Later Life Training 2013 Conference Spinal Alignment and corrective exercise: The importance of posture in the frailer older adult. PRESENTED BY SHEILA DONE We are all aware why posture and muscle balance are interrelated and extremely important for health. Static posture Length-tension relationships of your muscles and the corresponding alignment of the joints. Dynamic posture Alignment of the body during movement, length-tension relationship between working and opposing muscles are vitally important. Ultimately good alignments of all the body parts are essential to a healthy and fully functioning body. Muscle Imbalances Due Sedentary Lifestyles are a Primary Cause of Posture Problems The cumulative injury cycle illustrates how muscle imbalances originate. First, there is a trauma, which can result from repetitive motion with poor dynamic posture or poor static posture.
Common muscle imbalances www.dreamstime.com The most common muscle imbalances are caused by a sedentary lifestyle. A person seated for a large proportion of time, forms characteristic pattern of certain muscles shortening and opposing muscles lengthening. Conditions such as upper cross syndrome and Lower Cross syndrome become apparent.. How Can You Prevent and Correct Posture Problems Due to Muscle Imbalances? Address each of the imbalances in detail, strengthening lengthened muscles and lengthening the shortened muscles. Good postural alignment will help the older person to function better and will improve their quality of life. It is as important to set the base foundation alignment for each corrective exercise as it is to perform the exercise. If the foundation is incorrect, there will be reinforcement of faulty movement patterns.
Seated Foundation Position = BLEPS (Base line Essential Principles) Seated posture Sit in the first 1/3 of chair Feet and knees in alignment, feet flat on floor at hip distance. Sit tall on the sitting bones (ischial tuberosities). Crown of head lengthened, chin parallel to the floor. Shoulder blades drawn down into imaginary back pockets. Client should place palms, fingers 1 cm apart on alignment with navel. Feel that the finger tips move closer together. Exercise Diagram Purpose Coaching Points Mobility and setting up BLEPS. SIT ON FRONT THIRD OF CHAIR THIS IS WORKING POSITION Head Turns Shoulder Shrugs Sternal Lift Side Bend Pelvic Tilt Heel Lift, Toe Lifts & circles Prepares the mind & body for the work ahead. NOTE & PRACTICE REST POSITION Balance Visual Tracking Disassociate eye movement from neck movement. Look to left, look to right but keep your nose pointing directly forward. Keep shoulders down away from ears. Keep the nose forward. Allow the eyes to move in direction independently. Feet, knees Hip distance, neutral spine Tight rope stance, neutral spine Seated Sway envelope Trunk stability Strengthen the abdominals and spinal extensors. Seated Spine Twist. Thoracic & Cervical mobility via rotation. Trunk stability Isolation of movement. Feet Hip distance or wider. Good spinal alignment. Hip Hinge approximately 5-10 degrees forward Hip Hinge approximately 5-10 degrees backwards. Arms crossed at chest, or Cossack arms. Hips stay facing forward. (avoid fixed rotation for osteoporatic clients) Rotate at Waist first Rotate at Ribs Rotate at Shoulders, keeping them square. Rotate at neck.
Arm Floats adding comb Alternate Heel lift. Ankle mobility, pelvic stability. Shoulder mobility and stability. Co-ordinated movements & encourages kinaesthesia. (upper cross syndrome) Hamstring Stretch & Quad Strengthener. Lengthens the Hamstrings Strengthens the Quadriceps Introduce arm floats only. Neutral spine, float arms to shoulder line gradually increase range of movement. Combination Float arms to shoulder line. Peel opposite heel off. Combine Single Arm float, toe off and opposite heel raise No band With band to add resistance Pelvic Floor To strengthen the pelvic floor Passage Isolation Slow movements and fast movements Morcambe & Wise Shoulder stability and mobility. Aids clients for towel drying after having a shower, brushing hair and fastening a bra strap on ladies. Adopt the rest position. From Open Door position, medially rotate the right arm, and then reach behind back with right arm Laterally rotate the right arm, and reach behind the back with the right arm. Repeat with left arm Eventually put together (and sing... Bring me sunshine...) All 4 s Foundation Position = BLEPS (Base line Essential Principles) posture Hands should be directly under the shoulders Knees should be directly under the hips Feet and knees should be hip distance apart Neutral Thoracic & Cervical curve (as is possible) nose points towards the floor Cat Pedals Trunk stability against limb loading Upper body loading RESTING POSITION Shell Stretch or Slump position. All 4 s BLEPS Ensure that the knees under hips & hands under shoulders Neutral spine. Imagine sneaking the hand off without moving the shoulders.
Pin Point Trunk stability against limb loading Upper body loading All 4 s BLEPS Ensure that the knees under hips & hands under shoulders Neutral spine. Slide the leg back without moving the pelvis Avoid shifting the weight. Prone Foundation Position = BLEPS (Base line Essential Principles) posture Forearms should be on mat in a W position Feet and knees should be hip distance apart Neutral Thoracic & Cervical curve (as is possible) nose points towards the floor Gluteal Bracing Strengthen the Gluteal muscles Strengthen the muscles that support the knee. Ankle mobility Swan Dive Spinal mobility thoracic & lumbar extension by segmental control Core stability Shoulder stability Prone BLEPS Use prone squeeze as alternative for clients with reduced ankle/toe mobility Keep hips down on the floor Ensure neutral spine maintained. Prone BLEPS Arms in W position, legs slightly wider than hip distance Elbows stay in and shoulders stay down. Lengthen through the spine like tortoise emerging from shell. Maintain abdominal hollowing throughout. Supine Foundation Position = BLEPS (Base line Essential Principles) posture Client should lie on their back with their knees bent. Feet and knees should be hip distance apart Neutral Thoracic & Cervical curve (as is possible) cue that they should see more of the ceiling in front of them than behind them. Double Arm pullover Trunk Stabilisation against limb loading Shoulder stability & rib cage placement Shoulder mobility Isolation of movement Supine BLEPS Maintain the distance between ear and shoulder Spine remains in neutral and rib cage does not flare Aim to work towards symmetry, both arms achieving same range of movement.
Hip Roll Spinal mobility via rotation and segmental control. (Both upper and lower cross syndrome) Foot hover & heel slide Trunk stability against limb loading. Isolation of movement Feet & Knees together (ball between legs for hip replacement) Supine BLEPS Aim to keep feet together, rotate lumbar only Increase Range of Movement Supine BLEPS Visualise lifting the foot off the floor Maintain neutral alignment Hover foot Progress to sliding the foot away, keeping the foot close to the surface. Happy Days!! Many Thanks for attending this workshop Sheila Done Shebdone@aol.com