Upper Crossed Syndrome: How Pilates Can Help Today s Office Worker With a Common Dilemma

Transcription

1 Upper Crossed Syndrome: How Pilates Can Help Today s Office Worker With a Common Dilemma Mila Zenarosa Sharaf 11 September 2014 CTTC, Indianapolis, Indiana

2 Abstract: Today, with the proliferation of laptops, tablets and smart phones enabling us to be more mobile, it is becoming more common for us to be hunched over with our necks hanging down towards our small screens. Margaux is seemingly suffering from such a phenomenon. Some daily adjustments addressing her mechanics should help build her body awareness. But the true corrective involves rebalancing key muscles via Pilates. She is very interested in Reformer work first, so her plan will take her stepwise through a reformer repertoire to stretch and strengthen her upper body. We will also focus on stretching and strengthening so she can realign her back and pelvis to a more neutral position.

3 Table of Contents: Anatomical illustration 4 Background 4 Medical Restrictions 6 Fitness Level 7 Goal 7 Assessment / Recommendation 7 Program Framework 8 BASI Program 10 Conclusion 12 Bibliography 13

4 Background: Margaux is a 44 yo female working full time in an office setting. Her situation is

5 relatively typical of an office worker today. She spends several minutes getting ready in the morning, leaning over a bathroom sink. She has a 45-minute commute in the car, at least 6 to 8 hours in front of her laptop, and then another 45 minute commute home. She seals the deal with another 2 hours online in the evening tying up lose ends, answering personal s or watching some show via online streaming. She works out about 1 hour 3 times a week but still feels beaten down by the daily grind. Her aches and pains have driven her to try 3 mattresses and toppers in the last several years; she has gone through at least 4 different pillow types, various orthotics, arch supports and shoe styles. She comes in wishing for some help to pull her up structurally since she is hitting that time in life where things are taking their toll. Her neck, back and shoulders hurt. She tries to stay active and exercise and has had physical therapy on her shoulders but the problems persist. At her initial assessment I noticed a fatigue type posture, with predominant upper crossed syndrome. To put Margaux s syndrome in context, the average American adult spends eight and a half hours a day in front of a screen, whether it s on a computer, TV, mobile phone or other gadget. Users who spend the most time in front of a screen are in the 45 to 54 age group, dedicating nine and a half hours to this per day. The average adult spends 50-70% of their time sitting which may have far reaching implications. Dr. Emma Wilmot, a research fellow in the Diabetes

6 Research Group at the University of Leicester in the UK combined the results of 18 studies and included a total of 794,577 participants. The results showed that sitting for 6 or more hours a day increases your risk of cardiovascular disease and diabetes significantly. Today, activities that corrupt our posture and create havoc on our muscle balance compete with the amount of time we spend sleeping. The Bureau of Labor Statistics released the results of their time use survey for 2011: So now that we understand the broader context, let us get back to Margaux. Medical restrictions: None

7 Fitness Level: She works out regularly so has an intermediate level of fitness. Historically she has been very athletic but currently she walks, does yoga and hot yoga, has dabbled in Pilates on the mat in mostly group settings. She was not a huge fan of Pilates in the past because of the venue and structure, but a close friend recommended she try again with a more personalized approach to the practice on the reformer. Goal: She wishes to feel vital and free, unencumbered by posture, soreness, and daily fatigue. She feels slumping also impacts her overall mood. Assessment/Recommendation: I did an initial assessment with a roll down for postural assessment. She over tucked her chin to her chest, seems scrunched in the shoulders, tight through the thoracic and lumbar spine as well as the hamstrings. Her hips were posteriorly tilted. She slightly supinates. I recommend she practice Pilates to correct imbalances, but supplement this with daily triggers to remind her to stretch and recruit correct muscles for proper ergonomics. Specifically, she should be in Pilates 3 times a week with daily

8 stretches and posture check-ins to reinforce habits (stretches, kitchen sink movements, posture while driving, etc.). I feel strengthening her abdominals, back extensors, and hamstrings should help her lengthen vertically, mitigating her hypolordosis. Opening her through the chest, strengthening her Rhomboids and Serratus should help as well. Also rebalancing her Upper trapezius and Levator scapulae should alleviate her shoulder pain and instability. Below is a general approach, keeping in mind Margaux s enthusiasm is highly valued and her feedback to the repertoire will be incorporated to tailor her plan as she progresses. The approach consists of a BASI program within a broader framework. Program Framework Week 1-10 Session 1, I will take a baseline picture of Margaux from back, front and side as a baseline visual for her reference. Additional photos (front, back, side) taken at weeks 4 and 8 for visual reinforcement of progress At regular intervals during the day, she should practice: o Chest Stretch in Sitting: Extend arms behind you with elbows straight. Interlock fingers if possible. Gently lift elbows upward. You should feel a stretch in your chest.

9 o Shoulder Door Stretches for Pectoralis: Abduct shoulder to 90 degrees or less. Place hand on the door jamb and lean forward. Hold for seconds and repeat 3-4 times. While driving, she should adjust her seat so she is within arms distance, not over reaching forward, sitting erect, shoulders down with Scapulae tucked in pockets (right to left bottom pocket, left to right bottom pocket) Margaux s BASI program for Weeks 1-10 Margaux s feedback of how she is feeling, making any adjustments needed Week Margaux s BASI Program for Weeks Additional photos (front, back, side) taken at weeks 12, 16, 20 Continued daily stretches and postural adjustments made while driving the car

10 Margaux's BASI Program: Reformer Warm Up: Pelvic Curl Spine Twist Supine Chest Lift Chest Lift with Rotation Single Leg Lifts Footwork 3 reds Parallel heels Parallel toes V position toes Open V heels Open V toes Calf raises Prances Prehensile Single leg heel and toes Abdominal Hundred Prep Coordination Pelvic Curl Roll-up Spine Twist Supine Double Leg Stretch Single Leg Stretch Criss Cross 3 reds Parallel heels Parallel toes V position toes Open V heels Open V toes Calf raises Prances Prehensile Single leg heel and toes Hundred Coordination Short Box Series: Round Back, Flat Pelvic Curl Roll-up Spine Twist Supine Double Leg Stretch Single Leg Stretch Criss Cross 3 reds/1 blue Parallel heels Parallel toes V position toes Open V heels Open V toes Calf raises Prances Prehensile Single leg heel and toes Hundred Coordination Short Box Series: Round Back, Flat

11 Hip Frog Extended Frog Extended Frog Reverse Down Circles/Up Circles Spinal Articulation Stretches Hamstring Stretch Series: Standing lunge Full Body Integration 1 Arms Arms Supine Series: Extension, Adduction, Up/Down Circles Back, Twist, Teaser Prep Frog Extended Frog Extended Frog Reverse Down Circles/Up Circles Hamstring Stretch Series: Kneeling Lunge Up Stretch Series: Up Stretch 1, Elephant Down Stretch Arms Sitting Series: Chest Expansion, Biceps, Rhomboids, Arms Kneeling Series: Up/Down Back, Twist, Teaser Prep Frog Extended Frog Extended Frog Reverse Down Circles/Up Circles Bottom Lift Bottom Lift with Extension Short Spine Hamstring Stretch Series: Full Lunge Up Stretch Series: Elephant, Up Stretch 1, Up Stretch 2, Long Stretch Down Stretch Arms Sitting Series: Chest Expansion, Biceps, Rhomboids, Arms Kneeling Series: Up/Down

12 Circles, Triceps Shoulder Push Shoulder Push Single Arm Circles, Triceps Shoulder Push Shoulder Push Single Arm Legs Long Box Series: Hamstring Curl Lateral Mermaid Short Box Series: Flexion/ Short Box Series: Side Over Box Rotation Side Over Box (modification of (modification of arms crossed arms crossed across chest, not across chest, not raised overhead) raised overhead) Back Breaststroke Long Box Series: Long Box Series: Extension Prep Pulling Straps 1, Pulling Straps 1, Pulling Straps 2 Pulling Straps 2, Breaststroke Close Roll Down Roll Down Roll Down Conclusion: Margaux s ailments are common in today s society. Created and reinforced by improper ergonomics from activities pervasive in our daily living. Since she is active and interested in her physical health, a solid regimen of Pilates and changes in some basic habits should help her improve her body awareness, recruit the proper muscles and ultimately improve her posture and muscle balance. Helping her understand what has happened over time and caused the

13 imbalance will help her understand how good form will undo it. It will be important for her to feel and see the benefits from her hard work, since this will help anchor the discipline for the rest of her life. Bibliography: 1) Modification of Darwin cartoon on a T-shirt, 2) Reproduction of Upper crossed Syndrome of Vladimir Janda,M.D, by Erik Dalton, PhD, 3) Council for Research Excellence (CRE) and Ball State University s Center for Media Design (CMD), Nielsen-funded 4) Emma Wilmot, M.D., Diabetes Research Group, University of Leicester, UK, Diabetologia, October ) The Bureau of Labor Statistics, American Time Use Survey Results, Table 1. Time spent in primary activities 6) 7) Pilates Anatomy, Rael Isacowitz and Karen Clippinger, ) BASI Study Guide, Comprehensive Course