POSTURE PRECISION: UNRAVELING THE BIOMECHANICAL PUZZLE

As a child, did your parents tell you to stand up straight or do not slouch? Did they yell at you for being on your phone or computer too long? Did you listen to them? If you didn’t, you should have. Poor posture and improper body mechanics are the most common repetitive trauma people experience worldwide. In this week’s blog, we will introduce conditions such as Upper Cross Syndrome, Lower Cross Syndrome, briefly discuss common improper body mechanic tendencies, analyze ways to correct body mechanics, and explain what we can do to help.

Upper Cross/Lower Cross Syndrome (UCLCS)

UCLCS is a condition that occurs due to muscle imbalances and poor movement patterns. Both upper cross and lower cross syndrome are often caused by factors such as poor posture, prolonged sitting, improper exercise techniques and muscle imbalances. These syndromes are often associated with muscle weakness and tightness, leading to problems with posture, pain, and movement dysfunction. 

1. Upper Cross Syndrome
   • Upper cross syndrome is a postural condition characterized by tightness and overactivity of certain muscles in the upper body, coupled with weakness and underactivity of other muscles. The main muscles involved are:
     1. Tight/Overactive Muscles: Upper trapezius, levator scapulae, pectoralis major and minor.
     2. Weak/Underactive Muscles: Deep neck flexors, lower trapezius, serratus anterior, and the muscles of the cervical spine stabilizers.
   • The resulting pattern creates a cross of overactive and underactive muscles, leading to forward-rounded shoulders, an increased curve in the upper back, and a forward head posture. This can contribute to neck pain, headaches, and shoulder issues. Below is an image of upper cross syndrome.

2. Lower Cross Syndrome
   • Lower cross syndrome involves imbalances in the muscles of the lower back, hips, and pelvis. The main muscles involved are:
     1. Tight/Overactive Muscles: Hip flexors, erector spinae, and quadriceps.
     2. Weak/Underactive Muscles: Gluteus maximus, deep core stabilizers, and hamstrings.
   • This pattern leads to an increased arch in the lower back and a protruding abdomen. It can result in lower back pain, hip pain, and altered movement patterns. Below is an image of lower cross syndrome. 

Common Improper Body Mechanic Tendencies

Prolonged, repetitive improper body mechanics can lead to upper cross syndrome, lower cross syndrome, or both. Below is a list of bad habits that can lead to UCLCS.

• Forward head posture- leads to neck pain, upper back pain, and headaches.
• Slouching- leads to a rounded upper back.
• Text neck- leads to an increased cervical curve, neck pain, and headaches.
• Improper lifting technique- leads to complete spine pain and increases the risk of disc injuries.
• Carrying bags on one shoulder- puts strain on neck, shoulder, and upper back muscles.
• Poor sitting habits- prolonged, excessive sitting without proper support or with crossed legs can lead to poor posture, lower back pain, muscle imbalances, and stiffness.
• Overstriding- taking overly long steps when walking or running can lead to poor biomechanics and strain on hips, knees, and lower back. 
• Improper footwear- shoes with poor support leads to altered posture, discomfort, and strain throughout the body.
• Not using core muscles- failing to engage the core muscles while lifting, carrying, or performing activities can lead to instability and increase the risk of injuries.
• Improper desk setup- incorrect desk and computer setup can contribute to poor posture, neck, shoulder, and upper back pain. 
• Poor sleeping posture- certain sleeping positions can strain the neck and lower back. 

How Can Improper Body Mechanics Be Corrected?

Everything listed in the previous section can be corrected by simply being cautious and finding different exercises and stretches to help correct posture. Below are bullet points on how to correct the above listed improper body mechanics.

• Text neck & improper desk setup- When looking at your phone, make sure the phone is upright at eye level. This will prevent you from looking down and avoid an increased cervical curve. When working on the computer, make sure the chair being used is comfortable and has good back support. Having the keyboard and computer at a slightly elevated level will prevent you from looking at a downward angle, thus, avoiding strain on the cervical spine.
  • Note: Patients ask about standing desks. Are they good? Standing desks are good if you use them correctly. If you’re slouching and looking down at a monitor screen or constantly looking down when writing or typing, then they are pointless. If you elevate everything slightly at eye level and you’re standing upright, then yes, they are beneficial.
• Overstriding & improper footwear- Always make sure that you’re walking at an even pace and not overexerting yourself. With time it will become a part of muscle memory and it will happen naturally. It also helps if you are wearing proper, comfortable footwear. We discussed proper footwear on a previous blog. We won’t go into great detail about footwear, but as a reminder, find a good, supportive, closed toe shoe that is comfortable for you. Make sure you buy a shoe that is not too big or too small to prevent the risk of injury. To learn more about proper footwear, look back at our blog on proper footwear found at www.drlarrywilkinsspinalcare.com.
• Carrying bags on one shoulder- Did you know that the average purse weighs 6 pounds?  We all know that women love their purses, but is there a way to avoid spinal health issues and still be able to use a purse? Yes, there is. Only put items in your purse that you absolutely need. This will decrease the purse weight drastically. Another good idea is to get a smaller purse that can contain only the essentials, that way you can’t fill the purse with unnecessary items. Another great idea is the fanny pack, which is back in style. A fanny pack can be worn across the chest or around the waist. It’s best to wear it around the waist because pressure is relieved from the shoulder and neck muscles. The same rule applies for a fanny pack as it does for a purse. Only fill the bag with the essentials to lower the weight of the bag.
  • Note: Patients ask if there is a better way to carry a purse. There are three different ways that a purse can usually be handled. One is across the shoulder, one is crossing the strap around the neck, so the purse is around the chest, and the other is holding it in your hands. Is one way best for the spine? Each comes with equal risks, but with weight reduction, the bag could be worn comfortably in any position with little or no stress on the spine.
  • Note: Another thing that patients ask is if using a backpack purse is any better. Even though there is more support and stabilization using a backpack purse, they still come with the same rules and restrictions. If the bag weighs a lot, there is no benefit to the bag. Otherwise, they are great for small items and essentials to be placed in and still achieve proper spinal health goals.
• Poor sleeping posture- This one may be difficult to achieve because some people toss and turn throughout the night unconsciously. Even though you are sleeping in the optimal position, it doesn’t mean you can’t turn while you’re asleep. There is no way to cure this but there are some techniques that can reduce the likelihood moving throughout the night. First, the optimal sleeping position is lying on your back. If you find yourself constantly sleeping on your side or stomach, that could mean either your mattress is not comfortable, or your pillow is not comfortable. If that is the case, it may be time to buy a new mattress and/or pillow.
  • Note: Patients are always asking us for mattress recommendations. There is no right or wrong answer. You need to find a mattress that works best for you, whether it’s softer or firmer. You don’t need to spend thousands of dollars on a tempur pedic mattress for optimal sleeping patterns and reduction in spinal pain. To be honest, they aren’t as great as TV commercials make them out to be. The same applies for a pillow recommendation. Try some different pillows to see what is comfortable. Some pillows are designed specifically for cervical curve correction with different types of firmness. We do recommend a pillow like this. 

The following biomechanical corrections will include images of different exercises that help correct posture, positively restructure the curvatures of the spine, and eliminate UCLCS.  Note that these exercises help correct biomechanical structure and reduce pain. There is more than one exercise that can help correct body mechanics. We are choosing from the most common exercises and the high success rate they achieve. These exercises are just one half of what needs to be done to achieve all goals. Getting adjusted regularly, doing exercises at home daily, stretching frequently, and maintaining proper posture will help enhance proper body mechanics.

Forward Head Posture Correction 

The best exercise to help correct forward head posture is the chin tuck exercise. This exercise will activate and strengthen the deep cervical muscles and will help reduce neck pain, headaches, and will help correct the curvature of the cervical spine. Below is an image of the exercise and steps on how to perform it. 

• Place 2 fingers at the bottom of your chin.
• Gently tuck your chin in and retract your head backwards. At the same time, use your fingers to keep the chin tucked in the entire time.
• Hold the end position for 3 to 5 seconds.
• Relax your neck for a moment and let the neck come forward.
• Aim for 2 to 3 sets of 10 repetitions.

Brugger’s Relief Position Exercise

This exercise is to help reverse the tendencies of a slumping or slouched position. This will help reduce neck pain, upper back pain, and correct the curvatures of the cervical and thoracic spine. The exercise can be done in the sitting or standing position and should be done for 10 seconds every 20 minutes. Below is an image of the exercise and steps on how to perform it. 

1. Sit with your buttocks at the edge of a chair.
   2. Spread your legs apart slightly.
   3. Turn your toes out slightly.
   4. Rest your weight on your legs/feet & relax your abdominal muscles.
   5. Tilt your pelvis forward (ie. arch your lower back) while lifting your chest up
   6. Rotate your arms outward while turning your palms up.
   7. Hold your head high in the air, with a slight arch in the neck.

Proper Lifting Technique

One of the most common injuries we see in the office is lower back pain because of lifting something incorrectly. Most people don’t know the proper way to lift a heavy object off the ground. Below is an image of a proper lifting technique and steps on how to do it. 

• Keep a wide base of support. Your feet should be shoulder-width apart, with one foot slightly ahead of the other (karate stance).
• Squat down, bending at the hips and knees only. If needed, put one knee to the floor and your other knee in front of you, bent at a right angle (half kneeling).
• Keep good posture. Look straight ahead, and keep your back straight, your chest out, and your shoulders back. This helps keep your upper back straight while having a slight arch in your lower back.
• Slowly lift by straightening your hips and knees (not your back). Keep your back straight, and don’t twist as you lift.
• Hold the load as close to your body as possible, at the level of your belly button.
• Use your feet to change direction, taking small steps.
• Lead with your hips as you change direction. Keep your shoulders in line with your hips as you move.
• Set down your load carefully, squatting with the knees and hips only.

The McGill Big 3 for Core Stability

The core muscles keep your back strong, stabilized, and free of pain. When the gut starts hanging out, the lower back has a lot more strain because it is working on overload to compensate for the body’s mechanics. When this happens, symptoms of UCLCS begin to appear. Dr. Stuart McGill developed his theory, The Big 3, to help with core stability. He found that just doing three simple core exercises will help strengthen the abdominal muscles and reduce lower back pain. Below are images of each exercise and steps on how to do them.

NOTE: There are more core strengthening exercises that help reduce lower back. The Big 3 are simple to perform and don’t require a lot of upper body and lower body strength to perform where other core exercises require more skill to achieve. 

1. The Curl Up

Step 1: Lie on your back with one knee bent and the other straight. Place your     hands under your low back to ensure your spine remains in a neutral slightly arched position.

Step 2: Pick your head off the ground only a few inches and hold that position for 10 seconds.

Step 3: After a 10 second hold, relax your head back down to the resting position.

2. The Side Plank

Step 1: Lie on your side with your legs bent and upper body supported through your elbow. Place your free hand on your opposite shoulder.

Step 2:  Raise your hips so that only your knee and arm support your body weight.

Step 3: Hold this position for 10 seconds before returning down. Perform the same descending pyramid rep-scheme for each side.

3. The Bird Dog

Step 1: Assume a quadruped position with your back in a neutral alignment. Remember a ‘neutral’ position is a very slight arch and not completely flat.

Step 2: Without allowing any movement to occur at the low back, kick one of your legs backwards while simultaneously raising the opposite side arm until both extremities are fully straightened.

Step 3: Hold each extended pose for 10 seconds before returning to the starting quadruped position. 

What Can We Do to Help?

At our office, our number one priority is to remove nerve interference, enhance the nervous system, and keep patients at their optimal health. As chiropractors, we are trained to recognize poor body mechanics and correct bad habits. After the first visit, the doctors will create a report of findings based upon the x-ray findings and neurological exam results. A recommended treatment plan will then be presented that is designed specifically for the patient’s needs. Once the report of findings has been reviewed, the doctors will begin treating with a series of spinal manipulation treatments. 

Proper body mechanics will also be enforced so that patients can further regain optimal health and stay well. Our office provides several different exercise tools that further correct body mechanics. The doctors will also provide different exercise tips and stretches such as the exercises listed above. 

This week’s blog contains a lot of content and may be a lot to absorb all at once. If you have any questions about the content or the different exercise methods shown above, please  call us at (724) 547-3377 and checkout our website at www.drlarrywilkinsspinalcare.com for more content.

Yours In Health,

Larry E. Wilkins, DC

Brian M. Steinert, DC