PAIN-FREE POSTURE PROGRAM Core Stabilization for a Pain- Free Posture with Mary Ann Foster
ABOUT MARY ANN FOSTER Massage therapist since 1981 Somatic educator and movement teacher Author of Somatic Patterning and Therapeutic Kinesiology 2
THE PROBLEM Sitting in unsupported positions leads to muscle dysfunction. A lot of sitting can be uncomfortable or even painful without core muscle support and stability. 3
Complications to the Problem Chronic pain causes muscular holding and propping habits Neuromuscular habituation makes poor posture feel normal Sitting up straight hurts until dysfunctional muscles adapt to normal length 4
Research on Back Pain A team of Australian researchers specializing in the study of the stabilizing function of muscles found that only 10 percent of people with chronic low back pain could successfully control the transversus abdominis, while 82 percent of those without pain could control it. * Numerous studies suggest that learning to control this crucial stabilizer can not only alleviate low back pain, but can reduce its reoccurrence. * Richardson C., G. Jull, and B. Richardson. A dysfunction of the deep abdominal muscles exists in low back pain patients. Proceedings: World Confederation of Physical Therapists, Washington DC, 1995. 5
The Solution Improving posture Stabilizing with core muscle engagement Light isometrics done in place Mary Ann palpating lumbar multifidus 6
Core Stabilization Exercises - Used in Somatics - To improve posture and body patterning - To alleviate myofascial pain associated with poor posture - Used in Physical Therapy to treat stability dysfunctions -- injuries that occur when muscles acting as joint stabilizers fail to control movement within a normal range of function. As a result of lack of muscular control, the cumulative effects of joint motion beyond a healthy range lead to pain and injury. 7
Benefits of Core Exercises Perfect for traveling and sitting for long periods of time They are discrete, can practice anywhere, anytime Improve posture and alleviate back pain For practitioners and clients alike Aston Patterning Arcing exercise 8
Core-Sleeve Model Core stabilization integrates education and bodywork, here s how: Sleeve: Bodyworker does MFR on adaptively shortened (AS) muscles (Ms) Client learns to stretch AS Ms and strengthen stretchweakened muscles Core: Client learns subtle isometrics to engage core stabilizers 9
Core Stabilizers An integrated chain of postural muscles that we can tune up like the notes on a flute. When well-tuned, the core stabilizers o o provide postural support independent of joint motion. decrease excessive joint play during joint motion. 10
Optimal Posture Head over Thorax Thorax over Pelvis Pelvis over Feet Body aligns along vertical plumb line. 11 11
Postural Muscles Longus Coli and Cervical Intrinsics Serratus Anterior Lower and Middle Trapezius Lumbar Multifidus Psoas Major Obliques Respiratory Diaphragm Transversus Abdominis (TA) Perineum (Pelvic Floor) 12
Benefits Improve Posture Relieve Back Pain Improve Ease of Movement Look Better and Feel Better Prevent Injury After practicing these exercises for only two weeks, back pain I struggled with for years was gone! Now I practice these exercises everyday: when I drive, while I work, and even during business meetings AR - Satisfied client 13
Neutral Spine and Base of Support Seated Pelvic Rock Exercise Best practiced sitting against wall or upright chair Posterior Tilt Anterior Tilt Neutral Spine 14
Training Tips Start in neutral spine, over base of support. Set up feedback loop Contract slowly to engage slow fibers. Contract with isometrics using 1/3 maximum effort. Focus on control, not strength. If the muscle is already active, you will not feel any change. Have patience! 15
Transversus Abdominis Keystone of core stabilizing system Stabilizes lumbars and SIJs Secures form closure of pelvis Corrects abdominal distension Co-contracts with perineum Provides counterforce for downward force of diaphragm Contraction palpated as hollow above pubis 16
Transversus Abdominis (TA) 1. Place hands on lower abdomen below navel for feedback. 2. Relax abdominal wall. 3. Slowly, lightly contract TA. using 1/3 maximum effort. 4. Co-contract perineum. 5. Hold 6 seconds. 6. Breathe into lower ribs. 7. Relax 3 seconds, then repeat. 17
Diaphragmatic Breathing 1. Sit in neutral spine. 2. Place hands on ribs for feedback. 3. Breathe into lateral expansion of lower ribs. 4. Avoid belly breathing because it anteriorly loads lumbar spine. 5. Expand sides and tops of rib cage. 6. Compare with and without lower abdominal contraction. 18
Multifidi Stabilizes posterior spine, especially cervical and lumbar curves Restores length to excessive lordotic curvatures Each vertebral segment can contract independently Contraction palpated as bulge filling lamina groove Lumbar Multifidus 19
Lumbar Multifidus (LM) Objective: To feel lumbar multifidus fire 1. Start in upright neutral position. Hold lamina groove for feedback. 2. Lightly contract TA. 3. Lean at hips, maintain neutral spine. LM contraction will fill lamina groove. 4. Keep LM contracted and return to neutral position. 20
Lumbar Multifidus (LM) Objective: To correct excessive lumbar curve 1. Lightly contract TA. 2. Hold erector spinae for feeback. 3. To contract multifidus, pull lumbars straight back into elongated curve. Erector spinae lateral to multifidus should lengthen. 21
Neutral Spine and Top Load In neutral spine, head aligns over thorax as top load Forward head posture (Fig. a) Head shifts anteriorly Increases stress on spine Increases curvature Head over thorax (Fig b): Occiput lifted without lowering chin Sternum lifted without tilting pelvis 22 a. b.
Atlanto-Occipital (AO) Lift 1. Start with back of pelvis, thorax, and head against wall. Use pillow behind head if needed. 2. Engage TA & perineum in lower abdomen. 3. Breath into diaphragm. 4. Lightly lift occiput while keeping chin up until you feel a light stretch. 5. Hold for 10 seconds and breathe. 6. Relax for 3 seconds. 7. Repeat. Each time you do this, it should get easier. 23
Scalene Muscle Patterns WITHOUT POSTURAL MUSCLE SUPPORT, THE SCALENES PULL HEAD DOWN.. WITH POSTURAL MUSCLE SUPPORT, THE SCALENES LIFT THE UPPER RIBS UP. 24
Elongating Neck with AO Lift Relaxing SCM during OA lift, while lifting back of head against wall. 25
Psoas Major Stabilizes anterior lumbar curve Seats femoral head in socket Restores curve to flat lumbar spine Contraction palpated at distal tendon 26
Psoas Major 1. Hold distal psoas area for feedback. 2. Lightly contract TA. 3. Lift one foot to contract psoas and lengthen anterior lumbar spine. 4. Put foot down, repeat with other leg. 5. Alternate legs. 27
Psoas Major / Multifidus Rock 1. Begin in neutral spine with TA contracted. 2. Lean back to contract psoas major and lengthen anterior lumbars. 3. Lean forward to contract multifidus and lengthen posterior lumbars. 4. Alternate two actions to increase lumbar support., front and back. 28
Obliques Stabilizes lumbar spine during lower limb motion (important during rotation to protect lumbar spine). Controls rotation of waist. Transfers movement between upper and lower body. a. b. Kapandji s depiction of how a) contracted obliques narrow waist, and b) relaxed obliques widen waist. 29
Obliques Avoid twisting movements when obliques are relaxed (fig. a.) 1. Pinch sides of waist to monitor obliques tone. 2. Contract obliques by narrowing waist. 3. Slowly twist and control motion with oblique contraction (fig. b). a. b. 30
Putting it all Together Objective: Co-contractions of Postural Flute 1. Begin in neutral spine. 2. Do pelvic rock to establish base of support. 3. Co-contract perineum and transversus abdominis. 4. Engage diaphragmatic breathing with lateral expansion of lower ribs. 5. Lean forward to contract lumbar multifidus. Continued on next slide. 31
Putting it all Together Objective: Co-contractions of Postural Flute.. Continued from last slide 5. Lean back to contract psoas major. 6. *Widen shoulders front and back (lower trapezius). 7. *Elongate front and back of neck (neck stabilizers). 8. Breathe while again, mentally reviewing postural flute notes, from bottom to top. 9. Relax, then repeat the same routine. 32
TK WINS AMI AWARD 33