Things to Do Today

.....naw. I wrote down a detailed list and it was way boring and self-involved. Who needs that? Let's skip to the short answer-- this is a class-free day, so I can get going on a bunch of things.

I have a lab test and a written test on the cervical spine (that's a fancy-schmancy term for the bones in your neck) on Friday. I have a Radiology test in two weeks that I wanted to get started on. Finally, I still don't get the tempromandibular joint (that would be your jaw) and how it works-- which was painfully evident when you look at my test scores. (I knew the muscles and the therapeutic exercises cold, but missed all the biomechanics questions on that particular test.) So, it's time to go back and look at that again, because Karnak the Magnificent says there will be more of those questions on the final, and it would be a real shame to miss them TWICE.

things to do, butts to kick, places to go, tests to ace.... I am on track.

The perils of an acquired forward head posture

I think I'm a sick individual. Last module, I went on and on about the usefulness to society of preventing urinary incontinence. (Actually, since that's the issue that lands most people in nursing homes, and no one I've ever talked to wants to end up in one of those, it is useful to prevent that... if messy. But I digress.)

Now, since we're in the orthopedics module, I can get equally enthusiastic about acquired forward head posture..... which can be addressed via a combination of massage- therapy, stretching, and exercise.

What's forward head posture? Look at someone from the side. Does his/her ear line up with his/her collarbone? Can you drop a plumb line from earhole through collarbone and down through the hip joint... then slightly forward of the knee joint? If the person's ear is forward of his/her shoulder, they have a forward head.

How can you tell if you have it? Go stand with your back to a door. If your butt and upper back contact the door, but the back of your skull does not... you have forward head. If you are still in doubt, have someone take a picture of you from the side, and use a piece of paper as a straightedge on the photo.

So-- If you have this, or you train, or work on, someone who has it-- why do you care, and what do you do?

Well, here are the implications. One, you may also have problems in your tempromandibular joint (jaw), because the forward head posture stretches the muscles under your jaw, causing you to prefer to retrude (push back) and drop your jaw. (These would be the suprahyoid and infrahyoid muscles, thanks for asking.) Two, you may have shoulder problems. Particularly, you may have a winging scapula (inside lower corners of your scapula don't lie flat against your back), which may lead to shoulder impingement. Three, the habitual posture of the elderly is a stooped, forward one. Keeping your eight-to-fourteen pound head in front of the rest of you can accelerate that process and give you that elderly posture early. (Ugh!)

Now, why else do you care? Because the suboccipital muscles (the tiny ones right under the bump at the base of your skull) get short and tight as a result of this posture. And.... they are the ones that control the tiny fine movements that your head makes to keep your eyes and ears in the right spot. So... now you have affected your hand-eye and body-eye coordination. If you like to do risky things for entertainment, not that I know anyone who would SCA fight or whitewater kayak or anything like that *cough*, tightness in those muscles may cause trouble for you.

And the home run, for the massage therapists in the crowd? This posture can also cause tension headaches and trigger points (small, hyperirritable knots in muscle) in the shoulder girdle. Ow!

Okay, okay. My ringing indictment of the forward head has had an effect on you. Now you know you have one, you know why it's bad, and you want to know how you can fix it.

If you are a personal trainer, you look at your client to see which problems you need to tackle. Is it shoulders and neck, or just neck?

If neck.... teach the person to retrude his or her head. ("Protrude" is forward. "Retrude" is back.) That is, move the head backward as though it were sliding on rails... chin and eyes stay level, head moves backward in space. You can use these cues to get them to do it often enough that they make permanent postural changes: Tell them to hold the head-back pose for six seconds and repeat it six times... then to repeat that 6x6 set six times a day... always being careful not to overcorrect by bringing their head too far forward on the way back.

If shoulder also.... you will probably want to work the rhomboids (muscles that connect scapula and spine) with a low row, because they bring the scapulae together, and middle and lower trapezius with a middle row and a supported corner row respectively, coaching the person to feel the movement in the shoulder blades, not the arms. For added security, work the person's serratus anterior (push up, hold the "plank" position for five seconds pushing as far up as you can, feeling a burn under the armpit).

Result: No pain, good posture, person stands up straight, looks skinnier... which is why they probably came to you in the first place.

Okay, now if I were a massage therapist trying to treat this, I would explain that they have it, encourage them to do exercises, (hmm... I know a good personal trainer I'd refer them to ;-) and I would loosen the suboccipital muscles, treat trigger points in the shoulder girdle, trapezius, scalenes, and sternocleidomastoids, and check for pectoralis and pectoralis minor tightness.

Hmm... those of you who read my LJ who are trainers, or massage therapists, or who work out regularly and try this... please let me know if that was a good and helpful explanation, or too basic for you.