My last post was all about the psoas muscle and how it can affect the positioning of your spine and pelvis. Keep in mind that we are trying to assess bone position here, and if you have a lot of padding, don’t let that throw off your evaluation.
You may have discovered you were in a position where the entire spine is against the floor, without the normal lordotic curve of the lumbar spine (the waist area) so that all the way to the tailbone the spine is down but the tailbone itself is off the floor. The hamstrings are nowhere near the floor. If you were to take that spine to quadruped position, it would look like this:
So in this position, let your back relax to the floor.
There! Now just sit there for a while. Let the ribs down too. In the photo I’m keeping my head aligned with my spine, but you can let your head hang down too, so the top of the head is pointing to the floor. Let your internal organs drop forward toward the floor, to sit on the abdominal wall. Ahhhhh. Feels good. Let the tailbone float upwards. Hang out. If the knees are uncomfortable, place some padding beneath them.
If you want to, you can try this: lift the bottom rib in the front of your body down toward the pelvis (or up towards the ceiling – same difference). Try to do this without a lot of muscle. This will re-create the natural curve that should be in your rib cage. But it’s important that you don’t tuck the tailbone back under and round the lower back again.
With the hips and the knees bent like this, the pelvis does not have any muscular inhibitions to this action, other than the unfamiliarity with having a lumbar curve. Most chronic tail tuckers find this action very strange at first. As well, most people are surprised with how much they have to untuck to gain a neutral pelvis/spine. I suggest doing this beside a mirror. Let your spine go all the way at first. It probably won’t be too far. Once you correct the rib cage position, you won’t look like the old grey mare.
When you go about your daily activities, try to release the spine, sometimes that tail tucking is a habit, albeit one that is unconscious for the most part. If you are standing in a “bad puppy” posture, see if you can allow the tailbone to float back.
If you sit a lot for work (or on a horse), try not to curl the tailbone under and sit on it. This creates a lot of problems, not least of which is related to pelvic floor dysfunction. Your weight should be on the “sit bones” (ischial tuberosities) and tailbone should be floating above the chair seat.
About 100 years ago, before I became a full time Pilates teacher and then a RES™, I rode horses. I was one of those horse crazy girls from a very early age. I distinctly remember seeing a horse on TV before I could speak, and running over to the box and banging on the screen in an attempt to get the horse to come back. For whatever reason, I was passionate about them always!
I finally stopped riding about 7 years ago, as creating a business in the city was taking all my time, and truthfully, owning my own horse was not in the cards, and riding OP’s can be frustrating. I guess I will never realize my Olympic dreams.
However, I give a lot of thought to how the stuff I’m learning now would have been so helpful then. As well, my decades of riding horses are hard to forget, and I often use that movement background in order to help understand new concepts. When I have trouble sleeping, it’s not sheep I count, but tempi changes.
So I guess that whole world is still deeply ingrained.
It will come as no surprise to any rider that what they do when they sit on a horse will have a consequence in the behaviour of the horse, whether it was intentional on their part or not. Ideally, a rider desires to develop the horse’s natural abilities and does nothing to restrict him in achieving these abilities. But what if you are restricting him without your knowledge, or even with your knowledge but beyond your control? What if there were tension patterns inherent in your own body that prevented you from being fully in control of your own actions? Take those kinds of tension patterns onto a horse and your riding teacher suddenly has more to deal with than she can possibly hope to change (hard enough in a static body, never mind one on a moving horse!).
Take the psoas for example (psoa – Greek for loin). This is not one muscle that the name implies, but two. You have psoai (pl); one on either side of your body, deep to the spine, running from the level of your lowest ribs to the upper inside part of your thigh bone (called the lesser trochanter). They work independently, not symmetrically; in other words, they can do different things at the same time on each side of the body. If you are a meat eater, the psoas muscle is the tenderloin – that long, expensive, very tender piece of pork or beef that you see in the supermarket. (Since only about 50% of the population has a psoas minor, we will not address them here.)
Below the psoas, attaching to the inside of the pelvic bowl and running down to share an attachment point with it, is the iliacus muscle. This muscle has a very broad attachment on the pelvis and a very narrow attachment on the lesser trochanter. Historically, these two muscles have been unfortunately lumped together and termed the “iliopsoas.” I say unfortunately, because these muscles have different actions despite their one shared inferior attachment, and lumping them together has led to a great deal of confusion as to their individual functions.
Seen from the side, the psoas runs down through the trunk at an angle, from the spine forward towards the front of the abdomen, across the front of the pelvis and backwards again to the lower attachment point. It has many attachments, from the anterior transverse processes on the vertebrae, sides of the vertebral bodies, and even the intervertebral discs, running down to the inferior attachment point at the lesser trochanter.
As such it crosses many joints (spine and hip). Because your central nervous system is housed within the spine, the psoas is a mover of the central nervous system. It’s a large muscle that can reposition the rib cage, and also moves the legs. It can influence your upper, core and/or lower body. Hip flexion is but a small portion of what the psoas does, and it does this by bringing the femur out in front (it also has a part in chronically flexed knees) and not by anteriorly tilting the pelvis, as is often mistakenly believed.
The psoas major also has layers; the deeper layer and a more superficial layer. Deep attaches to L1-5 transverse processes, which means it has the potential to move lumbar vertebra relative to each other. Superficial attaches from T12 to L5 bodies and discs. It can therefore displace vertebral discs relative to the vertebral bodies.
Between the two layers is the lumbar plexus, which is a nerve complex responsible for nerve supply to abdominal muscles, back/spine muscles, pelvic floor, and adductor (inner thigh) muscles. Electrical flow to a muscle determines the health of the blood supply to those muscles. As well, the flow of lymph (waste) removal is dependent on this plexus and its health. So if the psoas is tight, and blood flow is restricted, all these tissues can potentially be negatively affected. (But hey, what do dressage riders need with abs, spine, inner thigh and pelvic muscles?)
We know that tight muscles that can’t release and yield back to their supple and original length will test as weak, and most of us have tight psoai (I’ll get to why in a minute). If a muscle is chronically shortened, it cannot generate force. If it cannot generate force, it cannot create vasodilation and increase blood flow to its tissues. If it cannot optimize blood flow, the tissues are not fed, and if they are not fed, regeneration does not take place, resulting in tissue disease and death. In the case of the psoas, not only is the psoas muscle itself at risk, but think of what a tight psoas does to the structures it attaches to, and the many nerve feeds to muscles around the trunk, hips, thighs and spine.
What does a tight psoas look like – how can you tell if you are tight, and in this discussion, how will that affect the rider? Here are some reasons the psoai can be tight: chair sitting (especially if you sit with a slumped spine and tail tucked), biking, running, treadmill walking or running, stair climbing, elliptical machines, tucking the tail (yours, not the horse’s), sucking in the stomach (to appear thinner or in a mistaken belief that this tones the abs), rib thrusting (either because the muscle is tight, or because culturally you have been trained to do so, or through sports such as gymnastics and ballet, or military training). All of these can result in a chronic rearrangement of the muscle fibres of the psoas.
Because sitting on a horse is still sitting, and most of us sit far too much as it is, even if you don’t do any of the other items on the list, it is very likely you have a tight psoas. Here’s how to test it:
Lie down on the floor, a hard wood floor is best for this. Lie on your back with your legs extended. The back of your thighs, your hamstrings, should be fulling resting on the floor. If they are not, this is an indication that your hips are flexed and your knees are bent (even minutely). Now, regardless of where your legs are relative to the floor, bring your attention to the rib cage. Are the bottom ribs on the floor, or are they too lifted? Sometimes the spine is off the floor all the way from the lower back to the upper shoulders. The broadest part of your ribs just below the bra line should be well grounded. One of the signs of a tight psoas is “shearing” of the upper lumbar vertebra. This is a term that means the upper vertebra are displaced forward (toward the front of the body) relative to the ones below them. This results in a “rib thrust” described above. So regardless of whether you have a rib thrust because your psoas is tight, or your psoas is tight because you have a rib thrust, you need to deal with that. Please note: the lower back or lumbar spine does not have to be on the floor. There has been some confusion as to what parts of the spine should be touching the floor if the psoas is long enough. The ribs, all the way down to the bra line should be touching, and the back of your thighs. The lower back should have its regular lordotic (forward) curve.
Do you see that in the above photo (of me) that there is daylight between my ribs and the floor, and my hamstrings (back of thigh) and the floor? If this looks forced to you, tilt your head and pretend I am standing. Not so different from a lot of postures out there. As a matter of fact, most people would think this was “good posture” maybe even for riding. (If you click on the photo it will enlarge for easier viewing.)
So if your psoas was optimal in length and could yield to its full length, the hamstrings on both legs and your lower ribs would be firmly on the floor. If one or the other or both is not, you have work to do. As well, one hamstring may be on the floor or closer to it than the other. Because we do not use our bodies symmetrically and the psoas muscles work independently, one can be tighter than the other. Standing on the ground, or in the stirrups in this case, will have the result of a pelvic/spine rotation. Do you find one lead easier than the other, or circling one way easier than the other? Has your coach repeatedly told you to bring one shoulder back or that you are leading with one hip? I don’t think I need to go into detail here how that would inhibit the success of any dressage movement (your riding coach can cover that).
The above demonstration just showed you how a chronically short psoas can change your posture, or position. If your goal is to achieve a free hip and leg, supple lower back, force generating abs for half halts and spine support on those big extended trots, inner thigh length for a deep seat, long, effective leg and deep heels, you cannot achieve an optimal position on a horse or anywhere else until you RELEASE the psoas! Stretching that sucker is not effective, because the fibres are chronically short – this means their resting length has been re-set to a shorter position. Stretching it will get you nowhere. The brain needs to be reminded where the attachment points (bones) need to be relative to each other in order to allow the muscle to release and eventually to yield and allow a healthy blood flow back to the area.
So far we have learned that a tight psoas can restrict your ability to move freely in the spine, hips and ribs, negatively effects the health of tissues surrounding it in the trunk, pelvis, abs, spine and thighs (potentially causing pain in any of those areas), can create rotations in the spine and pelvis, chronically shortens the legs by flexing the knee and hip, can create compression of the discs and shear the rib cage forward causing further damage to the discs (not to mention putting a large portion of our body out of balance with the centre of mass in the pelvis, and creating unstable environment for the shoulders – which would lead directly to contact issues). Holy cow – that’s probably enough to motivate anybody. But there’s more!
Your kidneys and adrenal glands are situated below the upper psoas attachment. The central nervous system is affected by a tight psoas, and anybody who works with animals knows that emotions can effect posture and vice versa. You know your horse is relaxed when that tail is loose and swinging right? What message does it send your horse when your CNS is clamped down? Your psoas clamps down when there is a reason to protect the vital organs in a “flight or fight” situation. Normally we would encounter such a situation very rarely, maybe a few times a year. However, in our society, we are more likely to have biological stress reactions on a far more regular basis. There is a chemical event that occurs during times of stress, and normally our body would be able to deal with these chemicals and clear them from our bloodstream and return to a normal state of health in a short amount of time. Because we are always giving this signal with a chronically tight psoas of the fight or flight response, our adrenal gland is constantly working, leading to adrenal fatigue, and eventually exhaustion.
How are you feeling when you walk up the centre line? A little nervous? Did your horse give you some “attitude” in the warm up? It’s very possible that the psoas shortens in response to the fear of being in front of a judge or riding a nervous horse that might decide to toss you on the ground at any moment! In any case, such a response on the part of the psoas is not going to lead to a relaxed horse or rider. So what can you do to release the psoas?
First of all, take this course: http://www.restorativeexercise.com/psoas-science/
For $40, or a lot less than one dressage lesson, you can listen to a 2 hour lecture by biomechanical scientist Katy Bowman on the psoas, expanding on what I have touched on here, and a one hour psoas exercise and release protocol that I suggest you do every day or as much as you can.
In the meantime do this release: in the test position above, bolster the shoulders and head/neck until the hamstrings are firmly on the ground. You can roll up blankets or use several pillows, a yoga bolster or even a sleeping bag rolled up. How much bolstering you need will be determined by how tight you are. The lower ribs are not on the bolster. In this position, you have nothing to do but allow gravity to act on the upper attachment of the psoas (lowest rib) and allow that to drop down to the floor. This might take 5 minutes, or 5 months. It depends on several variables.
This is only one psoas release but it is a good start. Remember, tucking the tail (posteriorly tilting the pelvis) and thrusting the ribs (lifting the chest and pulling the shoulders back) is not conducive to a relaxed psoas or a functional spine, pelvic floor or abdominals. That posture will only aggravate the issue.
Katy Bowman, M.S.
Alignment Matters: the First Five Years of Katy Says
Propriometrics Press, 2013
447 pp., $21.95
Disclaimer: I am a certified Restorative Exercise Specialist™ and hence, am biased to love this book. (I received this copy for free as a review copy.) So I will do my best to explain why this book should be required reading for movement educators and health practitioners, and what it has to offer to a casual reader, fitness nut, or someone looking for information or advice on many of the health and disease issues we are facing today.
The book in question is called Alignment Matters: The First Five Years of Katy Says by Katy Bowman. Bowman is a movement and health educator, director of the Restorative Exercise Institute, author of two books (so far), with a degree in biomechanics. You can read her bio here.
In Alignment Matters you will learn that you have the means at your disposal to effect the outcome of your physiology, this information is freely accessible, and you don’t need special equipment or fitness memberships to do so. Your alignment and your geometry are integral to your well being, and that information is often missing from your current sources of medical and fitness advice. In fact, what we are doing in our quest for fitness is actually the cause of some of those outcomes!
The book is a compilation of blog posts from the popular Katysays.com. As a regular reader of this blog, you might ask why would I want to have this information in printed form? Having a printed index is handy, as the search function on the blog can net you many choices and it’s sometimes hard to recall where you read that one snippet you are looking for. Also, the blog is written according to what Katy is thinking about and researching at the time, which can range from Pelvic Floor Disorders to Earwax, while the book is neatly arranged by category: Feet and Shoes; Knees, Hips and Back; Walking and Gait; Pregnancy, Childbirth, Babies and Children; Cardiovascular System, are some examples.
As an ancient person, I appreciate a paper book that you can load up with highlights and notes in the margins, carry on the bus and subway, read in the bathroom. The book also comes in an e-book version for people who have joined the 21st century. Also, not everyone has a computer or reads blogs. (I know – weird but true!) So although the material is available online, having it in an organized, easily accessible format is worth the price.
Bowman’s style is informal and conversational and as such, appeals to a wide variety of people. Her sense of humour is displayed on almost every page, which is appreciated when you consider she is dealing with often very serious subject matter. She is never preachy or judgemental (in this she is also my teacher) and lives the life she espouses, which continues to be an inspiration to the rest of us, as she drags us along to our furniture-free, vine swinging existence.
This is one of those books you will be quoting from at the water cooler and dinner table, annoying your colleagues and family with stories that invariably start with “Katy says…” (hence the blog name). You can read it from the beginning, or you can open at random. Most importantly however, don’t skip the Introduction section, which lays the foundation for the book’s premise. One of the best is “Manifesto” from 2011.
The information contained in this book is easy to understand, illustrated in many cases by photos and Katy’s own hand drawn masterpieces (not such an inside joke – but although they are often hastily and always simply drawn, they are effective at illustrating a point). The links that were hot-linked in the original posts are footnoted here. Research material that is cited is also footnoted. In other words, this could keep you busy for a long, long time. Or you could choose to adopt many of the simple changes to avoid or improve fallen arches, knee and hip osteoarthritis, osteoporsis, to name a few. But you will be drawn in to this book and it is a pleasure to read, not the dry, heavy eyelid inducing kind of read you suspect a book about alignment would be.
I think anybody can take something of value away from this book, and you are bound to come back to it again and again, as her words seem to linger in the mind and cast doubt on some of your hard held beliefs. Even if you choose to continue your current fitness habits, you will do so with new insights. Even small changes can have a profound effect.
A suggestion: if you do find posts that you are very interested in, go to the online blog and read the comments section. Katy often generously responds to readers questions with very detailed explanations and clarifications. It would have been impossible to include all the comments in a book, but some good information is still to be found there.
In the States, look for this book on Amazon.com. In Canada, you can order the book from the Restorative Exercise Institute online: http://www.restorativeexercise.com/book-store/
If you are local to Toronto, I hope to have copies available some time soon.
I like to challenge myself in my daily activities, not necessarily taking the easiest way, but doing something that will keep me feeling young and able. For example, when you put on or take off your shoes, do you have to sit down, or hold onto the wall? I like to see if I can balance on one leg while I put one shoe on, and then the other leg and shoe. I make it a balancing game. If I have shoes that tie, this takes longer. At first, I liked to do this close to a wall so if I did fall to one side, I had a wall to lean against. Now I can easily take my shoes on and off and never wobble.
Of course, if you have hips that don’t flex enough, or a real balance problem, this might be too much of a challenge at first, but it could be something to work toward. The same thing could be said for putting on your socks and pants. Do you have to sit on the edge of the bed to put your pants on?
Another thing I get a kick out of doing is standing on one leg and using the other foot to open kitchen drawers and even doors. I have lever handles on some doors, and knobs on others. Also, I’m very tall, so I can reach the handles with my toes, which a shorter person might not be able to do. You can always start by using your toes to “hold” things or pick up things from the floor and then transfer them to your hands (or the garbage if you are cleaning up).
I go barefoot as often as possible, definitely around the house and yard. The other day, I walked 2 kilometres barefoot in the city! I surprised myself because I really thought the cement sidewalks would be too hard and unyielding a surface to do this comfortably. But I found that after a few steps, I adapted my gait so that I would land softer and more along my mid-foot than a hard heel strike. Having a cushioned shoe actually allows and therefore promotes a harder heel strike than is really necessary. Of course I kept an eye on the ground in front of me for any hazards such as glass or dog poo (thankfully none was encountered). When I got home I headed right for the bathtub where I gave my feet a good scrub – they were filthy!
It’s too bad I don’t live in an environment that favours barefoot commuting. I’ll do it as often as I can though, as the benefits are strong. For one thing, my toes finally get to be as long as they want. Even with shoes that are big and wide enough, I find that the act of sliding within the shoe makes my toes (especially my second toe which is longer than my first, or big, toe) hit the front of the shoe and bend. I can see this pattern by my toe nail and the fact that my “Proximal InterPhalangeal joint” (or PIP) is constantly in contraction.
I grew up in a suburb of Toronto, not that far from where I live now. I went barefoot as a child all summer long, and we walked on sidewalks, tar roads, golf courses, in forests and parks, climbed trees, and I can remember daring my best friend (also a barefoot devotee) to walk on gravel walks and hot driveways. By that time, we had a good calloused surface that protected us. I find that the sensitivity of bare feet means you are hyper aware of what’s underneath your sole. Your foot can deform and adapt to the surface under it, providing that your foot is mobile enough to do so – if it isn’t, you need to do some work before you can safely negotiate an uneven terrain.
Here are some ways that I fit Restorative Exercise™ into my daily activities:
Reading the paper:
Using a yoga block on its side to facilitate an assisted squat. This is actually really comfortable. I also sit on the floor in many different positions. I’ve got my laptop on a low table here (it’s actually a Pilates reformer with a cover on it), but you can do similar things with a computer on a coffee table.
Listing while putting on shoes:
Remember to alternate the first foot that you put a shoe on. It’s different when the foot on the floor is bare.
I’m standing on one foot and using the toes of the other foot to open the door. And holding a cup of tea and a basket of strawberries. Multi-talented!
Not pictured: listening to the radio while in Psoas Release (heaven!). Now your challenge is to see how many things you do during the day that are actually little parts of what you do in class. Good luck.
I had intended to post a weekly “walk of the week” on my blog, but in truth, I do the same walk over and over, which would be pretty boring for you. I walk to work to kill two birds, so to speak, and I use the same route more or less, as I try to walk on natural surfaces (parks) and avoid the main streets if I can.
So I was really excited when my friend and Restorative Exercise™ colleague suggested we meet on our day off and go for a walk somewhere new. I searched the internet for “Toronto Walks” to see what would come up and got some nifty sites run by the City:
As well, there is this link to walks offered by the Royal Ontario Museum.
We ended up going on the self guided Don Valley walk. I was quite surprised to find an entrance to the Valley paths quite close to where I work, as I didn’t know about it before. It was a bright and sunny September day and it was just a beautiful walk. It will be even more beautiful when the trees start to turn colour.
I encourage you to search out similar walks, especially if you live in an urban area. Looking at these pictures, you’d never know this was taken in the middle of a huge metropolitan area like Toronto. The first one shows the Bloor Street Viaduct. (Joke: Viaduct? Vy not a Goose? Okay, that was bad.) The Bloor street subway runs underneath the road surface. It can be noisy.
This is the Don River. One of the prettier areas – a little rapids.
And this was taken at the top of Pottery Road, looking over the Valley. Seriously, click on this picture to see it bigger, it’s so pretty.
I was going through some old photos today looking for natural movement examples for a digital library a colleague is going to put together. The Restorative Exercise™ classes have begun (Tuesday was the first of eight classes in this series, to be repeated on Saturday mornings) and we started with feet and will work our way up the body. So imagine several adults in a room trying to wiggle their toes independently! There was a lot of groaning and laughing and general disbelief that feet can do these movements. As one participant put so succinctly, “My feet feel like solid blocks!”
These are pictures of an 11 week old baby – yes, not even 3 months old. So you can safely say these are natural movements!
Here’s an example of hallux abduction – or moving the big toe away from the other toes:
And here’s an example of moving the baby’s baby toe away from the other toes (abductor digiti minimi):
Here we have big toe extension:
Note how the other toes are completely relaxed and the big toe lifts straight up.
We spent some time in the class rolling feet over balls to lift those pesky metatarsal heads and get our toe “knuckles” back where they should be. Here’s what a transverse arch looks like in an unspoiled foot:
Click on any of the photos to see them in more detail. This is not my child in the above photos. This is my baby (she’s 23):
I had a lovely long weekend trip to Montreal this past weekend – five hours by car. Fortunately I was the passenger so I could move around and change positions often. If I had to sit in one position for five hours there would be a lot of stretching stops!
I always travel with my trusty “squishy ball,” a small 9″ ball that is often utilized in Pilates classes but which I use barely blown up behind the small of my back. Along with my ball, this time I brought along my new Yoga Tune Up® balls. These were a gift from a Restorative Exercise™ colleague who also teaches Yoga Tune Up®. These were terrific!
I started by placing them in the bag and placing them high up on my shoulders, between the car seat and my back. Then I just sat back and my own body weight pressed the balls delightfully into the muscles along my spine. After a few minutes, I would lean forward a bit and the balls would roll down an inch and I would repeat this all the way down to the sacrum. Then I would work my way back up, using my hands to place the balls.
I also figured out how to do some various Restorative Exercises™ in the car. Here’s a few.
WARNING: you should not do the exercises with the feet on the dashboard in a moving car! Airbag deploy could cause serious injury!
Top of Foot Stretch: with bare feet (are there any other kind?), shove your foot against the front windshield where it meets the dash in a wedge. I did this one foot at a time.
Hard to see here but the top of my foot is right against the glass and it is creating that shape of my foot (called plantarflexion). (Yes, it rained a bit on the drive there. But we had perfect weather all weekend!)
Head Hang: Drop your chin to your chest for a minute (this one is NOT for the driver!).
Head Ramp: Here’s one the driver can practice too. Keeping your chin low, slide your head back until the back of your skull touches the headrest. Hold it there, opening the area between your neck and your skull.
Finger Stretches: as easy to do in the car as it is on the couch at home, or in the office.
Toe stretches and foot massages: Cross your foot over the other leg. Place your fingers between your toes and “hold hands with your feet.” There are many various toe stretches you can do to your own feet. You can also use your toe stretchers or special toe socks in the car obviously.
Squat prep: Put your chair all the way back. Place both feet against the dash. If you have a squishy ball, put it in the small of your back to help maintain the lumbar curve. You can do this one leg at a time as well.
Twists: turn your trunk in one direction and hold for a minute, repeat on the other side.
I tried to change my sitting position as often as I could. Basically, once you get rid of your soft chairs and passive seated postures, it’s pretty hard to sit in one position for long. Being “fussy” is a good thing. Don’t forget to take a big bottle of water in the car. It’s easy to forget to drink when you are sitting still for long periods, not doing anything. This has the added benefit of making husbands stop for pee breaks and you can stretch your legs.
Imagine how thrilled I was when I got to Montreal and discovered my Airbnb apartment had a standing workstation. The owner is a costume designer and had this table set up using a couple of big plastic containers stacked one on top the other, with a cork board on top! Perfect for google-mapping stores and restaurants.
Recently I had a very interesting client evaluation. A woman came to me with shoulder issues. I had a look at her the way she would normally present herself and saw very clearly that she carried one shoulder much higher than the other. I took her in front of the mirror and asked her if she could recognize this. The answer was a resounding yes, and she also noticed that with her arms hanging straight down by her sides, one arm was closer to her body, and the other had more space between it and the body. So it appears that she had a lateral translation of the rib cage.
So before I go on; ask yourself: what would you do to correct this? What tools do you use and would you feel comfortable applying to this person? She didn’t really have associated pain with this condition – it was more a feeling of fatigue. One side in particular felt overworked.
I’m pretty lucky in that I have a piece of equipment in the studio that is used for Pilates called a PediPull. This is a long pole attached to a base at the floor, and at the top there is a T bar where we hang springs. Ordinarily it is used to stand against and pull springs with the arms. Essentially it takes Reformer arms series to standing. This time however, I used the pole to help my client find centre.
I stood her up with her back against the pole and her feet out from the bottom enough that she could put some weight and lean into the pole for better feedback. (You could try this against a wall but I find with the broader surface, it’s more difficult to get the same feedback as the pole provides. I’ve also tried a corner where two walls meet, but the edge was too sharp for comfort.)
Once she had this tactile reference behind her, I asked her to find pelvic neutral by placing her three bony landmarks: pubic bone and two ASIS, in a vertical plane. Once that was accomplished, I then asked her to drop her bottom ribs until they were also on the same vertical plane as the pelvic bones. This brings the bottom ribs up against the pole so that the broadest part of the thoracic spine is in contact, and the ribcage is neutral in its relationship with the pelvis.
If this is too much to follow, please reference this excellent blog post by Katy Bowman on neutral pelvis, with very easy to see pictures of Katy with her ribs out of alignment, and in alignment with her pelvis.
Back to the client: once the trunk was aligned, her head of course was forward, but that’s okay! I wanted to assess her shoulder mechanics on a neutral trunk. We then did some simple stretches in place to get the arms a bit more externally rotated. This exercise was followed by a few more Restorative Exercise™ positions for the thoracic spine and then I repeated the pole feedback exercise.
Then the magic happened; I took the client back to the mirror and asked her to try and find the feeling she had against the pole. She arranged her pelvis and rib cage and we looked at her arms. They were level! She went away determined to repeat the exercises from the session a few times daily and return a week later.
So the moral of the story is: how can you evaluate what you are seeing if you don’t have an objective baseline from which to evaluate? Restorative Exercise™ is a great tool to differentiate what you are seeing from what is actually going on. The old model of strengthening the long side, stretching the short, is not going to fix the “problem” if the problem is underneath. For example, working on the trapezius would not level her shoulders if the trapezius was only responding to the rib cage presentation! Katy has a great analogy: there is a vase of flowers on a table. The flowers are all askew and uneven, so you take some time and re-arrange the flowers until they look perfect, only to then realize the table legs are not level!
So level the table, and then see if what sits upon it is really the issue.
As part of the basic stance in Restorative Exercise™, I ask my clients to “release your knee caps.” Usually this request is met with a raising of the eyebrows, which is an interesting response, but not the one that I desired. The knee cap (proper name: patella) is embedded in a tendon of the quadricep muscles and is known as a sesamoid bone.
There are four muscles in the quadricep group. They live on the front of your thigh, and one of them, the rectus femoris, runs from the front of your pelvis right down to your shin. That’s a long muscle. It crosses both the hip and the knee, and can influence both of those joints. The patella is embedded in the tendon of the converging quadricep group, and the tendon that continues below the patella to the tibia is your patellar tendon (or ligament, since technically it attaches bone to bone). So when this muscle contracts, the patella is pulled up, towards the hip. At least, that’s what it looks like. The muscles of the front of the thigh tense, and the knee cap is lifted. But it is not just lifted. The action of the line of pull of this muscle acts also to pull the patella back towards the front of the knee joint.
The patella can increase the leverage of this muscle group and also acts to protect the knee joint itself. Which is a good thing. But if the “quads” are always tensing, the patella is always held tightly against the front of the bones that make up the knee joint, resulting in friction on both the back side of the patella and the front of the joint, leading to osteoarthritis for example.
So it stands to reason that releasing this tension would be good for the long term health of your knee. But how is this done? It sounds easy enough to stop contracting a muscle, but the truth is, we are so short in this muscle, and we stand in a position where our pelvis is projected out in front of us (from years of sitting and wearing shoes with heels – even minimal heels) that the muscle is often stuck in the “on” position. So much so that when I ask someone to tune in and turn off, they can’t even begin to fathom where that ability comes from. Of course, not everyone is unable, but enough people are that it is worth a blog post, and those who don’t get it, really don’t get it!
Here’s a tip for learning the knee cap release: lean against a wall with your legs out from the wall and your feet shoulder width apart. The knees are straight. Keep your butt against the wall and lean forward so you can look down and see your knee caps, like this:
Because you are shortening the rectus femoris, you are more likely to get a knee cap release in this position. Then when your brain learns the motor program, you can try it standing. Eventually you want to be able to control your knee cap at will. Like this:
Well the NYC workshop is over, and a great time was had by all. New Yorkers are a curious bunch and it wasn’t long before the room was abuzz with chatter and people asking questions and demanding more information! It was very exciting and rewarding to work with so many vibrant people. Unfortunately, many questions were asked that I could not answer without speaking over a teacher, and I hope that those people will continue their search for answers on this and other alignment blogs, or contact me by email for any specific questions.
My colleagues and I broke the workshop up into “Introduction to Restorative Exercise™” and “Pelvic Floor Health and Birth Mechanics” portions. The workshop was four hours long in a midtown location.
I spent a few extra days in NYC to celebrate my birthday and explore Brooklyn, which I hadn’t done before. I thought it might be fun to share some photos. Walk of the week definitely has to be the Brooklyn Bridge! On Sunday my husband and I walked from Brooklyn Heights across the bridge, through Chinatown, Little Italy, over to the West Village and all around, back to the East Village and all around, to Milk Bar for B’Day cake truffles, subway to Williamsburg, and then walked all around Williamsburg.
Update on Zuuk shoes: I did all my NYC walking in the Zuuk shoes and they were comfortable, wore well and didn’t chafe. My only complaint would be that they were a little hot, but it was 94 degrees one day, so it wasn’t surprising.
The beginning of the bridge, from the Brooklyn side. (My husband in white in the centre of the photo.)