Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Filtering by Tag: pelvic tilt

For the Bikers: Demystifying Spinal Flexion and Spinal Extension

I realized that in some of my previous posts, I've needed to clearly explain spinal flexion and spinal extension, and define what I mean by the "slump" of poor posture on the bike. 

First thing first, neither spinal extension nor flexion is inherently bad.  These are just a few of the natural positions our spine and core (more on that another day) are designed to perform in the course of the day.  The challenge is not simply the position, but the frequency with which the body adopts the position.  (Other spinal movements include lateral flexion/extension and rotation).

The image on the left  shows a traditional spinal flexion, in which the vertebral bodies are getting closer to one another.  The image on the right shows spinal extension, in which the back part of the spine, or spinous processes, are getting closer to one another.

The image on the left shows a traditional spinal flexion, in which the vertebral bodies are getting closer to one another.  The image on the right shows spinal extension, in which the back part of the spine, or spinous processes, are getting closer to one another.

Flexion, as a direction of motion term, means to decrease the angle in the joint or the two parts.  You flex a bicep, you shorten that muscle, you decrease the angle of the elbow joint, meaning forearm approaches shoulder. You flex your knee, you draw the bones of the thigh bone and shins (femur-tibia/fibula) closer together. Extension refers to an increase of the angle in the joint or body part, so extending the bicep is drawing the hand away from the shoulder, bringing the arm to straight, lengthening the muscles of the upper arms. 

This is a traditional yoga pose called cat pose, Image courtesy of Yoga Journal.

This is a traditional yoga pose called cat pose, Image courtesy of Yoga Journal.

In terms of the spine, spinal flexion is an action we perform when we typically do sit-ups or if you're a yoga person, many arm balances such as crow (bakasana), cat pose, and many forward folds.  If we think of flexion are closing down the joint or decreasing the angle of the joints (vertebrae), then flexion is bring the vertebrae closer to each other.  In many contexts, spinal flexion is also coupled with a posterior tilt of the pelvis, or a "tuck" of the pelvis.  In cat pose, the pelvis and spine (and neck) are all moving in tandem.

In cow pose, both the hips and spine move together, putting the hips into an anterior tilt and the spine into extension.

In cow pose, both the hips and spine move together, putting the hips into an anterior tilt and the spine into extension.

Spinal extension is something we want to do when we pick up heavy things, i.e., dead lifting, squatting with weights, helping someone move, etc.  It's also a large part of yoga asana in the category of backbends.  As a term, it's expanding the distance between the vertebrae, which is why backbends can feel really good at the end of a long day of playing or driving, when we've compressed our vertebrae.

 

Pelvic tilt,  which I've mentioned on many occasions before,  just as a refresher.

Pelvic tilt, which I've mentioned on many occasions before, just as a refresher.

 

 

 

 

So in our day to day lives, we want both of these actions in our spine and pelvis.  The problem is that most of us sit for many hours a day, and we sit in spinal flexion, coupled with a pelvic tuck (posterior tilt).  This means that we're spending let's say, 6 or so hours in flexion a day.  So when we choose our "exercise" or other movement activities, they can compound that flexion tendency, or undo it.

 

Quickie chart on pelvic tuck and biking.  See how posterior pelvic tuck brings the vertebrae closer together on the right?  Even if you have good pelvic form on the left, your spine is in flexion.  It's just how it goes.

Quickie chart on pelvic tuck and biking.  See how posterior pelvic tuck brings the vertebrae closer together on the right?  Even if you have good pelvic form on the left, your spine is in flexion.  It's just how it goes.

 

 

So back to biking.  Biking is an activity that inherently puts you into spinal flexion, and often into posterior pelvic tilt, because of the various factors at play, including how the weight is pitched forward, the height of the seat, the height of the handles, the type of bike, etc.  If you have a super upright cruiser bike, you won't be pitched far forward, whereas if you are training for an ironman and have a fancy racing bike (and have one of those crazy helmets), you'll be in super spinal flexion, even if you have good pelvic alignment.    My hope is that everyone can find a good pelvic alignment on the bike, and that we can look at our other movement patterns in daily life to undo that spinal flexion patterning. If you know that you bike a lot and sit a lot, start to pay more attention to how you sit, how often you sit, and what is happening in your hips and spine as you do so.

This is an image from the 2007 Ironman World Championships, featuring  Denmark's Torbjørn Sindballe.  I obviously have no knowledge of ironman training, but I can see that he has fairly decent pelvic form, but has to go into serious spinal flexion because the handles are low (and add to that neck extension, i.e. nose and gaze up while spine orients down).  This means he can go super fast, but I just hope he has a good bodyworker for when he's done!

This is an image from the 2007 Ironman World Championships, featuring Denmark's Torbjørn Sindballe.  I obviously have no knowledge of ironman training, but I can see that he has fairly decent pelvic form, but has to go into serious spinal flexion because the handles are low (and add to that neck extension, i.e. nose and gaze up while spine orients down).  This means he can go super fast, but I just hope he has a good bodyworker for when he's done!

On Shoes: Part 1

     There have been a good amount of useful articles lately about shoes and how they impact our posture and our spine. Why should you care? 

Question 1: Do you have back pain?  What about knee pain?

Question 2: Do you have bunions or baby bunions?

Question 3: Do you have plantar fascitis?

Yes?  Then you should care.  One of the tricky aspects of a performance based career is the performance attire, which for women, often translates to tall high heels with a small toe box.  Men aren't off the hook either though!  A small toe box (like these guys) can translate to gait issues and bunions.  Add that to wearing crazy dress shoes a few days a week, coupled with high heel boots, flats with small toe boxes, and turned out feet, and it's a disaster waiting to happen.  Not only that, your feet are the root of your standing position, whether it's in performance or in life, and can be the source of a whole chain of postural and muscular imbalances.

Even doctors 70 years ago knew that small toe boxes hurt the feet-yet we still have so many uncomfortable shoe options!  This is from my 1940's book "The New Modern Home Physician."

Even doctors 70 years ago knew that small toe boxes hurt the feet-yet we still have so many uncomfortable shoe options!  This is from my 1940's book "The New Modern Home Physician."

First thing-what's a bunion?  Basically, the muscles and bones around the big toe start to create a bulge on the medial side of the foot and the big toe turns laterally.  Huh?  Not only is it uncomfortable, but it's not pretty.  Both men AND women get them, and it's not just from high heels.  Notice how in the first image, there's space for the toes to spread a little.  Then in the second, the toe box (i.e. the space in the shoe for the toes) gets smaller and the toes start to cramp.  And then the third, the pointy shoe, is just a full out bunion fiasco.  Basically, you just want to have more space in your shoes for your toes!

I've seen this image in a few places, name  Katy Says  and a bunch of other foot related blogs which I think borrow it from her.

I've seen this image in a few places, name Katy Says and a bunch of other foot related blogs which I think borrow it from her.

Second- how do high heels affect things?  First of all, smarter foot people than I have written TONS about this, so if you're curious, there's lots more to read.  When you wear an elevated heel, you increase the posterior tilt of the pelvis which is a causation of the slumping of the upper spine.  In addition, heels flatten the natural curves of the spine, the weight distribution between ball of foot and heel is disrupted, and you start to reduce your joint range of motion.  Not only that, but you start to walk weirdly, taking little teeny steps and overarching your thoracic spine.  Remember, this includes all heels, which includes running shoes, boots, dress shoes, etc, not just fancy high heels for the ladies!

Notice how in the first picture, the woman has a natural curve to her spine?  The second image shoes how our gravity is pitched forward in heels (any heel here, folks), and the third shows the repercussions.  This woman bends her knees more, and the curves in her spine are exaggerated.  Some folks do the opposite, and hyperextend their knees and flatten their spine.


Here are a few other postural variations- the first example is similar to the above image, the second shoes more thoracic slumping, the third shows a neutral position, and the fourth shoes the hyperextension of the knees leading to forward thrusting of the chest.  Does that sound comfortable?

Here are a few other postural variations- the first example is similar to the above image, the second shoes more thoracic slumping, the third shows a neutral position, and the fourth shoes the hyperextension of the knees leading to forward thrusting of the chest.  Does that sound comfortable?

Don't believe me?  Here are some more articles:

Katy Says

Spine Health Institute

Dr Nick's Blog: What Happens With Traditional Running Shoes

And in addition, there are a TON of articles attempting to defend high heels.  Use your own myth busting skills here and think about it!

Great Posture: Another Reason To Wear Heels

Five Reasons Heels Are A Good Investment

Next post will be on some solutions to these dilemmas, as none of us (including me!) are free of heeled shoes with small toeboxes.






Sitting Better

by Kayleigh Miller

I thought I would initially write a detailed anatomical post about the finer points of sitting.  Frankly, this video demonstrates everything I would want to say, and more.

 

Katy Bowman, a fabulous and interesting lady in the realm of biomechanics, PFD (look it up.  I'm not explaining it.), and general foot well being has made this hilarious video.  The pelvis next to the human illuminates the fundamental basics of sitting-pelvic tilt.  She's demonstrating how posterior pelvic tilt affects upper body alignment, specifically by enhancing rounding in the upper body.

This image from  www.clinical-corner.com  basically just reinforces this idea.  Wow!  That looks uncomfortable...but we all do it sometimes.  It is also possible to be anterior tilting the pelvic too much, though that's more difficult to do while playing an instrument.

This image from www.clinical-corner.com basically just reinforces this idea.  Wow!  That looks uncomfortable...but we all do it sometimes.  It is also possible to be anterior tilting the pelvic too much, though that's more difficult to do while playing an instrument.

Next time you sit-maybe even now, play around with your pelvic tilt and see how the relationship affects your spine, head, and how you hold your instrument (or play piano or sing or conduct).  



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