How You Can Improve Your Posture

A 20-year University of London study looked at over 4,200 men aged 40-59 and found strong correlation between losing height and mortality. The authors speculated that slumping over postures caused a physical restriction of breathing which significantly increased risk of cardiovascular disease, stroke, and respiratory mortality. Link: pubmed.gov National Library of Medicine – Height loss in older men: associations with total mortality and incidence of cardiovascular disease . Women with a jutting forward head posture were found to have almost half again the risk of dying during the course of one 4-year study. Link: pubmed.gov National Library of Medicine – Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study . Looking at posture can give a tremendous amount of information about how a body is working. Link: pubmed.gov National Library of Medicine – Implications for the use of postural analysis as a clinical diagnostic tool: reliability of quantifying upright standing spinal postures from photographic images . Research shows evidence that poor balance and poor posture can result in pain conditions. Link: pubmed.gov National Library of Medicine – People with chronic low back pain have poorer balance than controls in challenging tasks . “The frailty of old age is largely reversible.” Rowe, J.W., and Kahn, R.L. (1998) Successful Aging. New York, NY: Pantheon, p. 102. Link: Cambridge University Press John W. Rowe and Robert L. Kahn. Successful Aging. New York: Pantheon Books, 1998 American Pediatrics Association, Media and Children: ( https://www.aap.org/en-us/advocacy-and- policy/aap-health-initiatives/pages/media-and-children.aspx ) – Recommendations by the American Pediatrics Association to reduce the amount of time children spend in front of screens per day. Armijo-Olivo, S. (2006) The Association Between Head and Cervical Posture and Temporomandibular Disorders: A systematic review. Journal of Orofacial Pain – A systematic review of the literature regarding head postural presentations and temporomandibular joint dysfunction. Chansirinukor, W. et al. (2001) Effects of backpacks on students: Measurement of cervical and shoulder posture. Australian Journal of Physiotherapy 47(2) – Research study demonstrating the correlation of heavy backpacks and decreased craniovertebral angles of children. Forward head posture is related to heavy backpack carriage based upon load and time spent carrying the load. Correa, E. et al. (2007) Efficacy of physical therapy on cervical muscle activity and on body posture in school-age mouth breathing children. International Journal of Pediatrica Otorhinolaringology 71(10) – An evaluation of correcting posture and breathing exercises to improve mouth breathing in children. Cuccia et al. (2008) Oral Breathing and Head Posture. The Angle Orthodontis 78(1) – Study demonstrating the difference in head postural presentation of children who have oral breathing respiratory patterns. De-La-Liave Rincon, A. et al. (2009) Increased Forward Head Posture and Restricted Cervical Range of Motion in Patients With Carpal Tunnel Syndrome. Journal of Orthopaedic & Sports Physical Therapy 39(9) – Study demonstrating the correlation of forward head posture and decreased range of motion in patients who present with carpal tunnel syndrome. Fejer R, Kyvik KO, Hartvigsen H. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2004;15:834–848. – The results of their study showed that patients with neck pain typically have more forward head posture while in the standing position. Fernandez-de-las-penas, C. (2006) Forward Head Posture and Neck Mobility in Chronic Tension-Type Headache a Blinded Controlled Study. Cephalgia 26(3) – Research demonstrating the correlation of a decreased craniovertebral angle and chronic tension-type headaches. Hansraj, K (2014) Assessment of stresses in the cervical spine caused by posture and position of the head. Neuro and Spine Sugery #593 – Study that demonstrates forward flexion of the head (as if to check a text message) increases the weight of the head dramatically in comparison to a neutral spinal presentation. Ho Ting Yip, C. (2008) The relationship between head posture and severity and disability of patients with neck pain. Journal of Manual Therapy 13(2) – Patients with smaller craniovertebral angles have greater forward head posture. The greater the forward head posture, the greater the neck pain disability. Houghton et al. (2015) Virtually Impossible: Limiting Australian Children and Adolescents Daily Screen Based Media Use. BMC Public Health 15(5) – Research study demonstrating the overuse of “screen time” by children in Australia. The utilization of screens exceeds the healthy recommendation of 2 hours per day by the American Pediatric Association. Jung-Ho, K. (2006) The Effect of The Forward Head Posture on Postural Balance in Long Time Computer Based Worker. Annals of Rehabilitation Medicine 36(1) – Research study showing the correlation of forward head posture in computer workers and the demonstration of balance disturbance. Kim, M. et al. (2008) Changes in neck muscle electromyography and forward head posture of children when carrying schoolbags. Ergonomics 51(6) – This study measures variations of muscle stimulation on EMG with the utilization of different styles of backpacks. Makofsky, H (2000) The influence of forward head posture on dental occlusion. Journal of craniomandibular practice 18(1) – A well established premise in the field of craniomandibular and cervical spine orthopedics is that forward head posture adversely affects mandibular position and therefore dental occlusion. Nejati, P. et al (2015) THE STUDY OF CORRELATION BETWEEN FORWARD HEAD POSTURE AND NECK PAIN IN IRANIAN OFFICE WORKERS. International Journal of Occupational Medicine and Environmental Health 28(2) – This research study demonstrates the correlation of poor posture in office workers and the increased prevalence of pain among workers with forward head posture. Ohmure, H. et al (2008) Influence of forward head posture on condylar position. The Journal of Oral Rehabilitation 35 (11) – A study measuring the correlation of forward head posture and TMJ disorders due to postural differences in symptomatic and healthy individuals. OSHA publication 3125 ( https://www.osha.gov/Publications/osha3125.pdf ) – OSHA publication demonstrating the prevalence of posture-related missed days of work. Raine S., Twomey L. T. Head and shoulder posture variations in 160 asymptomatic women and men. Phys Med Rehabil. 1997; 78: 1215-1223 – A research study showing the significance of head, cervical, and shoulder postural distortion patterns. Silva A. G., Punt T. D., Sharples P., Vilas-Boas J. P., Johnson M. I. Head posture and neck pain of chronic nontraumatic origin: A comparision betweeen patients and pain- free persons. Phys Med Rehabil. 2009; 90: 669-674 – A postural comparison study of asymptomatic patients and patients presenting with chronic neck pain. Szeto, G. (2002) A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. Applied Ergonomics 33(1) – Subjects demonstrated an approximately 10% increase in forward head posture from their relaxed sitting postures when working with the computer display. Zepa, I et al. (2009) Associations between thoracic kyphosis, head posture, and craniofacial morphology in young adults. Acta Odontologica Scandinavica 58(6) – Study demonstrating that patients who present with a hyperkyphotic thoracic spine have an increased atlantocervical angle.

The Real Causes of Poor Posture: More Than Just Injuries or Defects Often, when we think about poor posture, our minds immediately jump to physical injuries or congenital defects. While these certainly can contribute to postural problems, they are not the primary culprits in the vast majority of cases. Rather, poor posture is primarily a result of poor postural habits that we develop over time. This may be shocking to some, but it’s the reality that most of us face. Poor Postural Habits: A Closer Look Let’s take a closer look at some common poor postural habits: Slouching while standing or sitting: This habit forces the spine into an unnatural position and puts extra strain on the muscles and ligaments that support it. Forward head-leaning habits: Jutting the head forward to stare at a technical device (computer, cell phone, digital gaming device, etc.) places additional stress on the neck and upper back, leading to chronic pain and discomfort. Sitting for extended periods of time: Our bodies weren’t designed for prolonged sitting, and this can lead to muscle imbalances, weakened core muscles, and eventually, poor posture. Crossing the legs while sitting: This position can cause an imbalance in the pelvis, leading to alignment issues that resonate throughout the body. Standing with weight on one leg or shifting weight between legs: These habits can lead to imbalances in the muscles and may strain the lower back and hips. Weak standing posture – butt sticking out and/or belly protruding: This improper alignment may cause an unnatural curvature in the spine, leading to chronic back pain and other issues. Standing with knees locked in hyper-extension: This can put undue stress on the knees and lower back, leading to long-term damage. Sedentary lifestyle: Lack of regular movement and exercise weakens muscles and reduces flexibility, contributing significantly to poor posture. Addressing the Root of the Problem Understanding that poor posture is mainly a result of habits, not injuries or defects, empowers us to take control of our own health. We have the ability to change these habits and, in doing so, improve our posture. Here’s how I, as a Holistic Structural Therapist, can help you:  Assessment: Identifying the specific habits contributing to your poor posture allows us to target those areas with specific exercises and therapies. Education: Teaching you about proper posture, alignment, and ergonomics to empower you to make better choices daily. Personalized Treatment Plans: Creating a plan tailored to your unique needs and lifestyle, incorporating various techniques such as Trigger Point Therapy, Active Release, and more. Ongoing Support and Accountability: Regular check-ins and adjustments to your plan, ensuring that you stay on track to reach your goals. Conclusion Poor posture is not a life sentence. It is often the result of simple daily habits that have become ingrained over time. The good news is that habits can be changed, and with commitment, guidance, and personalized support, you can transform your posture and improve your overall well-being. Are you struggling with poor posture? Let’s work together to identify and change the habits holding you back. Reach out to me, Chahna, your Holistic Structural Therapist, and let’s embark on a journey towards a healthier you.

If you have ever been treated to a 60- or 90-minute massage and were told that you received a full-body “deep tissue massage”, either you or your massage therapist may have been seriously misinformed. The term “deep tissue” is probably the most over-used and misused term in massage therapy. “Deep Tissue” implies that the therapist will be penetrating into your muscle tissue, working IN BETWEEN your muscle tissue fibers – something that is impossible to accomplish with broad, gliding strokes over relaxed muscles. In fact, a thorough, full-body “deep tissue” massage would take several hours to several days to accomplish, regardless of the technique being used, and is not recommended for beginner massage recipients due to the large volume of toxins released during such a lengthy, aggressive process. Many will argue that true Deep Tissue techniques aren’t really “massage” at all because the client doesn’t get to relax until after the treatment is finished. In many cases, the treatment more resembles Physical Therapy than Massage Therapy, as the client is often required to participate by doing a good deal of the work. There are five primary techniques for accomplishing “deep tissue” between-the-muscle-fibers manual therapy: Active Motion: In this technique, the client is working with the therapist in order to flex and stretch the muscle being worked as the therapist is applying firm pressure on it. When the client flexes a muscle, the fibers spread and the therapist can wiggle in between the muscle fibers; when the client stretches or relaxes the muscle, it softens to allow the therapist to sink in a little deeper. The continuation of this alternating flex and relax/stretch allows for the most effective and painless penetration of the muscle tissue possible. Each muscle pair (the same muscle on both sides of the body) may take as long as 15-20 minutes to work efficiently, but can be lightly worked in as little as 5-10 minutes. Rolfing, Active Release, and Rossiter Stretching are examples of this type of deep tissue manipulation. Passive Motion: This technique is similar to the Active Motion technique, except that the therapist is working the muscle with one hand and moving the body part being worked with the other hand. This technique is much more relaxing for the recipient, but is much more taxing for the therapist. A full-body treatment using this technique by a single therapist is nearly impossible, unless your therapist looks something like Arnold Schwarzenegger. Conventional Myofascial Release (not to be confused with the John F. Barnes holistic approach) is one example of this type of deep tissue manipulation. Static Pressure: In this technique, the therapist is using thumbs, fingertips and even elbows to apply firm pressure to individual points on a muscle. In order to encourage the muscle to relax and allow penetration in this technique, it is necessary for the therapist to move very, VERY slowly, or not at all. One individual muscle may take as long as 20 minutes to cover sufficiently, and this technique often causes bruising and discomfort. Trigger Point Therapy is one example of this type of deep tissue manipulation. Muscle Stripping: There are at least two variations of Muscle Stripping: Rapid and Slow. Rapid Muscle Stripping is the most aggressive and painful of the techniques discussed here, but may also produce the fasted result in extreme cases such as chronic pain conditions caused by incorrectly-healed or untreated past injury. In this technique, the therapist is using knuckles or elbows to firmly and rapidly “strip” the muscle while the client is breathing deeply and performing a rapid stretching movement with the body part being treated. It is recommended only in extreme cases, or when a rapid result is desired. In Slow Muscle Stripping, the therapist is using thumbs or elbows with very slow, firm, deep movements. Negative Pressure: This technique involves the use of suction cups applied to the body, which causes the muscle fibers to expand and separate, as opposed to traditional pressure-strokes used in mainstream massage which compress the fibers together. By expanding the muscle tissue, it allows for additional space within the muscle for lactic acid and other toxins to flow and be released from the tissue more completely and more rapidly than with traditional massage techniques. The suction that occurs also forces body fluid to flow through the tissue, which further encourages toxins to be “flushed” from the area. It also allows the therapist to more effectively re-align tight muscle tissue fibers, which relieves the proverbial “knot” that is created by tension and excess lactic acid buildup. The down-side of this technique is the potential for “hickeys” to occur, which can be very alarming to a massage recipient who hasn’t been fore-warned about their potential for occurrence. This technique is also known as Cupping Therapy or Massage Cupping. Using less pressure and gliding strokes with the suction cups, Negative Pressure may also be used as a relaxing “feel-good” massage technique. Many people, including many misled or under-trained massage therapists, mistakenly believe that a Swedish-type massage (a massage consisting of long, flowing strokes) that is applied with very firm pressure is a “deep tissue massage”, but this is not an effective deep tissue technique, and this use of the term is inaccurate and misleading. Most commonly, deep tissue technique(s) are applied to one or two areas of the body during an otherwise relaxing, full-body, Swedish-style massage, which allows for a full-body treatment with focus to specific problem areas in a relatively short appointment-time. This may be what was originally referred to as a full-body “deep tissue” massage and may potentially be the origin of today’s misconception.

Of course, we all know how to undress and lie under a sheet on a massage table, but do you really know how to fully receive all the benefits obtainable from a massage? You may be surprised to learn that you didn’t – until now. Following is a self-checklist you can use to help you get your money’s worth from each massage treatment. BEFORE YOUR TREATMENT Think ahead. Pack a gym bag with a comfortable change of clothes if your treatment is scheduled after work. If your therapist doesn’t provide refreshments, throw in some nuts or a dried fruit snack – you may need the calories to help get you going after your treatment. If you wear contact lenses, consider bringing a case to put them in while you’re on the treatment table. Don’t forget your glasses to wear afterward, or your solution for putting them back in before the drive home! Don’t eat for at least an hour prior to your treatment. For one thing, nothing ruins a great experience like heartburn! Secondly, the process of digestion prevents your mind from drifting and this distraction changes the experience. Receiving a massage immediately after eating a large meal may also contribute to muscle cramps during your treatment. However, hunger is also a mood-killer, so make sure that you’re not hungry. If you must eat something, keep it light – just enough to satisfy you for an hour or two. Drink water. No, no really… drink more water. If you’ve heard it once, you’ve heard it a thousand times – water remains the most important element in bodywork. Most people who have received any type of bodywork already know that it’s important to flush toxins out of your system after a treatment. But did you know that it’s equally important to hydrate yourself before you get on the table? The pressure from your therapist’s hands pushes lactic acid out of muscle tissue into your blood and lymph, where it can then circulate out of your body. But if you’re dehydrated, your blood and lymph flow is sluggish and stagnated, and may not receive these toxins as readily as thinner, less viscous blood and lymph. If these toxins are unable to enter the blood and lymph, they remain in the your muscle tissue and can cause unnecessary post-treatment soreness. Don’t worry if you have to interrupt your treatment to use the facilities – the benefits far outweigh the inconvenience! Arrive on time – physically and mentally. Plan your schedule so you don’t have to rush to your appointment. If you’ve had a busy day, consider arriving a few minutes early so you can relax in the spa lounge (if available) and quiet your mind before your treatment starts. Some spas offer complimentary herbal tea – take advantage of this luxury, if it is available. Chamomile or Kava Kava can help take the edge off and help you relax. If your spa offers a sauna, hot tub or steam shower, consider scheduling a brief warm-up before your treatment. Turn off your cell phone. It’s your massage. Really, you can have it any way you want. But if you’re really interested in getting the most from your massage therapy session, eliminate distractions and make the most of the time you have on the table. Communicate with your therapist about your concerns, needs and expectations before you get on the treatment table. If you have special needs or health considerations, be sure to make these clear at the very beginning. In many states, massage therapists are not required to keep treatment records, so you may need to remind your therapist about your special needs prior to each appointment. If you have preferences in regard to room temperature, lighting, music type or volume, be sure to express these preferences, too. Your therapist wants your repeat business and will do whatever it takes (within reason) to ensure your satisfaction. Getting on the table. Don’t be bashful. Remember that certified massage therapists are trained and experienced professionals. Modesty and respect for personal space is a big part of any bodywork training. Whether you remain partially clothed or not, certified massage therapists are trained in sheet-draping techniques to ensure that your modesty is protected at all times. Generally speaking, the less you are wearing in terms of clothing and jewelry, the fewer “obstacles” your therapist will have to work around, and the more effective your treatment is likely to be. However, it is also imperative that you are comfortable. Don’t be afraid to ask your therapist how much clothing is appropriate to remove, if you’re in doubt. And above all, don’t waste energy worrying about it or feeling uncomfortable. Nothing ruins a relaxing, stress-relieving massage like more stress! DURING YOUR TREATMENT Breathe. If water is the most important element, then oxygen is a very close second. I have always found it amusing and ironic that, at the times we need oxygen the most – during concentration and exertion – is when we “forget” to breathe. When the therapist finds a “knot” and begins working away on it, the client tends to start concentrating on the area (and thus, holding his/her breath), as though waiting to see if the muscle will release. In fact, muscle release occurs on your exhale. So, if you’re holding your breath, the muscle is also holding its tension and it will not release. Also, you may have heard the expression “energy flows where attention goes.” Stagnated energy is largely the reason that muscular knot developed in the first place – concentrating your attention on it only adds to the problem. The best thing to do when this situation grabs your attention is to start narrowing your focus to your deep, rhythmic breathing. Try to visualize tension leaving your body with each exhale, and allow your body to relax a little more with each breath. Relax. No, really… relax MORE. Don’t engage your muscles to “help” lift the weight of your leg (or arm) while your therapist pulls the sheet under it. I know that you’re just trying to help, and that’s a really nice gesture. But in reality, it doesn’t help – when your muscles engage, your limb becomes rigid, and this not only makes the act of draping more difficult for your therapist, it has a reverse effect on the therapeutic value of your treatment. Energetically, it is impossible to give (expend energy) and to receive (conserve energy) at the same time. If you’re engaging your muscles, you’re giving. One of the primary objectives of massage is to achieve such a profound state of relaxation that you are able to receive the most healing benefit possible. It takes time to achieve such a relaxed state; each time you engage your muscles, you start the process over. Ask yourself what you’re paying for, and stop giving away priceless therapeutic value from your treatment! Be mindful about how much you talk during your treatment. I’m not going to tell you not to converse – sometimes a verbal release is just as therapeutic as a physical release. If you need to “vent”, and your therapist is comfortable sharing with you in this way, then by all means – vent! But be sure to ask yourself one question, first: what is it that you want to get out of your treatment? If you want to receive all the wonderful benefits obtainable from your treatment, then don’t distract your therapist – or your mind – with a lot of personal conversation, even if your therapist encourages it. Excited or animated conversation also causes your body to tense up. Consider saving the lengthy discussion for a lunch-date with your friends – it’s free, and then you’ll get more out of the treatment that you’re paying for. Communicate. With the above being said, be sure to tell your therapist if his/her pressure is too soft or too deep. A “relaxation” treatment should never be uncomfortable. Generally speaking, a “therapeutic” treatment may be mildly uncomfortable, at times, but should never be painful. A painful treatment will actually cause your muscles to become more tense, and will likely make you feel worse than you did before your treatment. On the other hand, a treatment that is too light may tickle (also causing your muscles to tense up), or may not be as effective or as pleasurable as you would like. So don’t be afraid to speak up if you’re not getting what you want. Your therapist wants to keep your business and will happily adjust his/her pressure to your liking. Also be sure to communicate your comfort level with regard to temperature. If you’ve never received bodywork while shivering, I can tell you from experience that it hurts – for days! If you feel chilled and your therapist has a table heater, ask that it is turned on or up, or ask for a blanket. Let go on two levels. Most people are aware that we hold mental and emotional stress within our bodies. If you don’t believe this to be true, then pay attention to what your body does the next time you receive sudden bad news. You’re likely to first feel a “knot” in the pit of your stomach that may then move up to your throat. Your shoulders begin to move upward and forward, as though attempting to shield your heart. Your spine may slouch as you sulk, and then you may get a painful “kink” in your neck that remains long after the feelings have passed. You may have heard the phrase “muscle memory”. The phrase actually has two meanings. It is most commonly used to describe a phenomenon that occurs when you practice an awkward physical activity until you can do it gracefully and without much thought. The second meaning is more literal – we actually hold memories of our past experiences within the cells of our bodies. The mind may forget, but the body never does! Muscle stimulation can stir up those long-forgotten memories. Pay attention to your thoughts, as your therapist begins his/her work and you begin to relax. If your thoughts are pleasant and enjoyable, then you shouldn’t have much trouble relaxing through your treatment. However, if bothersome memories begin to surface, you may have some emotional “letting go” to do before you can expect your muscle tension to let go and release. If your therapist is trained in Body/Mind Connections, he/she may be able to help you through this process by helping you identify core issues and where they are being stored in your body. The two of you can then work together to address the emotional and physical components of these issues simultaneously. This “dual action” achieves the most profound results in your healing process. Turn off your mind. During a quiet, relaxing massage is a great time to meditate, “zone out” or even fall asleep. Some people resist falling asleep during bodywork treatments because they don’t want to miss any part of this truly enjoyable experience. However, it is during these altered states of consciousness that you are most receptive to receiving the nonphysical benefits of the treatment, such as chakra balancing, energy clearing, etc. If you reach a state where you’ve lost time, or where you find yourself awake and yet dreaming, you did it right! Don’t worry if you’re not able to reach these deep levels during your treatment. This is something that can take years of dedicated practice, and there are still many other benefits you can receive from bodywork, even if your mind is overactive. If you’re unable to “check out” of your mental state, then just try your best not to follow your therapist’s movements with your mind. Don’t think about your work, your grocery list, or today’s “to do” list, either. Instead, think about a sunny beach, a trip to the mountains, a walk in the clouds, or anything that helps you relax. Remember: a relaxed mind = a relaxed body and a stressed mind = a tense body. AFTER YOUR TREATMENT Take your time. Don’t immediately jump off the table as soon as your therapist leaves the room. Open your eyes slowly and enjoy the ambience of the room. Gently bring your awareness back into the room. Sit up slowly and remain seated on the edge of the treatment table for a few moments, if you feel light headed. Now is a good time to consume a few calories to re-ground your energy if you feel off-balance. Dress yourself in warm and comfortable clothes before leaving. Drink even more water. Failure to flush toxins out of the body by drinking a lot of water after bodywork could result in excessive muscle soreness or nausea, not to mention that you’ve defeated the purpose of getting the treatment in the first place. There is no “magic number” of ounces you should consume, but the more water you drink, the better you’ll feel after your treatment. So remember – water, water, WATER! Getting on with it. If you have to return to work after your treatment, try to take it easy, but notice how much more energy and ambition you have! Otherwise, just use the rest of your day to relax. Enjoy your good mood, knowing that all is well with the world – at least with your world, at least for today. Take a hot bath, if you can. Try adding some sea salt or Epsom salt and some relaxing essential oils (like lavender or bergamot) or 2-3 chamomile tea bags. Notice how much more deeply you sleep, compared to usual, and how much more energy you have the next day! Above all, continue taking care of yourself with a healthy diet, exercise and regular maintenance massage – at least once per month, and once per week is ideal, if your schedule and budget allow it. Plant seeds for great future service. If the service you received met or exceeded your expectations, be sure to tip your therapist and refer a few friends. This will ensure that your therapist will be just as excited as you are for your next visit.