Health Coach Q & A
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What if I now have a Dowager's hump from bad posture at work which has progressed to extremely painful. What should I be doing to help find immediate relief and how can I correct this issue going forward?
Thanks for the great question! A Dowager’s hump is another term for excessive thoracic (upper back) kyphosis (curvature). The first thing you should do is get a referral from your doctor to see a physical therapist. A PT can assess the degree of kyphosis and teach you how to do exercises properly within your capabilities.
Generally, excessive thoracic curvature from poor posture is something that can be corrected. However, it can be complicated by things like vertebral fractures or other degenerative changes, so a thorough physical examination is important before proceeding with exercises to restore spinal alignment.
It is common to experience discomfort associated with this condition. Complications include pain and stiffness in your spine, between your shoulder blades, and in your neck; headaches; impaired breathing and digestion; muscles that fatigue quickly, and impaired mobility. If given the green light, many of the exercises discussed during today’s webinar are great for this condition. To see improvement, you will want to make time for stretching, mobility, and strengthening exercises daily. These include:
-chest stretch and chest openers
-child’s pose
-cat-cow
-supine show angels
-overhead reach
-scapular retractions
-chin tucks
Beyond these suggestions, postural retraining with a particular emphasis on avoiding forward head flexion and forward rounding of your shoulders will help to improve spinal alignment and reduce thoracic hyperkyphosis. Improved alignment will likely be uncomfortable at first. Take frequent breaks and do not push yourself to the point of pain.
I was paralyzed on the right side of my body so I can't lift my arm up all the way. There's a limit to how far I can only lift it up, so what can I do to eventually be able to raise it all the way?
We cannot offer medical advice, and we encourage you to speak with your doctor for specific medical conditions such as this one. There are many individual factors that need to be considered before developing a treatment protocol. If you have not considered physical therapy that would be a great place to start. A physical therapist (PT) can recommend exercises that support your flexibility and mobility within your current physical capabilities. They can also support passive range of motion exercises, which involve the PT helping you to move through a range of motion to improve flexibility and mobility. Passive exercises can be very helpful when you have limitations in your active range of motion.
What is a pre-stretch for the Kneeling Hip-flexor? Getting on the floor (on my knee) might be a bit too much for me to start.
A standing hip flexor stretch is a great place to start. Stand at about arms distance away from a wall. Place both hands on the wall and step one leg forward with a slight bend at your knee. You are stretching the hip flexors of your rear leg that should still be in a straight position (no bend at the knee). To intensify the stretch, tuck your hips slightly to point your tailbone at the floor. You should feel the stretch along the front hip of your rear leg. When you are ready to try the kneeling variety, this position can help better isolate the hip region. Using a pad under your knee can help improve comfort.
I would like to start pilates, but worried about injuries due to past surgeries. Do you think this is a good option for stretching, core power and balance, or should I stick to something less evasive?
There are different levels of pilates classes. Depending on the type of surgeries you have had it is a good idea to be cautious. I suggest looking for a beginner level mat pilates class. Most teachers encourage you to speak with them before class to express any specific concerns that you have. They can offer advice on which movements to modify or avoid completely to accommodate your concerns. It would also be a great idea to have a session or two with a physical therapist prior to starting pilates classes so that you can learn what movements are safe for you and which to modify or avoid.
I purchased a weighted Hula hoop. Do I stretch before using it?
Hula hooping can be fun! Be sure to choose a hula hoop that’s the right size for you. Measure the distance from the floor to your belly button. This distance, in inches, is a good starting point for the diameter of your hula hoop. Also note that heavier hoops are easier to control.
If you are using your hula hoop for cardiovascular exercise, you should do a short warm-up like you would before any form of exercise. Finishing your warm-up with some dynamic stretching and mobility movements is a great way to prepare your body for exercise. There are warm-up movements specific to hula hooping that would be a great option. Many online hula hoop classes begin with some hula hoop stretches and mobility drills that could provide you with some ideas. In general, these movements should target your core muscles (back, abs, each side of your torso) and hip muscles (hip flexors (front of hip), extensors (back of hip), abductors (outer thighs), and adductors (inner thighs).
I have been stretching a.m. and p.m. for months and while it feels great in the moment, I am not making progress. I think I have inflammation in my spine. Should I ever expect improvement?
First, if you are experiencing ongoing pain, it is a good idea to visit your doctor to discuss. After ruling out conditions that may require treatment, there are a few approaches you can take.
It is common for stretching to have the biggest impact immediately after a stretching session. Stretching improves blood flow to your muscles and promotes tissue relaxation. These immediate effects wear off, particularly if you then spend your day in positions that are not conducive to good posture. For example, if you stretch in the morning but then spend your entire day at a desk with few breaks, it will be challenging to see progress from your flexibility routine. Flexibility, mobility, and posture are closely linked.
Another suggestion is to revisit the exercises you are performing. Some stretches might be putting undue stress on your spine. A physical therapist can guide you in modifying or substituting exercises to better suit your condition and promote spinal health.
It is also possible that your spinal muscles are weak and that you need to incorporate muscle strengthening exercises into your program. Strengthening the muscles that support your spine, especially your core muscles, can relieve pressure on your spine and potentially reduce inflammation. If you have not tried some formal classes like yoga, beginner pilates, or Tai Chi, these could be great alternatives. Teachers are usually available to provide guidance and modifications to exercises as necessary.
Do you have any tips for yoga if I have had knee replacements?
Yoga can be a beneficial practice after knee replacement surgery, helping to improve flexibility, strength, and overall mobility. However, it’s important to modify some poses to protect your knees, start with a gentle approach, and consult with your healthcare provider before beginning. With the right precautions, yoga can be a safe and effective way to enhance your recovery and maintain an active lifestyle.
Start with gentle forms of yoga like gentle yoga, Hatha yoga, or chair yoga. These focus on slow, controlled movements and poses that don’t put excessive strain on the knees. Be cautious with poses that put a lot of pressure on the knees, such as deep lunges, full squats, or lotus pose. Modify these poses to reduce knee stress. The instructor should also be able to suggest props like yoga blocks and straps that can help to modify movements to be easier on your knees. Look for a qualified yoga instructor that can provide you with these types of suggestions.
What are good stretches for always tight legs and hips?
Where you actually carry tension in your legs and hips is important to investigate. For example, some people think that their hamstrings are chronically tight, but really they are excessively lengthened due to tight hip flexor muscles. A good analogy is a rubber band. If you stretch a rubber band to its max length, it will feel tight; however, it isn’t too short (tight), it’s actually too long. In a situation like this, restoring flexibility in the hip flexors (opposite side of the joint) would be the right approach to alleviate stress on the hamstrings.
Once you identify which muscles are actually shortened, a multipronged approach leveraging foam rolling and other trigger point work (e.g., a tennis ball) on painful areas (i.e., trigger points), static stretching of shortened muscles, dynamic stretching and other mobility exercises for joint range of motion, and careful attention to posture will help you make the most progress. If you spend a lot of time sitting, areas that typically require attention include your hip external rotators (like piriformis in your deep buttock region), hip flexors (front of hip), abductors (sides of hip), and calf muscles. The ACE exercise library has wonderful exercise suggestions for these areas.