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How Do You Breathe?

1/13/2018

3 Comments

 

Breathing is the key to life. If we can't breathe, we die within minutes.  Breathing is so essential to the health of our systems, yet rarely do people understand the connection and importance of HOW TO breathe effectively for the support of our core and the health of the shoulder girdle, hip complex, and lumbar spine.
Poor stability strategies and unconscious habits interfere with the proper movement of the muscles of the ribcage, diaphragm, abdominals and pelvic floor.  In order to have good stability to support the spine, we need to generate appropriate intra-abdominal pressure.  What I see over and over again with my clients is the inability to access the core muscles mentioned above during the breath cycle, as well as in functional activities.  A typical compensation pattern that people use is a pushing strategy to create strength, rather than allowing the muscles to activate and generate the intra-abdominal pressure.  This pushing strategy creates excessive outward and downward strain onto the pelvic organs and abdominal wall (think pelvic organ prolapse, urinary leakage, diastasis recti and hernias).  Not to mention over activation of the neck, shoulder girdle and paraspinals which impact neck/back/hip pain and function.

​Try this right now:

  • Lie down on the floor with your legs out straight
  • Bring your legs together
  • Keep your knees straight and lift both legs off of the floor about thirty degrees.
  • Notice: what happens to your abs?  Did they bulge outward?  What does your back do?  Does it arch?  What does your neck do?  Does it tense?
​How did you do?  In my experience, 95% of my clients use a pushing strategy: holding breath, pushing out into abdominal wall and pelvis, arching back and tensing or lifting the neck. Outside of pilates, or working out, this strategy gets carried over into daily tasks such as: getting out of bed, bending and lifting tasks, pushing open a heavy door, etc.   ​

So, what is optimal breathing for core function?

The first step is to become aware of the day to day habits that interfere with optimal breathing:
  • shallow breathing into chest and neck
  • holding breath
  • holding abs
  • locking down ribcage or gripping shoulder blades back and down
  • lifting shoulders to breathe (over activation of the scalenes, upper trapezius, levator scapulae)
  • squeezing butt cheeks (tightens the pelvic floor muscles)
  • ribcage and pelvic positions
The second step is to practice breathing.  During quiet respiration there should be movement in the intercostals (the muscles between the ribs), the diaphragm, the abdominals and the pelvic floor.  In order to have strength in the muscles, they need to move through full range of motion: lengthening and shortening. In this video, I talk about diaphragmatic breathing and core function.  Practice lying down, sitting and standing.  Each position places a different demand on the body. 
​Have fun and explore!

The third step is to begin to challenge the system.  Can you maintain the breath as you add a new skill or a new load?  Are you able to get movement into all areas of the thoracolumbar pelvic canister?  Quite often I observe tension and stiffness surrounding the ribcage.  Below I share a breathing drill to get mobility at the lower ribcage and diaphragm and a link from Dr Evan Osar on Three Dimensional Breathing. 
​Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
3 Comments

How to Decrease Neck Pain

8/18/2016

1 Comment

 
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Neck pain is a big drag!  Neck stiffness is so annoying! How often have you tried stretching and neck strengthening exercises that send you into more pain and stiffness?  I have totally been there!  One of my favorite ways to relax the neck is to start getting movement into the shoulders, shoulder blades and thoracic spine.
3 Movements for a happy & healthy neck (before you begin, check your neck motion: rotate each direction and then bring your chin to your chest.  Notice how far you move and how it feels):
  • Sidelying Trunk Rotation and Shoulder Windmill
  • Shoulder Blade Movement on Hands and Knees
  • Shoulder Stretch
Now recheck your neck motion and notice if it feels different: is it easier, not so stiff, more motion?
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
1 Comment

Improve Breathing & Decrease Tension

1/13/2016

0 Comments

 
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I know that you have heard it before: "Breath is life". Tuning into the breath is my top strategy for change in the musculoskeletal and nervous systems. Focused breathing creates movement in the body: movement of organs, fascia, muscles and ribs.  Optimal breathing allows for the vital chemistry exchange to deliver nutrition to all of our cells for health and vitality.
Let's face it, life happens, and it's not always full of breath....  We hold, we limit and we restrict.
This movement sequence below is a great way to release the muscles surrounding the chest and to improve the expansion of the ribcage for better breathing.
Breathing better allows the oxygen to flow to our muscles and nervous system which can decrease tension and bring the body into ease.

Soft Tissue Release & Ribcage Mobility 

This movement sequence was inspired by my exploration with Jill Miller's Yoga Tune Up™/Roll Model and Yamuna Body Rolling.
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
0 Comments

Tension Between The Shoulder Blades

12/10/2015

6 Comments

 
Help for tension in the shoulder blades
Just looking at the muscles in this picture on the left, you can see that there is a distinct connection between the head and the shoulder blade, and the shoulder blade to the arm.  You don't need to know the names or actions of the muscles to hypothesize that movement of the shoulder blades are key to healthy arms and a healthy neck.

Quite often clients come to see me with "knots" between their shoulder blades, rock hard upper traps, or a sensation that someone is stabbing them in the back with a hot poker. When I assess the movement and ability for the shoulder blades to move over the ribcage, the motion is almost non- existent.
In the video on the right, I share with you one of my favorite ways to get motion to the shoulder blades and freedom to the entire upper extremity!
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
6 Comments

Healthy Hands, Wrists, Elbows and Shoulders

5/15/2015

2 Comments

 
Self Myofascial Release of Forearm
There are many muscles that make up the forearm. The pic on the left is the superficial layer of the back of the forearm. The pic on the right shows the deep layer of muscles on the back of the forearm.
Did you know that there are 20 muscles within the small real estate of the forearm?  That's a lot of muscle packed into a little space. The forearm is divided into 2 compartments: anterior (front) and posterior (back). Generally the anterior compartment (8 muscles) flexes the fingers, the wrist, and pronates the forearm. Pronation is the internal rotation of the forearm resulting in the palm moving down or back. The posterior compartment (12 muscles) generally extends the wrist and fingers, and supinates the forearm. Supination is the external rotation of the forearm resulting in the palm moving up or forward. 
Think of all of our daily tasks, sports and workouts that require forearm activation: computing, gripping, holding, lifting, turning. pulling, pushing, reaching overhead, etc.  
Repetitive movements and forearm tension can lead to stuck tissues, decreased blood flow and less motion to the fingers, wrists, elbows, and even the shoulder. Eventually, this may lead to pain....
Do yourself a favor and spend some time to improve the health of the tissues in the forearm, and feel good while you are at it!
Below I share with you a self release to the forearm using 2 rubber balls, and a couple simple exercises to improve the mobility of the shoulder and shoulder girdle.

Myofascial release of the forearm


Exercises for shoulder mobility

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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Exercises For Computer Posture 

1/12/2015

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Computer Posture Exercises
A common computer position
Computer posture:
  • Forward head 
  • Upper cervical extension
  • Round (internally rotated and forward) shoulders
  • Hyperkyphosis of the thoracic spine
  • Flexion of the lumbar spine
  • Tucked pelvis
  • Stiffness in the entire  body from long-term sitting

Does this look familiar?  Look around your office...  Let's face it, it is prevalent, and we all do it to some extent. Hopefully you know that this position over time is hazardous to your health.... Just say "no".  This post is dedicated to beating the slump: 2 exercises to de-slouch the spine, and free up the neck, arm and shoulder girdle.
STEP 1:  Get some stimulus to the lats and the muscles between the shoulder blades.  As the arms have moved forward to type on the keyboard, these muscles are now resting in a lengthened position.  This active shoulder girdle stretch takes the muscles into more of a stretch, just like a sling shot, so they can contract back into resting position.

STEP 2:  Stretch the neck and arm.  Lengthen the tissues in the entire arm and neck by holding onto a door jam and leaning away.  This provides a traction stimulus to the wrist and shoulder, which is a wonderful reprieve after sitting hunched in a ball at the computer.

STEP 3:  Get up out of your chair every 30 minutes.  Walk to the water cooler, stretch your arms to the ceiling, stretch your legs, something simple before sitting down again. 

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
0 Comments

Relieve Upper Back Tension

3/4/2014

16 Comments

 
Below is a video sequence to address spinal mobility and upper back tension.  Before you begin, lie on your back with your legs out straight.  Notice the contact of the back of your legs, your low back, lower ribs and shoulder blades to the floor. After you complete the sequence, lie on the floor again and notice the change of your muscles and your connection with the floor.  Enjoy!
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
16 Comments

A Simple Solution for Rounded Shoulders

11/11/2013

9 Comments

 
PicturePectoralis Minor on the left. Pectoralis Major on the right.
Almost a year ago I wrote about the pectoralis minor's referral pattern into the shoulder blade and shared a lovely release using a tennis ball (you can read about that here).  I am back at it again with another post highlighting the pectoralis minor and pectoralis major.  Due to the location of their attachment sites on the skeleton, they can affect the function of the head, neck, shoulder and arm.
Pectoralis Minor attaches to the coracoid process of the scapula  and to the outer surfaces of the third, fourth and fifth ribs. Restriction here can pull the shoulder blade forward (you will see the bottom/inferior portion of your shoulder blade lift away from your body wall), potentially bringing the entire arm with it).
Pectoralis Major is a big fan shaped muscle that is attached to the chest at the sternum (breast bone) and clavicle (collar bone) .  The fan shaped fibers coverge at the arm and attach into the bicipital groove of the humerus.  Restriction in this muscle will pull the arm in front of the body and rotate your arm into internal rotation (with your arms at rest at your sides, look in the mirror: where are your elbow creases facing?  If they are turned toward your body, that is called internal rotation.  In neutral, the arms should rest at the sides of the body with the elbow creases facing forward).

Just get it off your chest and feel more free!

Before you begin with the exercises, do a motion assessment first.  Stand with your elbow creases and palms facing forward.  Lift your arms up and see how far you can lift without arching your back or letting your lower ribs lift away from your body wall.  Complete the movements as show below and then repeat the assessment.  For the first exercise you can use a tennis ball, but I prefer the high grip rubber of the Yoga Tune Up massage balls.
Picture
Place the ball at the groove, just under the clavicle.
pectoral release with a tennis ball at the wall
Lean into the wall. You can add more pressure by shifting your weight forward into a lunge. Find a tender spot and allow your muscles to release. Come down farther onto the ribs and find another spot. Work 2-3 minutes.
sidelying thoracic mobility
Lie down on your side. You may want to have a pillow under your head. Bend your hips and knees to 90 degrees, arms straight out from your shoulder.
Sidelying arm reach
Lie down on your side, bring your hip and knee to 90 degrees. Let your leg completely rest on the ground. Reach your left arm to the ceiling stretching your shoulder blades wide, then begin to reach toward your face/over your head. Then begin to sweep your arm in an arc of motion keeping your palm and elbow toward the ceiling from your head down to your side.
Sidelying pectoral stretch
Keeping your knees stacked on top of each other, begin to open up your chest by reaching your top arm toward the floor. The driver of this movement is thoracic rotation. Try to increase the motion by using your breath to get deeper. Take a breath into your ribcage and on the exhale try to get your shoulder closer to the floor. Repeat on other side. Hold for 1-2 minutes or until tolerable.
Sidelying pectoral stretch windmill
Once your arm gets to your side, turn the palm down sweeping back up in an arc of motion toward your face. You will complete a full 360 degree circle. Repeat the process 5-10 times on each side.

Reassess your arm motion:  Hopefully you have more freedom in your movement!

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
9 Comments

The Best Shoulder Stretch You Should Do Every Day

5/30/2013

14 Comments

 
Picture
Muscles that attach to the scapula: Left side of the pic you can see trapezius, deltoid. Right side of the pic you can see rhomboids, levator scapula, supraspinatus, infraspinatus, teres minor, teres major and serratus anterior.
Picture
Muscles that attach to the scapula: Pectoralis minor, bicep, subscularis, serratus anterior, teres major.
Movement of the arm requires joint mobility and muscular stability. Moving the arm requires appropriate muscle facilitation and mobility in the shoulder joint, the scapulo-thoracic joint (which is not a "true" joint, more of a physiological joint), the acromioclavicular joint (AC) and the sternoclavicular joint (this is the only joint connecting the arm to the axial skeleton).
Take a look at the pics on the left. There are a lot of muscles that can affect the movement of the arm, the scapula, the shoulder, and the clavicle. So... basically what I am pointing out here is that optimal muscle function of the shoulder girdle is key to a healthy pain free shoulder joint, neck and arm.  
Muscle, bone and connective tissue adapt to how we use them.  And typically during a day our arms are positioned out in front of the body: computing, driving, pushing a stroller/walker/cart. This positioning, along with all of our other daily habits of grasping, clenching and tensing can lead to shortened muscles, winged shoulder blades and internal rotation of the shoulder joint which can lead to impingement and eventual rotator cuff tendonitis/tear.

Hand Behind the Back Stretch

scapular winging
Before we get to the stretch, observe the position of your shoulder blades when your arms are down by your side.  Notice the medial edge and the lower angle.  Do they wing away from your back like mine?  Ideally the scapulae should be positioned equidistant from each other with no visual boney edges.  Winging of the scapulae is an indication of muscle imbalance.

Picture
Just for fun, see how you need to move your scapulae so you don't see your boney edges poking away from your thorax.  In this pic you can see that I had to move my blades forward and elevated a little.  Once the blades are in the ideal position you can really see some of the culprits driving this imbalance:  can you say tight pectorals anyone?

Hand behind the back stretch
Now for the stretch.  Bring the hand behind the back.  Make sure to keep your elbow straight down from your shoulder (notice how this makes me wing even more.  More than likely this will happen with you too).  Begin to bend the elbow as if to reach for your opposite shoulder blade.  Notice your elbow, did it start to go out wide?  If it did, you went too far.  Bring your arm back down so you can comfortably hold in position in a gentle stretch.  Believe me, this can be intense, don't let it. Hold for up to a minute.

Hand behind the back with shoulder blades wide
Now, let's refine the stretch.  You will need to have a mirror for this so you can see the position of your shoulder blade.
Bring your hand behind your back.  Move your scapula (usually forward and up) so that you do not see winging anymore.  Make sure to watch your elbow.  In this pic you can see that my elbow moved outward a little bit, and is not straight down from my shoulder.  The requirement or alignment marker for this stretch is to keep the elbow in line with the shoulder.  To correct that, I would need to lower my hand so the stretch isn't so intense.  Notice in the pic that the lower angle is still lifted away a little bit.  But because of my tension, I wasn't able to get completely flush with my thorax without moving my elbow.

Picture
Here is side view of me bringing the arm behind the back.
Picture
Here I am moving my shoulder blade forward so the shoulder blade doesn't wing.
Picture
This is what it looks like from the front. You can see how tight my pecs are. And I am smiling because I used to not be able to do this and now I can! Yeah!
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
14 Comments

Pain in the shoulder blade

11/20/2012

12 Comments

 
Pain in the shoulder blade
Not quite a month ago I wrote a post about raking leaves and waking up the next day with pain at my shoulder blade.  I was able to relieve it after a few minutes of exercise.  Well.... it came back after a weekend of hovering over my computer.
This time I had a different strategy:  address the tension in my neck and pectoralis minor.
Due to the attachment on the coracoid process of the scapula, tension in the pec can pull the scapula forward lifting the bottom edge away from the body, potentially creating dysfunction for the entire shoulder girdle.
I was inspired by Jill Miller's YogaTune Up® Blog on the pec minor. So I share with you pics from my 2 minutes of myofascial work with a tennis ball, and "bam" no more pain!  I used a tennis ball for this, but I recommend the high grip rubber of the Yoga Tune Up massage balls.

Pectoral release with a ball
Find the deltopectoral groove at the front of your shoulder.
ball release to pecs
Place the ball at the groove, just under the clavicle.
pec release with a ball against the wall
Find a corner and lean into the wall.
decrease shoulder blade pain with this pec release
You can add more pressure by shifting your weight forward into a lunge. Find a tender spot and allow your muscles to release. Come down farther onto the ribs and find another spot. Work 2-3 minutes.

I felt good all day!  Until I woke up the next morning and there it was again: pain in my left shoulder blade!  This time I released my pec minor AND added the ball release to the muscles at my neck just above my clavicle.  Five minutes later, no pain!   Check out how I did it by watching this video on the right. The video on the left is a another great way to get into the pec minor.
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.
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Contact:  Susan McLaughlin, PT 801.859.4142
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