Neck, Shoulder and Arm Pain Part 2: Strengthen Long Muscles

This is the second part of the tutorial on how to keep the shoulder girdle balanced to prevent pain in the arms, back and neck. In this segment we will focus on strengthening. We will begin with a tutorial on what it means to stabilize a winged Scapula, this is what will help us understand if we are in good form (or bad) Winged=BAD. 

How to Identify and Correct a Winged Scapula

Now we will cover three versions of Scapular Push-ups (to strengthen the shoulder girdle). You should perform 2 sets of 10 reps each per exercise, only doing the version your body is ready for. If you find it difficult to hold good form in a version of the Scapular Push-up (if your scapula are winging or poking out), stick with the previous version until you are strong enough to perform the next version of exercise with good form. However, you should continue to perform all versions, even when you are strong enough to successfully complete the most challenging version. Remember, the emphasis here is on proper form and muscular balance- so if you push ahead before your body is ready, you are setting yourself up for imbalance. 

Basic Scapular Push-up

Moderate Scapular Push-up

Intermediate Scapular Push-up

*to advance you may come up off of the knees into full push- up position when you are ready.

Now for our final exercise in the series: Breast Stroke, which will strengthen the back extensors and challenge the shoulder girdle to move properly. This exercise must be performed with the head neutral (ears should not drop below the level of the shoulders- imagine you are swimming and your head and shoulders are both above water, do NOT look out at the horizon, DO look down at the water below you. Start out with 3 sets of 5 reps, move up to two sets of 10, and then 3 sets of 10.

Breast Stroke

Finally- What is that Occipital Ridge I keep mentioning, and why is it so important? Well, for starters, it is a bony landmark on the back of the scull, that indicates the very top of the spine (where the spine and the head meet). This junction is crucial for shoulder health. Our heads are very large and very heavy, and they are held up by a very long and thin neck. Ideally the head stays positioned over the shoulder girdle, where it can balance with very little help from the neck. This allows the muscles of the neck to do their REAL job, which is to move the head around. Unfortunately, we often let our head drift out in front of us, which makes our neck muscles have to carry the load of the head constantly (and the head weighs more the further forward it is). This prevents the neck from doing its REAL job effectively, and soon turns into neck pain, imbalanced neck muscles, shoulder pain, and then finally arm, elbow, wrist pain. It trickles down, just like that. So, that is why I'm always talking  about that Occipital Ridge. I like to use it to check in, making sure our head is balanced with our shoulders properly, whether sitting, standing, lying on our back or tummy- we always need to check in on this balance.

Occipital Ridge

 

Low Back Pain Relief Part 1: Sitting

One of the most common complaints I hear from new clients is "I have pain in my lower back". This isn't surprising to me when I observe how they sit with their tails sheepishly tucked under, perched right on top of their butt cheeks. I mean it makes sense, those butt cheeks do make for a nice little cushion. Unfortunately this is disastrous for your back because it puts pressure on the discs, causing pain and discomfort. It also disrupts proper breathing, creates dysfunction in the shoulders and promotes laxity and weakness in the abs.

Since our bodies don't come with an owners manual, we tend to defer to it's agenda, which is to exert the least amount of effort as possible. This is actually pretty efficient in the short term, as it conserves energy, however, it is often deleterious in the long term. Hence back pain.

So here we go- learning how to sit. It may seem silly, but most of us have never actually learned how to do this properly. As usual, I am going to try and break this down into as few steps as possible. The sixth step is is for extra credit, and focuses on breathing.

1. Find your SIT Bones and create a Triangular Base

• Stand up
• Lift your arms up over head
• Arch your back
• Stick your butt out
• Keeping your butt sticking out, sit back down

You should feel two prominent bones underneath of you (meet your SIT bones- you are supposed to sit on them), your butt cheeks should be behind you (after all, that is why it is called your "behind"). Your SIT bones and your perineum should make a triangle, with even pressure on all three points. OK, so this is a good start. we have a wide, stable base to perch on.

2. Find your Pelvic Bowl and keep it from spilling

• Place your hands on your hips
• Notice that your pelvis makes a cylindrical shape (meet your Pelvic Bowl)
• Notice that when you sit on your SIT Bones, your Pelvic Bowl is upright, and if it were full to the brim with water, no water would leak out from the front or back of the bowl (because you aren't tipping the bowl)

 3. Find your spine

• Your spine should have the feeling that is extending up out of the center of your pelvic bowl
• Your low back should be gently (not forcefully) arcing forward (picture the front of a bow and arrow) 

 4. Balance the Pelvic Bowl and the Bowl of the Ribcage

• The ribcage is also a cylindrical shape and can be thought of as the ribcage bowl. In this case, the bowl of the ribcage should be stacked over the bowl of the pelvis. It's a balancing act, similar to building blocks or stacking rocks. 

 5. Create an HOURGLASS!

• WITHOUT changing the shape of the spine
• Pull the front of the belly in and up (you can actually lift your belly button up)
• Pull the sides of the waist in toward the spine (think- away from the shirt)
• Gently hug the back muscles in and up toward the spine
• At this point you should feel like an HOURGLASS- wide base, wide top, narrow middle that hugs in on all sides

6. You get Brownie Points for BREATHING

• Imagine that you can put a stopper in the middle of the hour glass
• Now pull the breath into the top of the hourglass only
• Feel the bowl of the ribcage fill out on all sides- front to back and side to side
• Feel the belly being strong and supportive, don't lose the stopper, we don't want to fill the belly- only the ribcage.
• This strengthens the ABS and the back, relieving tension in the shoulders, neck and ribs.

Bonus tools:

• Take some colored tape and use it to place three small X's on the base of your chair that form a triangle, this is where your sits bones and perineum should be. This will remind you to sit on your triangular base every time you sit down.
• Print out an image of an hourglass and keep it taped to your monitor, reminding you to sit up properly.