Ask the Physical Therapist

Denver • Lakewood 

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SymFit® Healthy Fitness System
Healthy Standing Posture

Healthy Standing Posture
 

SymFit Healthy Fitness System - Healthy Standing Posture
 

SymFit Neutral Spine Alignment illustration
  



The SymFit® Healthy Fitness System (SFHFS) was developed to bring a safe injury prevention based fitness to the community.  Those with current injuries need injury management consultation.  Those with minor aches and pains that are getting wore intense or frequent can likely prevent their condition from progressing into medical diagnosis's by improving their posture and modifying their fitness program.  The following injury prevention strategies are designed to help you identify if you fall into this category and to help you get on the path of neutral spine conditioning.

Healthy Standing Posture/Strategies:


The body is designed to move forward.  As a result of technological advancements we are sitting for a majority of each day.  Most of us sit in collapsed posture with our tail bone as the primary source of stability.  As such we start biasing to the left or right usually to the right and at the end of the day we are stuck in left rotation in our low backs and possibly with our right pelvis’s collapsed forward.  This is why most of us become right lumbar loaders.  Neutral Standing consists of the best foot position that allows us to successfully apply of the 4 SymFit® Neutral Spine Alignment Principles.  You should have equal weight through the big toe, little toe and heel of the foot in neutral standing posture

How to Get into Neutral Standing Posture: 


1.       “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment

2.       Maintain a “Head Nod” ™ to unload your neck

3.       “Connect Rib Cage to Pelvis” ™ to unload the low back

4.       Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading through the hips, knee and ankles
  • Right Lumbar Loaders may need to place their left foot forward in front of the right to help them keep weight through the right heel.   


Strategies for maintaining a Stacked Upper Back: don’t use back support. Perform your Hourly Mobility program to keep your upper thoracic spine mobile into upper back extension. 
  • The Spine Mobility Series is the exercise within the SFHFS that keeps you mobile in your upper back
  • The Chest Lift Series is the exercise within the SFHFS that strengthens your endurance for maintaining a “Stacked Upper Back”

Strategies for maintaining a Head Nod:
  • The Spine Mobility Series is the exercise within the SFHFS that keeps you mobile into a “Head Nod”
  • The Head Nod Series is the exercise within the SFHFS that strengthens your endurance in maintaining a “Head Nod”

Strategies for maintaining an Inward Spiral:

  • The Hip Mobility Series is the exercise within the SFHFS that keeps you mobile in hip internal rotation or “Inward Spiral”
  • The Walking Series and the Lunge Series is the exercise within the SFHFS that strengthens your endurance in maintaining a “Inward Spiral” of the Hip

Hourly Standing Mobility Program:

The body is designed to move forward.  Few of us have the luxury of having a job that allows us to be mobile throughout the day.  The SymFit® Healthy Fitness System (SFHFS) has developed hourly mobility exercises programs to counter the negative effects static postures as a result of technology. 

The SymFit® Hourly Standing Mobility Program:

1. SymFit® Bony Standing Rhythms (level 1 of the Lunge series). 
  • Get into the SymFit® Lunge series – get into a standing split position.  In a split position your pelvis is angled forward to allow the back hip to be in extension without low back loading.  Relocate your rib cage in line with your pelvis before going through your 4 SymFit® Neutral Spine Alignment Principles
  • Move your front knee around your front foot 8 times clockwise and then 8 time counterclockwise.  Emphasize internal rotation of the hip and ankle.  This is when the need comes inside of the ankle and foot.  You back heel can come off the ground. But try and keep the back knee locked into extension
  • Perform 8 bony rhythms with the other foot forward.

2. Sustained lung spine twists
  • Get into a sustained lunge and perform 8 spine twist in each direction
  • Remember, a spine twist is when your rib cage rotates in relationship to a stable pelvis.  As you spine twist to the right inward spiral the left hip; as you spine twsit to the left inward spiral the right hip.
  • Perform 8 spine twist from a sustained lunge with the opposite knee forward

Healthy Sitting Strategie
s:

The body is designed to move forward.  As a result of technological advancements most of us are sitting for a majority of each day.  Sit in collapsed posture with our tail bone as the primary source of stability results in a bias to the left or right usually to the right and at the end of the day we are stuck in left rotation in our low backs and possibly with our right pelvis’s collapsed forward.  This is why most of us become right lumbar loaders.  Neutral Sitting posture consists sitting up right onto your sit bone (Isheal Tuberosities) to allow successful application of the 3 or the SymFit® Neutral Spine Alignment Principles. 

1. “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment

2. Maintain a “Head Nod” ™ to unload your neck
3. Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading thru the hips, knee and ankles

The pelvis is stabilized in sitting so there is little to no core activation needed to stabilize it.  The upper abdominals should be

You should have equal weight through the sit bones.  Right Lumbar Loaders like to shift off their right and bias to their left sit bone. 

Strategies for Maintaining Equal Weight through Left and Right Sit Bones:

  • Towel Roll or Smart Roller when in a chair
  • Towel Roll or Smart Roller when Driving (empty water bottle works) - should we address driving

Strategies for maintaining a Stacked Upper Back: don’t use back support. Perform your Hourly Mobility program to keep your upper thoracic spine mobile into upper back extension. 

  • The Spine Mobility Series is the exercise within the SFHFS that keeps you mobile in your upper back
  • The Chest Lift Series is the exercise within the SFHFS that strengthens your endurance for maintaining a “Stacked Upper Back”

Strategies for maintaining a Head Nod:

The Spine Mobility Series is the exercise within the SFHFS that keeps you mobile into a “Head Nod”

The Head Nod Series is the exercise within the SFHFS that strengthens your endurance in maintaining a “Head Nod”

Strategies for maintaining an Inward Spiral:

The Hip Mobility Series is the exercise within the SFHFS that keeps you mobile in hip internal rotation or “Inward Spiral”

The Walking Series and the Lunge Series is the exercise within the SFHFS that strengthens your endurance in maintaining a “Inward Spiral” of the Hip


Healthy Driving:


Cars seats are designed to allow you to relax while driving.  Seat force a slump (Collapsed) posture.  Pedal promote a shift to the left sit bone to allow manipulation of the right foot.  There are some strategies for applying the principles of healthy sitting while driving
  • Right Lumbar Loaders may need a towel roll wedged into the back corner of their left pelvis to help them maintain weight on the right butt bone (ischial tuberosity). 
  • Strategies for maintaining a stacked upper back: Angle the back of your car seat as far forward as appropriate to promote upright sitting
  • Strategies for maintaining a Head Nod:  Raise you head support so that it is supporting you at the back of the skull
  • Strategies for maintaining an Inward Spiral: position your right foot outside your right hip to promote inward spiral
  • Right Lumbar Loaders may need a towel roll wedged into the back corner of their left pelvis to help them maintain weight on the right butt bone (ischial tuberosity). 

Healthy Sleeping Strategie
s:


Many clients share that the feel how they sleep contributes to their tightness’ and pain when they awake.  We have put a lot more thought into this theory than is probably healthy and this is what we have summarized.  When you go about your day in faulty loading your body does not have the opportunity to respond until your rest.  When we go to sleep our bodies have this opportunity and the muscles that were overloaded the previous day as a result of faulty loading have the opportunity to tighten.  We wake up and feel tighter so it is a logical correlation but not one that is supported by science.  When we sleep we are at rest.  Even if we sleep in faulty postures the effects are minimized because the joints are not loaded as they are when we are awake going about our day in faulty posture against gravity.  That being said we do feel sleeping in positions that stretch out the tight muscles that develop as a result of collapsed posture is beneficial. 

Strategies for Healthy Sleeping:

  • Side Sleepers: hugging a Body Pillow between your knees with hips flexed 45 degrees and knees 90 degrees
  • Back Sleepers: pillow or bolster under knees, cervical travel pillow under base of your skull helping you maintain a head nod
  • Stomach Sleepers: try and learn how to sleep on your side.  But if not successful we recommend a body pillow under left leg and start with your head nodded each night.
  • Those with Tight Calf Muscles or Tight Hip Flexors: sleep with that knee extended and the foot against a foot or head rest.  It will stretch the calf, hamstrings and hip flexors out.  Perform the SymFit® Bony Rhythms and SymFit® Ankle/Foot Self-correction techniques before going to bed.
  • Those with Shoulder Pain: a cervical pillow against the front of the shoulder will help keep the shoulder blade against the rib cage and the humerus from getting positioned forward in the shoulder socket. Perform the SymFit® Shoulder Mobility Program and SymFit® Shoulder Self-correction before going to sleep. 
  • Those with Back Pain: Perform the SymFit® Spine Mobility Program and SymFit® Pelvis Self-correction before going to sleep. 

Healthy Overhead Lifting
:


Overhead lifting is a complicated motion mechanically.  The shoulder blade should remain against the rib cage and most of us initiate overhead lifting from a slightly collapsed posture so we develop a shoulder blade hiking strategy which puts a lot of stress on the shoulder and neck.

 When performing any overhead lifting exercises follow these steps;

1. In front of a mirror get into Neutral spine alignment
  • “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment
  • Obtain a “Head Nod” ™ to unload your neck
  • “Connect Rib Cage to Pelvis” ™ to unload the low back
  • Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading through the hips, knee and ankles

2. Start with a bent elbow and extend your elbow as you lift your arm maintaining a stacked upper back

3. Keep your shoulder blade against the rib cage throughout your overhead elevation.

When participating in overhead sport activities be sure to perform the Healthy Overhead Sport warm-up and cool-down routine.
  • Strategies for maintaining a Stacked Upper Back: Healthy Shoulder Program at SymFit2 level strengthens your rotator cuff and lower traps sufficiently to allow you lift overhead without neck loading which ensures healthy shoulder mechanics throughout the lif
  • Strategies for maintaining a Head Nod: Head Nod Series at SymFit2 level strengthens the muscles under the base of the neck that stabilize the skull during overhead lifting
  • Strategies for maintaining a Neutral Pelvis: Pelvic Curl Series at SymFit2 level strengthens the lower abdominals ability to maintain neutral pelvis positioning during overhead lifting
  • Strategies for maintaining an Inward Spiral: Lifting Series at SymFit2 level strengthens the abdominals ability to maintain neutral hip positioning during overhead lifting

Healthy Walking
:

Walking is one of the most beautiful activities.  We start out sluggish as we are brought into the world and with some luck we hit our walking stride by time we are teenagers.  Excessive sitting starts to change our posture and loading patterns through the hips, knees and ankles and many of us start walking less than efficiently by our 30’s again.  We should be able to walk efficiently into our 80’s if we live a “Symmetrical Life”.  This has a significant effect on our attempts to stay healthy for the rest of our lives.  Let’s reconnect to how to walk efficiently.  It starts by reviewing how the body is designed to walk.

Postural Alignment:

1.       “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment

2.       Maintain a “Head Nod” ™ to unload your neck

3.       “Connect Rib Cage to Pelvis” ™ to unload the low back

4.       Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading through the hips, knee and ankles

Efficient Walking Mechanics:

1.       Swing the leg through only as far forward as you can maintain a “Stacked Upper Back” and vertical Pelvis”

2.       Land on the center of the heel

3.       Transfer to the outside of the foot before mid-stance

4.       Start transferring to the 2nd toe just after mid-stance by maintaining an inward spiral

5.       Push-off through your 2nd toe at toe off

When walking from neutral spine with the proper mechanics you should benefit from a slight propulsion at push off if you are able to maintain an inward spiral throughout the stance phase.  “Inward Spiral” is only accessible if your pelvis is maintained in a neutral (vertical position) which is only accessible neurologically if you maintain a “Stacked Upper Back”.  A “Head Nod” helps you maintain a Stacked Upper Back.

  • Strategies for maintaining a Stacked Upper Back: Chest Lift Series at SymFit2 level strengthens your lower traps sufficiently to allow you to keep your shoulder blades in their neutral position on the rib cage during running  
  • Strategies for maintaining a Head Nod: Head Nod Series at SymFit2 level strengthens the muscles under the base of the neck that stabilize the skull in neutral during walking
  • Strategies for maintaining a Neutral Pelvis: Pelvic Curl Series at SymFit2 level strengthens the lower abdominals ability to maintain neutral pelvis positioning during walking.
  • Strategies for maintaining an Inward Spiral: Walking Series at SymFit2 level strengthens the abdominals ability to maintain neutral hip positioning during walking.

Healthy Running:

Running can be a healthy cardiovascular option for most of us.  If you are currently running and encountering increasing ached and pains, we suggest that you see a SymFit® Physical Therapy consult as the source of the problem is likely mechanical.  If you are not a runner and wish to begin we suggest you complete the SymFit® Healthy Fitness System to SymFit2 level and then begin the SymFit Healthy Running Conditioning Program.  Like any new sport or activity there is a conditioning phase to begin it a low level and a conditioning phase the allows you to progress safely.  Life is too short to not do the activities you want to do.

Postural Alignment:

1.       Stack your upper back

2.       Connect Rib Cage to Pelvis with pelvis slightly angled forward due to the nature of your body weight being in front of your center of gravity

3.       Head Nod

4.       Square off your hips in a forward direction and inward spiral your hips to allow for symmetrical loading through your hips, knees and ankles.

Efficient Running Mechanics:
There are many strategies for efficient running and this is likely due to there are individual issues for each type of runner that best meets their needs.  We are not attempting to fill a running coach role as a private consult is needed to provide individual recommendations.  However, we will share truisms that will allow most running styles to maximize efficiently by limiting asymmetrical loading.


1.       Maintain a “Stacked Upper Back”

2.       Maintain a “Vertical Pelvis”

3.       Transfer to the inside of the foot at toe off so that your inner thigh stabilizers are involved in push-off

When walking from neutral spine with the proper mechanics you should benefit from a slight propulsion at push off if you are able to maintain an inward spiral throughout the stance phase.  “Inward Spiral” is only accessible if your pelvis is maintained in a neutral (vertical position) which is only accessible neurologically if you maintain a “Stacked Upper Back”.  A “Head Nod” helps you maintain a Stacked Upper Back.

  • Strategies for maintaining a Stacked Upper Back: Chest Lift Series at SymFit3 level strengthens your lower traps sufficiently enough to allow you to keep your shoulder blades in their neutral position on the rib cage during running
  • Strategies for maintaining a Head Nod: Head Nod Series at SymFit3 level strengthens the muscles under the base of the neck that stabilize the skull in neutral during Running
  • Strategies for maintaining a Neutral Pelvis: Pelvic Curl Series at SymFit3 level strengthens the lower abdominals ability to maintain neutral pelvis positioning during Running.
  • Strategies for maintaining an Inward Spiral:  Lunge Series at SymFit3 level strengthens the abdominals ability to maintain neutral hip positioning during Running.

Healthy Overhead Sports
:

Sports like tennis, swimming, volleyball, basketball and baseball require strong shoulder mechanics for overhead lifting and throwing.  If you are currently playing overhead sports and encountering increasing ached and pains, we suggest you see a SymFit® Physical Therapy consult as the source of the problem is likely mechanical or postural.  If you wish to begin playing overhead sports we suggest you complete the SymFit® Healthy Fitness System to SymFit2 level and then begin the SymFit® Healthy Overhead Sports Conditioning Program.  Like any new sport or activity there is a conditioning phase to begin it a low level and a conditioning phase the allows you to progress safely.  Life is too short to not to do the activities you want to do.

Postural Alignment:

1. “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment

2. Maintain a “Head Nod” ™ to unload your neck

3. “Connect Rib Cage to Pelvis” ™ to unload the low back

4. Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading through the hips, knee and ankles

Efficient Overhead Sport Mechanics:
There are many different challenges presented by the varied types of overhead sports.  We cannot provide specific consultation on you should best perform your overhead sport activity of choice.  However, we will share truisms that will allow you to to maximize efficiently and safety during your overhead sport activities by limiting asymmetrical and faulty loading through neck and low back.


1. Maintain a “Stacked Upper Back” to keep the shoulder blade against the rib cage to ensure healthy shoulder mechanics

2. Maintain a “Vertical Pelvis” to keep the base of your spine stable and low back unloaded

3. Use upper back extension to look up more than neck extension.  As soon as you load C5/6 you lose lower trapezius control of the scapulae on the rib cage

We can provide a safe conditioning program for you to remain in the game or start such sport activities safely.

  • Strategies for maintaining a Stacked Upper Back: Chest Lift Series at SymFit3 level strengthens your lower traps sufficiently enough to allow you to keep your shoulder blades in their neutral position on the rib cage during running
  • Strategies for maintaining a Head Nod: Head Nod Series at SymFit3 level strengthens the muscles under the base of the neck that stabilize the skull in neutral during during overhead sport activities
  • Strategies for maintaining a proper Shoulder Mechanics: Shoulder Stability Program at SymFit3 level strengthens your rotator cuff sufficiently to maintain neutral humeral head positioning during overhead sport activities
  • Strategies for maintaining a Neutral Pelvis: Connecint Rib Cage to Pelvis Series at SymFit3 level strengthens the lower abdominals ability to maintain neutral pelvis positioning during overhead sport activities
  • Strategies for maintaining an Inward Spiral:  Overhead Lifting Series at SymFit3 level strengthens the abdominals ability to maintain neutral hip positioning during overhead sport activities

Healthy Lifting (Squatting)

The most common cause for non-traumatic low back injury seen in the clinic is picking up something from the floor with a forward bend technique.  Our spines are not designed to pick objects up off the floor.  They don’t mind getting us down but they are mechanically not designed to bring us back up.  The SymFit Squat® Series conditions you to pick objects off the floor with minimal low back and neck loading.


Starting Posture for Healthy Squatting:


1. Get into a wide based of support with feet

2. “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment

3. Maintain a “Head Nod” ™ to unload your neck

4. “Connect Rib Cage to Pelvis” ™ to unload the low back

5. Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading through the hips, knee and ankles

Healthy Squat Mechanics:

1. Bend at the knees while hip hinging with a 1:1 ratio

Note: at the bottom of a proper squat you should be looking about 5 feet in front of you without loss of neutral pelvis, rib cage and skull positioning.



Healthy Lunging:
Squatting is the healthiest way to get to the floor but you dont always have enough space to move your feet outside your shoulder girdle.  For this reason, ae have a Lunge Series within the SFHFS to provide you with alternate lifting strategies.  Lunging also addresses favoring patterns the develop through the hips, knees and ankles.  Single leg strengthening restores stability symmetry.

The SymFit Lunge® Series conditions you to pick objects off the floor with minimal low back and neck loading.


Starting Posture for Healthy Lunging:


1. Get into a forward split and make sure your rib cage is in alignment with your pelvis at about 25-30 degrees off vertical

2. “Stack your Upper Back” ™ to establish the foundation for neutral spine alignment

3. Maintain a “Head Nod” ™ to unload your neck

4. “Connect Rib Cage to Pelvis” ™ to unload the low back

5. Maintain an “Inward Spiral” ™ of the hips to ensure symmetrical loading through the hips, knee and ankles

Healthy Lunging Mechanics:

1.       Bend the back knee to load the front knee in such a way that you drop almost straight down with little forward movement.  Keep both hips inward spiraled.

Note: as you lunge down your pelvis has to rotate backward to accommodate the change in hip position so at the bottom of a lunge you are more vertical than at the top.