs, abdominals, Scalenes, SCM) with soft tissue techniques (Active release, PIR, massage, Dry needling, Graston technique – all work well)

  • Home exercise prescription: Hip flexor stretching, pectoral stretching- 3 x 30 second holds twice every day. Foam roller thoracic extension stretches. Ergonomic advice

Once the patient is moving better I start to incorporate strength and stability work.

  • Dead bug exercises,

  • ‘Y’ exercises for scapular stability,

  • gluteal activation exercises (see What is Hamstring Dominance?)

  • Bruggers relief position whilst at work – every hour for the first week. Progression to Bruggers relief with theraband.

  • All the while continuing with the home stretching

Of course every patient is different with their presentation. The stresses and strains they put on their bodies will be unique to them and their bio-mechanics. The above treatment techniques are a rough guide to what I have found useful. However assessing the bio-mechanics of a patients feet, pelvis, looking at their pillow, exercise routine and stress levels are also useful to rule out other possible contributing factors.

Education is also a key step in the long term health of any patient. A real understanding of the importance of good posture, keeping mobile and functional is just as important as any home advice. Arming the patient with knowledge and tools so they can go onto educate their family, friends and colleagues is a duty of care we should all be implementing.

Encouraging Yoga, Pilates and exercises classes are a great way for patients to stay mobile in a fun structured way. Encouraging mobility exercises as part of their already existing exercise routine is a great way for patients to stay compliant. Patients who have to make changes in their routine to accommodate their exercises tend to give them up.

In summary the numerous knock on effects of a dysfunctional thoracic spine means that its correct identification, treatment and rehabilitation is crucial for the health of our patients. This includes looking beyond the thoracic spine as the sole area of dysfunction. Giving our patients the tools and education on how to prevent recurrences empowers them to take control of their own health and function.