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Super Scapula! 5 Simple exercises working towards a pain-free upper body

8/27/2017

1 Comment

 
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Have you ever wondered why EVERYONE seems to have a sore neck and shoulders? It can manifest as shoulder tension, a stiff neck, that niggle between the shoulder blades, or the more severe rotator cuff issues.

There is clearly an issue with our modern society and the way we are using our upper bodies. Or NOT USING. Let's face it, we rarely use our upper bodies to undertake the movements we were designed for. We've traded climbing, throwing, hanging, swinging, and fighting type movements for desk jockeying, holding our steering wheel and working a mouse.

I will never forget the very large, very muscular ex-sportsman who said to me in dismay and embarrassment, "Mouse Shoulder? You're saying I have mouse shoulder??"

This post is for all of you that would like to introduce more functional ways of training your upper body for better mobility, less pain and increased strength...but are not sure where to start. Enviously watching ninja warrior while laying on your couch, wishing you kept doing those chin-ups you used to be able to do. Or just wanting to be rid of that headache from carrying around your child (who refuses to be more helpful than a dead weight) all day long.

These exercises are a fantastic starting point for anyone wanting to move better through their upper bodies, without having to bore yourselves with a "one muscle at a time" approach. Each exercise has a direct progression into a whole body, functional movement. Make sure you take the time to develop the movements and build strength in each direction before progressing.

**If you have pain in your upper body, please see your health care team before beginning an exercise rehab program. Nothing beats 1:1 care for pain and dysfunction, please contact the appropriate professional if you have pain or difficulty with any of these exercises.
Super Scapula 1: Getting Unstuck

A bit of mobility to start us off today, let’s get those shoulder blades moving and open your thoracic spine.

Hinge from the pelvis to bring your torso parallel to the floor, and find something steady to place your hands on: countertops or kids play equipment works great for this. Gently press your chest towards the floor for a lovely stretch, but if you have very mobile shoulder joints, think more about pressing down through your hands.

A: Slide your shoulder blades up and down (elevation/depression) your back. “Sticky” spots are ok to work through, if you get sharp pain in the shoulder joint, back off and/or stop the exercise. Work through 10-20 reps.

B: Inhale, press down into your hands to lift the chest, thinking of opening the sternum and collarbones (go easy on the neck). Exhale to lengthen the spine back to neutral. 10x
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Finish with another stretch, then return to standing, take a few deep breaths and notice the difference!
Super Scapula 2: Find your stabilizers

Find a bit of wall, and place your hands at shoulder height. We are going to mobilise the shoulder blades into protraction/retraction, (apart/together), and wake up an important muscle called serratus anterior (starts under the scapula and wraps onto the side of the rib cage). Be aware of pecs and upper traps trying to take over here.

Another key to finding the lovely stabilisers is to really focus on the contact of your hands on the wall. Spread your hands and feel each part of the palm and fingers connect into the wall.

A:
Keeping your spine straight and your elbows still, slide your shoulder blades towards eachother (chest moves towards the wall), and then connect into the wall to spread them apart (move your chest away from the wall). It’s a fairly small movement, don’t try to make it too big, do 10-20 here.

B: Wall push-ups – Keep the scapula neutral now (in the middle of the range) and focus on NOT moving them as you bend your elbows to come towards the wall, and connect into the wall to push away 10-20x.
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Make it harder: You can do each of these as a single arm exercise, which advances the core work as well. Use the same idea of stability when progressing into regular push-ups.
Super Scapula 3: Learn to Hang

You need something to hang on here. I’m using a gymnastics ring, but in an ideal world you have some monkey bars or a pull-up bar and get your hands shoulder-distance apart. 

Bring your legs forward and bend your knees, almost like you’re sitting in a chair under your arms, and take as much weight as you’re comfortable with into your arms.

Slide your shoulder blades down your back (head lifts and neck lengthens), then with control, let the shoulder blades slide back up towards your ears. 10-20x
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Make it harder:
If this is all feeling easy, stabilise one arm and core, exhale to take the opposite arm off for a few seconds before placing it back onto the ring. See what happens to the body when you support with one side vs the other.
Super Scapula 4: Crawling Prep

So this starts out the same as Day 2 (on the wall) except you’re on hands and knees. Spine stays still/neutral. If you have no idea what’s going on in your spine put a pool noodle or broom stick down the length of your spine (or get a helper to hold it here). 

A: Protraction/retreaction. Let the chest lower towards the floor without the elbows bending or spine changing (retraction). Connect your hands into the floor to spread your shoulder blades (protraction), just watch your spine stays neutral.

B: Thoracic rotation. Press one hand into the ground and protract so much that your other hand lifts off the ground and you rotate through your upper body. If you know your anatomy, really visualize the connection from serratus anterior, through to the obliques to get the rotation.
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C: (not shown) Push-ups. Stay on hands and knees (easier) or head to plank, keep shoulder blades stable and spine straight (no head dropping) for good push-up technique. If you cannot stabilize the shoulder blades like you did on the wall on Day 2, you are not strong enough YET in your stabilizers for the load you are placing on them. So reduce load (back to hands and knees or wall) and keep practicing!
Super scapula day 5: Single arm challenge

Sit with your knees bent to one side, ground your hand on the other side so it is in line with your bent knees (should be forward of shoulder joint). Keep your ribs lifted away from the ground, your torso should be on an angle.

A: Start with just the shoulder blade moving toward your ear, ground your hand to slide it down again. Spine and ribs should stay stable.

B: Tricep press up. Bend your elbow to lower as far as you can keep shoulder blade stable, ground the hand to press back up (keep shoulder wide, not popping forwards).

C: Still keeping the shoulder wide, ground the hand and knees, lift through the bottom side of the waist to come into a lovely side bend.

Go for about 10 of each or as many as you can maintain technique.

As you get stronger and can safely progress each of these exercises, try to have a play with the bigger movements every day; find a set of monkey bars, go across forwards or sideways; practice different crawling techniques; work on progressing that chin-up; play catch with your kids, alternating arms if you can. And remember that if you have to sit at a desk for much of the day, you really should be doing some of these correctives every day to bring a bit of balance back to your body.

Please get in touch if you have any questions about these exercises or movement-stuff in general.

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Enjoy and happy moving xx
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1 Comment

Protect your body while baby wearing: 3 back-saving tips

1/27/2017

4 Comments

 
​Babywearing, in case you are not familiar with the term, is the name we give to the act of strapping a child to our body with an (often) expensive device or strip of material. 

​For me, babywearing was an enjoyable pastime with my first child, and the only way to survive when the second was born.  I have no idea how people do the playground outings, out-and-about naps, or cook dinner during witching hour without wearing their babies.  It is a beautifully natural practice that is seen in many cultures throughout the world.  It can mean literal survival for the tribe-mum that needs to gather food, or the premature baby that thrives from the warmth of their mother's chest. For the rest of us, it is a way to bond, nurture, and cope with everything a new baby brings to our lives.
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Photo by Belle Verdiglione Photography, Birth and Motherhood Photographer - Perth, Australia
​As much as I love babywearing, my professional side has a few issues with this practice.  As an Exercise Physiologist and Pilates instructor specialising in everything pregnancy and postnatal, I see these issues daily with my mum clients. 

Our bodies go through a lot in the process of motherhood; we give birth or undergo major abdominal surgery to get the baby out, and then without any time to truly recover and rehabilitate (especially with subsequent children), we strap a growing weight to our body and carry it around for hours on end while doing non-body friendly things (like hefting a 3 year old into the shopping trolley).  The extra load can mean more work for the pelvic floor, and saying goodbye to healthy backs and necks.
​My kids were on the larger side, which made me so very greatful for having the body knowledge to manage any issues that came up. I was able to work through and rid myself of back pain, stop a migraine level headache before it got bad, and maintain pelvic floor function with the extra load.

I tell you this so you know it is possible to baby wear without doing damage to your body, and to empower you to prioritise your body as you raise your young. Back pain, weak cores and dysfunctional pelvic floors are common in early motherhood, but it doesn't mean that you have to put up with these issues.  

Here are a few simple tips that can help you continue to babywear and nurture your little human for as long as you both require. 

1.  Choose your carrier wisely

I will admit that I am nowhere near a babywearing expert, my expertise lies in the movement and alignment of the body.  So as a body expert, my first tip is to tell you to enlist a babywearing expert!
 
There are good carriers, not so good carriers, carriers that are good on some people’s bodies and not others, and so on.  The most important thing to realise is that everyones body is different, so you may not love the babywearing device that your friend loves, and your partner may need a different fit than you. 

Find something that works for you and your baby, and if you are struggling I would suggest two great resources:
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  • Local babywearing meet-ups and libraries (click here for Perth links)
  • Baby wearing consultants (some Perth experts: Piara Waters, Fremantle, Mandurah) 

A local Approved Babywearing Consultant, Francesca Candaten, was kind enough to share these tips for getting the right carrier and fit:
  • "Make sure you purchase an ergonomic carrier with wide padded shoulder straps to avoid them digging into your shoulders. The straps should also be adjustable so that the carrier can be fitted according to the wearer's body."
  • "To achieve maximum comfort and safety make sure the wrap or carrier is worn high and tight." 
  • "Avoid wearing the baby in a forward facing position. In such a position, the wearer's centre of gravity changes as the baby is not carried close against the wearer's body. This puts unnecessary strain on the wearer's back."
 
When baby wearing, it is also important to keep the variety principle in mind.  Your body and your baby’s body thrive when responding to a variety of different loads and forces. If you are going to babywear for 1+hours per day, it is ideal to have a few different carriers on hand, or learn a few different techniques with a woven wrap.  Doing the same thing all the time, or wearing a ring sling on only one shoulder, is where your body can get into repetitive issues. 

In my personal experience, I loved a more structured carrier for long outings, something secure around the hips to take weight off the shoulders, and a ring sling worn high and tight around the house.  I made sure to switch shoulders each time I used the ring sling, and would switch up devices each time my baby napped so he was in a slightly different position and the load to my body was altered.  Switching to back carries as soon as bubs was sitting independently also made a big difference, especially for longer walks or big trips around the supermarket.

To wrap up ;) use the experts to get the right fit and device; make sure you and your baby are getting the variety needed to keep your bodies happy; and listen to your body so that you know when it's time to take a break.  

​2.  Your alignment while wearing.

Ok this is a big one.  Life saver. Game changer.  And it applies to holding babies as well as carrying them.
 
When you are in good alignment/posture, your bones should effectively distribute the load throughout your body. Your pelvic floor should mirror your diaphragm, making it effective and primed to work. Your core muscles work naturally and efficiently, allowing abdominal separations to close. Pressure is well distributed through your system, again allowing ab separation to close and taking the load off of pelvic floor. So as you can see, standing in a good alignment is one of the keys to good postnatal healing.  When we add a load, such as in babywearing, alignment becomes even more important, but we often end up in our worst (default) positions.
The main tip to remember is: BACK YOUR BUM UP.
 
The picture on the left is how I often find myself standing (and I observe many mums doing it), especially when the baby is small, as your chest makes a nice pillow if you thrust your pelvis forward and tilt your ribcage back, but this is SO yucky on the body.  You are basically hanging off your ligaments, creating excess pressure in your abdomen (poor pelvic floor), straining your abdominal separations, and loading that lumbar spine. 
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All I’ve done in the righthand picture is backed my pelvis up over my heels, allowing my ribs to come forward and down.  Try backing the weight right into your heels, almost to the point where your toes lift off the ground, and you will get to a position where you feel like your bones are stacked and weight is distributed more evenly through the body.  This position takes the load off the pelvic floor, and puts your core into a position where it can work for you automatically.

Think about being wide through the shoulder girdle; so you are not letting your shoulders roll forward or consciously squeezing them together.  Your head should stack on top of the rest of your spine, but it may take some chest opening (see corrective exercise below and/or an amazing manual therapist) for this to happen effortlessly.   Your upper body muscles may have to do more work when you are maintaining good alignment, but it is the most efficient way for your body to carry load.

Good alignment should be effortless, not rigid and difficult, so have a play with these postural tips but try not to force your body into positions it is not yet ready for.  Most importantly, start to be mindful of what posture you often find yourself in, especially when you're getting sore and tired.

*This short video demonstrating good pregnancy alignment illustrates the same postural correction you need to make when baby wearing*

3. Corrective Exercise 
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At the end of the day, if you are going to be wearing or carrying your baby for hours on end, a few corrective exercises will go a long way to restoring balance in the body.  These are a few of my lifesaving exercises that I do everyday, I hope you enjoy them as much as I do. 
 
**If you are early postnatal or having pain/dysfunction, please see your healthcare team (GP, women’s health physio, etc) before commencing an exercise program **
 
Windmill Stretch
Goals: stretch chest, rotate/mobilise spine, restore breath.
  • Lie on your side with a pillow under head, knees bent up and both arms stretched in front of you.
  • Windmill one arm around in a slow circle keeping it in the same plane (parallel to floor), reaching up to brush your ear, and back towards the floor, allowing your ribcage to open towards the ceiling.  Try to keep your knees and pelvis stable. Feel the chest opening, but the goal here is not to get the arm to the ground.
  • After 3 windmill rotations, find the position that needs the stretch the most (should be felt in chest/arm not deep in shoulder joint), and hold here for 5 breaths, allowing arm and ribcage to breathe towards the floor.
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​Side Hang
Goals: stretch lateral line, restore breath to rib cage, alleviate neck pain.
  • Find something overhead you can just reach with one hand (monkey bars, top of door, etc).
  • Take the weight into that arm and very slightly lean in the direction of the arm that is holding on.
  • Depending on where you are tight, you can feel this stretch anywhere from the armpit/shoulder, down to the pelvis, and it will often feel different on each side.
  • Breathe into it, imagine the ribcage expanding like an accordion as you breathe, and melt those tight muscles.
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Hip Rolls
Goals: Spine moblility, pelvic floor/core strength, restore balance to body.
  • Lying on your back with knees bent (hold onto pillow/ball between knees), take a few breaths, allowing pelvic floor to contract on exhale and relax fully on inhale.
  • Start rolling towards a bridge position (picture below right), lifting only one vertebrae at a time off the ground.  Take as many breaths as you need, watch you don’t “pop” or over-lift your ribs at the top. Ground your feet into the floor to connect the glutes, and make the range smaller if you feel your back muscles doing too much work.  
  • Roll back down the same way, feeling each vertebrae make contact with the ground, relaxing completely at the bottom.
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Wear all the babies, they’re only small for such a short time, but remember to take care of yourself.  The whole oxygen mask on the plane thing, right?  If you have any questions or comments I would love to hear from you! Happy babywearing you super-mums.
 
If you want more:
  • Check out my Restore Your Core and Pelvic Floor: 30 Day Program.  We start the next group edition Sunday, March 5th, so get in quick! Full program link HERE, or try the first 3 Days Free!
  • Here's some more information on Diastasis Recti and Whole-Body Pelvic Floor Rehabilitation. 
  • Kanga-training is a fantastic option for baby wearers looking for group fitness, as all trainers are certified and knowledgeable about postnatal healing.
  • Nothing beats 1:1 care if you have pain or dysfunction.  See your local women's health physiotherapist or get in touch with me if you have questions.
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    Author

    Stacey Pine: Movement specialist, Exercise Physiologist, STOTT Pilates Instructor, Body nerd

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    Core Stability
    Diastasis Recti
    Movement
    Pelvic Floor
    Postnatal

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