Corrective Exercise Strategies for People Who Sit Too Much: Part 1

All right folks here we go, because there is so much material to cover on this subject I have decided to break it up into two parts. Today we will be talking about corrective mobility exercises that can be utilized to combat some of the effects of sitting all day. Sitting in that smart car for 15 hours over the course of a weekend really started to get me thinking. The average person with a desk job who isn't very active probably sits this much EVERY day at least 5 days per week. Let’s say an hour commute to the office, 8 hours of sitting, an hour home, and 4-5 more hours of eating dinner/watching TV. Sitting this much not only affects the musculoskeletal system, but has also been linked to more serious diseases like cancer and diabetes. I think the picture below, not that I'm an evolution advocate, accurately depicts one of the two paths modern humans are likely to go down- if not both…

So what are we suppose to do about this sitting epidemic outside of  "don't sit as much"? Before I answer that question I'd like to make a few basic suggestions. I usually tell people to get up at least every hour and walk around, stretch tight affected areas and do a few burpees (just kidding). If it's absolutely not an option for you to get up that often you need to make sure you’re in the most ergonomically/biomechanically correct position possible. I should note that this should be done anyway regardless if you can take a walk every hour or not. Achieving this position can be done through various back support devices, ergonomically designed chairs, proper desk height, and most importantly awareness of your position. Pictured below is an optimal ergonomically correct sitting position.

So having a clear understanding of how you should be sitting (when you have too) and knowing how you actually sit let's talk about some corrective exercise strategies. I am going to keep this pretty simple so that it will be of utility to you right away. Taking a top down approach lets first discuss the cervical and thoracic spine (neck and upper back). I'm not going to discuss any cervical spine exercises today but it is important to pay attention to your position here. We don't want any forward head posture that's going to excessively recruit the upper traps and cervical flexors/rotators. This can lead to a ton of neck pain and discomfort. I use a simple cue in the gym that can be applied here to correct this, "Make a double chin." This successfully "packs" your neck into a more neutral position putting less strain on the neck muscles.

Moving to the thoracic spine if you think about the position you sit in all day your upper back is pretty hunched over (flexed). Spend enough time in flexion, oh say 15 hours a day and there will be some carry over of that position into your normal standing posture (hunchback). The problem with being stuck in this position is that it affects the force couple with the shoulder girdle. When this relationship is screwed up it can affect scapular movements such as upward rotation resulting in subacromial shoulder impingement and several other pathologies. The good news is the t-spine can be easily mobilized and stretched in both extension and rotation with a couple simple exercises using a foam roller.

Starting position:

The first exercise mobilizes the thoracic spine into extension.  You're going to set up with the foam roller right in the middle of your upper back. Support your head and neck with your hands and interlace your fingers, with your elbows close to your ears pointing up towards the sky.

Finishing position:

From here, I am going to brace my core (tighten the core) to "tack my ribcage" down and extend backwards on the foam roller.  I usually hold the extended position for 1-3 seconds and come back up. It's very important to do this slowly and not to allow your ribcage to flare up. If it does you’re moving through your lumbar spine and not your thoracic spine, which is NO BUENO! You can roll to different segments of your t-spine to mobilize but DO NOT try to do this on your lumbar spine (low back).

The second t-spine mobility exercise works to improve rotational mobility. This is extremely important for many overhead athletes, especially swimmers.

To start, lie on your side and flex your top knee to 90 degrees. Slide a foam roller underneath the flexed knee that runs parallel with your body. Next, make sure your hips are stacked and body is in one line. Extend your arms out in front of you and put one hand on the other like you are giving yourself a high-five.

To initiate movement brace your core, keep your knee on the roller, and rotate back as far as you can with your top arm only. Do NOT allow any rotation to occur through your lumbar spine (lower back), all the movement should come from your upper back. Also, do not push past any restrictions you feel as you go back. I usually do 2 sets of 6 reps per side for this exercise; you can do more as needed.

Moving anterior (forward) to the t-spine lets address the pectorals (chest) or more specifically the pectorals minor. Just as the t-spine gets stiff in that flexed posture we sit in, the chest muscles becomes short and stiff.  Once again, spend enough time in this position and there will be some plasticity. Pectoral tightness pulls the shoulder girdle into protraction (rounded shoulders/hunchback). The bigger problem is the pectoralis minor as it tips the scapula forward when it’s tight. This accompanied with serratus anterior weakness makes for a very unstable shoulder position that is very prone to injury especially in overhead/throwing populations. Here is a simple stretch you can do to stretch the pectoral muscles while also engaging your glutes and core.

To start you need to choose the correct stability ball for you. Sitting on the ball your knees and hips should be flexed at 90 degrees. Once you have chosen the right ball roll out into a bridge position from the sitting position. Engage your core and glutes but don't arch your back. From this position outstretch your arms to your sides, bring your hands slightly above the shoulder. Having the hands above the shoulder ensures you are stretching the pectoralis minor and not just the shoulder capsule. I do 2 sets of this exercise with 30-second holds; you can do longer if necessary.

Lastly let’s discuss the hips, I am only going to attack the hip flexors today but it should be noted there are a lot of other areas that usually need attention. The dysfunction to this area resulting in sitting usually causes the most discomfort. Just like with the other tissues if you spend enough time in hip flexion those muscles will shorten. This shortening will carry over in normal standing posture and every other movement as well. When the hip flexors become tight they pull the pelvis into what we call anterior pelvic tilt. This in turn puts a lot of pressure on the lower back and forces us to move through the lumbar spine to get range of motion (ROM) in many activities.

There are several muscles that can initiate hip flexion but the llippsoas and rectus femoris (one of your quad muscles) do most of the work. In order to correct this spine posture we need to mobilize the shortened tissues, then lengthen them with stretches, and strengthen the antagonist muscle group (the glutes). I am just going to go over the stretches today to give you something to use right away.

Both of these stretches are pretty aggressive, you may need to modify the first one and or skip the second one if you are really tight. For the first stretch start in a half kneeling position, squeeze your glutes and roll your hips under you (like your going to hump something). This will bring your pelvis into a posterior pelvic tilt and put a stretch on those hip flexors. If that feels easy, then you can elevate your back foot. Start with a medicine ball to elevate your foot and work your way up with aerobic steps until your using a plyo box like the one pictured. You may also want to use a dowel or foam roll while you’re in this position as a balance aide. Its very important to do the hip tuck otherwise you will not get the effect of the stretch and are probably moving through your lumbar spine.

The second stretch commonly called "spiderman" is initiated from a lunge. Step into a forward lunge and sink your hip down towards the ground.  Put one hand on the foot that’s in front and the other on the ground directly under the shoulder. If this position is too intense you can set your knee down to take off some tension. I like to oscillate in this position and search around for tight spots. I usually do this stretch as part of my dynamic warm up; I do 10 reps total holding for 1-3 seconds in the bottom position.

There you have it folks 5 easy ways you can improve your posture with almost no equipment. Feel free to leave comments below or email me if you have any questions at s.ferguson89@gmail.com. Make sure you sign up on my email list, and share my blog with your friends! Be back soon!

Update and articles you should read

Hola! Sorry for my absence, I was at the Anytime Fitness conference in Scottsdale, AZ over the weekend. Having spent a collective 15 hours in a smart car (not recommended for road trip or manhood), my post on corrective exercises for posture has become more detailed. I expect to have it done in a day or two but in the mean time, here are some articles you may find interesting.

First is an article by Chris Powers PhD, PT, FAPTA who is Co-Director of the Musculoskeletal Biomechanics Research Laboratory and the Director of the Program in Biokinesiology at USC. This article focuses on the biomechanics of the lower quarter and how important gluteal activation is for knee function and protection.

As some of you know I have had many issues with me knee but with the help of Doug Hoogendyk PT, DPT, Cert. MDT, CSCS and the team at Movement Performance Institute (Founded by Chris Powers) I have been able to adopt a hip dominant running strategy and stay out of pain. Yay!

Hip Strength & Control: The Key to Protecting the Knee




Second is a very recent article by Eric Cressey of Cressey Sports Performance. In this article he discusses the balance between aesthetics and health for trainers and their clients. I can definitely identify with this article and I'm sure many of you will too.

Training Programs: Are Health and Aesthetics Mutually Exclusive?







Be back soon!

The Importance of a Movement Philosophy

Welcome back! Before we get into today’s topic let me preface it by saying I was not indicating in my last post that you should buy the "muscles in minutes" book and start drinking protein shakes to lose weight (you'll get my humor). Moving forward today I want to talk about what Gray Cook would call a movement philosophy.  Basically, a systematic way in which we approach movement, movement dysfunction, and exercise in terms of rehab and performance.

Speaking of those two terms "rehab and performance" until very recently there has been far too big of a gap between the two.  Don't get me wrong, I know a ton of really talented and intelligent Physical Therapists but unfortunately they don't have the capability (mainly because of insurance) to take someone all the way back to 100%. And the insurance company generally forces them to only work on one issue at a time. This is where the strength & conditioning coach, personal trainer, or fitness professional has the opportunity to bridge that gap (hopefully) or send the person back to rehab (no bueno). There is a lot more I could say on this topic but my point is that there is a no mans land between rehab/physical therapy and training for strength, performance, or to just get back into shape.

People like Gray Cook, Lee Burton, and Kelly Starret have been instrumental in bringing this issue to light. Unfortunately, the system is still the system and the bureaucracy of healthcare hasn't changed much. So lets say you get a new client at the gym and you do all the usual body composition tests, medical questionnaires, and get an idea of what there goals are. Then from their throw them right into a workout that involves loads (weights) when you have absolutely no idea how they move or what restrictions they may or may not have. It's only a matter of time before a poor movement pattern that has been loaded repeatedly, reaches the pain threshold that sends up the red flags and the sirens saying "we got a problem"!

Unfortunately this happens all too often and is actually very preventable with physical therapy. However, it is very difficult to get a prescription for physical therapy if you are not in PAIN. In lay man's terms "get injured first then we can talk." This is why it is so important for fitness professionals to have a tool, screen, test, ANYTHING to get a movement baseline to give us some direction. As Gray Cook always says, "If your not training for function, your training for dysfunction."

The FMS or Functional Movement Screen is a widely recognized tool for assessing movement QUALITY not QUANTITY i.e. (sets/reps) like we are so use to doing. The screen involves a series of 7 movements that can reveal many movement compensations throughout the kinetic chain.  From there, we can work to correct many of these issues through exercise and other modalities before loading any particular movement pattern. It isn't until compensations have been revealed, a corrective exercise strategy implemented, and a passing score after being re-screened has been achieved that a strength program should be implemented. In other words, make sure you have your shit together before you try to start moving big weights.

The FMS performance pyramid provides a great visual to help us understand this. If you are lacking movement quality but have tons of movement quantity its only a matter of time before the pyramid topples (injury). This is why we must focus on the quality of movement before anything else.

With the recent debate at Stanford between Dr. Stuart McGill and Gray Cook, with Craig Liebenson as the moderator, the FMS has come under question. Many clinicians feel that there are better more accurate ways to assess movement and that the FMS isn't good at predicting injury. In my opinion, the FMS wasn't necessarily created for clinicians but for personal trainers, strength coaches, and any other fitness professional as a tool to assess movement and prevent the exact scenario I discussed earlier.

Many trainers have developed their own process for assessing movement and that's great! It doesn't have to say FMS on it as long as we are doing something to get a baseline.

To summarize this post in a few points:

1.) Implement a diagnostic tool/system/process to assess movement.

2.) Focus on movement QUALITY before movement QUANTITY.

3.) Don't wait for a small problem to become a big problem (painful) before doing something about it.

That's all for today folks, I'll be back in a few days to discuss exercise strategies to improve posture in light of our horrible habit of sitting all day. If you have any questions feel free to email me at s.ferguson89@gmail.com. Thanks for reading!

Welcome to Ferguson Performance Training!

Hello everyone and welcome to the first ever blog post of Ferguson Performance Training! It’s been a long time coming but I am excited to share my knowledge and experiences with whoever decides to follow me here. This page is still a work in progress but I wanted to at least get something up here. Before I delve into any nitty gritty topics, let me first tell you about myself and how I got into this industry.

Once upon a time about 7 years ago, I was about 70 pounds overweight tipping the scales at 220 pounds (I'm 5'10'' on a good day). After exiting a long-term relationship and knocking off some other non-sense I was involved in I decided I wanted to lose some weight. I started by running on the beach at night and riding my bike on the bike trail. After a while I picked up an EZ bar some plates and a pair of 25lb dumbbells from Sports Authority. I had no idea what I was doing and my "lifting" sessions included bicep curls, upright rows, and what I now know is called a floor press. I started to drink protein shakes and buy books titled "Muscles in minutes" like most teenagers would and slowly but surely the weight started to come off. 

Fast forward 6 months and I was down nearly 60 pounds and was now working two jobs compared to the ZERO I had before. I heard of a new gym opening in town and decided to go check it out. It was called Anytime Fitness, and they were still in pre-sale at the time but I signed up for a membership and was told they would be open within the next month. I didn't know it at the time but my life would be changed forever from this moment.

When the gym opened and I started going but still didn't have any idea what I was doing. They had a trainer working there and this guy was jacked! I instantly knew I wanted to be like that guy, and I would watch everything he did whenever I could. I got a phone call one day randomly from Aaron who was and is the owner of the gym and asked me if I would be interested in working there. Within 2 weeks I had my interview, quick both of my other jobs, and was officially a membership salesman. I continued to watch the other trainer and finally gathered enough courage to ask some questions. He told me I had a great personality to be a trainer and recommended the National Academy of Sports Medicine Personal Trainer certification. I bought it the very next day and within 6 months I was certified and started training people for free to get experience.

Fast-forwarding quite a bit, in 2012 I transferred to California State University, Fullerton to complete my Bachelors degree in Kinesiology. By this time I had been training for 3 years and feeling the early stages of burnout because of my loaded gym and school schedule. I considered many other career options and graduate schools including Physical Therapy, P.A and O.T. I graduated this past May having completed 70 units in 2 years and radically shifted my knowledge and mind-set on exercise, training, and performance. I realize now after navigating the many twists and turns of my life that I am exactly where I am suppose to be, doing exactly what I am suppose to be doing.

Since I started working as a trainer my specialty has leaned towards assessing musculoskeletal dysfunction and corrective exercise.  Although I do still train many individuals for performance, I always attempt to identify dysfunction first. I have trained individuals from elite level tennis players to people in there 80's with bi-lateral knee replacements and everything in between.

The goal of this blog is to share with the world the knowledge and experiences I have gained through my experience in the industry. I don't have any big plan or direction I will head so if anyone has any input on subjects they are interested in feel more than welcome to shoot me an email at s.ferguson89@gmail.com. My next post will be on my movement philosophy and how I approach training from practical perspective.