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Self Care: Stretching and Movement

Self Care:  Stretching and Movement

Stretching tight areas both feels great and can be very therapeutic. Frequency- how often you stretch, is more important than duration. Move around a bit in each stretch and find the stuck spots- don't just stretch where you have the apparent reward of going further, but stretch where you have the most limitation. Remember for these and all the stretches, don't try so hard that it hurts- teaching the muscles to relax is the most important part. Finally, there are almost always patterns of tight muscles pulling against muscles which need to be strengthened. Exercise will help keep the body in balance.

Back of the neck and upper spine

Spend a lot of time at a computer? Got a "knot" in the upper back, near the base of the neck? This is a great stretch for helping with tension in that area.

While sitting at a computer using a keyboard, the arms are extended and internally rotated, the shoulders are forward(scapula protracted) and usually held up(elevated) and the upper spine has too much forward curve(kyphosis.) All of this compresses the chest, reducing respiration, and puts a muscular strain on the upper back- the cause of those knots. The more you hunch forward, the harder the upper spine and neck muscles work to keep you from falling onto your keyboard. The more you can keep your head and torso upright, the less those muscles will work to maintain balance. (Rigidity is bad too, but that's another article.)

The idea is to stretch each involved body part the opposite of the way it is held while sitting at a computer. The arms reach back and externally rotate. The shoulders are pulled down and back instead of up and forward, and the torso straightens and elongates.

Here's how it works: Stand up and put your hands behind you with the fingers laced together. Now take a big breath in, and then as you exhale pull the hands downward with the arms straight. As the arms pull down, the shoulders come back and the chest moves forward and up. Take a few more deep breathes, each time filling the lungs, expanding and raising the chest, then pulling the shoulders behind you and the torso gently bent backward on the exhale. Don't try to bend too far right away.

Additionally, the back of the wrists and forearms get stretched, and by turning the hands over, from knuckles down to palms down, the inside of the wrists and forearms are stretched as well. By externally rotating the arms, pulling them back and then up, you include rotator cuff muscles and the front of the deltoids. Pulling the shoulders and arms back lengthens the pectorals(major), the main culprit with slumped shoulders and a constricted chest.

Two more important benefits are increasing awareness of your posture, and creating a new habit of holding your self more upright and balanced.

It doesn't take long, so try to do this at least once an hour. Talk with your therapist for modifications appropriate to your own body and other stretches and strengthening that may be helpful.

Sides of the neck and tops of the shoulders

When the sides of the neck or the top of the shoulders are tight, this stretch may help. It is so easy it can be done while seated(and still looking at the computer even.)

Sit up straight, leaning back a bit if the chair supports you well. Let one arm hang straight down by your side, and grasp the bottom of the chair seat. Some chair and arm combinations may not work well for this but they usually do.

While hanging on with your hand, lean to the opposite side. As your torso tilts away from the grasping hand the shoulder will be pulled down. At the same let your head tilt in the same direction as your torso, and the side of the neck will be stretched.

Remember to let gravity do the work. On each exhale think about releasing the muscles between the head and shoulder a little bit more. After five to ten breathes switch sides.

This stretch also works while standing. Try holding the edge of your desk to try.
 

Chest and shoulder blades

Bringing the shoulders forward too much is usually linked to shortening in the pectoralis major(the large muscle under the breast) and the serratus anterior, a muscle connecting the shoulder blade to the ribs. These two stretches will help loosen and lengthen them.

Both use a door jamb or similar fixed vertical object to push against. For the pecs, stand with one arm with the upper arm horizontal and the forearm vertical near enough to the doorway to brace the elbow against the edge. Turn your entire body so that you have just a  mild stretch. Now as you inhale, push your elbow gently against the door jamb and hold the pressure for a few seconds. Now as you exhale, gently rotate your hips and spine to increase the stretch. Stay in this new position and repeat the breath cycle and turn twice, each time getting just a little bit more stretch.

The serratus stretch is similar, but is done with the arm straight. Stand a bit further from the doorway with the arm level and straight in front of you. In this stretch, instead of the arm rotating at the shoulder, you are pushing the shoulder straight back and the shoulder blade is moving closer to the spine.  Follow the same process of a slight isometric push(pressure without movement) as you inhale, and then turning the rest of your body to create the stretch. If you are doing the right shoulder, gently turn your body to the left on the exhale. A slight forward lean will help also. 

Front of the Hips

Sitting in a chair shortens the front of the body from the knees to the head. This includes the hip flexors- the rectus femoris, the psoas major, the psoas minor(if present, not everyone has this muscle), and the illiacus. The spine is typically bent forward as well, shortening the abs(rectus abdominus.)  From the lower ribcage up to the head is also shortened, but isn't the emphasis for this stretch. Here we focus on the muscles and connective tissue attaching to the anterior pelvis.

Stand, or visualize standing, for a moment. Your body is upright, your legs underneath you.  Now raise your right knee. This is flexion of the right hip.  Note that the movement is between the upper leg(femur bone) and the pelvis, and that this is the angle of the hip when you are sitting. Stretching this area requires the knee to go in the other direction, behind your body.  It won't go as far of course.

To do the stretch at your desk or a table, stand near the edge and put both hands firmly on the top to help support your weight. One leg extends behind you, with the knee nearly straight and the heel up. This is the side being stretched. The other leg goes in front, with the knee bent and the foot flat on the floor. Your body will lower into a gentle lunge as you do this, and as it does, keep your weight well supported with your hands. The hip and leg muscles will relax more if they aren't being used to hold all of your weight.

Keep the torso upright, or even bending backwards a bit. Remember that the stretch is between the leg and the hip, so if the hip tilts forward the hip flexors aren't lengthened. Imagine a long, smooth arc from the back foot to the top of the head. Keep the shoulders back and down and the chest up for optimal form and completeness. Follow the suggestions given for the other stretches on breathing and releasing into the stretch, and then switch sides.

A similar, and deeper, stretch can be done with the knee on the ground. Some padding will be needed to protect the kneecap on the floor, and press your hands onto the front knee for support and to keep the torso upright.

Hamstrings

One of the most common stretches people do is for their hamstrings. Anytime you see someone stretching, they will probably bend forward to try to stretch the hamstrings.

It is a good intention- too much time sitting can lead to the hamstrings shortening. Those short hamstrings can contribute to low back pain, and they can be injured in sports. Unfortunately most people stretch in a way that puts all the force on the upper back and little on the hamstrings themselves.

First, a bit of anatomy. The hamstrings are comprised of three muscles- the biceps femoris, the semimembranosus, and the semitendinosus. All three attach at the pelvis and cross the knee to the lower leg. Stretching them requires straightening(extending) the knee, and bending(flexing) the hip(femur/pelvis joint).
 
The incorrect way people try to stretch the hamstrings is stand up, bend forward, and round the back as much as possible. The upper back is being stretched, and that is something most people have too much of already. Being bent over puts a shear load on the back, just while it is stretched and less able to support itself. The hamstrings, being stronger than the extensors of the upper spine, get almost nothing. Don't bother trying to touch your nose to your knee, or touching your toes with your hands.

Instead, keep the spine neutral while stretching. Don't bend at the waist, but at the top of the leg. The leg can be angled in front of you with the rear leg bent, but better is to elevate the leg being stretched. Find a step, chair, or other solid support for your foot. Stand up straight, and keeping the back neutral and strong, tilt your body forward. Do not worry about how close your nose gets to your knee. If you are able to bend more than about 45 degrees, use something higher to elevate the foot.

A few things can be done simultaneously to involve more muscles. First, add the calves by using
a support that has a back you can push your foot against.  Steps work well for this. The heel is on top of one step, and the sole is pressed against the front of the next higher step. The adductors can be stretched by turning your hips and upper body away from the extended leg, and the abductors get stretched by rotating your torso toward the leg. And still- bend at the pelvis, not the waist, and definitely not the upper back.

 

Positive Massage Therapy client feedback:

I definitely could still feel the massage this morning, which is amazing because normally after I get a massage I feel exactly the same the next day. It was really great to meet you, and I will definitely remember your tips about stretching and posture!
Thanks,

-Jessica M., Menlo Park

 
     

 
 
 
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Positive Massage Therapy
Los Altos, California
650.814.3949