Musicians' Health Collective

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

Filtering by Tag: posture

Suzuki Turn-Out No More

Who decided that we should all stand with one foot forward and externally rotated?.jpg

     I started my humble music career as a Suzuki violinist, beginning at the age of 6.  While there are many useful and important things I learned in my early training, standing position was one that has posed confusion as I've aged.  Let me explain a bit more, for those non-violinist or violists out there.

This is a perfect example of learning "proper" violin stance.  Start with the feet together, then turn the feet out (externally rotating hopefully from the hip, hopefully) and then step the left foot forward.

This is a perfect example of learning "proper" violin stance.  Start with the feet together, then turn the feet out (externally rotating hopefully from the hip, hopefully) and then step the left foot forward.

When one learns beginning violin, often one is told to turn the feet out and step the left foot forward.  I learned this way, and stood this way for a long time.  (Over 15 years, at least).  A few years ago, I started noticing that in yoga, pilates, and weight training, we were told to have both feet pointing forward, at least sometimes.  I instead wondered, why do I always turn my feet out when I play, and does it actually serve me?  I have since started experimenting with this concept. 

This adorable image is from Shirley Givens' violin series, showing that left foot turnout.  In addition, the illustrated girl puts much more weight on her left foot, enhancing the asymmetry of the stance.

This adorable image is from Shirley Givens' violin series, showing that left foot turnout.  In addition, the illustrated girl puts much more weight on her left foot, enhancing the asymmetry of the stance.

So what's the big deal?  Our feet naturally point forward or with a minimal turnout, and you may already remember that when you walk with your feet extremely turned out, there are potential consequences for foot, knee, and hip issues.  (In addition, when feet point forward rather than externally rotated, the musculature of the foot is better able to support the body in standing and walking, and the ankle joint is able to articulate more fully.)  From a biomechanical perspective, I don't understand why music educators have been teaching students to externally rotate their hips while standing, and I definitely don't understand why one foot needs to be in front of the other.  I just don't.  (Who decided this was a good idea?)  However, I don't only care about the feet, but I care also about what is happening in the hips too.  When one hip is perpetually externally rotated (left hip), we can exaggerate that asymmetry out of the practice room, and in our daily walking, standing, and movement lives, even if we don't intend to.  That means that one set of external hip rotators is constantly working more than the other set, which can affect the muscles, bones, and connective tissue over time.  What does that mean? 

See how the right side is higher than the left?  Mine is the opposite-my left side is shorter than my right.  Pelvic tilt Image from http://medical-dictionary.thefreedictionary.com/

See how the right side is higher than the left?  Mine is the opposite-my left side is shorter than my right.  Pelvic tilt Image from http://medical-dictionary.thefreedictionary.com/

Side note, I came to this conclusion because of certain issues I was having in my hip, and that I was seeing in other colleagues of mine.  Here are some of my personal symptoms, which may or may not be yours:

1. My left hip has consistently turned out more than my right, whether I'm in music mode, standing, cooking, walking, running, etc. This can simply manifest as the foot turning out, at least in appearance. Both hips want to turn out in standing though.  I've been working on gently bringing the legs back to neutral, and found that to be helpful.

2.  This in turn can cause my left external rotators of the hip and the low back muscles to be unruly.  (Muscles include my gluteus medius, TFL, Quadratus lumborum, and the iliotibial band of fascia.

3.  I also have the beginnings of a baby bunion on my left foot which may be impacted by the external rotation of the hip.

4.  From a combination of asymmetrical music-making, left side dominance, and a host of other things, my entire left side is loads tighter (less range of motion from sole of the foot up to the shoulder!) than my right, which means that I sometimes have back pain and other issues on just the left side.  

So what's the solution?  Start to get curious. It's also important to remember that correlation does not imply causation- my left hip/back issues aren't inherently caused by the turn out, but I would venture to say that the perpetual external rotation has impacted things.  I will say that my pain has diminished exponentially since I've been doing pilates and other movement activities that have challenged my hip range of motion and stability.   

Ask yourself:

-How do you stand when you're playing? Where are your feet, knees, and pelvis?  What sort of shoes do you normally wear?  How might those be affecting your lower body?

-How do you teach your students to stand?  If you have a specific way of teaching stance, why do you teach what you do? 

-Try standing differently.  Maybe feet closer together, more parallel, right leg in front, both legs in the same orientation...give yourself permission to experiment, and perhaps that will change how you teach.

-Do you sit when you practice at home, and if so, what are your legs doing?

-If you photograph yourself (or video) while playing, what does your standing look like in context?

-Do your feet turn out when you walk/run/play/sit/etc?  Start experimenting with changing that setup gradually and see if it changes how you feel.  It can have ramifications all around the lower body, specifically feet/knees/hips/spine, but maybe affects other aspects as well.

Playing an instrument requires movement within the body- it's not meant to be a static endeavor, but repeating the same position in perpetuity for twenty plus years may not be the best.  

 

What Does Rib Thrusting Look Like?

To read more from Katy or some others to address the rib flare, visit www.nutritiousmovement.com

To read more from Katy or some others to address the rib flare, visit www.nutritiousmovement.com

This week, I've been working with my private clients about stabilizing the ribs, whether in supine movements or extensions, and it can be helpful to have some visual context.  This is a little of what  rib thrusting or rib flare looks like, and how it is an aesthetic goal in many movement disciplines, here's a short gallery of different shapes and people demonstrating (most likely accidental) rib thrust.  As mentioned in my previous blog post, it can sometimes be misconstrued as "good posture" to have the shoulders back and chest broad...but pushing the ribs forward of the midline of the body compresses the lumbar vertebrae, negatively affects the pelvic floor and diaphragm, and can really limit actually spinal mobility.  Some people will naturally have a pelvic flare, either from movement habits, activities, (gymnastics, cheerleading, ice skating, dance, etc) or just a lifetime of movement habits.  There's nothing wrong with you if you have a little of this, but starting to be aware of it will not only improve your athletic performance, but may also help reduce pain, risk of diastasis recti, or other issues that may be present.  This rib thrusting is very common in yoga-land, especially in the context of standing postures, downward dog, and back bends.

(Click through the gallery to see different images)

In some fields, like gymnastics and dance, the rib thrust may be an aesthetic goal or just be a consequence of executing a movement (i.e., do the movement at any cost to the physical body).  For those of you who have been a little perplexed about the rib thrust and what it looks like, hope this helps!  (And take a look at my previous post for more specific details on what rib thrusting is)

Rib Flare, or Where Are Your Ribs in Relationship to the Rest of You?

Sometimes at social gatherings, people will ask me to fix their posture, AKA. "Tell Us what we're doing wrong, right now!"  This is what I tried to tell them, albeit only somewhat successfully.

As musicians, movers, and teachers, most of us have been taught "good posture" markers, like sit/strand up straight, shoulders back, head upright, suck in the belly.  Ironically, many of these cues will not yield good posture at all, but will hide the body's deficiencies through overcorrection.  For most of us, this was continue out into our daily activities, including yoga, weight lifting, running, etc. and yields rib thrust or rib flare.  What is this, you ask?  Take a look at this image below of Katy Bowman, biomechanics movement goddess. 

Image from  Nutritious Movement .  Go read her books now.  I'll wait.

Image from Nutritious Movement.  Go read her books now.  I'll wait.

Take a look at the three difference variations of posture (there are infinite variations- these are just a few).  Which one looks "the best" to you?  Number three?- in which the body is upright and the shoulders back?  Or Number Two, in which the spine looks slightly rounded or kyphotic?  Also look at the vertical plumb line between the three images- only number two has the head stacked over the heels.  In both image one and three, the head is trailing forward of the heels.   Which image do you most resemble?  The "best aligned" posture of these three is not number three, but number two, in which the body's natural spinal curves are preserved, and the head, ribs, and pelvis are all in a unified line.  Number three reveals the rib thrust, which can be defined as the ribs moving forward of the pelvis which then does gnarly things to the lumbar (low back) spinal vertebrae.  This is separating an aesthetic marker (shoulders back, chest forward) from a true body alignment marker (ribs and head over hips and heels).

Time out: What are forces? Has it been awhile since you studied physics? (For me, over a decade, so force = mass x acceleration) Fear not- gravity (a force) is still working with you. There are other forces (non Star Wars related) working on you as well in movement, including tension, compression, shear, and torsion. Go read about them here!

Image from  Leslie McNabb.

Image from Leslie McNabb.

So even if this whole force thing isn't making sense, you can see that the ribs are shifting forward of the pelvis, right?  What that does is compress the lower vertebrae, as well as make for some unhappy soft tissues, a dysfunctional core (can lead to diastasis recti, especially when pregnancy and post  natal issues are coming up ), and a possibly dysfunctional pelvic floor (incontinence, pain, etc.) amongst other things.   (See this woman on the right?  Does she have "good posture" or is she just masking her body's dysfunction by pushing her ribs forward and throwing her shoulders back?

Most of us have some degree of rib thrust, but it will manifest more often when wearing high heels, because the body is trying to mask the inherent distortion that high heels creates for the spine.  (Gentlemen, most likely your dress shoes have a heel, so you are not immune to this conversation)

Bad posture to bad posture- not bad to good!  Image on left shows the over-rounding, or kyphosis of the upper back with the pelvis forward of the heels, image on right shows rib thrust, to appear to have "good posture."

Bad posture to bad posture- not bad to good!  Image on left shows the over-rounding, or kyphosis of the upper back with the pelvis forward of the heels, image on right shows rib thrust, to appear to have "good posture."

Let's review- in the rib thrust, the bottom most ribs are shifting forward of the pelvis, which draws the scapula back and creates the illusion of good posture (upright body, broad collarbones).  It is in fact masking the issues at hand, which are lack of mobility in the thoracic spine, and possibly hyper-kyphosis, as seen in the image on the right.  So what can we do about the over-slump?  Start to work on thoracic mobility, shoulder mobility (with stable ribs), and keeping the bottom-most ribs down.  

So first, do some exploration, and see where you fall in the spectrum- where are your ribs hanging out?

Here's some more reading about rib thrusting!

"R U A Rib-Thruster" by Katy Bowman

"When Good Posture is Actually Bad for You" by Leslie McNabb

"When Is a Backbend Not a Backbend?" by Jenni Rawlings

Detangling the Pecs: Part 3

Image from  Erik Dalton

Image from Erik Dalton

This week, we've looked a little at what the pectoral muscles do, specifically the pec minor, and how restriction with the front of the chest muscles can bring the shoulders protracted and internally rotated.  Now, how can we start to create change within those muscle groups to better balance out the shoulder joint?

1) Address the restriction on the front via awareness: is it a result of your instrument? Your sitting habits? Your driving habits? Do you notice your shoulders slumping forwards in daily activities?

2) Correction with outside feedback: It can be tempting to just think "I need to bring my shoulders back and down," but that's not helpful either.  The shoulder joint is highly mobile, and even though restriction in the front may be an issue, there may be other culprits that could use attention, whether it's in the neck, the spine, or the shoulders themselves. In addition, a shoulder blade moving forward, or protracting, may also be internally rotating. (see video below)  I'd recommend seeing some sort of movement professional (PT, massage therapist, pilates teacher, trainer, body mapper, Alexander Technique teacher, etc.) and ask for some feedback.  (As always, if you're in a place of acute pain, see a doctor for a full assessment!) Although I primarily teach pilates and Yoga Tune Up®, there are many well educated movement professionals in different fields that can help you identify your issues.  One thing I find helpful is to take pictures on a phone of your shoulders/collarbones, and just use those as a reference as you start to make changes.

The infraspinatus and trees minor are key muscles to look at strengthening.

The infraspinatus and trees minor are key muscles to look at strengthening.

3) Mobilize and Work to strengthen your external rotators of your shoulder: So for every muscle group that contracts, there is an opposing muscle group that's relaxing.  The muscles on the back of the shoulder blade are primary external rotators of the shoulder, and can help bring the arm bone back and done, but without forcing it in an inorganic way.  How does one strengthen these muscles? Most movement disciplines have some form of strengthening built in of these muscle groups, but here are some of my favorites:

This may seem really easy, but if the spine and ribs are stable, and the arm bone not moving forwards or backwards, it can be a real challenge.

This may seem really easy, but if the spine and ribs are stable, and the arm bone not moving forwards or backwards, it can be a real challenge.

1) This classic strengthening exercise involves either a theraband or a set of small hand weights (like the dinky vinyl coated ones).  One can do it standing or side lying, but essentially, the goal is to keep the upper arm bones, or humerii, stable as you pulse the hands away from the body.  This video shows how to do the same exercise in standing, with a theraband.  One can also do it in standing without any resistance.

2) Reassess your plank poses, downward dogs, or even quadruped/ hands knee poses.  Many times I see students in internal rotation from the onset of class, and learning how to externally rotate the arms in weight bearing positions in critical, especially if you practice weight bearing positions.  One of my favorite Jill Miller videos is about the challenges of downward dog for the shoulder.  If you're a yoga student, this video is a must!  Here are a few other blogs about the challenges of Downward Facing Dog.

3) Look at where you may be missing range of motion in your shoulders: I love shoulder flossing, either with a theraband, Fletcher Pilates towel, yoga strap, or other device.  This great video by Christine Jablonski shows one of my favorite Yoga Tune Up® exercises.  Although this isn't a particular strengthening exercise, it can help bring awareness to where you need mobility in the shoulder.

4) Bring some length to the front of the chest via floor angels.  This is one of my favorite exercises, and it can be down with the upper half of the body on a foam roller or bolster or block.  The number one objective is to keep the ribs down (which the woman on the right is NOT doing) to really assess where your actual range of motion is. Once the spine starts moving, you've lost the intention of the exercise.  This is a classical Katy Bowman exercise, but this video  also describes it well.

Although there are many ways to strengthen the shoulder and start to bring change into the shoulder joint, here are a just a few ways to get started~

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