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Motion Dynamics™ LtdNewscase study
By admin Self-help , ,

THE POSTURE OF SITTING

There are many ways humans communicate with each other. The way you walk, speak, run sit or stand speaks volumes about who you are and how you feel in your environment. Let’s look closer at the way we sit.

There is the right way, the wrong way and your way to sit. Yes, we all have very different builds.

A slovenly posture whilst sitting could imply that you are bored, couldn’t care less, are tired and de-energized. You would rather be at home than at work, no enthusiasm.

Slouched, sloppy and inactive are words that come to mind when thinking of our sitting habits.

How do we learn to sit more upright and gradually learn to unsaddle ourselves?

Sitting posture tips:

Use what I call a 50-minute chair. One that is not ergonomically designed and allows you the opportunity to get up every 50 minutes. Can be a simple stool that you sit on.

When seated you should always have your knees below your hips to encourage a natural Curve in the lower back. Use a wedge cushion under the buttock to create that lift.


Computer screen should be around 28 inches in front of your eyes. Your eyes are lined up
with the top of the screen so that you are looking slightly downwards.


Never cross your legs when seated as this throws the hips and pelvis out of alignment.
Your feet should always be planted on the floor or a footplate. When the foot is off the floor you lose the neural connection to your spine. The spinal muscles turn off!


Be fidgety and move around as much as you can when seated.


Stretch your spine by bending your spine forwards when seated to look between the legs.
Hold stretch for 2 seconds and repeat 8-10 times.


Rotate the spine left and right once every hour to open up the joints of the spine and warm up the spinal muscles.
Every 50 minutes get up and get a glass of water to re-hydrate and to switch on those extensor muscles.


Enquire about standing desks or what is called sit/stand desks. You burn an extra 200 calories a day when standing rather than sitting. Also, it helps to rev-up the metabolic system that will allow you to activate the enzyme lipase. Our natural fat burners.

Posture is a body language that we all can read innately. Does that mean we should be

conscious of how we sit, stand and move?

In my observations posture is the reason why we gravitate towards each other and why we are continuously reading each other’s non-verbal body language. You are either attracted or repulsed by how someone carries themselves. It happens at the deepest intuitive levels. HR and AI (Artificial Intelligence) are looking at posture to reveal attitude, energy levels and willingness to comply.

Can we improve our postural habits?

Something strange happens to our bodies when we get past the heady age of 40.
Our muscles start to lose tone and shape and we begin to gain more adipose (fat) tissue. An indication that our metabolic system is changing, slowing down as we are not as active as we once were.


Over consumption and lack of fiber in our diets mean we are not eliminating toxins and we are accumulating unnecessary extra weight which makes us move more sluggishly, creating extra compression on our joints.
For example, the knee takes 5 times more load than any other joint in our body. A 10-pound extra weight translates to 50 pounds of extra load on our knees! Our nervous system is our main command and control for movement. It sends back via the central nervous system a feedback in microseconds of the pressure and the sensations surrounding the joints and soft tissue. We are starting to wear and tear at much earlier ages that we should.
Many anthropologists and anatomists are saying that humans are so well designed that we should be expected to live for 120 years or more. It is what we do to our bodies along the way that wears and tears the cartilage and the soft tissue.

Sitting is a form of compression. You place 8 times your bodyweight up your joints in the lumbar spine when you sit than stand. Your lower back is being compacted by the full force of gravity and the forces of your own bodyweight as well as the way you sit. If you are not sitting evenly on the 2 sitz bones in the lower pelvis you will likely be overloading the disks on the heavier side and more importantly de-hydrating the soft tissue surrounding the disks in between the joints. When they begin to desiccate or dry out you have lost shock- absorption and you have lost disk integrity. You are in fact weakening your spine. 90 percent of all the people we see at Motion Dynamics who work sedentary jobs in offices have fundamentally weak lower backs. In fact, weak spinal muscles that support them all the way to the top of the neck. Those multi-layers of muscles have atrophied and lost the reflexes to create the necessary upright support.


The key for any postural correction work is to get the mechanical alignment right. An even distribution of your own body weight between the left and right side. Then we need to stabilize the weakened postural muscles. Eventually we can add weight and load and start the process of really strengthening our bodies. As we get older, we need to do more strength work not less. We need to remind those reflexes that upright is efficient, we move with greater ease and with less resistance. More energy rather than less is our goal.

Sit less, stand and move more.


Chris Watts is CEO and Founder of Motion Dynamics Ltd.
www.motiondynamics.hk
info@motiondynamics.hk
Tel: +852 28823397

By admin Case Studies, Self-help , ,

Active Assisted Isolated Stretching Treatment of a patient with chronic back during pregnancy

Objective:

The purpose of this Case Study is to demonstrate and discuss the effectiveness of Active Assisted Isolated stretching treatment on a patient with back pain caused by pregnancy.

Clinical history:

The client was a 38-year-old woman who experienced chronic back pain during and after her first pregnancy. The discomfort was most severe first thing in the morning. Initially, this pain was highly debilitating. The client described it as feeling as though it moved in multiple “arcs”, vertically and horizontally, across her lumbar spine. On rising, she would engage in movements that warmed the lumbar joints, and the pain would quickly diminish. The symptoms of her back pain started during the 2nd trimester of her first pregnancy. She would wake up with an inflamed and sore back at the L4 and L5 region of her lumbar spine.

The client had been diagnosed with disk herniation with a right-side bulge and disk narrowing in L4 and 5. This diagnosis was made by her orthopedic doctor after she underwent a physical examination and performed a range of motion tests. At the request of the patient, no x-rays or MRI scans were performed at that time, due to concerns regarding the potential damage to the fetus from radiation.

The pain was localized to the segments mentioned above but did on occasion refer down the right side of her body. The client is generally very fit, engaging in Pilates classes and stability resistance training 2 times a week. She otherwise led an active life, caring for and playing with her first child on a daily basis. She also has a very positive demeanor and is very determined to stay fit and pain-free.

The back pain described above began during her first pregnancy and persisted right through to the end of that pregnancy. She still experienced back pain after giving birth to her first child, but it was much more tolerable than during the pregnancy. However, she continued to wake up with soreness and irritation in her back. Her first child is now two-and-a-half years old. It was when she became pregnant for the second time that her back pain returned with increased severity.

She came to Motion Dynamics for alignment training (postural re-balancing) on the 2nd month of her 2ndpregnancy.

Analysis:

On performing the initial postural assessment, it was noticeable that the misalignments were all around her hip/lumbo/pelvic structures where there was significant anterior pelvic tilting on both ilia with ensuing lower back lordosis.

The pelvis was tilted 25 degrees forward on the right side and 15 degrees on the left side, with a distinctive right dominant hip shift translating the extra weight to her right hip. The right gluteus medius and minimus were weak and hypertonic with poor range of motion in abduction (25 degrees).

The right-side rectus femoris at the AIIS origin was very sensitive to the touch as were the right-side hip flexors indicating weakness and hypertonicity to those important postural and phasic muscles groups. There was a distinctive shift or translation of her body weight to the right side with a very noticeable head tilt to the right side and shortening of her right sterno cleido mastoid muscles.

 

The entire spinal erectors were weak and unsupportive, and the client was incurring a lot of neck pain especially in the suboccipital region. The levator scapular on the right-side insertion point on the superior angle of the scapular had trigger points and was very sensitive to touch, as was the transverse process of C2 on the right side.

Treatment:

We mapped out a flexibility protocol plan for the coming weeks of her pregnancy to re-balance the client’s musculo-skeletal system. With optimal alignment and good functioning joint mechanics, we were able to have her move well and freely without restrictions and irritation. Then we addressed the muscle imbalances, especially in the lower back and gluteal muscles. These were all very weak and neurologically deficient.

We started the first trimester deconstructing some of her faulty structure and movement patterns, building a strong but balanced foundation using Active Isolated Stretching techniques to unwind the right-side muscle shortening.

I used the principle of 3 sets of AIS stretching on the right side to one on the left to help retrain the neuromuscular patterns of movement. The tightest tissues were in the Iliopsoas muscle group. She only had 5 degrees of hip extension on the right side.

Once we gained the full 20-25 degrees of extension and reactivated the gluteal and hamstrings on both sides, she was able to stand much more upright since her pelvis had shifted back to its neutral position.

Her postural muscles were very slack and weak, and much work was done to stabilize the spinal extensors using Active Assisted trunk hyperextension stability exercises and Assisted oblique trunk hyperextension for the latissimus dorsa, intervertebrales and quadratus lumborum muscles.

The client initially found these very challenging. At the start of treatment, she was only able to perform 4 repetitions of each exercise. Eventually, we were able to build these muscles so that she could perform up to 3 sets of 10 repetitions.

The client could only perform these exercises in the first trimester due to the fact they were performed in a prone position off the table. During the second trimester, all back-stability work was performed on a mat using the isometric tabletop exercises that target the deep multifidus muscles.

At the start of her 2nd trimester, she was only able to perform a 60-second hold on each side. When we finished the 2nd trimester she was doing 3 minutes holds on each side.

Most of the pain that she experienced when we first saw her had diminished by the end of the 2nd trimester.

The 3rd trimester saw the client grow rapidly around the trunk and at one point she was carrying 38 pounds more weight. Her calves were cramping at night and she was retaining fluids around her ankle.

We used Active Isolated Stretching for her lower body, having her lie in a side position with a wedged pillow under her abdomen to provide support whilst working on her calves, hamstrings hip flexors and quadriceps, as well as her gluteus maximus.

Conclusion:

The client gained pain relief from the Active Assisted Stretching to the point where she rarely experienced calf cramping. Her lumbar spine was aching and uncomfortable, but she had no sharp pains from the excessive forward pelvic tilting.

We used an elastic belt to help support the extra-abdominal load and I used manual therapy soft tissue release more specifically Neuromuscular (NMT) techniques to relax the lower back and make sure the lumbar vertebrae were gliding well.

I kept up the AIS flexibility and stability training right up to the final session even using AIS for the adductors to open up the pelvic floor which was fully functional in terms of range and stability. The maximal range in abduction is 90 degrees with an internally rotated hip. She was at this end range by the final session.

Notes:

We found that the client really enjoyed knowing the tiniest detail of each area of progress that we were able to make. She developed a strong kinesthetic and somatic sense along the journey. Her understanding of her own positioning and center of mass was key to the client being able to subconsciously make the necessary long-term changes to help de-pressurize the joint and soft tissue structures.

The mother had a natural birth and delivered on March 26th 2019. The baby was 7lbs and 6 ounces. The birth was comfortable and, after the month of confinement that is tradition for Chinese mothers, I was able to see her at the beginning of May. She is now having a period of abdominal bandaging to firm the abdominal muscles and I will start to see her again for post-natal stability training. The focus will be on the pelvic floor and the pelvic and lumbar extensors.