If you're interested in reading more on ideas presented in the article below, I suggest reading Alignment Matters. If you'd like movement instruction via video, start with Alignment Snacks: Let's Do the Twist.
Remember Mama Sweat's Kara Thom from back in the all-things pelvic floor days? Well she remembered me when her body starting taking issue with her favorite pastimes. After a couple of email exchanges (read those here) addressing her habit of consuming more "exercise dessert" than "movement vitamins," I came up with a plan for her to follow, starting with her psoas.
Communicating with someone via email is fine, but in order to really quantify Kara's movement capabilities, I needed to get my eyes on her. Thank you, Skype!
Like many of my imaginary friends on the Internet, I had never actually talked to Kara in person. Or on Skype, which is the new "in-person," apparently.
(If you're wondering what awesome lens filter I am using to get this image quality, it's called "Two-year old, almond butter, coconut oil.")
Kara and I covered a lot of material. As much material as one can cover with a total of 7 kids wandering to and fro. And a puppy.
See the puppy?
We also covered the fact that we were wearing the same outfit.
Kara's accompanying message with her texted picture, "Ignore the laundry." Oh I do, Kara. You have no idea how I ignore the laundry. See pic.
1. The first thing I had Kara do was stand so I could see how she distributes a load throughout her body. She carries her pelvis in front of her feet. This means a lot of things, but in the case of her hip and spine issues, it means that she is masking tension elsewhere by displacing her body -- the parts she can move -- around the parts that have stiffened.
2. Then I had her back her pelvis up until the hip and knee and ankle lined up vertically. To accomplish a vertical leg she had to bring her torso forward, which gives me an idea of the resting tension in her psoas and spinal extensor muscles. This:
is the resting position (no elastic loads in the muscles) of her body. Kara is a major rib thruster, a habit that shears one vertebrae relative to the ones below and creates a ton of wonky load to the vertebral ligaments and discs. To mask it, she habitually pushes her pelvis out in front and rotates her torso back. Very common in those that "got back." You don't have as much back as you think. You've really "got front." As in ribs, out in front.
3. We made over her spinal twist. I explained how she is carrying her rib thrusting into some of the other exercises she is doing to help her spine, like yoga. If she continues to rib thrust while she twists, then what she is doing to "help" is really doing additional harm. These are her new twisting guidelines:
Guideline 1: Eliminate the thrust of the rib cage before beginning a twist. This means the head, neck and shoulders should be bolstered with a blanket or two (or seventeen) to keep the rib cage in line with the neutral pelvis. This eliminates the shear and places the vertebrae and musculature in an orientation best suited for torsional loading.
Guideline 2: Twist only go as far as you can without taking the ribs with you, no "forcing it" allowed. This ensures she stays on the “edge” of the boundary set by her current abdominal muscle tension.
(P.S. Rib cage bolstering is also part of my "diastasis recti" recommendation. Before you do any motion of the trunk, get rid of vertebral shear!)
This is Kara bolstered to the point that the back of her ribs rested comfortably on the floor.
And this is her twisting after finding a neutral spine.
Without the bolsters, you could fit an entire fleet of Matchbox cars under her lower ribcage when she was supine.
Kara's musculoskeletal issues are manifesting and disc and hip labrum degeneration, but the reason she keeps loading her body excessively at these points has a lot to do with immobility of her upper body -- a very tense shoulder girdle and neck.
Her habitual stance to stay upright despite body tension pulling her forward does just as much (if not more) tissue damage than her high-intensity/high-load exercise. This is one of the reasons taking an athlete off of exercise doesn't always heal a problem. You've got to get rid of the body's adaptation to a training pattern as well. This is where movement vitamins come in.
4. Upper body "nutrition": Super Supple Shoulders (a lecture and movement class to learn how shoulder tension is masked by rib cage displacement) and a 25-minute neck and shoulder mobilizing session. You can take the shoulder "Alignment Snack" class she's doing for free. The class explains more than I can in a post (click here -- it's at the top of the page. Update or change browsers if you can't get it to play.) and FYI, this just in from Kara: "Oh. My. God. Seriously. I could hardly do any of it. That was one of the hardest hour workouts ever." <---- This woman is a triathlete, peeps. Restoring your body is no joke. Just because it's gentle doesn't mean it is easy.
5. Lower body "nutrition": The Pelvic List.
One of the reason Kara's trunk is so tight is that she has almost zero lateral hip strength. Don't get me wrong, the woman is a buff rock star and can outrun a ton of people. But she's done it recruiting almost nothing in her glutes and lateral thighs. After years of local -- to the lateral hip -- atrophy, the hip and vertebral joints have broken down. Her gait pattern to date has depended almost entirely on her psoas, quads and quadratus lumborum and she's got the resting body position (tense spine, sheared vertebrae and chronic hip flexion) to show for it.
Kara has been walking to replace her running, but now her new walking (using the lateral hip muscles) will replace her old walking (not using the lateral hip muscles). She's just dialed her body a step closer to moving well.
You can read about the session from Kara's perspective here (click). I'm going to go do some laundry. Not.