cycling, exercise, fitness, golf, lower crossed syndrome, manual therapy, pain, physical therapy, posture, upper crossed syndrome
Bad posture is the greatest risk factor for musculoskeletal pain in our culture. The average American spends 7+ hours at a computer, interactive phone, or television screen. A century ago, the average American spent most of his / her time doing manual work in the field or factory. With this change in work style over the past 100 years has come a pathetically severe increase in spinal pain and dysfunction. We have converted into a society that has to find / make time to stay fit and strong for prolonged postural endurance. With this change in lifestyle, more people do not exercise because they do not know how to incorporate them into the day. WHY IS THIS SO BAD? Because, it leads to muscle imbalances (weakness/paired with shortening) in the upper and lower body thus creating a perpetual cycle of worsening symptoms.
As a level 3 TPI Medical Professional (Titleist Performance Institute), this is important topic because many of my golfers are at the desk all day, then hit the course in the same posture. This performance on top of dysfunction predisposes them to a laundry list of ailments: neck, shoulder, back, hip, or upper extremity pain, Carpal Tunnel, Tennis elbow, Golfers elbow, and Headaches just to mention a few. This dysfunction can also affect endurance athletes just as severely (cyclists, runners, rowers, swimmers). The challenge with all these sports is that they require maintaining a slightly flexed posture for long duration. Our guts, abdominal, Upper and Lower Traps, and Serratus Anterior (boxer muscle) are not conditioned to do this if you already have slouched posture. In If you are a weekend warrior do not train for your sport, you are predisposed to the diagnoses above. You might think, oh, this won’t happen to me. Just wait, it will happen if you don’t train correctly.
The science behind it
Overuse of some muscles in your body creates inhibition of the the muscle on the other side of the joint. Technically the agonist gets tight and the antagonist gets weak.
1. Upper Crossed Syndrome (UCS) – by Dr. Vladamir Janda
- Shortened Upper Trapezius, Levator Scapula PAIRED with a Weak Lower and Middle Trapezius
- Shortened Subocciptials and Sternocleidomastoid PAIRED with a Weak Longus Coli (deep neck flexors)
- Shortened Pectoralis Major and Minor PAIRED with a Weak Serratus Anterior
2. Lower Crossed Syndrome (LCS)
- Shortened Iliopsoas PAIRED with a Weak Gluteus Maximus
- Shortened Erector Spinae PAIRED with a Weak Rectus Abominis
- Shorted TFL and Quadratus Lumborum PAIRED with a Weak Gluteus Medius
In layman’s terms: if you have flexed hips (from sitting), a forward head on neck/neck on shoulders, and rounded shoulders it leads to these muscle imbalances. When do you technically have UCS or LCS? When the impairments above lead to pain or dysfunction in your daily life or with sport. Think you are at risk or have it? It is not too late. Start doing your corrective exercises now.
1. Assess your desk posture and set up – This might require purchasing a new chair, desk, or keyboard and getting rid of the lap top. Key rules in desk posture:
-Feet flat on the ground
-Chair at a slight decline to keep your pelvis in neutral
-Elbows at 90 deg with your keyboard just above lap level (this might require installing a keyboard tray under your desk)
-Wrists at neutral and mouse at same level as your keyboard (this might require installing a mouse tray on your keyboard tray)
-Screen at eye level during good posture. This one is killed by using a lap top or working from the phone because you are constantly looking down.
-Make sure you don’t need glasses or don’t have screen blindness from staring at the screen too long. This will lead to slouching.
2. Do corrective exercises to reverse your posture throughout the day. Stretch the tight muscles and strengthen the weak ones. See below.
3. Force yourself to take a break while working at the computer every 20-40 min. If needed, time yourself with an application on your computer.
4. If you are already having symptoms of spinal pain, headaches, or shoulder pain contact a medical professional (MD, Physical Therapist, or Chiropractor). If the impairments have not become painful yet, seek body work from a massage therapist or learn exercises from a personal trainer.
5. Do not train the dysfunction you have! If you know you have this, change your workout routine now! The benefits will outweigh the “rest period” from your typical lifting or exercise routine. The most common misconception is that biceps and chest should be worked more than the upper back. In reality this TRAINS your postural dysfunction. Anther misconception is that working the Lats is working the back. Well yes you are working the back but at the shoulder the Latissimus Dorsi is an internal rotator. If there is an imbalance, your shoulders will begin to round forward creating a slouched posture.
My Favorite Exercises for Prevention:
1. Foam roller exercises – angles in the snow, scissors, transverse mobilization, pec stretch and threading the needle
2. Scapular strengthening combined with rotator cuff exercises – Y’s, W’s and T’s on Physioball
3. Gluteal strengthening – bridges, clams, and balance exercises that work on coordinating the gluteals with core muscles
4. Stretching the Hamstrings (if they truly are short), hip flexors / Quads, Pectoralis Major and Minor, Latissiums Dorsi/Quadratus Lumborum and suboccipitals. In my experience, stretching the Upper Traps and Levator Scapula may provide short-term relief but the symptoms usually won’t change until you correct the other imbalances. This is why you sometimes feel like you get no relief from a massage on your sore neck/shoulder muscles.
5. Core stability exercises for endurance – NO, not sit ups. Doing planks and half kneeling exercises where you have to use your stability against the gravity or position you are in work better for waking up the weak muscles.
Golf’s C posture by the Golf Fitness Guys
Greg Rose’s Lower Crossed Syndrome – from Titleist Performance Institute on Golf Channel
Ergonomic options for the laptop computer
Jess: Great article that applies to most middle aged golfers. I see S posture constantly yet few people are aware that they have the problem. Janda was a true pioneer, I own the domain name VladimirJanda.com in fact.
Stunning, I didn’t heard about that until now. Thanks!
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Pamela witthaus OTR/L, CHT said:
Could you post pictures of the exercises you recommend
or e-mail them to me?
Thanks for your blog. It is very informative.
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