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!