January 17th, 2012 3:58pm - Posted By: Adam St. Pierre
Lately in the running biomechanics lab we’ve seen a lot of “running” injuries that are directly related to posture. I put the word running in quotation marks to signify that these injuries, although manifested during running, are not caused by running. Running, which magnifies stress, is just the straw that broke the camel’s back. Poor running posture can result in increased injury risk for your back, hips, knees, ankles, and feet! Additionally, each month, we fit many cyclists to address posture related issues. A poor cycling posture can result in excessive pressure on the hands/arms/crotch, increased neck and back pain, as well as decrease power production and performance. Outside of the sports science lab, many of our physical therapy patients are seen for low back, shoulder, neck, arm and hand pain resulting from poor posture.
I hope you are now open to the power of posture and are asking yourself, “what is good posture?. Luckily for athletes and non-athletes a like, “good posture” is the same for everyone! Good posture entails a neutral spinal and pelvic alignment. Because the spine naturally has curvature it is not optimal to have a straight spine. A neutral spine entails having the amount of curvature that you are supposed to have; no more no less.
Many people who spend time sitting at a desk all day have developed excessive curvature of the thoracic and cervical spine. The resulting “hunched forward over the keyboard staring at the screen” position is not healthy and can lead to improper function of the arms and neck. Over time the muscles of the chest (primarily the pectorals) get shorter and tighter and the muscles of the back (latissimus dorsi and trapezii) get longer and weaker. Doing a simple rowing exercise can strengthen your back muscles, while stretching and massage of the chest muscles will help them to elongate. Ensuring that these muscles stay balanced as well as focusing on correcting the hunched sitting posture that so many of us use throughout the day can help to prevent problems with the upper torso and arms.
Lower back issues tend to be more related to the position of the pelvis, which is directly related to the amount of curvature in the spine, particularly the lumbar spine. When working with athletes and patients I frequently refer to a “neutral pelvis”. To get a feel for a neutral pelvis, try this simple exercise:
•Stand up and place your hands on your hips.
•Imagine your pelvis as a bowl.
•Tip the bowl forward so water spills out the front, tip the bowl backwards so water spills out the back
•Settle into someplace in the middle where no water spills out.
You can also do pelvic tilts while sitting or lying on your back. While lying on your back, rotating your pelvis forward will lift your low back off the ground while rotating it to the rear will press your low back against the ground. Interestingly, by pressing your low back against the ground, your lower abdominal muscles will be activated: this is a great position to do any abdominal strengthening that involves lifting your legs off the ground. Otherwise, if your back is allowed to arch, excessive load can be placed on your lower back resulting in back pain.
Neutral pelvis is important for anybody who sits, walks, or stands, and is especially important for athletes. During cycling, neutral pelvis allows you to utilize your gluteeus muscles to produce power. Your glutees provide a significant amount of your power on the bike. Having too much anterior or posterior pelvic tilt may result in less than optimal power production. Try this exercise. Set up your bike on a stationary trainer. Ride at a set wattage for 5 minutes while tilting your pelvis as far forward as you can, then ride 5 minutes with your pelvis tilted posteriorly, then try 5 minutes with a neutral pelvis. You will notice that it is easiest to maintain the wattage with a neutral pelvis. Improper pelvic alignment can also strain your lower back and/or hamstrings while cycling.
When sitting in a chair, proper spinal alignment has your ears over your shoulders, which are in turn over your hips. When cycling, in order to reach the handlebars you have to have to tilt forward. Your ears, shoulders, and hips should still be in a line, but this line is no longer vertical. This means a neutral pelvic alignment will actually be rotated forward with respect to the saddle. This should press your sit bones firmly into your saddle. Unfortunately, due to a poorly fit saddle, this rotated forward position may result in excessive pressure on soft tissue. Often, this causes individuals to rotate their pelvis rearward in order to relieve the pressure. Instead, however, they should have sought another saddle that adequately supports their sit bones and allows them to assume the proper position.
We see many runners with excessive anterior (forward) pelvic tilt.
This often goes along with excessive amounts of forward lean or an excessively long stride.Too much anterior pelvic tilt puts stress on the lower back and can lead to a variety of dysfunction including pain and impingement of the nerves leading from your spine to your legs. Additionally, because this position inhibits the function of the glutes, it may also impede performance and cause injury. Without the glutes, your upper thigh is free to rotate inward, resulting in excessive pronation of the foot and a valgus (knock-kneed) knee position. No amount of stability at the foot will correct for weak glutes! When physical therapists talk about glute strength, they are generally referring to the gluteus medius. The gluteus medius controls the alignment and rotation of the upper thigh and is chronically weak in runners and cyclists (which is often directly related to knee pain during these activities). Strengthening of the gluteus medius requires lateral motion. There are some very simple exercises to work your glute medius using a circular thera-band. Clams, Monster Walks, and Hockey are some of my favorites. While not directly related to posture, these exercises are worth mentioning!
To conclude, good posture is the neutral alignment of the head, spine, and pelvis. When standing, your ears should be over your shoulders, your shoulders over your hips and your hips over your feet. When sitting the same is true, minus your foot position (obviously!). When running you should maintain the relationship between your ears, shoulders, hips, and feet, but the entire line leans slightly forward (key word is slight). The same is true for cycling, excepting the feet again. Maintaining a good posture throughout daily life will help you to avoid pain and dysfunction of your arms, legs, and back. It will also allow you to get the most out of your workouts, while keeping injury and discomfort risks at a minimum. In addition to strengthen back and core muscles while stretching chest muscles; check your posture frequently throughout the day. Often times just thinking about proper postural alignment is enough for you to maintain good posture.
Posted in: Biomechanics
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