The impact of office working on the body: alleviating upper crossed syndrome through Pilates Ali MacLennan 4 April 2017 CTTC Guildford 2016
Abstract It is a well-documented fact that, more often than not, people in the UK today are spending too much time sitting down, hunched over a computer screen and not dedicating enough time to their physical wellbeing. A recent report by the British Heart Foundation stated that more than 20 million adults in the UK are physically inactive, with women being 36% more likely than men to be classified in that way. The report also found that the average man spends a fifth of his life sitting equivalent to 78 days per year as opposed to 74 days per year for the average woman. Spending hours on end at a desk or behind the wheel of a car, for example, can take its toll on the body in many ways such as poor posture, aching, rounded shoulders and a stiff, forward-stooping neck. Other serious health problems can be associated with a sedentary lifestyle such as heart disease, obesity and diabetes. Mental wellbeing can also be affected as well. Adopting a healthier lifestyle and making an effort to increase physical exercise can do wonders to counter the effects of working in today s deskbound society. Pilates can play a really important role in addressing some of the postural, physical and mental issues mentioned 2
above and this paper demonstrates through a real-life example how this can be achieved. 3
Table of Contents Contents Anatomical Description... 5 Case Study... 9 Conditioning Programme for Lucy Smith... 11 Conclusion... 14 Bibliography... 15 4
Anatomical Description The diagram below shows the 5 regions of the spine: Image 1: regions and curves of the spine As the diagram above demonstrates, the spine is not a straight line but has a series of curves: the cervical and lumbar regions are curved such that they are concave to the back, while the remaining regions are concave to the front. The exact form of these curvatures varies between people. If we focus on the upper extremities, the muscles affected by upper crossed syndrome are shown in the following diagrams: Images 2 & 3: Major muscles of the upper extremities 2) front view 3) back view 5
In a well-balanced body in side view, it is possible to effectively draw a Plumb Line from the ear lobe through the middle tip of the shoulder, midway through the trunk, the greater trochanter, the area just in front of the middle of the knee, right down to the area just in front of the ankle: Image 4: The Plumb Line Upper crossed syndrome is associated with the shoulders, arms and chest (the upper-cross muscles). It is essentially a muscle imbalance as a result of poor posture and is characterised by tightness of the upper trapezius and levator scapula on the back, crossing with tightness of the pectoralis major and minor. Weakness of the deep cervical flexors on the front of the body crosses with weakness of the middle and lower trapezius. This pulls the shoulders and head forward and encourages the upper back to curve more giving the upper body a slouched appearance. The upper back, shoulders and neck start to develop muscle tension / stress, which causes a dull aching pain. 6
Image 5: Upper Crossed Syndrome Postural changes associated with upper crossed syndrome include: Forward head posture Increased cervical lordosis and kyphosis the hunchback Image 6: forward head posture Elevated and protracted shoulders Image 7: lordosis & kyphosis Rotation or abduction and winging of the scapula Image 8: protracted shoulders Image 9: winging scapula 7
Upper crossed syndrome is typically found in individuals who sit for long periods of time, perhaps hunched over a computer, and who continually exhibit poor posture. 8
Case Study Name: Lucy Smith Age: 42 Like many others, Lucy is a busy professional who spends the majority of her day in front of a computer. She travels extensively with her work, driving for several hours at a time around the country as well as regularly taking long-haul flights for business. Lucy works in a very pressured environment and, as a result, also works long hours and has a high level of stress in her working life. As a result of this, she admits that she hasn t previously found the time or energy to exercise regularly and describes herself as unfit and out of condition. Increased tension and aching in her shoulders and lower cervical spine as well as a general desire to take better care of her body has prompted Lucy to take up Pilates. She has done mat Pilates in the past but not for a long time and has never tried equipment Pilates. Lucy has recently taken a 6-month sabbatical from work and is looking to concentrate on her health and wellbeing during this period. She has signed up for private equipment Pilates lessons twice a week. Lucy has confirmed that she has no specific injuries and is looking for a programme that will help to improve her posture and alleviate some of the aches and pains she currently feels. We have agreed to focus initially on releasing the tension in her shoulders, opening up and 9
stretching her pectorals, as well as strengthening her back extensors. In addition, however, focus will also be given to building strength generally, increasing flexibility and stretching the entire body. 10
Conditioning Programme for Lucy Smith I created a programme (see following page) that specifically incorporated a number of exercises designed to open up and strengthen Lucy s shoulders, upper back and arms. By its nature, the BASI Block System is designed to ensure that every part of the body is conditioned in turn and so, whilst specific focus was given to alleviating the upper-crossed syndrome, each session was holistic in terms of strengthening and toning the entire body. The programme also includes progressively more complex or challenging exercises to act as a motivating factor so that Lucy could see and feel the improvements in her body and so that the sessions did not become monotonous. I included other exercises in some of the sessions from week 11 onwards but the programme shown was typical of the regime for Lucy. 11
Weeks 1-10 Weeks 11-20 Weeks 21 + Pre-session Roll Down Roll Down Roll Down Warm up Foot Work Abdominal Work Hip Work Spinal Articulation Stretches Full Body Integration Arm Work Pelvic Curl Spine Twist Supine Chest Lift Chest Lift w/ Rotation Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Prances Single Leg Heel Single Leg Toe Step Barrel: Chest Lift Reach Frog Circles (Down, Up) Openings Bottom Lift (to be attempted from week 5 onwards) Ladder Barrel Shoulder Stretch 1 Shoulder Stretch 2 Or Step Barrel: Shoulder Stretch Lying Side Scooter Upstretch 1 Arms supine series Extension Adduction Circles (Up, Down) Pelvic Curl Spine Twist Supine Chest Lift Chest Lift w/ Rotation Leg Lifts / Leg Changes Leg Circles Chair: Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Single Leg Heel Single Leg Toes Hundred Prep Hundred Co-ordination (to be added in from week 15) Cadillac: Basic Leg Springs Frog Circles (Down, Up) Walking Bicycle & Bicycle Reverse Cadillac: Monkey Original Or Tower Prep Standing Lunge Elephant Upstretch 1 Upstretch 2 Arms sitting series Chest Expansion Biceps Rhomboids Pelvic Curl Spine Twist Supine Double Leg Stretch Single Leg Stretch Criss Cross Cadillac: Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Prances Single Leg Heel Single Leg Toe Hip Opener Cadillac: Breathing with Push Through Bar Bottom Lift with Roll Up Bar Step Barrel: Supine Leg Series Scissors Bicycle & Bicycle Revers Openings Helicopter Short Spine Or Long Spine Ladder Barrel Gluteals Hamstrings Hip Flexors Or Kneeling Lunge Cadillac: Sitting Forward Side Reach Kneeling Cat Stretch Shoulder Push Shoulder Push Single Arm 12
Leg Work Lateral Flexion / Rotation Back Extension Triceps Chair: Leg Press Standing Chair: Side Stretch Chair: Swan Basic Hug-a-tree Salute Single Leg Skating Ladder Barrel: Side Over Prep Ladder Barrel: Swan Prep Chair: Frog Front Side Over on Box Breaststroke Prep (leading to) Breaststroke Post-session Roll Down Roll Down Roll Down 13
Conclusion Lucy was able to maintain the ongoing commitment to two sessions a week for the duration of her sabbatical. Initially in the first few weeks, she found some of the shoulder stretches were quite uncomfortable due to the tightness in her shoulders and pectorals, however as the weeks progressed her discomfort noticeably reduced. Her overall flexibility and strength improved significantly and by the end of the 20 th week, Lucy stated that the aches and tension in her shoulders had almost completely disappeared. She also found the sessions to be very valuable, not only in terms of her physical wellbeing but mentally as well, stating that it was an hour of escapism and was incredibly stressrelieving, so much so that she has now returned to work but continues to attend regular sessions to maintain her new-found level of wellbeing. It is commonly known that regularly sitting at a desk, driving for long periods and / or taking long haul flights takes its toll on the body, tightening muscles and can cause stiffness and pain. However, by regularly undertaking a Pilates regime (either mat or equipment), the effects can be substantially reduced or even eliminated. 14
Bibliography Books 1. Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, 2013. 2. Isacowitz, Rael, Clippinger, Karen. Pilates Anatomy. Human Kinetics, 2011. 3. Calais-Germain, Blandine. Anatomy of Movement. Eastland Press, 1993. Websites 1. More than 20 million Britons physically inactive http://www.bbc.co.uk/news/health-39457993 2. Upper Cross Syndrome. http://www.chelseaosteopaths.co.uk/upper-cross-syndrome/ 3. Identifying Upper Cross Syndrome for Dummies (part 1) https://www.crossfitinvictus.com/blog/identifying-upper-crosssyndrome-for-dummies-part-1/ 4. Upper Crossed Syndrome Part 1 http://drfranksessa.com/2013/07/upper-crossed-syndrome-part-i/ 5. Winged Scapula Syndrome http://www.paindoctorfortlauderdale.com/winged-scapulasyndrome/ 6. Training your back muscles properly http://relentlessgains.com/training-your-back-muscles-properly/ 15
7. Lumbar lordosis the deep curve in your lower back http://www.lower-back-pain-toolkit.com/lordosis.html 8. Forward head posture and what you can do about it http://www.losethebackpain.com/conditions/forward-headposture/ 16