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8 Stretches to Correct Poor Posture

Causes of Poor Posture

Poor posture is so common I see some degree in every patient who walks through my door. Upon completion of care I routinely teach the the 8 stretches to correct poor posture. The upright posture of human beings is a delicate balance of many muscles resisting gravity.  When we develop bad habits in posture it puts excessive strain on muscles as they work at a disadvantage against gravity.  The causes that lead to poor posture are vast and range from prolonged positions at work to our emotional states.  In this article we will discuss the most common issues in the upper body because they result in more presentations into my office as pain.

Starting at the top Anterior Head Carriage is when someone is holding their head to far forward.  The average weight of the human head is 8 pounds and as we move our head forward out of our center of gravity the new lever arm on the muscles greatly increases.  This excessive work on the muscles in the back of our neck and upper middle back leads to chronic fatigue and development of trigger points in the muscles. This leads to neck pain upper shoulder and middle back pain. Also as a result of carrying our head forward it results in the muscles at the base of our skull overworking to tilt our head up to see forward.  Trigger points in these sub-occipital muscles can lead to tension headaches.  In this posture the muscles in the front of the neck shorten and become tight which can result in nerve compressions such Scalene Syndrome.

As the head carries forward we simultaneously start rolling our shoulders forward.  The forward rolling of the shoulders occur as the chest muscles shorten and pull the shoulder blade forward.  The muscles that oppose the chest muscles in the middle back get lengthened and fatigue faster.  The fatigue leads to trigger points and pain in the middle back and upper shoulder area.  The tightness in the chest can cause nerve compression leading to Thoracic Outlet Syndrome.

In combination with the above muscles imbalances we also start to develop an increased curvature of the Thoracic spine.  This excessive curvature is called Hyper Kyphosis.  Hyper Kyphosis is most likely due to prolonged head posture.  Hyper Kyphosis leads to middle back pain along the spine as the muscles get trigger points from overwork caused by carrying the head forward.

8 Stretches to Correct Poor Posture

  1. Snow Angels.  Lay on the floor on your back, with palms up at your sides slowly make snow angels with your arms while keeping your hands on the floor. It is best to perform this exercise with a foam roller.  Lay on the foam roller so that is is running along your spine with your head resting on it.
  2. Kyphosis Stretch:  Using the foam roller perpendicular to your spine, lay your back on top of the foam roller in the center of your middle back with your arms overhead.  Slowly roll downward until you get to the start of your low back.  Never use the foam roller on the low back.  Begin again by starting at the base of the neck and roll all the way down to the start of low back.  Once at low back roll slowly back up to base of the neck. Repeat 5-10 times depending on how tight you are.
  3. Head hanging off Foam Roller:  Lay on the foam roller with it running up your spine like in Snow Angels.  Scoot your body up so your head is not resting on the foam roller.  Let your head hang off the edge.  Hold the stretch until you feel a release and then scoot a little higher and repeat.  when your head easily touches the floor you have scooted high enough.
  4. Chin Tucks. While seated look straight ahead and bring your chin straight back slightly causing your head to tilt forward.
  5. Cervical Flexion and Extension stretch.  While seated tilt your head as far forward as you can bringing your chin to your chest. Then alternate the opposite direction by looking up. Hold each position several seconds.
  6. Cervical Curve Support. Roll up a towel and place under your neck while laying on your back. Just lay still and relax allowing head the rest back as towel supports you neck curve.
  7. Standing reach back:  While standing reach arms overhead as far as you can.  Then bring them back as far as you can while arching back and looking up.  Hold as long is as comfortable.
  8. Standing Rotation:  Stand with arms lifted to 90 degrees at your side like you are making a T.  While reaching back with arm turn as far as you can to right in a twisting motion following with your head and gaze.  Then in one motion turn to the left as far as you can making sure your head and gaze follow.  This motion is moderately fast and smooth.  Each time try to twist and look further.  Repeat 5-10 times.  Be careful the first few attempts to make sure you do not get to dizzy.


Scalene Syndrome

Scalene Anatomy.

Scalenes are a group of three muscles originating from the sides of the neck vertebra running down and forward attaching to the first and second ribs.  Front and middle scalene attach to the first rib and the back scalene attaches to the second rib.  The function of these muscles is to help elevate the rib cage during a deep inhalation. The front and the middle scalene along with the first rib create a triangle of space between them. This space allows all the nerves that travel down the arm to pass through. If these scalene muscles are tight they cause compression passing though the triangular space.  Usually this nerve compression will affect only one major nerve such as in Anterior Scalene Syndrome. In severe cases it can affect multiple nerves causing many symptoms in the arm down to the hand such as in Costoclavicular Syndrome combined with Anterior Scalene Syndrome..

 

What are the symptoms of Scalene Syndrome

Because this compression can affect any nerve of the upper extremity it can create many symptoms.  The symptoms can resemble nerve impingements from a herniated disc in the neck to carpal tunnel.  Scalene Myofascial Pain Syndrome can also affect muscles in the upper extremity mimicking many common muscular conditions such as rotator cuff injuries and tennis elbow.  Diagnoss is every difficult because it mimics many other conditions affecting the upper extremity and we really do not have reliable orthopedic tests to confirm a diagnosis.

Common symptoms include:

  • Numbness in the arm and hand affecting any and possibly all the fingers
  • Pain radiating down the arm
  • Pain in the shoulder and middle back
  • Pain on the side of the neck
  • Neck stiffness
  • Weakness in the arm and hand

How is Scalene Syndrome treated?

We successfully treat Scalene Syndrome with Chiropractic Care and Massage Therapy in our office.  A goal of the treatments is to relax the scalene muscles and correct the postural imbalance that led to the tightness. The cause of Scalene Syndrome is related to having an Anterior Head Carriage posture.  For correction we teach home care stretching and workplace modifications to correct the cause on anterior head carriage.  I also see cases related to motor vehicle whiplash type injuries and on rare occurrences we will find chronic respiratory issues as the cause.  Scalene muscles work hard when someone is having difficulty breathing such as in chronic asthma or COPD.  In cases related to respiratory overwork we have the patient consult a primary care physician to assess and manage the condition as we continue with Chiropractic Care and Massage Therapy.


How to relieve neck and shoulder pain at work

Working on a computer causing neck pain at work?

Many people who have office jobs seek Chiropractic and massage therapy to relieve their neck pain at work.  Prolonged sitting while working on a computer causes many people to develop poor posture.  When we use a keyboard and stare at a computer screen we tend lean our head forward and pull our shoulders forward.  This posture causes what we call anterior head carriage and rounded shoulders. In this position we put excessive lengthening and strain on the muscles on the back of neck and upper back.  The lengthened muscles get overworked causing them to become painful and stiff.  The shortened muscle in the neck and chest becomes very tight and can lead to common nerve compressions such as Thoracic Outlet Syndrome and Scalene Syndrome resulting in tingling in the hands.

Anterior Head Carriage

This is the term used to describe when a person has a posture in which they carry their head to far forward.  In normal posture your head should be aligned over the middle of your shoulder when viewed from the side.  People that have this posture also have a tendency toward an excessive amount of kyphosis in the middle back.  The middle back normally has a curve that peaks in the middle back curving forward a slight degree as it goes up toward the neck and also curving forward as it goes down to the low back.  Excessive anterior head carriage causes the upper part of the curve to become excessive.  Many people notice this posture in themselves as a hump developing in their upper back at the base of the neck. This posture results in lengthening the muscles in the back of the neck and upper back and shortening of muscles in the front of the neck.  The lengthened muscles fatigue fast and result in pain in the back of the neck and the shortened muscles can cause nerve compression resulting in Scalene Syndrome.

Anterior head carriage commonly result in the following symptoms:

  • Neck pain
  • Shoulder pain
  • Headaches at the base of the head
  • Tingling in the fingers

Rounded Shoulders

When spending many hours working at a desk the poor posture we all develop is to roll our shoulders forward.  This can be due to a combination of Anterior Head Carriage and poor work space ergonomics.  If you are reaching to far at your desk it will cause you to hunch your shoulders forward.  This posture results in shortening of our pectoralis muscles which pulls our shoulder blades forward resulting in lengthening of our middle trapezius and rhomboid muscles.  The lengthened muscles fatigue fast and result in pain in the middle back. The shortened muscles can cause nerve compression resulting in Thoracic Outlet Syndrome.

Rounded shoulders commonly result the following symptoms:

  • Pain in the middle upper/middle back
  • Pain in the front of the shoulder
  • Pain in the chest
  • Tingling in the fingers

How to relieve your neck pain at work

The first step is consulting a Chiropractic Physician to get proper care to alleviate your pain.  We also instruct patients on an in depth stretching and strengthening plan to work on at home and work.  We also go through detailed changes that should be made to their work environment called ergonomic planning. The most important goal is to stretch out the tight muscles and strengthen the lengthened muscles. Read 8 Stretches for Poor Posture I will give some basic ideas that can be started at home.

 

For more stretches read our Yoga For Neck Pain Blog 

 


Thoracic Outlet Syndrome

What is thoracic outlet syndrome?

Thoracic outlet syndrome is a nerve compression that is very common in the shoulder. two of the three main nerves traveling down the arm go under a muscle called the pectoralis minor in the shoulder. It is very common in people with rounded or rolled forward shoulders to have tightness of the pectoralis minor muscle. This tightness compresses the nerves when our arm is in certain positions especially while sleeping on your side.  Patients will note they wake up in the night with a numb hand.  It is also common for people the experience pain in the upper back and shoulder. This is because of strain of these muscles related to rounding of the shoulders forward. This is common to see in people who work on computers, weight lifters, and people who play sports such as tennis or baseball.

Commonly thoracic outlet is a combination of 2 nerve impingements referred to as a double crush syndrome. The second impingement is between the scalene muscles and the first rib in the lower neck.  The second impingement called Scalene Syndrome is always suspected when a person experiences numbness in the hand.  This syndrome is also the result of tight muscles resulting in nerve compression.  It is also commonly associated with forward head posture referred to as anterior head carriage.

What is the treatment ?

Chiropractic Care in conjunction with Massage Therapy and home stretching is very effective at eliminating Thoracic Outlet Syndrome. Treatment is focused on stretching the tight muscles in the chest and correcting the trigger point buildup in the upper back, neck, and shoulders.  If scalene syndrome is also involved treatment also addresses the tightness of the involved scalene muscles. In most cases posture issues at work need to assessed and corrected to aid in healing.