It is important to listen to your client and always hone your skills. Listen to this testimony of a client.
All of us know of parents, grandparents, neighbors, anyone that comes into your mind that you have noticed a change in their posture over the years. Is this now happening to you? Maybe? Changing posture is a very insidious occurrence. We don’t physically notice the changes until we can no longer reach high up in the cabinet for that special bowl we need. Or, our lower back becomes stiff from sitting for even as much as 20 minutes. Or we can no longer squat to the ground as we were once able. Or turning your head as you back up your car is now either stiff or painful. You then develop alternative methods because you can no longer perform these movements. Why is this? Losing the range of motion in any one joint causes changes and alterations in many other areas in your body that you are not aware of! This is especially true when there is not a traumatic event to associate the changes with. Let us review a few reasons why this occurs and then a few methods to combat the soft tissue changes that ultimately change our posture.
Soft Tissue Has Power!
Normally, we do not think of our soft tissues has having power, but they certainly do. Fascia, the newest accepted organ of the body is meant to be strong, elastic, and slide and glide as we move. It has a covering, whether thick or thin, over every part and parcel in our body. Fascia is strong and is known to have contractile powers, yet not eccentric abilities. Eccentric means the ability for a tissue, as in muscle to contract, yet become long at the same time. This means that fascia once contracted repeated over time may have the tendency to want to remain in the position. This is one reason that creates abnormal forces on tendons and joints. With this being said, static postures that is your worst repetitive motion, awkward postures, highly repetitive motions without rests, unexercising, incorrect food intake, emotional stressors, all together form to create changes within your body that you cannot detect until; until you cannot turn your head normally until you cannot squat to the floor normally until you cannot reach high into the cabinet for the bowl, and until you feel that stiffness upon standing when only sitting for 20 minutes. All of this changes your posture. Now you may notice that increased thoracic curve if looking in the mirror, or your shoulders are so far forward, you have these indents between your pecs and collar bones.
Regain Your Power Over Your Soft Tissue!
I am not the pessimist or fatalist. I am heralding a trumpet call for any individual that really wants to create optimal changes in their body. Even if you have Parkinson’s, you can maintain optimal postures for much longer periods of time. My husband is proof of this. What are some methods to create changes for an optimal body posture? It does demand commitment of daily work, 5 – 10 minutes. Your diligence will pay off. Will the changes happen quickly? It takes the time it takes. The more time you put into this the faster the results. And, no, the results are not permanent. This is a lifestyle change. First, you want to take a baseline of where you are in your joint motions:
Since pictures are worth a thousand words, here are movements that are considered normal and you should strive for:
Thank you SFMA for this picture!
These movements should not cause pain! Do not attempt if you already know you have joint movement challenges in any of these areas. This is meant to bring to your attention how malleable we can still become.
STRATEGIES TO INCREASING YOUR OPTIMAL POSTURE AND MOVEMENT
Many of us have challenges in one or more joints. Choose the least restricted joint and begin to slowly use a dynamic movement, rather than a prolonged stretch, to increase the range of motion. Laying down is a great method to use for neck, shoulders, hips, knees, and low back. Remember, this is how babies begin to increase their range of motion and strength; they are laying down first because they do not have the trunk control sit up. So, babies begin by wiggling and jiggling, and discovering a hand, a foot, and work on that movement. They do not know they are exercising and increasing in the range of motion along with muscle strength and control.
The best method is to contact a professional to educate, teach, and empower you to optimize your soft tissue so you have power over your soft tissue!
Our society is more than full of forms: application forms, loan forms, insurance forms, and the beloved, consent form. We are so inundated with forms, almost daily, we become somewhat numb, or the level of automaticity raises to the point we do not carefully read what we sign.
The other facet to a consent form, is the development of a form. This short blog will refer to consent forms for mainly outpatient physical therapy clinics. With growing regulations at the state and Federal levels, growing methods to offer, and growing patients, a consent form is a foundational piece to any clinic.
What Should a Consent Form Contain?
Most clinics prefer to keep a consent form as simple as possible, yet, in the wake of our recent and continuing challenges of the invisible beast, outpatient clinics now have additional opportunities to offer patients. All, in my view, should be explained, disclosed, and signed by each patient, with a copy handed to them for their own records.
Basic Material in a Consent Form
- HIPAA Privacy Acknowledgement
o Includes who and who not to divulge medical history to
o Some clinics prefer for HIPAA statement to be separate
- Clinic policies of treatments that maybe used
o Should always state patient have right to refuse
- Risks and benefits of treatments
- Attendance policy
- Places for date, time, and signature of patient or legal guardian signature
Additional Items in Consent Forms
Therapy clinics are now adding a “release of liability”, “hold harmless”, in the consent forms. In a search of forms that are online at many physical therapy clinics, the liability waiver is increasing as compared to consent forms 5 years ago.
Also added to consent forms, or are additional consents for electro stimulation, traction, or other modalities. Some clinics create a completely different form to sign, as not all patients will utilize that modality.
The topic of interest today is the telehealth consent. This is a new and upcoming form in the utilization of outpatient physical therapy and deserves some small comments. Such questions as; can you use Apple Iphone Face Time or Duolink as a telehealth method? As both ends are strongly encrypted, so far these forms of “telehealth” are allowable. Maybe not so in the future. The caveat to any telehealth visit, is the consent and understanding that the patient at home allows and understands that if he/she does not live alone, the medical conversation may be overheard and seen. It the patient wishes for the telehealth conference to be private they must ensure that on their end. The conversation should be recorded, and consent must be attained in the consent form and at the beginning of the call. This protects both parties. As this technology is new, with many many grey areas still to be configured, voice recording important; and, if the clinic is using a telehealth 3rd party company, the entire recording of voice and video can be captured.
Take Home Points?
- Semi-annually review all types of patient forms.
- Apply telehealth to the consent form, even if the use of an Iphone would be utilized.
- Obtain consents for recording conversations, even with just a follow up phone call.
- Strongly consider the Liability Waiver addition. Sometimes it is important that patients understand they are the more active person in the therapy duo. The feedback of the patient in every exercise, modality is important. If the patient is not successful, neither will your business.
- Begin to look for that 3rd party telehealth system that fits into your budget. Many clinics visualize the need, but to actively use it is another.
- Strongly consider the patient signing a consent and liability waiver each visit. This is important as patient’s values, ideologies, and expectations changes. Having them sign the form with each visit again rolls back to the statement that it is the patient who is the more active person in the therapy duo. This serves as a strong reminder.
Forms are the foundation to a strong business model. Do NOT throw money away.
Most of us can hear the echoing voices in our minds of our mothers and grandmothers, “sit up straight”, “stand up straight”. They were right. The collection of data, we call research, begins to tell a story behind what our grandmothers said regarding posture. As psychology and human factors continue the climb ladders of research and understanding, postures convey more than a good or bad habit. Postures reveal your emotions, perceptions of yourself, and certainly, how others perceive you.
Posture helps good or negative memory recall
Research: a learning curve that helps to shape how we think, do, and act. Research is a type of cell phone, many individuals rely heavily upon it, and would be in a quandary without it. History of mankind continually exposes that the peoples of the world had considerable amounts of knowledge about many things; there was no research to substantiate it. We now rely on great historians to support the knowledge of the past. Much of human knowledge can be considered “common sense”: do not walk and then stop in front a fast-moving vehicle if you want to live. Much of human knowledge also has varied parameters of opinions and conjectures, creating confusion in decision making for some. In the case of posture and different memory recalls, research does affirm erect posture will elicit better memory recall of good memories in contrast to slouching posture will recall a higher percentage of depressing memories (Erik Peper, PhD, BCB, et al., 2017). Many of us, when we stop and think, can relate times of trouble, we might remember slouching, almost an attempt to hide our faces. When assuming that posture, those unhappy and troublesome memories are easier to recall.
TAKE HOME POINT
When experiencing troubling times, sit up and stand up erect. Use your memory to facilitate positive changes that are often required when traveling through those valleys.
5 Postures, 5 Emotions
A very interesting study conducted by a group of researchers at Psychological Sciences, University of California, Merced, CA, USA, (Eric A. Walle, et al., 2017) used actors to portray 5 emotions: joy, sadness, fear, anger, and disgust. An interesting point is the study used photoshop to remove the actors’ heads and changed all photos into the same grey color as to remove as much outside influence. The focus was to only view the body, without the facial expression, as facial expressions, in past research reveal inconsistencies (Allison Winters, 2005). Anger, fear, and disgust were the most often chosen, 79%, correctly by the participants that viewed the photos. Joy and sadness had variations yet were considered to still have statistical significance.
Postures do display our internal emotional state, without looking at the face. I venture to say most of us have watched people moving about and we automatically perceive something about that person.
TAKE HOME POINT
There is always someone watching you. If you are planning an interview, an important meeting with the organization’s decision makers, a first date, your posture is talking when your lips may not be moving.
First impressions are your posture.
Postures in the Form of Exercise Movements
Yoga, Tai Chi, Qigong have a common thread: static and dynamic postures that are specific in length of time a posture is held, the sequencing of the posture, and the movement that takes place shifting from one posture to another. As a physical therapist and provider for employee injury prevention, these forms of “exercise”, are remarkably familiar. The fourth common thread that yoga, tai chi, and qigong have, as compared to exercise equipment, is the mindfulness that is integrated into these forms of exercise. History shows that these types of body and mind exercise movements are to bring the body and mind together to create a harmony of the two. Harmony brings on homeostasis, which, in turn, allows a calm emotional state of being, safety, and facilitates physical healing. American western thinking wrestles with this concept from gyms to medicine: the body and mind are separate, even though the human body and mind are one (Budiman Minasny, 2009). Body work therapists are very familiar with this concept as emotions from the past are often elicited when performing bodywork on a client (Bruno Bordoni1, et al., 2014).
Salient to these types of mind-body exercise, is the relaxation response created. Fascia, a large organ that is the holding matrix in the body is only just beginning to surface with research that correlates and upholds the mind and body as one.
“The number of receptors in the fascia far outnumber those in the muscle and around the joint [55,56]. Within these mechanoreceptors, the majority of input comes from the interstitial receptors that are intimately connected to the autonomic nervous system. Stimulation of these intrafascial mechanoreceptors leads to an altered proprioceptive input to the central nervous system, which then results in a changed tonus regulation of motor units associated with this tissue. The result is relaxed, freer moving and more pliable tissue.”
Meditative Movement, Energetic, and Physical Analyses of Three Qigong Exercises: Unification of Eastern and Western Mechanistic Exercise Theory
Penelope Klein 1,*, George Picard 1,2, Joseph Baumgarden 1 and Roger Schneider 2
Also, in conjunction with how fascia behaves and is directly linked to the central nervous system is how this tissue, when moved properly reduces inflammatory responses and assists with DNA repair, (Penelope Kline, et al., 2017). New theoretical models of how the mind and body are connected are a frontier for physical, emotional, and healing capabilities of the human body.
TAKE HOME POINT
- Emotions directly affect your posture
- Practicing mind-body exercises evokes the body’s relaxation response that facilitates stable emotions, allows for the body for physical healing, and increases physical stature and abilities
What has this to do with Safety in the Workplace?
Postures can certainly reveal our emotions internally. If we can allow ourselves to learn, recognize, then change, our emotional stability will preserve us from accidents at work, home, or sport. Changing your posture via some of the topics discussed, will also have a direct affect on your peers at work and family, not to mention your emotional stability and well-being.
Well-being ranks high in organizational surveys. Most of us, in our American culture, are facing exceedingly more stressful situations, out of our control. In the workplace, it is important for our emotions to be stable; not the yo-yo, the ups and downs, from a look, a word, added assignments, we are now thinking this is our new normal. No, it is not your new normal. How we change by being proactive will change us and others in a positive manner.
Allison Winters, M. (2005). Perceptions of Body Posture and Emotion: A Question of Methodology. The New School Psychology Bulletin, Volume 3, No. 2,.
Bruno Bordoni1, et al. (2014). Skin, fascias, and scars: symptoms and systemic connections. Journal of Multidisciplinary Healthcare, 2014:7 11–24.
Budiman Minasny, P. (2009). Understand the Process of Fascial Unwinding. INTERNATIONAL JOURNAL OF THERAPEUTIC MASSAGE AND BODYWORK, VOLUME 2, NUMBER 3,.
Eric A. Walle, et al. (2017). Postural Communication of Emotion: Perception of Distinct Poses of Five Discrete Emotions. Frontiers in Psychology, 0.3389/fpsyg.2017.00710.
Erik Peper, PhD, BCB, et al. (2017). How Posture Affects Memory Recall and Mood. Biofeedback, Volume 45, Issue 2, pp. 36–41.
Penelope Kline, et al. (2017). Meditative Movement, Energetic, and Physical Analyses of Three Qigong Exercises: Unification of the Eastern and Western Mechanistic Exercise Theory. Medicines, 4, 69; doi:10.3390.
Whether your client is from your personal training facility, out patient physical / occupational therapy, an athlete preparing for the upcoming season, or the industrial athlete, all of them, have the same in common, which, is to be successful in the reasons the client came to see us to begin with. This comes to the point: the clients’ willingness to understand instructions and their consistent performing of the specific movements for at home or at work. I don’t wish to be portrayed as the movement tyrant, yet to contrast the length and breadth of work and passion that health and wellness professionals invest in their clients, we are the educators, facilitators and cheer leaders. We cannot “get” them better, without their all-in commitment.
Expectations and the relationship established begins with the first meeting. Cultivating rapport with your client is number one. This is where you listen. Listening will establish their particular learning style, preferences, life history; all of which are ingredients to the outcome. Clients that are attaining their goals, building commitment, and changing habits that feed into attaining their goals will be long life relationships and wonderful referrals.
How do we really know if our client is really practicing their assignments?
People that know me, hear me say often, “one size fits one”. This is veritable. For that reason, it is incumbent on us as health and wellness professionals to discern minute details of our clients. It is the details that determine if our clients are utilizing the new information, if they are struggling, or possibly not as committed as we are expecting. Here, your critical eye for movement, posture, and listening will speak volumes to you if your client is slacking, trying without the results, or truly displaying their gains.
- Rapport building
- Expectations from both of you at the very beginning
- Ensure your client truly understands and demonstrates what they are learning
- Can they verbalize and teach that back to you
- How many times can they discern the proper movement pattern from the incorrect one
Surface electromyography, Semg, has been in existence for a number of years. It is recently now gained attention and respect of many professional sports teams, college teams and others that wish to hone in on why they are moving they way they do. Abnormal movement can be created by a host of issues that most often are not occurring at the location where your pain or weakness is experienced. Using Semg can determine muscle firing patterns and aberrant firing patterns that you are not aware of. Here is an example of someone that works in packing for export, and moves 75 lbs of 4’ x 8’ pieces of plywood several times a day. NIOSH would probably look down on that, however, this is the reality of many industries that export via trucks, and shipping containers. This is a fact of life, yet, if one can move better, than less risk of soft tissue break down and injury will occur. AND, the worker’s physical abilities will remain strong as they age.
By simply using a different and effective techniques, this worker will not have to use as many of his muscle firing capability, thereby, his fatigue rate will lessen dramatically in addition to the aforementioned reduction of several risk factors that are common in physical industries.
And the wonderful aspect of using Semg is that there is no limit on what can be found that the human eye, camera, ergo assessments will never pick up.
WHAT IS THE SIGNIFICANCE OF CHANGES?
Every sensor demonstrated a dramatic improvement via less muscle activation to perform the same job, just a different way.
Call us at 803-275-7675 to have us help you create a safer work environment!
THE WORLD WE CANNOT SEE
There is a vast world that humans cannot see with the naked eye. Many of these life forms / organisms are foundational to the existence to the homeostasis of this earth. Some maybe beneficial to humans while others create havoc, sickness and death. With great thanks to the researchers, thinkers, and scientists that lived before us, we know more about these seemingly invisible creatures, some that are harmful to the point of death for humans. We also know some methods to reduce or eliminate them from harming us. The single best method is hand washing. Washing your hands sounds simple, easy and a “no brainer.” Yet, in light of recent explosions of COVID19 worldwide, hand washing is getting a close look. So, let’s see at what researchers are looking at and some of their conclusions that will help us to avoid sickness and more importantly spreading sickness!
TOPICS OF RESEARCHERS: the subject of hand washing is quite extensive, so we reviewed the CDC and WHO recommendations and their topics of research and reports. At the end of the discussion there will be bibliographic links to both the WHO document and the CDC website.
Topics of handwashing:
- Steps of washing your hands (World Health Organization, 2009)
- Wet hands
- Use soap and lather
- Continue to lather and rub hands for at least 20 seconds. The more time spent here actually breaks down more bacteria and viruses.
- Dry hands
- Types of soaps, alcohols, detergents used and which is the most preferred
- Rinsing hands to remove as much of soap, bacteria, and viruses as possible
- Drying hands is a very important step to further remove unwanted contaminated debris from your hands
Steps of Washing your Hands
- After wetting hands, and applying soap, it is recommended to turn running water off. That can propose a problem depending on how faucets are designed. Suffice to say, that is your call. AND, although wetness supports the increased ability for bacteria and viruses to remain on hands, the following steps are required.
2. Using soaps or other chemically based detergents are useful in that their chemical make up increases the destruction of the contaminants. Also, important here is that using soaps increases your tendency to rub hands together that increases friction which is another method to the
destruction of contaminants. The interesting discovery (although it may be a no brainer to you), is that this step when performed for longer periods of time dramatically reduced the amount of any residual contaminants on the skin. So 30 – 40 seconds, or longer maybe required.
3. Rinsing hands. Obviously clean running water is preferred to a basin of water, to increase the thoroughness of removing the soap and any remaining live contaminants on your hands. (CDC, 2020), (World Health Organization, 2009)
4. Drying your hands. This is an interesting and important component as research is indicating. Always use disposable paper towels. Using any reusable cloth towel only allows for any live remaining contaminant to now be on the surface of that towel. Paper towels were also found to be superior to hot air or high speed air hand dryers . Air dryers can increase any live remaining contaminant into the air, thus cross contamination occurs. Your hands need to be completely dry; No WETTNESS post drying. Again, remember, wetness allows bacteria and viruses to survive. And, since these creatures can be so harmful, completely drying your hands is essential. (Cunrui Huang, et al, 2012)
Don’t ignore or be so cavalier regarding such a simple yet so very effective means of destroying those invisible organisms that can cause human lives!
CDC. (2020, March 20). Show Me the Science – How to Wash Your Hands. Retrieved from CDC: https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html
Cunrui Huang, et al. (2012). The Hygienic Efficacy of Different Hand-Drying. Mayo Clinic, 87(8):791-798. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538484/
World Health Organization. (2009). WHO Guidelines . Geneva: WHO. https://www.who.int/gpsc/5may/tools/9789241597906/en/
So, what are bacteria? Bacteria are microscopic, single-celled organisms that thrive in diverse environments. These organisms can live in soil, the ocean and inside the human gut. (Vidyasagar, 2019) We hear of “good bacteria” and “bad bacteria”. Bacteria mostly self reproducing organisms, (key word is mostly), and some bacteria we know well: there are the good bacteria, known as flora found in many foods and supplements.
- Bifidobacteria: species commonly used in foods and supplements
- Lactobacillus: found in the small intestine, mouth and female genital region
- B. animalis: found in certain yogurt products
- L. acidophilus: found in the small intestine and female genital region
Humans’ relationship with bacteria is complex. Sometimes bacteria lend us a helping hand, such as by those 4 mentioned above. In other cases, bacteria are destructive, causing diseases like pneumonia and methicillin-resistant Staphylococcus aureus (MRSA). (Debra Rose Wilson, 2017)
Most bacteria multiply by a process called binary fission, according to the Cornell University College of Agriculture and Life Sciences. In this process, a single bacterial cell, called the “parent,” makes a copy of its DNA and grows larger by doubling its cellular content. The cell then splits apart, pushing the duplicated material out and creating two identical “daughter” cells. (Department of Microbiology, 2020)
We do know that in recent years of using anti-bacterial soaps and detergents, certain bad bacteria are now resistant to many used detergents, alcohols, and other bactericidal chemicals.
Viruses are much smaller than bacteria and do not reproduce themselves as many types of bacteria can. Rather, a virus needs a host in order to survive and multiply because the have either DNA or RNA and do not have the capability read themselves, thus requiring a host cell to reproduce. (Vidaysagar, 2016) Once a virus comes into contact with a host , it injects it genetic material into the host, thereby taking over. Sounds horrible! Viruses can also lay dormant for long periods of time before becoming active. Some viruses also, when active reproduce exponentially.
Recent testing around the world regarding COVID19 is a mad rush to arrest this exponentially contagious menace. Since much of the virus shedding (being the most highly contagious without symptoms) occurs prior to becoming symptomatic, the more the individual comes into contact with people that are contagious without symptoms or the virus lands on surfaces this increases the number of people that can be infected. (Yates, 2020)
(Wei Zhang, et al, 2020) have been researching how much of the COVID19 virus a person is infected with determines how sick they become. “The mean viral load of severe cases was around 60 times higher than that of mild cases, suggesting that higher viral loads might be associated with severe clinical outcomes. We further stratified these data according to the day of disease onset at the time of sampling.’‘ The more infected and sick the patient, the positive test of viral infection remained longer than those with milder symptoms. This data indicates that, similar to SARS in 2002–03,6 patients with severe COVID-19 tend to have a high viral load and a long virus-shedding period. This finding suggests that the viral load of SARS-CoV-2 might be a useful marker for assessing disease severity and prognosis.
TAKE HOME POINTS
At this time, what are take home points?
- Wearing facial nose and mouth protection is very important. To reduce your risk of inhaling any airborne droplets, that is now know to travel further than 13 feet
- Frequently keep your hands as clean as possible
- Change your clothing and shoes when coming home from areas such as grocery stores, gas stations, pharmacies; anywhere social distancing is difficult and you don’t know who was traveling down that aisle before you.
- Wipe off mail packages and other packaging you intend to bring into the home
Debra Rose Wilson, P. M.-B. (2017, March 17). 6 Most Common Types of Probiotics. Retrieved from Healthline: https://www.healthline.com/health/types-of-probiotics
Department of Microbiology. (2020). Cornell College of Agriculture and Life Sciences. Retrieved from Cornell University: https://micro.cornell.edu/research/epulopiscium/binary-fission-and-other-forms-reproduction-bacteria/
Vidaysagar, A. (2016, January 6). Whar are Viruses. Retrieved from Live Science: https://www.livescience.com/53272-what-is-a-virus
Vidyasagar, A. (2019, April 25). Bacteria: Definition, Types and Infections. Retrieved from Live Science: https://www.livescience.com/51641-bacteria.html
Wei Zhang, et al. (2020). Viral dynamics in mild . Lancet Infectious Disease, s.
Yates, C. (2020, April 5). Caronavirus is growing expotentially – here is what it means. Retrieved from The Conversation: https:Theconversation.com/coronavirus-is-growing-exponentially-here-is what-that-really-means-134591
SERIES 2 : YOU CAN EXERCISE WHILE WORKING AT YOUR DESK
To recap the first series on working from home, we focused on the chair. If the equipment you will be using for extended periods of time doesn’t fit, you will be sore, achy and miserable. And, this is not the goal. Monitoring height and placement of a keyboard and mouse are as important; that will be in another series. So, we must think, humans are meant to move and not be sedentary. The voluminous amounts of research that reports the deleterious affects metabolically, physically and emotionally are almost scary to think of what we are doing to ourselves. There is no one to blame but yourself. If you are reading this, then the likely hood that you desire changes that can fit into a hectic lifestyle that you may not have the ability to control well are high. This short paper is only to begin to introduce to you the idea, developing the commitment and carry through, as many of us want the change, but never seem to get there. So, the concepts you will learn are:
- You never arrive nor attain – you are always in a state of arriving and changing.
- Routine is in the commitment of daily. Yes, daily. No days off to speak of.
- Moldability is the ability to adapt to time, internal awareness of yourself, (physically and emotionally), and change what you do and how you do it that day.
- Your imagination is your own limitation. Learn to build from concepts about yourself, your capabilities to build a tool box with the learning you might garner here.
- True honesty about yourself. Only you know about you. And, most of the time, it takes a life time learn about ourselves – the reason why human factors is such a difficult area. We don’t know ourselves like we think we do.
THE 15 MINUTE OR LESS RULE
Our company performs a lot of surface electromyography (Semg) on employees and clients. Why? This information allows us to visually see how the muscle that the sensor is on is working. Years of research now shows that muscles fatigue rate can be faster or they can mis-fire secondary to a multitude of reasons. What is consistent in 99% of people we use Semg on is that the muscle show patterns of fatigue well before the person is even slightly aware of any fatigue, soreness, stiffness, or other physical symptom. Our data shows that muscles begin to show changes around the 13 minute mark of static positions, repetitive motions, or heavy lifting. The question now becomes whether the fatigue is good or not good. This requires the professional to understand how to read and interpret the findings. In our case here for the person that spends many hours at a computer, upper trapezius and spinal erector muscles fatigue quickly. More so in women than men. Forearm extensor muscles also fatigue prior to 15 minutes from use of the keyboard and mouse. PPS has not tested, but the data is out there that the gluteal muscles we sit on for such long periods of time begin to lose their speed of firing. Yes, the gluteal muscles work because we are standing and walking, but at a slower rate and not as many muscle fibers fire. This now adds to the complexity of why so many people have joint and tissue problems. Other muscles must take up the slack that other muscles are not performing. Mind you, all of this is taking place and you are not aware of it. It is something that you don’t feel, until so many changes have taken place, joint problems, pain patterns set in.
What Happens Every 15 Minutes?
You must find a timer that will reset every 15 minutes. When the timer goes off, you will change your posture, and perform one exercise and one stretch. It will be in the developing of this repertoire that will make you successful. The success will come in various positive adjustments:
- You are now consistently consistent with the 15 minute protocol.
- Instead of noticing that right upper trap trigger point at 2 hours, you don’t notice it until later in the day, followed by not at all!
- Your stamina is increasing, which, means you are increasing in strength.
- You may not be as irritable, because now you are accomplishing much more than the work you are employed to do, but at the same time, you are exercising, a commodity that is a necessity not a novelty. And the quality of work produced is better, because you are better focused on work than that tight low back or sore lateral elbow.
- Interacting with the family is not a chore now.
- This list is endless.
You know, we are not rubber bands and don’t “stretch” like we think. Yes, there are many elastic components in our body; none the less we are not rubber bands. Our tissues actually slide, glide, through and around each other that creates the movement. And our tissues are very well connected, like a forest of spider webs after a light misty rain. When you “stretch” you are encouraging tissue gliding to its fullest capacity. In the beginning, stretching is often frustrating, because we are now very aware of how tight and adhesed our tissues have become. Using the 15 minute rule, you will see changes quicker. THE MOST IMPORTANT RULE WITH ANY STRETCH IS THE QUALITY OF THE MOVE AND ALWAYS TO NO PAIN!
Quality ensures the optimal movement and the NO PAIN says you are not being aggressive, which, can damage tissues you are attempting to become more flexible and strong.
Any exercise holds the same truth: Quality not quantity and to NO PAIN. Exercises serves many purposes:
- Build strength
- Build stamina
- To optimize movement patterns
The number 3.) is where you will be taking your best guess, as there is no professional to watch, guide, and teach you the correct movement from the wrong movement. This is a kinesthetic exercise as well. You must think about the movement: how does it feel, and where? Is one side easier than the other? And watching YouTube may not give you the answer, because you are not that person you are watching. You have a different life history, different medical or physical abilities or challenges, and certain different tissue adhesions. So, here we will make the beginning easy and have more writing on what is and is not the way to perform an exercise. And do not hesitate to contact us so we can help through video conferencing.
FOREARMS / UPPER TRAPEZIUS / NECK
How often we take for granted a part of our body until we cringe at the thought of picking up something small. Much of the time it is due to the forearm tissues being so adhesed that the smallest of function required causes pain.
When stretching, you can use them as a slow movement or hold for 5 – 10 seconds. Holding a stretch for longer periods of time, slows down the speed of the muscle firing ability for a while. Not a bad thing after a work out. But during the day, using these as slow movements helps to restore normal firing patterns in addition to the all important tissue gliding.
SERIES ONE: YOUR CHAIR IS THE FOUNDATION FOR A BETTER POSTURE
The ability to change your posture yet maintain a good posture when working at a computer for extended time periods is like good real estate: location, location, location! Without going into extreme details, good and changing postures maintain optimal joint alignment, uses various muscle groups for sustaining of different postures, that ultimately reduce those nasty trigger points on either side of the base of your neck, low back stiffness, and other stiff joints. Most often we sit in chairs at work, that have rollers on them, side arms, and some handle mechanisms to change the height or tilt of the chair. And if the chair you use does not help you when at work, your physical complaints begin to over ride your ability to focus on tasks at hand. In many organizations, you may not have a choice of the chair that is good for you. Now that you may be working from home, your choices and adaptations expand immensely. For an example: at work you would like to sit on an exercise ball, but the company policy is no exercises balls to be used as chairs secondary to liability reasons. At home, you can certainly use an exercise ball as a choice.
Lets begin with the “I don’t have a chair with wheels, and that would certainly be nice to have.” Find one or two chairs, that will fit several postural changes and attach furniture sliders on the legs by attaching them with sticky backed Velcro.
This way the sliders are easily removed. Placing sliders on the legs allows to push the chair around without too much friction and resistance. If your home office space is hardwood or tile, use the thick felt pads and attach them in the same manner with Velcro.
At home, you can make most chairs fit for changing your posture frequently, thereby reducing over fatigue of postural muscles. The key component is when changing your posture, work in a stretch or a 15 second exercise. All which helps to “reset” muscle firing patterns and to normalize postural muscle firing rates.
So, you have picked out a few chairs. The next step is to figure out which one or two will work better for you. The chair is a piece of equipment that can determine your pelvic position. This is important to determine optimal pelvic alignment first.
GOLD: The Position of Your Pelvis is the Foundation to How the Rest of You Aligns!
I wrote a piece before about good posture in sitting, and, I think redundancy builds in the habit; so let’s review how pelvic alignment really aligns the remainder of your spine that includes your head. Your pelvis, made up of 3 bones on the left and right side of your body connect to your sacrum, the triangular bone at the base of your lumbar spine. All together these bones form a bowl shape. Your hips are also apart of the pelvis. The red circle surrounds this pelvic region. The picture to the right shows the person in what is called a “posterior pelvic tilt”. Nothing wrong with that, but this tilt of the pelvis is actually dictating how the spinal bones will align traveling to the head. This posture creates a domino affect to the rest of your torso, including your shoulders. And, with prolonged static postures, as is common in computer tasks, the muscles associated with posture begin to behave abnormally, that you cannot detect. By the time you detect muscle soreness, fatigue, headaches, or joint stiffness, this abnormal muscle firing and firing patterns have been going on inside of you for a long time.
Current ergonomic postulates state that the hips and knees should be at a 90 degree angle for proper sitting postures at seated work stations. Yet when hips are flexed at 90 degrees, the pelvis is more apt to be in a posterior position. The many individuals will correct by increasing the pelvic tilt to an anterior tilt that increases lower lumbar disc pressure. All of this information, still very basic, may appear to be too detailed, yet it is in the understanding of your position, that will empower you to do and correct properly.
The picture to the left has the hips in more of a 100 degree angle, which, is good. Now begin to look up the spine: The red line shows the true plumb line. So, in this picture, the person is leaning back slightly, which increases shear force on the sacrum, increases a forward head and rounded shoulder posture. I would not use this picture as a good visual for seated posture.
Learning from Visuals
Since most of us have difficulty “feeling” where our body’s are in space and understanding and feeling a correct manner verses what we are used to doing, (usually not correct), and if there is no professional to truly help you to discern and self correct, then good visuals are another method. Since this paper is to talk solely on the chair, the above are pictures that can help you to learn an optimal posture that you can sustain. Let me repeat here again that sustain static positions are the worst repetitive motion, therefore sitting for long periods of time at a work station, say, longer than 15 minutes, reeks havoc not only on the musculoskeletal system, but metabolically as well. Use some of the short visual basics as choosing and using a chair to your greatest advantage!
If you ever have any questions, feel free to reach out to us!