 a show designed to bring you the best physical therapy tips and exercises to decrease pain and get you back to doing what you love. I'm your host, Christine Linders, board certified orthopedic physical therapy specialist. Today, I challenge you to join me in another 14 day challenge to a better feeling body and a happier you. In the short videos that follow, I'll teach you simple stretches and exercises that you can do every day in a minute or two and enjoy less pain and more physical freedom. As promised from last show, I'll start with the best exercise to alleviate pain in your back. Then we'll go to the shoulder, the elbow and wrist, the neck and your jaw or TMJ, temporal mandibular joint. Let's start with a video to help you learn one thing you've been missing when it comes to alleviating your back pain. And that is to engage your deep core muscles properly. To learn to engage your transverses abdominis correctly and engage your anatomical girdle, I'm gonna show you how to do it in standing first. So you're gonna stand up and I'll visualize that for you. You're gonna put one hand on your diaphragm here, one hand on your belly button below and you're gonna pull your belly button in like that. So you just suck it in, suck it in. You don't wanna 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 wanna pull it in from here. Your transverses 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 those of you that know me, this is redundant. For those of you that don't, I have suffered two serious back injuries. One when I was in my early 20s playing beach volleyball and the other one was lifting a patient in my mid 30s. I herniated two discs in my low back and I had numbness in my inner thigh down the back of my buttocks all the way down to my foot and my leg became very skinny. That was around 2012 or 13. And so learning to suck it in and learning to engage my deep core and practicing the principles that I've been teaching patients since the year 2000 when I learned how to suck it in and I learned about the transverse abdominis was pivotal in me helping myself to recover and avoid back surgery. So I talk about this very frequently because I see a lot of news alerts on Good Morning America over the years in Shape Magazine, all these news channels talking about back pain and they continue to say there is no specific treatment for low back pain and I continue to write into them with no response to tell them, yes there is. And so I keep talking about this because I want the message to get out to everyone that you can suck it in, you need to engage your deep core because studies have shown those with back pain, their deep core is functioning in a delayed fashion and those without back pain, their deep core is functioning. A second their brain has a thought for motion and before the arm moves to reach for something or before the foot moves to take a step. So I harp on that and I also have finally my book is gonna be coming out that everybody will be able to get. It's a shorter version of what I was trying to launch. That's gonna be coming out soon so I'll explain that in more detail but I want you to really take that on, share the video with your friends. So let's move on to the video about our shoulder. One of the best things you can do for your posture is to strengthen the muscles that support your posture especially if you've been sitting prolonged at your desk or if you have neck pain. Here's what you do. You take a band, put it around a banister and do what I call the eye. You keep your elbows straight and you pull your arms down and squeeze your shoulder blades. Squeeze your shoulder blades, lift your chest. Then you do what I call the T. You open your arms wide, squeeze your shoulder blades, lift your chest, squeeze your shoulder blades, lift your chest and then you do the W. Pull your thumbs back. Pull your thumbs back and squeeze those shoulder blades to enjoy better posture and a pain-free neck. That is one of the best exercises that you can do in minutes for your shoulder. And the reason why is that your shoulder bone sits on your shoulder blade, which sits on your rib cage. And if you have poor posture, that shoulder blade gets pushed forward, the shoulder bone, your humerus gets pushed forward and your rotator cuff now has to reach out and strain and hang on to the ball to keep it on the socket. If you are working on good posture with those eyes, the T's and the W, you're gonna be keeping the quarterback of the shoulder, the shoulder blade in the right spot so that your rotator cuff can just control the ball on the socket with ease. I do those every day. I've had five shoulder surgeries. I'm trying to prevent a six, I grew too fast and I play lots of sports. So I'm always working my rotator cuff and I'm always working my shoulder blade to make sure there's no strain on my rotator cuff. And so far the five surgeries I've had had nothing to do with my rotator cuff. My rotator cuff is healthy. I just was a little bit too flexible. So that's the best exercise to do for your shoulder. Now let's talk a little bit about your elbow and your wrist. Now a lot of people are working from home right now. And so they might not have their best desk setup and you could be getting tennis elbow or golfers elbow. You could be getting carpal tunnel from having to type on the keyboard this way. And I wanna let you all know that it's very important, regardless of whether you're sitting on your sofa to work, if you're standing to work, that you have this part of your hand or your elbow supported on the surface. You don't wanna type like this or type like this because that puts a lot of strain on your muscles that are attached at your elbow and the carpal tunnel itself. So if you have pain in your elbow or your carpal tunnel, let's go to the video on wrist. This is a great thing to do if you have elbow pain, massage the muscles on the outside of your arm. You can grab them and wiggle them side to side, massage the muscles under your arm too, like on the other side right there. That's if you're bending your wrist too much and then you stretch those, you pull your hand down, then you stretch it back the other way. You wanna pull a little bit. Yeah, that's a better position to pull more in the hand than on the fingers to stretch those muscles out. It's great to take breaks while you're typing and do that throughout your day. So when I'm working, I will stretch them like this or I will stand and stretch them on my thigh. I'll just stretch it like this because I'm standing off a network or stretch it like this. I'll do it on the table too. So it's important to really stretch yourself out because I'm using those muscles to grab patients' limbs or to massage patients to get rid of their pain or hold an arm after surgery to range that shoulder, which brings me to a question I got this morning about rotator cuff. I was asked and I'm often asked with those who have a rotator cuff tear or a rotator cuff injury if they can rehabilitate it without getting surgery or then they need to get surgery. And most surgeons will send people to physical therapy, especially if it's not a complete tear where the tendon has snapped in half because so many people are able to work their other rotator cuff muscles. There's a few of them, there's four of them. And so where one is lacking, others can take up this lack. And also every muscle in our body has one action and at least another secondary action. So we use other muscles in the shoulder to help support the rotator cuff. And a lot of people are able to avoid surgery on their rotator cuff by doing this and we call them copers. And they gain the range, they gain the strength and they're able to get back to their golf game, get back to their tennis game, me, get back to my volleyball game. If that doesn't work, then they go down the surgical route. So I hope that answers your question. And also I had a question about hyper extending your elbow. I play beach volleyball and so do many of my friends. We were doing a training session this morning and three of us had hyper extended our elbows. You go to get that ball and maybe it's, you think it's coming hard and it doesn't. So you kind of reach and your elbow hyper extends and then it hurts for the minute. You're not sure what to do afterward because it doesn't hurt anymore then you go to play again and ouch, it's right there. So same thing that video I showed before, massage out the muscles in the area. You wanna start doing some gripping, some isometric gripping, first your fist then you can grab, this is too big but you know, something to do a gentle grip like this, something small, a squeezy ball, a washcloth. And then you wanna start doing some exercises that work the wrist extension. A weight all the way up, slow down. Weight all the way up, slow down to start stabilizing this joint that you just hyper extended. You can also use kinesio tape. I was kinesio taping my arm in a little bit of flexion so that when I went like this it had a little bit of a restraint. My brain felt the tape and went, oh yeah, don't let it go that far. So that's another good tip for you if you've hyper extended your elbow. Let's go to the next video to talk about how you can be hurting your neck. I decided to go to Lanakai Beach this morning to show you why you have neck problems. So when you have poor posture, let me show you this side. When you have poor posture and you're sitting like this and your neck is a little bit forward of your shoulders, the back parts get more compressed and the front muscles get more stretched out. So you really need to work on getting your posture up so that you can open up the nerve root. I talk about posture because it's so important for us to maintain our normal spinal curves. The neck has a gentle sloping backwards curve. Your middle back has a gentle sloping forward curve and your low back has a gentle sloping backwards curve. But as soon as you slouch, that curve in your middle back becomes very forward and the curve in your neck and the transition point where they come becomes like this. And so there's too much compression that goes on that. So if you're slouching like that with your head up, like I showed in the video like this, all these joints and discs are getting compressed and a lot of people who sit like that at their desk, I've seen tons of New York City because so many people are sitting at their desk are having pain running down their arm. And that's just because when you look up the canals where the nerves exit your spine and come down to your arms, get narrow. When you look down, they open. So when you're slouching like that, it's essentially like looking up and the space that those nerves have is compromised. And if you sit like that every day for five years for 10 years and you're not doing say a stretch or something like I showed the best exercise, that's undoing the sitting posture, you can get pain down your arm or a disc herniation because it has nowhere else to go. So let's go to the next next video to learn more. So if you notice that you maybe can't turn your head to the left as far as you can turn your head to the right, it could be because you're starting to get some arthritis or overlap or some osteophytes or bone spurs in that and those neck joints, what happens in our 30s, by the way. So if you're sitting like this, you're just contributing to the problem. In order to gain range of motion so you can turn and view traffic, turn to look right and left equally, you wanna make sure you get your posture upright. Let those joints slide like they were designed to do. And then once you're up properly, you can stretch your neck. I like to put my hand in the base of my neck and pull up towards the top of my head and over to stretch. Up and over to stretch. Also, now it's a ear-to-shoulder stretch. You can look down at your armpit and stretch that nice muscle in the back. Look down to your armpit, then you come up again, pull your neck up towards the top of your head to eat a long gait. Bring it over. Now I'm in good posture. I'm not cranking my head forward. I'm pulling up and then over to stretch that I'm gonna look at my armpit. Stretch this nice back muscle here. Then you can do the stabilization exercises after we're done. Enjoy a better feeling neck. That is one of my favorite neck stretches. And the reason why I pull upward towards the top of my head as I go over is because I don't wanna just yank my head over and compress the muscles on this side. I wanna elongate those neck muscles to really stretch. I have also injured my neck. I had a car accident when I was about 20. T-bone from the side, a guy ran a red light. But then I also had a rear end accent in the freeway. And so my neck on an X-ray is kind of shifted forward. And in order to avoid having a neck fusion, because I really wanna play beach volleyball as long as I could possibly do it for. And that would stop me from doing it. I work on elongating my already extremely long neck to decompress and stretch those muscles. Those muscles run in the back from bottom up. And so elongating them is like stretching them. A lot of people that have compression there, if you're just pulling it over to the side, you're not getting the elongation of that muscle. And that's what we want to lengthen that muscle. So now let's look at the next video where I will show you some of the best exercises you can do for your neck. My patients love them. I've used them for the past 20 years. Let's take a look. If you are suffering from neck pain, whether it's the top of your neck or the base of your neck from too much sitting, looking down at a book or a puzzle or too much working from home, there's some great things you can do right now to get rid of your neck pain. One of them is exercise your postural muscles. You wanna take a band and squeeze your shoulder blades and rotate your hands out. Keep your elbows in, lift your chest, lift your chest, lift your chest. You can also do it at shoulder height. Keep your chin down so you have a long neck. Squeeze those shoulder blades. Squeeze those shoulder blades. One of my favorites to get rid of my neck pain, I had a car accident when I was very young, is to take a band and use your thumb and your first finger here to keep the band flat. Put it right in the back of your head here, stretch the band so you're pushing your head back into the band and then rotate your hands in and out like this. So you wanna tuck your chin and push back into the band. You'll feel a stretch in the back of your neck. And then also if you wanna do some chin tucks, I tend to do them sitting in the car where I have the car seat here and I'll tuck my chin down to make my neck long. Chin tuck, chin tuck and also tucking my chin and pushing it into the car seat. Tucking my chin, pushing it in the car seat. If you were gonna lay down and do it, it would look like this. You would tuck your chin, make a nice little double chin, you'll feel a stretch on the base of your neck. And then the second one is the tuck and squish. Tuck and squish the table. It's very gentle. Tuck, push the back of your head into the surface. Tuck, back of your head into the surface. And if you're just suffering from a little bit of tension at the end of your day, grab your hand, pull upward at the base of your neck and then over to get a nice stretch. And then breathe and then switch sides. Grab your other hand, pull upward on your head and over, drop the shoulder down and get a nice stretch and enjoy much less pain in your neck. Hi, those exercises, they take about two minutes, maybe less because I was talking you through them. I have many patients right now who have injured their neck doing projects at home, working from home, yard work because they're not having the right position or their neck is a little bit more up and compressed. So everyone's coming back and that's how I designed these exercises. I do them as well, but I've been asking my patients over the past two months when they come in and say, you know what, that exercise really helped. I ask, because not everybody does everything that I suggest, they pick the favorites, the ones that work the best for them. So I've been asking which ones and those have been the ones that everyone's saying including a foam roll stretch, which not everybody has a foam roll at home. So I put a pec stretch. It's important to stretch out the pec muscles in front because number one, we use our pecs all day long because everything we do is in front of us. So overuse, overuse. That's just the way things are. Our eyes are in front, not in the back of our head, although sometimes we wish they were. So it's important to stretch the pec muscle and one way to do it is on the foam roll. Another way to do it is to stand in the doorway and stretch your chest. So let's go to the next video for the pec stretch. Stretch out these tight pec muscles right here that are holding you down to bad posture, making your shoulder at risk and hurting your neck. You're gonna put your arms like a T in a doorway. Elbows are straight. You're gonna put one foot in front of the other. Raise your elbows a little bit higher than shoulder height. Then you're gonna push and bend the front leg and push with the back leg and lift your chest and breathe in and then exhale all the way to the bottom. Then you're gonna breathe in quick and exhale all the way to the bottom. You could reset your arms a little higher if you need to to protect your shoulder and you're gonna push with the back foot and lift your chest. Quick exhale all the way out and then another deep breath in and exhale all the way out. What it does is it takes your pec minor and pulls your ribcage up. So instead of being stuck like this, it opens you up. So enjoy that. Okay, thank you. So thank you to Noel, my coworker for taking these videos. I usually am doing them on my own. So that was fantastic. So I learned the concept for using the pec minor to pull the ribcage up in a class by Mary Master. I had her on the show in March and April to talk about her genius contribution to physical therapy and to many patients. And I put it into practice in that stretch for myself with the breathing, putting the pecs on stretch and breathing up because it lifts your chest. Instead of just standing in the doorway and stretching or a lot of people are just stretching this way, all this way just to stretch it, use breathing, your pec minor attaches from your ribcage to your shoulder blade. It goes straight through there. And so you need that shoulder blade, remember to have a healthy shoulder and you need to pecs to be open to have a healthy neck. So it's an easy stretch to do. You should feel no pain other than the tightness in your chest when you go and breathe. And Mary Master showed me one that I probably learned in her class but I didn't remember where she said, use it this way, straighten your arm out. No lazy elbows, I remember. That's for you, Mary. And you raise your arm into like a V position and you will follow your hand while you take a quick inhale. You go, you should try this again. Again, and then one more time, I always do three. And afterward, you not only expand your lungs but you connect to your ribcage which opens up your chest and don't forget to do it on both sides. Okay, so let's talk a little about the TMJ. It's the Temporal Mandibular Joint. It is a joint that sits right about here just in front of your ear. And a lot of people that have headaches or achy jaw or upper neck pain or pain that's going across their head, clicking when you go to open up or bite into a sandwich, grinding at night, those folks will have Temporal Mandibular Joint Problems or TM Joint Problems. And so I have suffered them as well. Sometimes you can sleep on your side in a wrong place and it pushes your jaw and you wake up and you're like, whoa, why do I have a headache? So you massage the muscles first which I'll show you in a minute. But I also wanted to talk a little bit about the joint mechanics before I show you the video. And when you go to first open your mouth like this, this joint is like a ball and it spins first. And then as you get further open, it translate forward. So if you want, you could put your fingers there to feel and open your mouth. Mine translates too quick on this side. I tried to, I corrected it. So to correct that, let's go to the video on the jaw. You are suffering from tension in your jaw or even headaches kind of at the base of your skull. You might be clenching at night or grinding your teeth. Also, if you bite into a sandwich and you feel a pop on one side or the other, your jaw might not be aligned right and a very quick and easy way to help you get your jaw aligned is to place the tongue up in the roof of your mouth, not behind your teeth, but up in the center of your mouth and then open and close your mouth. It's not a lot of pressure. It's a little bit of pressure. You put your tongue up in the roof of your mouth and then you open and close like this. You can do 10, 20, 30, 40, 50, 100, 500 times. You could do it at the light while you're sitting in your car. What that helps to do is it helps to restore the role of your TMJ, your temporomendibular joint. When you open up your mouth, it first rolls and then it glides forward. But if you don't get the roll to spin, it glides forward and that's where you get that pop and that pain. So you want to tongue and roof, open and close. Many times also you can massage your masseter muscles, the ones in your cheek here. Stay right under the bridge of your cheekbone here and then you massage down, up. You can go forward, back. You can push up and then open your mouth to give it a stretch. You can go in circles, really just try to release those muscles in your jaw when you're chewing and you will feel so much less pain in your jaw. Also, doing a nice mindfulness meditation before you go to sleep can help relieve some stress that's making you clench at night. Enjoy. That's so important for anybody that's suffering from jaw ache, jaw pain, clenching. I worked on someone yesterday for about a minute just like this through her mask and I said, I'm sorry, I'm just digging around this mask area and she goes, no. She goes, whatever you just did, helped so much. She has head pain up here and I have a lot of people coming in with head pain. I've been doing different kinds of techniques to treat it but your jaw and your first cervical vertebrae, that whole area right there is just millimeters away. So it's really important to help yourself feel better to be your best self. So you can enjoy life to the fullest to do these simple tips. So to wrap up, I challenge you for the next 14 days to do something good for your body. Spend one to two or more minutes a day, pick some exercises, pick a body part, massage out that elbow, stretch out those forearms, suck your stomach in, really engage your stomach before you move, stretch your neck out, do the postural exercises. Remember the posture not only helps your neck, it helps your shoulder, it frees you from pain, it helps your back. And I just wanted to show one more thing because I forget to tell many people about this. I published an article two years ago here on the transversus abdominis and why it is so critical learning to activate it to get rid of low back pain. And so it actually explains everything, it explains everything about the epidemic. I illustrate exercises and explain them for how to progress yourself through beginner to more advanced exercises to train your deep core muscles. And you can access that if you Google Christine Linders and the word transversus abdominis, T-R-A-N-S-V-E-R-S-U-S, A-V-D-O-M-I-N-I-S, you will get this article. The link they sent me is extremely long, but it's open access. And the link that they post to share actually is linked up to a different article. So I wanted everyone to be able to access this incredible article where you can learn everything you need about having to access your deep core and then maybe you can tell good morning America about it or shape magazines so they can get the right information out there. So we can get this 80% epidemic down of everyone that's gonna have that back pain. That's my mission, that's what I want. And I want that for you and everyone. So thank you for joining me on thinktechawai.com. Thanks everyone for watching and for tuning in. And remember, life is better when you listen to your physical therapist, aloha.