Just about everyone in every market will have an acronym they use to help you remember the why’s, what’s and how’s. We are no different. One of the main principles we adhere to when going through a Functional Movement Evaluation are the A B C’s of our Intergrated Functional Movement System. Today I’m going to talk about…
A = Alignment
We see all sorts and in this post I will speak to alignment as it pertains to posture.
Here is the interesting part; most healthy people (no pain, no symptoms) would tell you that they were standing up straight…until they see their picture. On a quick side note, I had a conversation with a member this morning who mentioned that their partner had visit with a kinesiologist and went through an assessment similar to what I have been talking about in my recent posts. One issue had to do with alignment. I asked if they took pictures or had their partner remove their shirt to check posture. The answer was no. For obvious reasons I don’t assess women without shirts but I do have them wear loose sleeveless tops or t-backs so I can see their shoulders. But guys, shirts off please. If any of the clients above had their shirts on, do you think you could have identified the imbalances, particularly with the man in the middle? Look close and you’ll see I land marked his spine at T2 and the top and bottom of the medial boarder of his shoulder blades. He is far from neutral but you could never have seen this with his shirt on.
Anyway, alignment during static posture can raise red flags that when pieced together with movement impairments and passive tests can help identify the actual cause of the clients pain or problem. Rarely is the case where the site or area of pain or discomfort is the site of the problem. From the last post where I quoted Dean Somerset saying, “The reduction in hip internal rotation is merely a symptom of something else not working properly…” applies to a host of other issues and I want to give you an example that is very common. It’s called Upper Crossed Syndrome. In simple terms its an imbalance of overworked and underworked muscles of the upper chest, back, neck and shoulders.
Postural alignment is a large contributing factor that leads to Upper Crossed Syndrome. Typically the person will complain of upper back and neck tightness and possibly head aches. When asked if they have done anything about it, common answers include massaging the back and neck, stretching the back and neck and taking muscle relaxants. When asked if they have seen any benefit from their treatments, they tell me it’s short term relief. In other words, they have been treating the symptom, not the cause of the problem. This is a perfect example of why stretching the tight doesn’t fix the problem.
Let’s look at how people with UCS will typically stand:
This young man is only 14 years old and from my experience, represents the typical forward head posture of many young people. This constant forward head posture can lead to a rounded upper back where the shoulders will tend to roll forward. When you place that person on their back to do a Pec Minor Length Test, it will look like this:
Normal distance from the acromion process (red dot) to the table is about 1 inch. (Sahrmann S. Diagnosis and treatment of movement impairment syndromes. London: Mosby; 2002). I commonly see 2-3 inches!
Over time, the muscles of the upper back and neck get lengthened and the muscles of the upper chest get shorter. As a muscle lengthens to a point where it exceeds it’s capacity, the myofacial tissue will lay down trigger points. (Etiology of Myofascial Trigger Points. Current Pain and Headache Reports, 16(5), 439–444. http://doi.org/10.1007/s11916-012-0289-4) This is a way that the body protects itself and to correct it, we must first understand the cause and then reverse it.
So, we know that the muscles in the upper back and neck are lengthen and the muscles of the upper chest are shortened because we took pictures, made landmarks did some tests and recorded the results. Now we know that we are no where near neutral alignment. To get back to neutral or as close to neutral as possible, we need to shorten and strengthen the muscles of the upper back and shoulders and lengthen the muscles of the upper chest and avoid text neck by bringing the neck back into alignment with your shoulders.
To shorten and strengthen the upper back and shoulders, do exercises like rows and prone trap raises…no that table in the gym is not for massages!
These simple exercises may be part of one persons routine but to another, it would be a form of corrective exercise. Regardless, my point is that everyone is different but getting back to neutral alignment may be key to solving life’s aches and pains. In the next post I’ll cover “B”. It’s something that we do on autopilot but in most cases, that pilot could use some retraining:)
If you are interested in having a Functional Movement Evaluation done, just give us a call and we’ll get you booked in!