 Aloha and welcome back to Movement Matters. I'm your host, Christine Linders, physical therapist and board certified orthopedic clinical specialist. I'd like to welcome you to my special two-year anniversary edition, Hosting Movement Matters. And I'd like to thank you all for watching and Think Tech Hawaii for allowing me to be here with you today. So I would like to first open up with how I got started in video number one. OK, now smartphones have become a fifth appendage. OK, and we have them all the time in our hands. Why don't you tell us a bit about that? And let's take a look at image three. OK, so in image three, you can see what I see so often in the waiting room while people are waiting for you to come get them or walking into a coffee shop, on the train, on the plane. We love our phones. They're great. They can entertain us. They provide information. They allow us to stay in touch for people near and far. But when you sit like that on your phone, you're not thinking about the fact that your head, which is somewhere between six and eight pounds, is hanging on your neck muscles and then all of that is hanging on your lower back until something hurts. And that's where we're at risk with phones. We need to be aware to have good posture while we use these glorious devices. OK, so I go to seminars or meetings and I want to look at my phone underneath the desk or the table. Is that OK? Yeah, I suppose that would be OK, but it's not OK for your body. So when you're leaning down to look at your phone like that, trust me, the presenter knows what you're doing. You may as well just do your neck and back a favor, glance at your phone up here, get your message done, and then put it away. OK, and so I know a lot of our viewers are actually streaming this on tablets, OK? Yes. Now, are there any concerns about tablets? And we can take a look at Image 5. That is on how technology is ruining your neck and back and how to solve it on much more on medicine. And thank you to Catherine Orr for having me on my first episode interview so that I could get my own show and tell all this to you today. So the message in this video is everyone's working at home. You need to be able to sit up straight, keep your body in proper alignment, and be able to use those glorious devices. So this whole show is going to be all about little clips from each of my shows to bring you the best information. So in video number two, we're going to talk about the secret to getting rid of low back pain. Today, I'm going to drop the mic on back pain. I, your virtual physical therapist, will be giving you the evidence-based solution you've been looking for to end back pain for good. Let's go straight to video number one. Let me introduce you to your secret weapon to end lower back pain and get a flatter stomach. Your transverse abdominis, or TA, as I call it, is your deepest abdominal muscle. It's been around since the beginning of time, just waiting for you to call on it to help support your back. But no one told you it was there. If you have back pain, you need your TA to form the anatomical girdle with your deep back muscles to support your spine. You see, the TA contracts just after your brain has the initial thought for motion. Your brain thinks, I want to reach for that glass of milk. Your TA fires, then your arm moves. Try it. Pull your belly button in toward your spine. Go ahead, suck it in. Now that you know it's there, use it before you move and enjoy a pain-free lower back. So there you have it, the secret to ending low back pain. I've been using this technique since 2002 or three. And each time, even now, today, that my patients learn it, they always come back saying, that really works or that made all the difference. I even had one gentleman say about four years ago that he felt victimized, that he'd had back pain for 35 years and no one told him how to suck it in, no one told him how to engage his anatomical girdle. So when you engage your anatomical girdle, when you suck it in, you activate your trans versus abdominis muscle. It's your deepest abdominal muscle. And it runs sideways across your body like this. So it also gives you a narrower waistline or a flatter stomach, as I usually say, because it works. It holds your contents in. But also more importantly, when you suck it in, you activate your deepest low back muscles. And those back muscles stabilize vertebrae for vertebrae stigmatally in your spine. And that's what keeps those vertebrae safe and prevents them from shifting or being vulnerable while you go about your day. So here's the step by step on how to suck it in to activate your anatomical girdle in video number two. To learn to engage your trans versus abdominis correctly and engage your anatomical girdle, I'm going to show you how to do it in standing first. So you're going to stand up, and I'll visualize that for you. You're going to put one hand on your diaphragm here, one hand on your belly button below, and you're going to pull your belly button in like that. So you just suck it in, suck it in. You don't want to pull it in from here too, because then you stop your diaphragm from breathing. You can hear how it changes the sound of my voice when I do that. You just want to pull it in from here. Your trans versus abdominis. And if you see it from the front, the fibers run this way. So when you pull your belly button in, you see it shrink my waist. Belly button in, belly button in. So practice that in standing first. That way you can use it. Pull your belly button in. Bend to pick something up. Pull your belly button in. Reach for the car door. Pull your belly button in. Put your short on up over your head. Enjoy. For anyone suffering low back pain, you need to learn how to suck it in, and that is engaging the deepest abdominal muscle, the transverse abdominis, which when you contract that and you pull your belly button in, it activates your deepest back muscles and it stabilizes your spine. And at the end of that video where I tell you, suck it in before you bend to pick something up, suck it in before you roll to get out of bed, the reason why that's important is because the transverse abdominis is designed to fire a fraction of a second after your brain has the thought for motion, but before the motion happens. And so let's go to video number three to learn more about that. That point to be huge, suck it in before you move. The way the transverse abdominis was designed was so that when my brain thought, I have an itch on my face, before my hand would move, my transverse abdominis would fire and my arm would move up to touch my face. That's how it's been designed to work. But when you've had back pain or an injury or poor posture, et cetera, that mechanism might not be functioning well and that might be why you have pain when you go to move out of your chair or pain when you get up in the morning or pain when you've been sitting poorly at your desk. Your anatomical girdle is not stabilizing your spine as it should. So that's your transverse abdominis. The image up there is your multifidus muscles. They are the deepest, segmental, final stabilizing muscles. So get used to those two words because those two critical muscles are what you're going to need to get out of back pain or good. It is great to learn how to suck your stomach in when you're standing because that's how you're going to function while you're up washing dishes, bending to wash your face. But it's also important to learn to engage the transverse abdominis and the multifidus together to do it in neutral spine. Now the low back has a backwards shaped curve. And so the next video is going to show you how to learn laying down to suck your stomach as your anatomical girdle. Two years, five years, 35 years, you need to suck your stomach in to stabilize your spine. Take that message to heart and learn what you need to do to get out of pain. So if you were in your first session with me and you came in with back pain or whatever your problem is and I'm teaching you how to activate your deep core, what I have people do is to lay down on their back to learn it so you can learn what is called neutral spine. If you're slouching, your spine is not neutral spine. The spine has three curves. I'll show you on the skeleton actually. It's a little bit twisted, but there's a backwards curve in the neck here. There's a forward curve in the middle back and then there's a reverse curve in the low back. It goes backwards again. This person's had a little trouble. But it goes backwards, forwards, and then backwards again. So when you're slouching, you're taking yourself out of the nice low backwards curve that you have here. So neutral spine is that backwards curve that we were made to have in our low back. And so if you tend to be a sloucher, you may need to sit up a lot. You will have to sit up a lot straighter to get into your neutral spine. So let's go to video number four to learn how to suck it in a neutral. You must learn to suck it in from neutral spine, which is the natural curve in your low back to know that you're engaging the transversal dominance correctly. So you want to land your back with your knees bent up. And what you want to do is you want to suck it in from here. Pull your belly button in. Pull your belly button in, just like that. You don't want to tuck your buttocks under or press your back flat. You don't want to pull your diaphragm in. And what you can do is you can place your hand on your diaphragm just below your rib cage. And you can place your hand just below your belly button here at your belly button. And you want to pull your stomach in without pressing the diaphragm. So your belly button in, belly button in. And you also want to pull your belly button in here. You can see it narrowing my waistline. Belly button in. That's neutral spine. Belly button in. To progress that, you can pull your belly button in. Lift your right foot one inch. Keep your belly button in. Lift your left. I'm a little weak there. I've had a back injury. Belly button in. Lift. That was better. Okay. So it's great. So you want to practice sucking your stomach in to activate your anatomical girdle, your transitional dominance, and then progress to a one inch march to help you stabilize your low back and end pain. Moving on to how posture can be giving you neck pain, back pain or shoulder pain. I want to explain a little bit more about those curves. So when your head moves forward and you're in this slouched position like this, your ear is in front of your shoulder and that creates an accentuated curve in your neck. Oftentimes as well, while your shoulders are forward all the time as well, I should say, when I see it in the clinic every day, the pec muscles here get short and they get short just because you're in that position all the time. And then you go and you wash dishes and you do your work on your computer and you tend to your baby and you play with your pets and you do laundry and everything that all of us have to do. And they get tighter and tighter and tighter. And you continue to slouch and slouch and slouch. And so pretty soon you want to sit up straight, but you're fighting against these tight structures here from accumulation of posture and activities. So you need to stretch them out. That's the quickest way to save your neck, save your shoulder, save your back as well as sitting up straight. But sometimes it's difficult to sit up straight. If you have these tight muscles pulling you down. So let's go to video number five to see a pec stretch. So let's go to video number 10 where we get a great pec stretch. Hey, so you just finished your surf session. You just finished hunkering down over your laptop and everything in the front of you is tight. And you don't want back pain and you don't want hip pain and you want to be able to go and enjoy your day. So it's very important. I do this every morning and I do it at work to stretch out the stuff in the front that got tight. So you're going to stand in a doorway. I like to have my arms and what I call it is the T position straight at shoulder height or slightly above. You put one foot in front of the other and use your back foot. You exhale and then you press forward with your back foot and inhale and you stretch. You'll feel it get tight right across here. Then you push back and you inhale. Now you can exhale from that position and it gets very tight. Inhale again. Lift your chest. You can also look a little bit to the right. Breathe in. Now you stretch more of the left side. Then you come back. Look a little bit to the left. Breathe in. And then relax and enjoy a better posture. I've got a question. Thank you for setting this in. If someone only has time to do three stretching exercise in the morning, which ones would you suggest? Wow. For a total body. Well, I would definitely say doing some sort of a peck stretch like I just showed you in the previous video. And if you don't have shoulder pain, you can also wrap your arms behind your head and cross your hands like this. And press your elbows back and breathe in. To open up your chest. You can also tilt side to side. To open up your chest and tilt the other way while you're sitting up straight. Open up your chest. If you have back stiffness, you can hug a knee to your chest while you're laying. In bed. It's kind of hard for me to show some of the other ones, but you can also stand and face a wall. This way and reach up the wall. To stretch. And I will show you at the end of the show today, another stretch, which I believe everybody should stretch their cows. So we just showed a stretch about posture and how to really help to open up yourselves. To get in better posture. Let's go to video number six, where we show some exercise exercises. You can do to improve your posture. Okay. I'm going to give you 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 going to 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 ten 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. That's long. Everything feels good. Enjoy feeling better, everybody. Those are my go-to with or without a band. I've been doing them for decades to help with my neck and my shoulders at the end of my work day. I have been doing those exercises for, I hate to say decades now. I had a car accident in college. I think it was 19 or 20 years old. And so I became a physical therapist around 24 years old. I've been doing exercises similar to that to help myself not have neck pain from the car accident. And I have learned that, and I learned it before as a PT. When I was studying in college, that if I was looking down at a book or slouching over, I had severe pain and made my pain worse. So I started instinctively sitting up straight, not just because my mother and my grandmother and everybody always told me to sit up straight, but also because my neck didn't hurt when I was up very straight. Then I became a physical therapist and I became aware of different exercises that you can do to help strengthen the muscles. I felt like I couldn't hold my head up. I just wanted it in a movie to just hold my head or sit against a sofa and put a pillow back there to rest my head on. I didn't have the strength. And I didn't know until I became a physical therapist. So a lot of these exercises that I show you in all of my shows over the past two years are a mix of my physical therapy expertise as well as my life filled with different injuries and accidents that have led me to have pain or injury in one or another part of my body. So that's a great introduction to our next video, which talks about neck pain. Now these exercises are the fastest way to get rid of your neck pain, to get rid of headaches that are generated from your neck pain, and improve your posture if you are slouching and your head has migrated forward. So let's go to the next video. Now, sometimes I get that little numbness on my pinky. So, and that's actually a common problem around all my friends that surf mostly shortboarders. And they always say, I got that tingling in my finger. We were talking about that last night. And when you mentioned that you had other buddies or other surfers that were having that same problem, I was super fired up about the show today. And you know, I was going to save the videos for later. But Eric, let's go to video number one right now. We have neck pain or worse of pain or tingling going down your arm coming from your neck. The first thing that you want to do is get your head and your neck in a better position. It's usually from poor posture or holding your neck in the wrong position for too long over many years. That happens when surfing, when you're paddling and you're kinking your neck up like this, or if you're slouching or looking down at your phone or hanging your head forward when you sit. So the first course of action is to do some exercises to help your neck and get it in a better position. So you get a, this is a squishy pillow. You want to first do what I call a chin tuck. You nod your chin down, make a nice double chin. Nod your chin down. Make sure not to lift your head. Nod your chin down. What that does is it starts to strengthen the deep neck flexors that when your head is craned forward, they get very weak and it also helps to stretch out the muscles in the back of your neck down here. So that's what I call the chin tuck. The next one now that you stretch these muscles out and you're starting to strengthen this is to move your head back over your shoulder where it belongs. So you tuck your chin and squish the pillow gently. Tuck. You don't want to push really hard. You don't want your body to come up. You just do a tuck and then squish. Tuck and then squish. And that starts to bring your head back in between your shoulders that takes all the tension up here for people that have headaches, eye grains I call them right in here. So first tuck, you do 10 of those. And next tuck, squish. You don't actually have to do them all the time on a pillow. You can do the tuck up against a wall. You can do it sitting in your car seat at the light and you can do the tuck and squish into your car headrest as well while you're at a light. My favorite exercise. Take the time to watch this video or go to my other videos that are specific for neck pain. To learn these exercises, they take seconds to perform and you can enjoy so much less pain when you do them. And if you do them consistently, you'll enjoy a better posture, less headaches. It's freed my neck. And so that's why I'm showing you just a few of these things that are the keys to get rid of your back pain, get rid of your neck pain, improve your posture, decrease your shoulder pain in all the videos that I've done. So let's look at the next video to talk about how to stretch your pecs. One of the best stretches I've come up with over the years to help your neck and to help improve your posture and get from this position to this position to allow your head and neck to move back is the doorway T chest stretch. Now that stretch is not new per se, but how I add breathing to it really enhances the stretch. So you want to get in a T position like this with your arms at or just above shoulder height, elbows straight. We want to protect your shoulders. You're going to put one foot in front of the other also to protect your shoulders. And then you are going to exhale all your air and then take a sharp breath. Inhale with your back foot. You're pushing forward. Inhale. Another one. Inhale. You can also turn your head to the right and turn your chest a little to the right to stretch more on the left side. Inhale. Switch your feet and then repeat to the other side. Turn. Turn your chest. Breathe in. Why this is so useful and works so well to get rid of neck pain is because your pec minor attaches from your shoulder blade underneath into your ribs. And so when it's tight, it holds you down and you're trying to do all these exercises. You want to stretch it out first so you can get into that beautiful posture and save your neck. The reason why I'm showing you that video again is because there's some good explanations in there as well. Like I was trying to explain about how the pec gets tight, hold your chest forward, but also the breathing. The breathing helps to take the pecs and pull you up. Try that stretch. I do it every day at work. I show people all the time. I lean in. Breathe. And it opens up my chest. If you're stressed out, it decreases the tension in your body when you take that rapid deep breath. So try these stretches. So I have a question from a viewer. So thank you for sending these in. I sometimes feel a twinge in a body part while exercising, my knee or my ankle. It's a very difficult question. Does this mean I should stop or can I continue? That's a good question. It's a very difficult thing to decide whether you should continue or whether you should stop. There's no right or wrong answer. However, I get twinges in my body all the time. I've had injuries. I'm pretty sure now, now that I've injured my wrist, I think it's been everywhere, unfortunately. So I have to do these things to maintain my body, but I'm not sure if I should continue. I'm not sure if I should continue. I'm not sure if I should continue. I'm not sure if I should continue. So I have a brief twinge. No problem. Your body's just letting you know something's out of place. Maybe you twisted in a class. Maybe you stepped wrong if you're outside running or you got turned the wrong way while you're doing a certain activity. One twinge is not the end of the world, but if you get a twinge every time you do it, you need to stop and look at your alignment, but if it's just one twinge and it goes away, that's okay. That happens to me too. And I'm very aware of my alignment. I work at it all the time. So I hope that answers your question. And let's go to video number nine to learn how to sit in your chair. Everyone is working from home right now. And so we need to be able to sit in a chair in a sofa, everywhere with the proper support. Let's look. To sit in your chair properly and avoid low back pain. It's important to use some props. So you're going to need a decorative pillow. And a blanket or rolled towel or something like that. So I have an accentuated curve in my back. So I'm not rounded. So I'm not rounded. So I'm not rounded. So I'm not rounded. So I'm not rounded. So I'm not rounded. So I'm not rounded. So I have an accentuated curve in my back. So I'm not rounded. I'm more too swayed as my body type. So when I sit in a chair, and you too, you want to scoot your buttocks all the way back. You don't want it here. You want it all the way back. You want to take your decorative pillow on a diamond shape like this. Put it down in your back. So you can support the curve in your back. Now that's perfect for me. This might be too much for someone who say rounded. So if you are rounded, then you can just take a flat blanket. It's not as abrupt. And then squish it into your back. So it keeps you upright, especially if you like to slouch in. You can't slouch. You'd fall forward in this position. Now you can use this on your sofa, on your futon, your hard firm kitchen chair, your recliner. This is all great. Because the key is you want to keep your spine in neutral. And not slouch like this all day compressing your spine in a bad position to get rid of your back pain. So those are all great tips that I really want you to absorb. Take notes. Watch the video again when I post a link. And if you need more information, I did publish an article in the hospital for special surgeries orthopedic journal last September on the trans or subdominous and everything you need to know to get rid of your low back pain, strengthen your deep core, strengthen your multifidus muscles. It has illustrations. And I'll be showing a link if we can pop that up where you can view that article for free. It's published open access thanks to the hospital for special surgery. So please read that article and digest the material. Show your friends, show your family, and that will help you get on your way to ending low back pain. I apologize. That link is the link that gets attached to my article when you look up the huge link, but that link does not link to my article. If you Google Christine Linders and trans versus abdominis, you will see the article in that major medical journal that was published on everything you need to know to get rid of your low back pain using the trans versus abdominis and multifidus and the suck it in technique. So now to answer the question of foot pain, ankle pain, what do you do? Let's go to video number 11. If you have plantar fasciitis, which is the painful, painful condition right at the bottom of your foot here, the most likely cause is overpronation and that's what happens when your arch collapses. And the reason why that happens is because of a tight calf. So what you want to make sure of is that you stretch the calf. When this calf is too tight and your ankle doesn't have enough range of motion to do this, then your arch will collapse and do this. So the number one thing you need to do to stretch the calf is to hold your arch up. Don't let it collapse. Point your foot in a straight line. Put the other one in front, keeping the arch up and bending the knee. You might only go this far. You can bend and do a dynamic stretch 10 times this way. But you do not want to let this arch collapse. You want to keep the arch up and stretch the ankle, not the arch. Then you need to bend your knee again. Don't let the arch collapse. You can also roll your arch over a tennis ball. Do some nice toe curls. So I hope you're enjoying these videos. I know they're a little bit of everything, but I wanted to show you some of the best highlights of the last two years of hosting movement matters. And I have a third question. Thank you so much. What activities are best for overall health in order to stay healthy and avoid injury? That's very broad questions. There's so many activities. Number one, get some daily exercise. Movement matters. Get your body moving. Motion is lotion. Your joints need the synovial fluid in there to flush, to keep the joint surfaces healthy. Your muscles need blood flow to keep them pliable and healthy. And your organs need that movement to stay healthy. So move. If for me, I don't run so much anymore, but I can run in deep soft sand. I can ride a stationary bike that gets me moving. Some people walk. Other people who can't walk, like people, maybe when I get older with all my ankle injuries, get in the water. We live in Hawaii. It's a beautiful place. For those of you that don't live in Hawaii, it's a challenge now because of the pandemic. You might not be able to go get in a pool, but when we open and we can get in a pool, get in the water, do some exercise in the water. You're so supportive. It's a great workout for the health and well-being of your joints and your body as well as for weight loss. So to wrap it up, I would like to go to video number 12, where it shows a quick little beach workout or in-home workout that you can do. If you want to get a great workout, but you just want to be at home and do it, I choose to be... Lay down, buddy. I choose to be at the beach to do it. You can do some side stepping like this in a skin-to-crouch. Side step, crouch, side step, crouch. You can pivot out and lean. Pivot out and lean. Do like 20 or 30 repetitions each. You can just sit and do squats. Suck your stomach in. Keep your butt back and squat. Squat. You can pulse. Pulse. Keep your stomach in. Keep your back straight. And I love to do... Suck your stomach in. Come back and do the bicycle. Okay, buddy. Do the bicycle. Let your dog lick you. Suck it in. Do the bicycle. You can lay on your back. Do bridges. Suck your stomach in. Do bridges. Suck your stomach in. And that would be your quick workout with reps. And there's your feel good for today. Thank you, everyone, for tuning in. Thank you so much to Think Tech Hawaii and all our sponsors and donors for the best last two years of hosting this show. If you want more, you can check me out on YouTube or on Instagram. Life is better when you listen to your physical therapist. Aloha, everyone.