Core Strengthening: The Wellness Station Way!

What is our core, what does it mean to have a strong core, and what are the best methods to achieve this?

Many of us associate the idea of having a strong core with the ability to stay active and independent as we age, maintain our balance, avoid injury, ease back pain, or perhaps maintain a trim waistline.

Although the idea of core strength is popular and highly sought after, what we are really after is core responsiveness: how efficient and with how much precision are our core muscles able to respond to the needs of our environment and our intentions. In other words, how well are our bodies able to do what we want them to do in a given situation?

This responsiveness depends on our neuromuscular system- the intricate connections between our brain, spinal cords, and muscles. It is crucial that this responsiveness includes all of the tiny muscles that connect each of our vertebrae, which are vital for dynamic stability, proprioception, and the ability to "change shapes" depending on the needs of the situation.

In the world of traditional physical therapy and fitness, the idea of core strength is often reduced to "core stability", and focuses on the ability to brace and hollow the abdomen. The general notion is that we must be able to keep our core very tight and rigid during movement, lest we injure our spines. This rigid stability utilizes the large, long muscles that travel up and down the spine, neglecting the tiny muscles in between each vertebrae. This is not how we function as human beings!

As we live in a three-dimensional world, our bodies need to be able to efficiently change shapes based on the situation we are in. By only training ourselves to keep our cores tight and thus restricting movement, we are behaving in a linear manner that is not conducive to our dynamic, three-dimensional world. Although this type of core engagement can be helpful in some situations (perhaps if a pet or a baby decided to crawl on our stomach!), far more often this approach is selling ourselves short and could actually put us at a higher risk of injury, pain, or limited function.

   Consider the example of a stack of blocks connected by elastic bands as referenced in our Ehlers Danlos blog post, illustrating the difference between segmental vs. rigid core responsiveness. The traditional approach to core stability is similar to the example in which the blocks are connected only by four long rubber bands, in which the vertebrae (like the tower of blocks) are undifferentiated and controlled using the large, long muscles of the spine. This would neglect the small muscles of the spine that allow us to move with efficiency, fluidity, and balance. Our approach at The Wellness Station reflects the example in which the tower is connected by smaller rubber bands in between each block, allowing the structure to form a variety of complex shapes and forms, representing segmental spinal responsiveness.

Our core is our spine- we need to be able to move our spine in the three dimensions. Flexion and extension, side bending, and rotation. Each of our many vertebrae are capable of movement, and our deep spinal muscles (including the transversospinales and the segmental muscles) allow this movement.

By engaging in mindful movement practices to target these muscle groups, we can strengthen our mind-body connection to these areas, thereby improving responsiveness of our core.

This is truly what core strength is- our ability to move our spines into different shapes efficiently, mindfully, and powerfully depending on our intention and the circumstance we find ourselves in.

Here are some examples of mindful movement drills that engage the body in three-dimensions, and target segmental movement of the spinal column. Enjoy!

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Movement, Physical Activity, & Exercise: Comparing and Contrasting

The terms movement, physical activity, and exercise are all related but have key differences that can be helpful to understand.

There are no clear boundaries between these terms, and a lot of the differences are semantic or contextual. Generally speaking, movement is the broadest umbrella category, physical activity is a form of movement, and exercise is a structured form of physical activity (see fig 1).

Every single one of us living organisms perform movement, although plants are not mobile, in that they do not move from one place to the other. They grow and move in response to the environment, typically through sensors that detect light and temperature. Those with a central nervous system, such as humans, likely developed our brains in order to become mobile. Movement allows us to seek novel environments, escape predators, seek food and shelter, procreate, and more.

As humans, our highly developed brains have bestowed on us a keen sense of self-awareness, which allows us not only to move but also to be aware of our movements, and consciously change our movement based on the situation and environment, as well as our goals and intentions. With this comes the ability to be aware of the quantity and quality of the physical activities in our lives, and to intentionally participate in exercise.

Figure 1

Exercise is a form of physical activity, but all physical activity is not necessarily exercise, unless you want it to be!

This difference is blurry, and involves self-awareness and mindset. Physical activity is defined as any movement of the body that requires energy expenditure, typically beyond the energy expenditure that would happen at rest. Even when we are lying down, sitting and relaxing, there is movement happening based on our position changes, baseline neuromuscular activity, and breathing. Once the energy expenditure increases beyond baseline, it can be considered physical activity. This could be as simple as standing up and  walking around, and could also include household chores, using the stairs, or hobbies such as gardening, painting, and playing an instrument. Exercise on the other hand is generally considered to be a physical activity that is planned, structured, and is carried out for a specific purpose, such as for the physical and/or mental health benefits (improved aerobic capacity, muscle strength, balance, bone density, mood boost, weight loss, and more). 

In our current state of affairs, intentional exercise has become extremely necessary to counteract the conveniences of modern life in which we are living less variable and more sedentary lifestyles. We are spending more time inside interacting in a two-dimensional world (screens), driving everywhere instead of walking, working sedentary desk jobs, and eating hyper-palatable processed foods that are delivered to us on a silver platter. Compare this to the lives of our ancestors who lived within the context of a natural environment, hunted and gathered their own foods, walked to all destinations, and performed physically demanding daily tasks that were not buffered by the technological advancements of our times. We have to intentionally exercise to maintain and improve our health and fitness. Because of this, for many, exercise has become a chore, a checklist item that we should be doing. 

Achieving Optimal Health and a more Joyful Life

How can we change our mindset to seamlessly bring about greater health benefits from what we are already doing?

One way is to recognize the physical activity that you are already getting in your life, and get excited about the health benefits that it can bring about! Taking the stairs? What a great opportunity to tune into your body mechanics and develop strong legs to support your joints. Gardening? Think of all the strength and mobility you can develop from all of that squatting, bending and lifting. Doing chores? An excellent way to sneak in some low intensity aerobic activity. Better yet, play some fun music while you do the chores to help feel some rhythm in your body. 

But why would changing mindset make any difference?

Considering these daily tasks to be exercise might help to promote a greater attentiveness to your body during these activities, and can also promote confidence in your ability to be an active person. Benefits can also occur via the placebo effect, meaning that simply by believing that what we are doing is helpful, it will become more helpful!

Consider Langer’s (2007) study, in which a group of 84 hotel maids were assessed on physiological variables that can be affected by exercise. Most of the maids did not intentionally exercise outside of their jobs, and believed that they did not get nearly enough exercise based on the recommendations for health benefits. The researchers split the maids into two groups, an experimental and a control. The experimental group was educated on how their jobs were extremely physically active, and they were actually getting more than the daily recommended amount of exercise for an active lifestyle, whereas the control group was not given this information. After four weeks, the physiological measures were reassessed, and while the actual behavior did not change, the experimental group experienced statistically significant improvements in blood pressure, weight, body fat, waist-hip ratio and more. Simply by believing that what they were doing was helping their health, their physiology actually changed.

In addition to recognizing that what we are already doing can be beneficial, consider questioning your relationship with exercise further. If exercise is a chore that you have to make yourself do, it is crucial to flip the switch. You might even forget the word exercise if it brings about a negative reaction within you. Find a physical activity that you truly enjoy, regardless of whether you feel like you should or should not be doing it. Remember that movement is what makes us alive, and choosing to move is what makes us human. Move just for the sake of moving, which is the best gift you can give to your entire self.

At the Wellness Station, you might have noticed that your practitioner probably does not tell you to exercise more, as that language could perpetuate the you should be doing this narrative. Rather, we encourage clientele to develop a positive relationship with movement through intentional practices as well as a lifestyle that is biased towards being more physically active. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

https://pubmed.ncbi.nlm.nih.gov/17425538/

Posture Part II: Strategies for Improvement

On a previous blog post titled Posture: Does it Matter?, we discussed some of the nuances of posture, breaking down “good” and “bad” posture related to both psychosocial and biomechanical/physiology principles, how the dynamic nature of posture might be more aptly named as acture, and what factors could potentially influence a downward spiral into inefficient postural tendencies.

With a more clear idea of what posture is and is not, we can now discuss some practical ways to improve our posture from the inside out as well as the outside in.

Many of us with postural issues require hands on, neuromuscular training facilitated by a professional to help to relearn efficient movement patterns from the ground up. However, there are also regular strategies that all of us can bring into our daily lives to help enhance our postural awareness, comfort, and prevent issues arising from our habitual posturing.

Change Positions, Move Often

We have the wonderful ability to choose what posture is best for us in any given situation. Sometimes being in more of a flexed position will be desirable, sometimes being more upright will be desirable. Consider cycling between three or four shapes throughout the day rather than always trying to find one “correct” position. What works for us in one moment will not be the best choice in another, and what works best for one person will not be the same as what is best for a different individual. When a specific posture is desired for a prolonged period of time, consider what will allow for the greatest sense of comfort, ease, and support. Notice what your ease of movement is when you are turning and reaching for things, trying to find a position where you can have more freedom of motion. Generally speaking, the most efficient posture will be an upright carriage in which the bones of our spine are stacked, so each bone is able to receive support from the bone that is beneath it.

Another strategy is to move more often throughout the day, establishing a system of movement breaks, stretches and short walks throughout the day. By dynamically changing the length, tension, and blood flow into a variety of tissues, it is less likely that any particular area will get sore, tired and overworked, and less likely that habitual postures will become an issue over time. See our Movement Snacks blog for some ideas on how to bring small movement breaks into the rhythm of your daily routine. A regular, well-rounded fitness routine will also help, which might include a blend of activities that promote cardiorespiratory and musculoskeletal health (e.g. aerobics, strength-training, yoga). Additionally, here are some gentle yoga stretches that you could do throughout the work day-

Consider putting up sticky note reminders to move, stretch, walk around, and change positions throughout the day.

Tips for Finding Effortless Sitting Posture

The following description includes some tips for sitting ergonomics to help support an upright carriage. While most people find these strategies to be helpful and comfortable, keep in mind that one size does not fit all.

• Feet flat on the ground

• A chair with some degree of firmness, with hips at least as high as knees.

• Back support behind low to mid back. A partially deflated children’s ball, folded towel or blanket, or any other object that is comfortable can provide this support

• Head on top of rib cage, rather than significantly protruding forward. Vision and size of text on the screen can play into a forward head tendency, so check that you can see the screen well without craning your head forward. 

• It may be helpful for your screen to be directly forward of eye level, rather than higher or lower.

Enhance body awareness

If we are not aware of our body position, we have much less ability to change it. To further enhance your ability to feel and sense your posture and choose efficient options, consider regularly practicing embodied practices such as yoga, qi-gong, tai chi, body scans, and Feldenkrais lessons, which will help improve postural awareness. Becoming familiar with some “landmarks” of our body can be helpful, such as awareness of where on our pelvic bones we are sitting, where on our feet we are standing, where our chest bone, nose, and eyes are oriented towards. Some lessons that may be helpful for posture that most Wellness Station clients will be familiar with are the pelvic clock, easy turning, and shoulder elevators. Here is an example of the pelvic clock lesson to help you bring a better sense of ease and awareness into your sitting posture. 

To become more aware of your standing posture and ability, use a protruding corner in your house or a door frame to feel the back of your body. Stand against the corner or the edge of a door frame with knees slightly bent, feet slightly in front. First, get a general sense of how much of you can make effortless contact with the edge from the back of your pelvis to the back of your head. Then, tuck your pelvis under so your low back makes contact with the edge. Keep your low back in contact with the edge, as you try to bring your mid and upper back in contact with the edge. Roll your upper back up and down the edge a few times, keeping your low back in firm contact. How much of your upper back can easily contact the edge? Bra strap level? Top of shoulder blades? Regularly checking this can give you a sense of your posture and any changes over time that might be occurring in your ease of effortless stacking.

Ask your Wellness Station practitioner to provide you with additional lessons to help enhance your senses with consideration of your individual needs, limitations, and goals.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:

1. Image address:

https://centr.org/images/article/Back_exercises-2.jpg

The Importance of Unilateral Exercises

Most movements can be divided into two categories: unilateral or bilateral. Unilateral exercises are asymmetrical, in which one side of the body (e.g. one leg) is performing an action that the other side does not. Bilateral exercises are more symmetrical, in which both sides of the body are doing roughly the same thing. Both types of exercises are important and functional, but unilateral exercises will facilitate certain benefits that cannot be obtained from bilateral exercises alone. Some examples of unilateral exercises are: reverse lunge, single-leg bridge, single-arm overhead press, split squats, and single-leg deadlift. Examples of bilateral exercises include a squat, deadlift, barbell overhead press, push up, and bridge. In real life, we engage in both types of movements extremely often.

But, because life is rarely symmetrical, unilateral exercises tend to be more relevant to daily life.

Standing on one leg to pull your pants on. Reaching for the glass on the top shelf. Walking. Running.

Bilateral and unilateral exercises both serve a crucial role in functional fitness. While more force and power can be created with bilateral exercises, unilateral exercises require greater balance and stability. They can bring awareness to compensations and imbalances between sides of the body that can easily be overlooked during bilateral movements.(1)

For example, if one has weakness in the left leg characterized by a difficulty in distributing and generating forces, maintaining balance, or moving through a functional range of motion under load, a unilateral exercise will make this extremely clear. If one only ever did regular, bilateral squats, the right leg would continue to overwork, perpetuating a compensatory pattern that could contribute to issues down the road. While we should not expect that our two sides should be equal in their ability, it is helpful to be aware of our unique characteristics and engage in movements that will provide a stimulus for positive adaptations to occur. 

It is important to recognize that with most unilateral, “single leg” exercises, both of your legs continue to carry out an important job. Put simple, one is the mover, and one is the stabilizer. Contrary to what might be evident visually, it is the leg that is not moving that actually has the more difficult job. One leg is weight-bearing, and one leg is non weight-bearing (or bearing less weight than the other leg). The leg that is holding our weight is responsible for maintaining our balance and control of the movement, while the other leg is free to move through space. Consider walking. At each moment in time, one leg is holding your weight, foot on the ground, allowing you to move your other leg forward. By becoming more aware of where we are holding our weight, and which leg is free to move, we can refine our coordination, balance, and efficiency of movement. 

Mime Walking Example

Mime walking is a standing movement lesson that almost all Wellness Station clients learn early on. Many of us begin to have difficulty gliding our pelvis to shift our weight, which can be evident from a forward-flexed posture, short step length, and difficulty standing on one leg. This lesson helps to bring about greater elegance and ease to walking by teaching awareness of weight shifting from one leg to the other. The basic idea is to glide the pelvis to one side (e.g. right) so one leg holds your weight while the other leg lightens up, and then repeat on the other side. Once this concept is learned and felt in the body, countless variations and progressions can emerge that will translate into improved function and ease of walking.

Single Leg Stand to Reverse Lunge

To further progress mime walking, we can apply this motion into a single leg stand. We become aware that one leg is holding us up and controlling our movement and stability, while the other leg is free to move through space. Applying this into a single leg stand to reverse lunge flow is a dynamic way to improve balance, strength, and awareness of our differences from side to side. 

If lacking in steadiness and ease, gently hold on to a support surface with a hand (put your hands in the kitchen sink!), or don’t move the non weight-bearing leg through such a large range. 
If more challenge is desired, move in slow motion, increase the range of motion of the non weight-bearing leg, and/or hold a dumbbell.

Sit to Stands and Squats: Unilateral Bias

A basic squat or sit to stand movement can be changed to have a unilateral focus by holding more weight through one leg intentionally. Coming up onto the tip toes of one foot is a way to do this. 

If lacking in steadiness and ease, use a higher chair, and/or don’t come up as high onto the tip toes (keep more of the non weight-bearing foot grounded). Or, hold on to the kitchen sink as you do this motion. 

If more challenge is desired, use a lower chair or squat through a deeper range, move in slow motion especially on the way down, hold a dumbbell at the chest, or even practice hovering the tip toes off the ground. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Sources: 1 https://www.self.com/gallery/single-leg-exercises

Effort vs Discipline: Creating a Sustainable Home Exercise Program

A sustainable movement practice is not about doing easy things- it’s about making difficult things easy, and even elegant.

Think back to a time where you may have had difficulty with the sustainability of your home exercise program. Perhaps you attended physical therapy for a while, but would not find time to practice your exercises at home. Or you did for a while, but after stopping therapy, the exercise routine started to fade away. Maybe you found you lacked the discipline or the motivation to perform the exercises regularly.

On the other hand, perhaps you had an exercise routine that was simply too much. You put in excessive effort into it, and you found that it was energy-draining, and perhaps actually felt worse after doing the exercise rather than better, and eventually you began to avoid it. These kinds of routines are not sustainable- they do not last over time. 

What are some keys to creating a sustainable routine to maximize the therapeutic effects? Finding the balance between effort and discipline is very important. We want to have discipline- the ability to train ourselves in a consistent, habitual way. However, we don’t want our movement routine to be overly effortful. If we put in too much effort into the movements, we won’t look forward to doing our routine, because it will drain our energy and not be very enjoyable.

You may recall that Feldenkrais-inspired movement lessons emphasize whole body coordination and thus the same action is now accomplished with LESS EFFORT -that is why, especially to children, highly skilled athletes make very difficult activities look easy!

Rather than striving for a strict discipline in which we force ourselves to go through effortful motions, how can we develop a sense of playful discipline, in which we regularly engage in enjoyable movements?

One mantra to consider is a little bit, very often, with ease. It can be difficult to develop a consistent routine in which we are engaging in movement very often. Some helpful strategies could be creating a safe space to dedicate to movement at the same time every day, perhaps first thing in the morning. This may start out as a very short time, five or 10 minutes, and may gradually expand as it becomes more habitual. Gentle movements should also be sprinkled throughout the day, especially during prolonged sitting. One might consider a reminder system such as a phone timer for a brief movement break each hour, or putting up sticky notes near the computer screen. After the initial growing pains of establishing these lifestyle habits of moving very often with ease, positive habits will be formed that will make it much easier to sustain these changes over time. 

An excellent way to build discipline and improve motivation is to focus less on the outcome, and more on the experience. For example, consider healthy eating habits. One strategy is to educate people on how terrible sugar is for you, and all the health benefits of green vegetables. This strategy actually might not be that helpful because it focuses too much on what we should and should not do. However, most of us have a tendency to crave things that perhaps we would be better off without. Only engaging in things we “should” be doing can be draining on our will power. A better strategy would be to fully engage in the experience of a positive health behavior. Take time to slow down and enjoy that delicious veggie bowl. Consider all the nutrients that soaked in from the soil and sunlight, the stunning visual of all the colors, the smooth or crunchy textures, the explosion of tastes in your mouth, and the embodied sense of nourishment after giving your body the building blocks it needs.

Now, apply this to movement! Try not to force yourself to do something just because you think you should be doing it. How can you fully experience the movement? What sensations can you feel? How might it be nourishing your tissues? What can you learn about your body and your tendencies while engaging in movement? What can you have gratitude for in regards to how your body functions? How might this impact the quality of your experience and your relationship with healthy movement practices- and your whole self?

Rather than striving for a strict discipline in which we force ourselves to go through effortful motions, how can we develop a sense of playful discipline, in which we regularly engage in enjoyable movements?

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team