Correcting the Forward Head Fault

As I'm sure you've heard millions of times before, modern technology isn't doing our bodies any favors. Spending hours a day texting or hunching over a laptop is physically morphing out bodies. We're altering our fascia, compressing our spines, and stretching our muscles in ways that contradict our biology. Our traps are tight, and we're riddled with back pain.

Does your posture resemble that of the guy on the right or on the left?

The farther forward your head gravitates, the more weight your cervical spine (neck) has to support: in a "neutral position," the neck only bears about 12 pounds of load, but if your head juts forward only 2 inches in front of your center of mass, your spine now has to support ~32 pounds of load. When the spine has to work harder, so too, do the muscles that buttress (haha) the neck. If you've ever experienced neck pain, then I would wager that your posture needs improvement.

The "ideal" posture involves the joints to be centered from the top of the head, all of the way down to the lateral malleolus of the ankles. Notice how neither the rib cage nor the chin shift too far in front of the pelvis–these are both common compensatory patterns.

Ultimately, when it comes to addressing this dysfunction, I have a three-pronged approach:

1. Correct postural awareness. Cueing and awareness can go a long way. Forward head posture goes hand-in-hand with rounding of the upper back (kyphosis). Once you show a client where their center of mass is, they have a better understanding of proper alignment, and they're better able to recreate that position on their own.
2. Instil proper breathing mechanics. Chest breathing with an incomplete exhale will only aggravate any postural deviations. Full breaths initiating at the diaphragm with minimal chest expansion will promote optimal bodily function and positioning. Your breath influences every other muscular sequence in your body, and should be the priority of any corrective exercise program.
3. Strengthen the core and the neck flexors. The neck is an extension of the core, and, as such, if you display forward head posture, then we need to look there for answers. Similarly, I often find the neck flexors (sternocleidomastoids) to be weak or lack muscular endurance in these individuals.

Try this test: lay on your back, and pick up your head about 2-3 inches off of the ground. Hold your head up for 30 seconds. If you feel tightness in your neck, or your muscles start to twitch within that time, you need to build up the muscular endurance of your neck flexors. If you failed that test, then you definitely need some work.

Here's a good place to start:

1. Neck flexion
2. Cobra pose
3. Neck retraction against the wall
4. Neck nods
5. Bench neck bridge* (Note: This exercise should be used with caution, as there is the potential to strain your neck extensors. Start with holds of only 5-10 seconds for two sets. Gradually increase the lime you hold this movement.)

I would recommend performing two of these exercises at least two or three times per week. When it comes to improving posture, you have to be consistent and deliberate with your corrective exercises. If you stay on top of your drills, but continue to slouch at your desk, then there's little value to your postural training.

Another thing I've noticed is that the neck is often one of the first places people look to for help. Let's say they're struggling on their last pull-up. What do we see? The neck cranks into hyperextension to inch the chin over the bar. If you're grinding out that final biceps curl, you again see the neck shift forward to the rescue. These patterns are important to be mindful of during your training sessions. Don't use the neck to cheat your reps!

Once you treat your neck alignment, you'll notice that the rest of your spine will assume a better position, and you may even notice fewer incidences of back/neck pain and headaches.

Performing these exercises regularly, along with practicing proper sitting and standing positions will have a lasting impact on how you carry yourself. 

Works Cited:

1. Falla, D., G. Jull, T. Russell, B. Vicenzino, and P. Hodges. "Effect of Neck Exercise on Sitting Posture in Patients With Chronic Neck Pain." Physical Therapy 87.4 (2007): 408-17. Web.
2. Watson, Dean H., and Patricia H. Trott. "Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance." Cephalalgia 13.4 (1993): 272-84. Web.
3. Zito, G., G. Jull, and I. Story. "Clinical Tests of Musculoskeletal Dysfunction in the Diagnosis of Cervicogenic Headache." Manual Therapy 11.2 (2006): 118-29. Web.

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5 Exercises to Strengthen Your Neck

In the prequel to this post, I explained why so many of us carry a lot of tension in the neck. Stress, poor posture, and breathing can all contribute to elevated shoulders and a heavy head. I taught you a few quick movements that will strengthen the muscles of the chest, back and shoulders, and today I want to teach you some more exercises that will emphasize the neck musculature.

Lately, I've initiated my posts with a little bit of an anatomy lesson, so I'd like to continue that trend and talk a little bit more about the prime movers of the neck and their functions. First, we have the sternocleidomastoid muscles. I know, that name has a hell of a lot of syllables. The sternocleidomastoids (say that 10 times as fast as you can) are two big, strips of muscles that are on either side of your throat. They rotate the cervical spine (the neck), flex your neck forward, and also flex it laterally. Next, you have the scalenes. The scalenes are several tinier strands that wrap around the front of the neck. They work in conjunction with the sternocleidomastoids and laterally flex the neck and help you breathe. There are several other muscles in the neck, of course, but these are going to be the few that I discuss for the purposes of this post.

Now, the majority of people spend most of their time in cervical flexion, meaning that they are looking down at a computer, a book, or a smart phone. The upper trapezius are lengthened and over-active, while the sternocleidomastoids (SCM) are shortened and tight. When upright, many people maintain this position, because the body is lazy and doesn't like to recruit any more muscles than it needs for a given task. We walk around all day looking like the hunchbacks of Notre Dame.

The primary role of the head and neck, though, is to maintain joint centration and navigate our centers of mass. If our heads are cranked forward, now the entire system is out of line. Your center of mass has shifted from its ideal position, your "center," directly over your pelvis. Ideally, we want the earlobes in line with the shoulders.

If your center of gravity is too far forward or backwards, all of your movements will be altered from your clean and jerk to your 40 yard time. Alignment = optimal mechanics and balance.

Many coaches of sports like wrestling and football prioritize training the neck to avoid concussions and other potentially traumatic traumas to the head. While many of these teams make use of high-tech machines to isolate the neck, I believe neck training is best done (especially initially) without any added weight. Your head should be more than enough!

Here are 5 of my favorite exercises:

1. Neck flexion

2. Neck Extension

3. Lateral Flexion  

4. Neck Rotation (prone) 

5. Neck Rotation (supine)

Each of these movements can be done for 1-3 sets of 10 repetitions. I recommend starting out with only one or two sets, because you may find that you will be fairly sore after these exercises. The great thing about these movements is that they don't require equipment, and they won't take you long. I recommend my clients do them upon waking up or before bed.

The idea is to realign your center of mass so that you can perform most efficiently. Your balance will improve, you will better your hip and shoulder stability, and all of your muscles will function as they should. Find your center and master your body.


Works Cited:

1. Collins, Christy L., Erica N. Fletcher, Sarah K. Fields, Lisa Kluchurosky, Mary Kay Rohrkemper, R. Dawn Comstock, and Robert C. Cantu. "Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports." J Primary Prevent The Journal of Primary Prevention 35.5 (2014): 309-19. Web.
2. Falla, D., G. Jull, T. Russell, B. Vicenzino, and P. Hodges. "Effect of Neck Exercise on Sitting Posture in Patients With Chronic Neck Pain." Physical Therapy 87.4 (2007): 408-17. Web.
3. Keating, Jennifer. "Predicting Short Term Response and Non-Response to Neck Strengthening Exercise for Chronic Neck Pain." Journal of Whiplash & Related Disorders 4.1 (2005): 43-55. Web.

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Breathe Your Way to Bigger Lifts (Part 2)

A few weeks ago, I wrote a post on breathing properly for your lifts. This week, my friend Nate Henry, a competitive powerlifter, wrote a wonderful follow-up article. His strongest lifts include a 523.5 pound squat in competition, and a 535 pound squat in the gym, weighing 206 pounds. His best meet total is 1,372 pounds! He is also currently pursuing a bachelors degree in Kinesiology and an NSCA CPT. If you want to move big weights like this guy, follow his advice.

I mean...look at this guy.

Brief Squat Overview (Kinesiology)

Before I get into anything, let's review all of the primary muscles that are used within the squat because a lot of people overlook them.

When you’re lifting or doing anything and figuring out what muscles are being utilized, you have to analyze the dynamic (moving) joint to be able to identify the muscles worked. The muscles being worked are the ones that are fighting against the load.

As you squat there is movement in these joints:

• Hip (femoral acetabular joint, femur connects in the acetabulum in the coxal bone) 
• Knee (tibio-femoral joint, where the femur connects to the tibia)
• Ankle (taleo-tibula joint, where the tibia meets the talus)
• Spinal column (vertebral column)
•  Sacroilliac (SI, or lumbo-sacral) joint which is where the column connects to the illiac.

Analyzing the movement against resistance, standing up when you squat, we can identify the action of the muscle taken. In this case:

• Hip extension
• Knee extension
• Plantar flexion (ankle)
• Spinal extension (and depending on the lifter, there can be a posterior or anterior pelvic tilt in the SI.)

Rather than listing out all of the muscles involved, here are some nifty graphs I made to show what muscles are responsible for what movement:

Keep in mind these are only the primary muscles and these do not include the statically loaded muscles or the secondary muscles involved in the movements.

Now what?

Now that we’ve identified all the muscles we can get into this cueing business, the muscles will come into play a little later. Outside of reminding everyone reading this that their set up is the most important part of the squat (don't rush it, set up every set the same, etc.). I’m going to assume you’ve squatted before in your life, and I'll get right to it.

One of the biggest things that helped me advance my own squat was learning to properly brace and learning to “breathe into my lower back.”

A lot of lifters rant about “getting tight” and “getting your breath,” but what the heck does that even mean? It’s one of those things that if you know it, you get it. If you don’t, it’s hard to explain fully.

The whole point of getting “tight” or bracing is to prepare your body to handle load. Usually in the form of the Valsava Maneuver (holding your breath). However, a lot of people can’t even breathe correctly without load, so getting your breath and bracing properly is hard to do if you’re just starting out.

Rather than explaining it further, Arianna has written an awesome article already!

That breath and bracing is the most important and overlooked aspect of the squat next to having a proper unrack/walkout.

The reason this is so important is because if you’re not bracing completely you’ll put a lot of pressure on different muscles. We talked about spinal extension as one of the movements in a squat right? Well, when you’re just bracing the frontal core (the rectus abdominis plays a huge role in stabilizing the muscles responsible for spinal extension), you’re leaving your back completely unprotected, even with a belt! When you’ve got something heavy on you, that weight will zero right in on your weakest part of the back and that’s how back injuries happen and why.

This cue is especially important for low bar squatters who tend to use more extension in the back to leverage heavier weight on the way up.

To add to that, a lot of lifters might get the back tight (flexing it rather than creating the tension through the diaphragmatic breathing) and then tip forward because there is no brace on the front. This can also create some havoc within the muscles being worked. The quads may try to take proportionally more load than needed and the hip extensors try to pick up the slack. Things can get weird.

The point is, you need to brace and create that pressure. This is how I learned to do that.

Why breathe into my lower back?

Your core musculature wraps all the way around. A lot of lifters just breathe into their stomachs, creating little pressure, and not getting 360 degrees of tightness throughout all the musculature, extrinsically, nor intrinsically. They lack the understanding of what full abdominal expansion feels like; that’s where this cue comes in handy.

Put your hand on your lower back. Breathe into your stomach with a proper breath (fill it like a balloon). Not much going on in the lower back right? Or the sides, really, correct?

Now, do the same thing but try to breathe into the back while still trying to fill in the balloon (if that’s not helping, try to breathe into the lower back lying on your back and try to focus on pushing against the ground). If you’re doing this correctly, you should feel your back, stomach, and sides fill with air. Put your hands on your sides as well, you’ll feel it.

This is what I mean by breathing into your lower back. Proper inhalation helps your muscles in the core/lower back get tight/brace. Think of your core musculature as your body's own belt.

Using this, let's go over a quick squat without getting too much into the whole process:

1. Approach the bar, get your hand placement. 
2. Without rushing, get under the bar and get your placement down (high/low/hybrid). Dig into the bar, get the hands set, get everything nice and stable. 
3. Get your hips under you (both feet, not split stance this will prevent injuries in the back as well)
4. Breathing into your lower back, and getting the full breath first, unrack the bar.
5. Take your first step back, settle. 
6. Bring your other leg back, settle. Adjust this foot if need. 
7. If you’re squatting really heavy and the bar is whipping, let it settle. Good walks, make good lifts.
8. If you let out some air during the walk, retake the breath but make sure you create pressure during the walkout phase because even though you’re not squatting, you’re still having to move around that weight. 
9. Squat
10. Stand up
11. Retake the breath (don't descend without completing the breath!)
12. Repeat

I like using Chad Wesley Smith as an example, since he’s the one who introduced me to this cue. Here he is squatting 825 for a double.

Notice the control, the time put into the set up, and how he breathes. Now, Chad is an Elite Squatter. He’s quick about it. Take your time.

The cool thing is this applies to all disciplines: CrossFit, Powerlifting, Strongman, Weightlifting, Bodybuilding.

Try these tips, and add serious weight onto your lifts.


Works Cited:

1. Nuckols, Greg. "Squat Mechanics – The Red Pill." Strengtheory. N.p., 23 Feb. 2015. Web. 02 June 2015.
2. Smith, Chad W. "10 Steps to Great Squatting Technique." JTS Strength. N.p., 20 Aug. 2014. Web. 02 June 2015.
3. Smith, Chad W. "Squatting Specifics - What Technique Is Best for Your Sport?" JTS Strength. N.p., 22 Aug. 2014. Web. 02 June 2015.

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The Ab Exercise You're Doing Incorrectly

You work these muscles 23,000 times a day, on average, but chances are, you're using them incorrectly. In our sleep-deprived, high stress lifestyles, many of us are breathing incorrectly several thousand times a day, everyday over the course of our lives.

The core musculature like the rectus abdominis, diaphragm, internal and external obliques also allow for efficient breathing. If you're not breathing correctly, the sequencing and integrity of all of these muscles will be compromised. Your hours of "ab circuits" will all be for naught.

In my opinion, emphasis on proper breathing while training (or just normal daily function) is paramount. Here's why:

• Improved intra-abdominal pressure (core stability)
• Prevents facilitation (overuse) of trapezius, scalenes, and sternocleidomastoid muscles
• Teaches proper diaphragmatic activation
• Proper core sequencing for all activities
• Improves ability to return to parasympathetic nervous system (reduce stress)
• Better recovery and reduced risk of injury

Intra Abdominal Pressure

In any big lift like a squat, bench, or deadlift, creating sufficient intra-abdominal pressure is mandatory for safety. To quote Dr. Yuri Verkohansky, "Without breath-holding, far greater pressure  is exerted on vulnerable structures of the lumbar spine, in particular the intervertebral disks and ligaments." Basically, if you're not breathing correctly, you risk herniating a disk or placing additional shear forces on your vertabrae. I see far too many lifters getting under (or over, in a deadlift) a loaded barbell without sufficient abdominal bracing.

Shoulder Stability

If you breathe through the neck and chest, as many people I interact with do, your shoulders are going to remain in a shrugged or elevated position. This means the shoulders are unstable and you will have an increased risk for rotator cuff tears, dislocations, pectoralis major/minor tears, or labral tears. If the muscles normally used to stabilize your shoulder, like the serratus anterior, are forced to help you breathe instead of performing their primary roles, your shoulders are in danger.

Hip Stability

Similarly, the stability of the hips will also be compromised without proper breathing. Muscles like the quadratus lumborum may become overactive if the rectus abdominis or external obliques aren't firing correctly.

Conditioning

If you're training your aerobic energy system, which requires oxygen to function, and you're not getting sufficient oxygen into your lungs, guess what? You're not going to be able to run/bike/swim as hard or quickly as you would otherwise. Shallow, chest breathing is not optimal for oxygen uptake. Rather, deep breaths through the diaphragm are ideal.

Recovery

Chest and neck breathing is the result of the sympathetic,"fight or flight" nervous system taking over, while diaphragmatic breathing brings the body back to the parasympathetic "rest and recover" nervous system. Remaining in the sympathetic nervous system = increased recovery time. If you're trying to train hard and improve performance, you need adequate recovery.

Have I convinced you just how important your breath is to all facets of training and general health yet?

Now, take a moment to monitor your own breaths. Are you breathing through your mouth? Does your chest expand as you inhale? Do your traps constantly feel tight?

The ideal way to breathe is through the nose, with the tongue on the roof of the mouth (which will encourage diaphragmatic expansion) and expand the belly and the ribcage with each breath. Your ribcage should expand 360 degrees with each inhalation. We want lateral expansion of the ribs at the same time as it expands forward and backwards.

Now, I'm going to give you some tips on how to improve your breathing habits. Here are three of my favorite "core" and breathing exercises:

• Crocodile Breathing

• Lay down on your belly with your hands crossed in front of your head
• Take a big breath in through the nose with the tongue on the roof of the mouth
• Focus on expanding the stomach and the lower back as you inhale
• Exhale slowly and completely through the mouth

• Manual Resisted Breathing

• Lay on your back and have a partner sit next to you.
• The partner should place his/her hands on your stomach
• As you inhale through the nose, keep the tongue on the roof of the mouth
• Partner provides gentle resistance to your diaphragm during inhalation
• Hold your breath for 1-2 seconds at the top
• Exhale slowly and completely through the mouth

• Kettlebell Breathing Drill

• Place feet hips distance at a right angle against the wall
• Hold a light dumbbell or kettlebell on the belly (10-15 lbs)
• As you inhale, focus on pressing your stomach up against the weight and expanding the rib cage
• Count to ten as you inhale, pause at the top, and count to ten as you exhale through the mouth

These are three fantastic exercises to bring your body back to the parasympathetic nervous system and find some peace from your chaotic day. If you take these simple steps to improve your breathing, I can guarantee you that the results will be profound. You will improve your mechanics, become more stable and mobile, and, most importantly, inch towards a more stress-free lifestyle.

Just breathe!

Works Cited:

1. Anderson, Tim, and Geoff Neupert. Original Strength: Regaining the Body You Were Meant to Have. N.p.: n.p., n.d. Print
2. Dooley, Kathy. "The Professional Website for Dr. Kathy Dooley" | Dr. Dooley Noted." The Professional Website for Dr. Kathy Dooley" | Dr. Dooley Noted. N.p., n.d. Web. 10 Apr. 2015.
3. Myers, Thomas W. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Edinburgh: Churchill Livingstone, 2001. Print.
4. Oliver, Jocelyn. "Breathing Archives - NeuroMuscular Reprogramming." NeuroMuscular Reprogramming. N.p., n.d. Web. 23 Apr. 2015.
5. Swift, A. "Oronasal Obstruction, Lung Volumes, And Arterial Oxygenation." The Lancet 331.8577 (1988): 73-75. Web.
6. Tsatsouline, Pavel. Kettlebell: Simple & Sinister. N.p.: n.p., n.d. Print.

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Breathe Your Way to Bigger Lifts

Check yourself: as you read this, are you taking deep, full breaths, or is your breath shallow and inconsistent?

I've found that my clients have the tendency to forget to breathe as the they lift. They're getting ready for a max back squat and they step under the bar with a completely unstable abdomen.

You take, on average, over 20,000 breaths per day, yet somehow, in today's stressful society, breathing is not always automatic. When people are anxious or preoccupied, they may forget to breathe, or their breathing may not be of adequate depth.

The respiratory system, courtesy of www.philschatz.com.

Now, above I've placed a photo of the respiratory system. As you can see, there is a lot going on there. Many people who are stressed or are in the sympathetic nervous system response (fight or flight), will breather primarily through the neck and chest--this is usually easily visible. Someone who is calm and in the parasympathetic nervous system should breathe through the diaphragm, and you will note that their bellies and lower ribcages will expand as they inhale.

The respiratory system obviously provides our brains with oxygen, but it also helps to stabilize our abdomens. When we inhale, the diaphragm contracts and presses up against the lungs, and as we exhale, the diaphragm relaxes.

A proper diaphragmatic breath helps us create intra-abdominal pressure. On a compound movement like a squat, deadlift or bench press, maintaining that intra-abdominal pressure is imperative for safety of the spine and maximal power output.

He may be cute, but we certainly don't want to emulate his physique!

My friend Wileen, a Licensed Massage Therapist and practitioner of NeuroKinetic therapy, gave me this wonderful example--she said that without sufficient intra-abdominal pressure, the body is much like the Slinky Dog in "Toy Story." Essentially, the abdomen will be soft and unprepared to handle a sufficient load.

Would you rather lift with a body like that of Slinky Dog or that of Buzz Lightyear? I have my money on Buzz Lightyear any day of the week.

A heavy lift requires a substantial amount of tension in the body, from the feet, all of the way up to the torso. Without that necessary rigidity, the risk of injury is exponentially higher, and the amount of energy we are wasting comes in droves.

A strong core creates bigger lifts. We can't optimize the strength of the thorax without proper spinal bracing via the breath, so therefore, a stronger breath means more weight on the bar! You follow me?

Now, down to the nitty gritty. You may be wondering how you should breathe on these big lifts. There is a technique that many lifters employ called the Valsalva maneuver. This is just one way to breathe to take advantage of the intra-abdominal pressure. I will warn, though, that anyone who has a history of high blood pressure should not breathe this way, as it does raise the blood pressure even more. Ideally, we want to inhale through the nose, which facilitates a full contraction of the diaphragm. Then, we should engage the abdominals. I tell my clients to imagine like I'm going to punch them in their stomachs. Once they have that down, they may begin the movement. During the hardest part of the movement, or the end of the concentric phase (think of standing up on a deadlift or squat or locking out an overhead press), they should forcefully exhale through the mouth. If they are doing a set with multiple reps, they should repeat this before each repetition.

This photo of the Valsalva maneuver in action demonstrates an iron clad core. As you can see, the airway is cut off and the diaphragm is contracted abdominal cavity expands. This individual is ready to move big weight.

Many people use lifting belts to enhance this effect. The belt acts as somewhat of a tactile cue to improve that core stabilization. I won't get into that too much today, though, as that is enough material for an entirely new post.

As you can see, the way you breathe has a profound impact on your performance, both in and out of the gym. It's is extremely important to learn how to maintain intra-abdominal pressure throughout a heavy lift for both efficacy and safety.

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Breathing Exercise Secrets - How To Breathe Properly When Running And Exercising

Breathing while running may prove difficult. Proper breathing is critical for performance and running enjoyment. The better you breathe, the more oxygen is supplied to your body and working muscles, thus performance and stamina improve drastically. Unfortunately, most runners find it hard to find the best breathing rhythm.

In fact, most struggle and fall short of their real potential.Nevertheless, proper breathing can be taught and learned. It's just another skill that needs a bit of practice and diligence.

As a result, here are two breathing techniques that can help.

In From the Nose, Out From the Mouth

When it comes to setting a running-breathing rhythm, nose breathing is the way to go. Inhaling from the nose will help you keep running intensity on the low (thus prevent fatigue and overtraining), stabilize heart rate and improves focus levels. However, during high intensity running session, relying solely on the nose can be tricky. For that, make sure to use your mouth as well in the inhalation process.

Nevertheless, on the exhale, make sure to use your mouth for the task. Exhaling from the mouth helps the elimination of the highest amount of CO2, thus help prevent discomfort and fights off fatigue. In addition, this type of breathing also promotes a sense of relaxation and easygoingness.

Deep Breathing

The reason why most runners find it hard to breathe properly during running is that the most are chest breathers. Sadly enough, chest breathing is a very inefficient when it comes to getting the highest amounts of oxygen delivered to the working muscles. Opting for this breathing pattern will only leave you suffering from the chest aches, and fatigue both during the session and afterwards.

Instead, the way to go is to opt for deep breathing. Also known as diaphragmatic or belly breathing, this type of breathing involves the use of the belly and core muscles in the processes of inhale and the exhale. Opting for deeper breaths does two things: first, it allows the delivery of the maximum amount of oxygen to the body.

Secondly, it makes the process of waste and CO2 elimination more efficient and potent. Thus leading to superior running performance and results.

However, deep breathing is hard to master. For that, you need to practice it in the comfort of your home before you head out for a run. Doing so will only improve your running performance, it will also make out of you a better human. Yogis have known this for centuries, now it's your time to reap similar rewards.

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