I just completed a four-day intensive and immersive Functional Anatomy for Movement & Injury (FAMI) workshop at Mt Sinai Medical Center in New York City. (Mt Sinai has special meaning for me – it’s the place where I was born and our first child was born!) As FAMI co-director Matt McCulloch stated, this was an
anatomy clinical course on steriods!
Here I am writing about the portion of the daily lab devoted to what movement professionals should know when guiding folks in rehab, such as physical therapy, or movement, such as in yoga or pilates. This portion of the lab was facilitated by Michael Ballentine, DPT. Included in his many credentials are having received his clinical doctorate in Physical Therapy (hence the initials DPT), being a continuing education faculty member at Kinected, and working at PhysioArts, a dance medicine clinic in NYC.
Day 1 was spent covering the back. Michael said we have a postural bias for wear and tear, meaning how we sit and stand will impact the wear and tear on our back. Please take a moment to sit down at a table and mimic the way you tend to sit while at your computer or while sitting at your desk or while sitting in general. Are you hunched over? Turns out that sitting bent forward puts the most pressure on our vertebral dics.
The way your back works is when you bend forward, your discs are compressed at their front. At the same time, the rear portion of your discs are dealing with stretching, or tension, as the front folds forward. The combination results in a lot of pressure on your vertebral disc.
When you are standing in proper alignment, the spongey material between your discs is evenly dispersed. Proper alignment is the posture we aim for when in standing Mountain Pose or seated Mountain; it is also the basic anatomical posture.
Michael focused much of his talk on dealing with herniated discs. However, many of his points are useful for simply building and maintaining a healthy back. The bulk of what comes next is taken from the handout he provided. The information in [brackets] is added by me.
GUIDING PRINCIPLES OF PHYSICAL THERAPY & REHABILITATION
- Teach posture and awareness of “efficient” spinal alignment. [Again, this is done when learning Mountain Pose, and is often repeated for all standing yoga poses, as well as supine poses. All movement should be slow enough to insure that proper alignment is maintained.]
- Increase myofascial/joint/neural mobility. [For those of you who, like me, are not sure what myofascial means – it refers to a layer of loose yet strong connecting tissue that touches upon all muscles from head to toe. The point here is to gently increase back mobility, which in turn impacts mobility of the rest of the body.]
- Develop neuromuscular control/strength/endurance. [The more you use a muscle, the stronger it will get.]
- Improve body mechanics, ergonomics. [As teachers of yoga or other movement practices, we can go beyond the poses and relate them to daily life. Ideally, as practitioners, we will focus on alignment beyond our yoga mat!]
TIPS FOR THE FITNESS PROFESSIONAL
- Build awareness of and strengthen the lumbo-pelvic region.
- Emphasize “neutral pelvis”.
- Strengthen lower extremity muscle groups (e.g. quadriceps, gluteals).
- Encourage flexibility in hip flexors, hamstrings, adductors, and abductors. [ADductors - add - move towards the body, ABductors - abduct/take away - move away from the body.]
Michael mentioned specifics to avoid when dealing with herniated discs. I have tried to focus this post on the suggestions of his that benefit the development of a strong, healthy back, particularly as they can be applied to the practice of yoga. However, if you are dealing with yourself or someone else who has a herniated disc, focus on NO BLT – no bending, lifting, twisting. As Michael said, our
joints prefer mid-ranges