 and welcome back to Movement Matters. I'm your host, Christine Linders, physical therapist and board certified orthopedic clinical specialist. So here in Hawaii, there's a thing called a jabong and I wanna tell you all what it is. What is a jabong? A jabong is a pomello fruit. It is this very large part of the grapefruit family fruit. However, my whole life, I grew up with my dad eating grapefruit every single day and I have tried my whole life to eat it with ruby red and all these things, but the tartness just, I can't get through it. So I have my first jabong a month ago and I have become a jabongaholic. I'm looking for, it's not in season yet. And I love it because it looks like a grapefruit on the inside but it's got these thick vesicles and they just burst of flavor in your mouth but they also are sweet. So I am looking forward to getting a jabong in January or in a couple months when they become in season. So now more importantly, for this show, I wanna talk about what is creating pain in the necks and the backs and the shoulders of our children and ourselves. These things are called smartphones, tablets and other portable devices. Now, while these devices are amazing and they provide us miraculous amounts of information and convenience, the problem is, is that we are looking down at these devices and hanging our heads next and our low backs in poor postures. And how I know that this is a problem is because for about the last seven or eight years, I have been treating teenagers to young 20s with neck back and posture problems and they come into the clinic and they sit and they're hung down staring at their devices. And I wanna save us, all of the adults, all of the older people, all of the youth from having deformity in their spine. So today we're gonna learn about what is good posture and how do we get there? How do we improve it fast? Let's go to video number two so we can learn that. You wanna fix your posture now so that you can keep your neck and back healthy or you could get rid of your neck and back pain. But how can you change your posture if you don't know what good posture is? Let's talk about good posture. So good posture means your ear is over the central access point of your shoulder right through your hip. So if I'm here, my shoulders forward of my hip and my ear is forward of my shoulder. So that's not good posture and neither is this because my ear is not lining up over my shoulder. So when you're looking down at your phone, that's not good posture. If you're sitting in a chair or your sofa like this, that's not good posture because your ear is not over your shoulder and your spine is rounded. Good posture is where you're sitting upright so that the central access point of your hip and your shoulder and your ear all line up together. Your head is not in front of your body, your shoulders are not in front of your body. So to help you achieve good posture, whether you're sitting on your futon, sitting at your kitchen table, sitting in your desk here, sitting on your slouchy sofa, all you need is a cup or decorative pillows and maybe a rolled towel or something to support the natural curves in your spine and you can feel like you're slouching and melt into that sofa. Well, this does the work and you're in good posture so you're not harming your spine, your shoulder, your neck, your back. So you just put this in the lower part of your back, you scoot your butt all the way back to the seat and then you support your lower back. You can use a fleece or something. I kind of squished it in there. So I relax but I can't really slouch. I can do it a little bit but not too much. Now if you feel like you're more rounded here, you can take a rolled towel blanket or something and place it between your shoulder blades to kind of open up your chest this way. I work on a futon when I'm editing so I sit here like this and all I do instead of tilting my head down is I nod my chin down and I work on my laptop. So now I'm in good posture, I'm very supported, I'm very relaxed, that's about as much as I can slouch but I'm completely relaxed into the pillow. So try some of the strategies at home so you can enjoy good posture. That is a very quick way to help support your spine and set you up for success to get you into better posture. So when you're looking down at your device, looking down at your crossword puzzle, looking down at your laptop or hunching forward, I call it the follow your nose principle. Your nose, if it's held up, your posture is up. If your nose goes down, your head, your neck and your spine go down. And now why I am so passionate about children is because I want children to grow up and develop their movement patterns to be good because ever since we're young and we're crawling and we're learning, our body is developing movement patterns and our muscles are developing movement patterns and our brain is adopting movement patterns. And so when you are in a movement pattern that is hung forward from two, three, five, six, seven years old, then you go to school and you're hung forward and you are in that hunched forward movement pattern, the muscles on your front of your body are in a shorter position. And we like to say they're like short and strong and the muscles on the back of your body, all your pastoral stabilizers become long and strained and weak. And your body and your brain adopt that pattern as normal. And so now you get into my clinic at 15, 18, 22 years old and I'm saying sit up straight and you're looking at me like I'm nuts because you think you're sitting up straight because you've been in that position for five, 10, 15 years. So I wanna help our youth to have the opportunity to develop those proper movement patterns. Now, what do you do? Reminders, I remember being a child and my mom would remind me and that's kind of a pain. And if you're working from home and you've got your kids doing your studying, especially during this pandemic, they're at school, you can't control it, they're at home, they're with their friends, they're in college. How do you correct them then? That's what this show is for because I'm gonna show you strategies that set you up for success. So you can also set reminders on your phone and there's also posture straps that you can use. Let's go to video number three which is a clip from my old show Kids and Devices where I talk a little bit more about this. An image now, image number five that shows someone just relaxing by the pool side on their phone and this is a similar position that I mentioned earlier about the 14-year-old girl that I'd seen that had a fracture in her back. She was studying in bed like this. So for hours with her leg straight and she didn't mention it until I had corrected her sitting posture when she came in to see me and was wondering why her back still hurt and that's what she told me. I said, you're not sitting in bed like this, are you? And she said, yeah, I'm sitting like that with my leg straight out. And so I have image number six which shows what can happen to your neck when you're looking down prolonged like that on the phone. So this is someone who's in her mid-20s who had been looking at phones for probably at least 10 years. Now kids have them from, you know, three or four years old devices they're looking down on but I took this picture of her because she was having neck and back pain and I wanted to let her know, yes, we can correct that. It's gonna take some time but those first few vertebrae when you're hanging your head face down start to migrate more forward over time. It's not in one year, it's over several years because your head is heavy, it's between six and eight pounds and so the head is hanging on those vertebrae so eventually you become formed like the position you hold yourself in most and so the vertebrae are accommodating for your head being forward. So that is something that I wanted to point out that another problem and why people are getting back pain and neck pain is because your spine, the form of your spine is actually changing if you're doing it for extended periods of time over a duration like two years. So now in image number seven, you'll see that this is a picture of someone's looking at their phone just relaxing but the head, you can see the head propped up against the sofa. That's the same thing as looking down minus gravity. It's creating a stress right on those vertebrae so in image number eight, that's a good way if you wanna lay down and watch your phone. Just keep your spine straight, hold the phone up, rest your elbow on the sofa and then you're not putting any dangerous harm on the young developing spine. This is my nephew, he's 10 years old so I was hoping to have them call in but they're in activities. So in image number nine, here's an image of my niece on the left side of your screen just relaxing, looking at her phone, texting friends and I showed her in the right side of your screen hey, this is how you prop the pillows, scoot your buttocks back, support your back so now her neck doesn't have the pressure of the headboard pushing it forward. So Tajma, let's go to image number four where we can look a little bit more. This is a great image from the Ministry of Health and Welfare on the Korean Academy of Medical Sciences and that does show what happens. Form follows function is a term that I've heard in physical therapy for the last 24, 25 years and that is a great example of form. That's how we're formed on the left side of your screen and then function, if you hang your small bowling ball of a head forward and you follow your nose down into your tablet, down into your device, down into your games, down into your book, your crossword puzzle for a period of time collagen is constantly turning over your bodies. The muscles are learning information about the positions you hold your body in first and then you end up looking like some version of the picture on your right and I am in the business of getting people out of pain. And so the reason why I wanna do these shows is I want you to have some examples of how you could be harming your body without knowing it and I wanna give you strategies on how you can help your body to develop better movement patterns. Nobody's perfect, I'm not perfect. I struggle with my posture, I work on my posture, I work forward for my business and so I'm always doing some of the exercises that I will show you soon. So I have a question and it is, how do I get my kids to sit up straight while they're looking at devices? Now, that's not an easy question to answer but I think the key is to get them up and moving periods of time. I was interviewing my mom a couple of days ago and asking her mom, what did you do for us? And she goes, well, you would play a tarion, you would sit hunched cross-legged on the TV but we were looking up at the TV so it kind of corrected itself and she said, most of the time you're outside like running around, riding bikes and doing whatever and her thing as a grandmother was, kids are just inside too much now. They're inside too much because there's too much to do inside. There's cool devices and games and videos and things that I didn't have growing up and my mom didn't even have those games. TV was the big thing that came out when I was a youngster and then it was, wow, look what I could look at. So I think reminders, getting kids up and moving, engaging them in something, cleaning your room, go outside and run around for 20 minutes, help me do this, anything that you can do to get them off devices, set timers. We had one hour of cartoon time that we could watch on, I think it was Sunday mornings and my brother and I turned it into two because we all deserved one hour each. So those are just a couple of quick tips you can do anything like that but I think the key is to set a timer to get them off the devices and get them moving around as soon as they can when they're children and games and movement games are a great way to do that when you're a child then it's fun too. So let's go to video five where we learn how to undo a forward posture. Nobody's perfect, not even me. We slouch sometimes, we catch ourselves slouching while we're in the middle of a project or while we're at work. What do you do to correct that so you don't get injured and you don't suffer pain? You need to undo that activity. So whatever that activity is, if you are a sous chef or you're at home cooking dinner for your family and you're bending forward cooking, if you are sitting at your desk job and you have to look forward at documents and then up down at the keyboard, if you're a physical therapist and you're working out a patient, you're in sub-optimal postures throughout your day and you need to do things to undo that so that over time, compounding day after day, you don't get postural deformity where your neck becomes fixed forward or you get that hump at the back of your neck from your neck forming a different way because you're looking down all the time. You need to undo that and there's a couple of simple things you can do. One of them is my favorite, whether you are 20 years old or 90 years old, this works. You will clasp your hands behind your head and neck like this. If you're already really forward, then I tell people, push your head into your hands and then press your elbows back. Press your elbows back. Don't let your pull yourself forward. Press your head into your hands. Squeeze back. Squeeze back. You can do 10 times while you're at work if you catch yourself slouching. You can also do the, looks like a W, squeeze your hands back like this. Hands first, not elbows. Hands first. Squeeze and activate those postural muscles. You can grab opposite elbows this way. Rest your head against push back. Lean to the side and breathe. Lean to the other side and breathe or you can just simply squeeze your elbows back. It's so important to undo the postures that you're in. A surgeon bending down for hours on end is going to need to work the upper back muscles, stretch out so that 10, 20 years later, they're not walking around like this because that's a position that they hold their body in most. I want to give you very simple, easy strategies that take seconds and minutes so that you can feel better. And that exercise is a great one. I'm currently using it on people from their 20s to their 90s. And the feedback I get with this one is amazing. In the video, you see me extending my spine a little bit and that's just because I'm a super bendy, flexible person. But if you are stiff and you are rounded like in that image earlier, you're not going to be able to do that. You're just going to be squeezing your shoulder blades back and that's the point of the exercise is to squeeze the shoulder blades back, lift your chest up to the ceiling and get some opening in the front and re-educate those movement patterns. Let's go to video number six where we can learn a little bit about posture straps and how they might be able to help you. Okay, so you're aware your posture isn't perfect and you want to sit up straight, but you can't remember or you have a desk job and you want a little bit of help. Many people ask me about these posture straps. So I found one that's great. I had a patient bring his in and they showed me this posture strap. And so basically you just slide it on like a halter and it goes like this. But where I see the problem is that you can still slouch over that even if it's tight because of where it comes on your shoulder. So I messed around with it a bit and I found a great way to do it and that's if you put it on upside down like this. So if you put it on upside down here, you just feed one arm through. It's kind of helpful to have somebody else put it on you so you don't hurt your shoulder so you can reach back here and then you could fit it so it's in the center. I can adjust it a little bit better but I won't just for the purposes of this video. And then what you do is sit up straight, squeeze your shoulder blade and then you cinch it down here to hold the arms back into rotation this way so that it basically pops you up like that. So they're great posture straps can work but I think you just have to reverse them but it's another option to help you get better posture. That's a great little trick and it's another way for you to give your brain some input about the position that your body is in. So if you're sitting on your sofa with the pillow behind your back watching TV, that's a great time to put the posture strap on because it's going to get your body in that position where your brain can then say, oh, I got to fire muscles and keep myself here. Great idea to do that. If you're sitting eating dinner, it's another great idea to open up your posture. If you're sitting, reading a book or working out across the repuzzle, that's a prolonged period of time where you could be sitting and getting involved in your puzzle or your knitting or whatever you're enjoying. Great time to put a posture strap on for 30 minutes to an hour to re-educate your body. You'll see every time you go to slouch, oh, you can. You cannot slouch when you put it on the way I showed you. So you can play around with that and you can always reach out to me. I can give you some links on how to find that. Let's go to video number seven where I show you the stretch that I do one to four times a day to undo the tightness in my chest from working forward with everything that I do, including all of us, everything we do is in front of us. And this very critical muscle, the pec and the pec minor continue to hold you down into poor posture. So you can do all the exercise in the world, but if you don't stretch that muscle out to rebound yourself into a ideal posture, you're gonna be fighting an uphill battle. So let's go look at that video. This is my favorite stretch I do it every day, several times a day to open up my chest after working forward all day long. So all you have to do is find a doorway, straighten your arms out to the side and learn how to stretch these pec muscles that are holding you down and pull them up. I like to do it this way because instead of having a stretch that just does your chest, I try to use the pec minor to pull your rib cage open and really open your chest so I incorporate breathing. So you're gonna go into the T position, not the W for this exercise, but the T. You're gonna put one foot in front of the other because you never wanna hang on your shoulders like this. One foot in front of the other, you're gonna bend the front knee and then the magic is gonna be to push the back foot up onto the toe and at the same time, lift your chest and take a big breath in like this. Push up and inhale and feel this pull and open up your chest. Inhale, I usually do a few. Push through, lift your chest and inhale. You can also turn a little bit to the right, push your chest through, lift your chest, inhale and breathe. You can also switch your legs, turn to the left, push through the door, inhale and left your chest and feel all this open up and enjoy better posture. I want you to try that stretch. If you are watching right now, I want you to stand up. I want you to go in a doorway, spread your arms wide like you're in the shape of the letter T. Put one foot in front of the other like you're in a lunge position, bend the front leg and then push up onto your back toe and inhale and take a deep breath in. Come back, exhale and then inhale. Take a deep breath in. You should not have any pain. So if you do, check your position. Make sure you're putting your weight on the front leg. A lot of people like to keep their feet next to each other and then put their arms wide and lean into the door, but that's too much weight to put on your chest muscles and your shoulder joints. So I want you to try that. Every time I do it in the clinic, everybody always says the same thing. You feel it so tight, it's hard to get that last bit of air in there, but they always say, oh wow, I feel so much more open. Let's go to the final video today, which is a clip from a previous show. Your posture is causing your pain to learn some band exercise that you can do. Now that you've stretched out, just strengthen your posture muscles. My top, get rid of your shoulder pain, get rid of your neck pain, get rid of the tightness that you felt sitting at your desk stretches. Number one, you are gonna rotate your hands out to the side, keeping your elbows in like this and squeezing your shoulder blades. Number two, arms at shoulder height. Pull back squeezing the shoulder blades till the band hits your chest. Number three, I call X's. You form the angle of one X, pull back, squeezing those shoulder blades, keep your chin down and your neck long, switch the other X and squeeze. I like to do 10 of each and then the last one, arms up over your head, pull down and lift your chest. Come back up, pull down and lift your chest. Neck long, everything feels good. Enjoy feeling better, everybody. Those are my favorites as well and I feel like the ones that I showed you today are some of the simplest exercises that you can do to help improve your posture quickly. So let's talk about how you can remember. I like to set reminders for people or look around, are you with your family member right now? Are your children around you? Are you at work and your coworkers are around you and you can kind of glance and see, are they hunched forward? Are they sitting up straight? What is their position and what are they doing? Cause I believe that to end, decrease our pain and end this low back pain epidemic that we have, we all need to be collectively more aware of our posture. And I think a great way to help is encouraging people to, hey, you're looking down, you could get pain that way or hey, try to lift your chest and sit up a little bit better or do this little exercise to re-educate your posture muscles, you will feel better. And when we feel better, we perform better at work. We perform better in our lives. We're happier, we feel more confident. Try it, if you tend to be a little bit more hunched because you were not aware of your posture and you are right now, lift your chest and sit up straight. That's actually a technique that people use before they go into a public speaking episode. They stand up straight, they stand proud and they feel kind of victorious. And it gives you this rush of confidence into your brain, your body, your nervous system. So there's more to posture than just avoiding and getting rid of neck pain, back pain and shoulder pain. It's about how we exist in our world to ourselves and to other people. So to sum up for today, help our kids, our teens, ourselves, our parents to feel better in our necks, our backs, to end our pain, to allow our bodies to move more optimally, to reset these muscle patterns that maybe we have developed in a faulty way so that we can feel better, remind yourself, set timers on your phone for five minutes, sit up straight and then when the timer goes off you might be slouching again. That's right, I gotta sit up straight. If you need to use a posture strap, even if you use a posture strap for 15 minutes to help hold yourself up, that will work. Remind your kids to get up frequently or yourself, set a timer, get up frequently, go get a drink of water or walk around your room, walk around your office and sit back down. Not only will that movement have helped your body, your cells, your tissues, your heart, your circulation, everything for your wellbeing of your organs, but it will clear your mind and allow you to sit back down and have a fresh thought process so that you can start work again. I hope you have enjoyed the show today. I enjoyed doing it for you. I wanna say aloha and mahalo for joining me today and for all of you Trekkies, live long and jabong. Life is better when you listen to your physical therapist. Aloha everyone.