Pain Relief For Arthritis Happy Valley & Sandy, OR

Fix Your Sit Part II

Fix Your Sit Fix Your Sit Part IIThe Least You Need To Know:

  1. Sitting isn’t the problem; it’s how you sit that needs to be fixed.
  2. Use a screening tool to assess how different postures effect you before you try to fix them.
  3. Develop a plan to change your posture and take steps to limit the time you spend in positions that you don’t do well.
  4. If symptoms don’t resolve with basic changes consider seeing a physical therapist.

Interpreting The Test:

If you haven’t read how to and performed the “stick test,” do that first. The test will help you understand how your back moves in response to changing positions. Remember, this is just one test and is not able to assess the complexities of how you move, your medical history, or the specific demands of your life.

Standing Problems

When you perform the stick test, if you can’t manage to make the three landmarks rest comfortably, then there are things to work on. Most people who have trouble with this when standing in their normal position will fall into one of two categories, either” the stick flops around because I can’t make it touch at my tailbone and shoulder blades at the same time” camp or the “I keep hitting myself in the back of the head” camp. The first thing to do is to try to reposition your body so that the stick lands nice at the three landmarks (tailbone, shoulder blades, back of head)- we call this a neutral position. Can you make it work? What part of this feels unnatural, difficulty, or painful?

Seated Problems

Most people will have some difficulty with this. If you find that when you sit on a flat surface you can’t line up the three landmarks, again assess which camp you fall into (the stick flops or it hits you in the head). Try to reposition yourself and make a note of what is difficult. Does it change from standing to sitting?

Start taking note of how this position changes over time. It always does. The real question is why does it change and when does it change? If your posture changes in the first 2 min of sitting then we have a real problem. If you can sit without loss of neutral posture (stick hitting all landmarks comfortably) for an hour without difficulty and your work doesn’t demand that you sit longer than 30 minutes then there likely isn’t a problem.

Fixing Your Sit

Before we get started, none of the interventions we are suggesting should be used if they increase your pain or feel punitive (this isn’t punishment). If generic advice (what is contained in this article) isn’t working then come see us, your Physical Therapy specialists in Happy Valley, OR or your nearest Physical Therapist who focuses on orthopedic and postural injuries.

If moving from standing to sitting causes you problems, here are some ideas for cleaning up your seated posture. Firstly, do less of it or at least break up how much you do. If you can turn 1 hour of sitting into 3 sets of 20 min with 30 seconds of getting up and walking around, you will improve how your body tolerates the seated portion. Even if sitting doesn’t cause you pain, it doesn’t mean that it isn’t taking its toll on your body. Anytime we spend a lot of time doing a specific task our body will only be good at that one thing. Unless you are a professional sitter (and none of our bodies are designed for this) here are some simple suggestions that should be used after long periods of sitting:

Thoracic Extension (below) – One indicator that you could benefit from thoracic extension is the stick test not finding contact with the middle of your back. This is commonly lost after years of sitting, and it is a gradual loss. Recovering this is a slow process so get started now and make it part of how you combat sitting. One of the hardest part about getting your thoracic spine moving is that as the spine becomes more stiff it tends to move more from areas above and below the target area. Try using a block, two tennis balls taped together, a rolled up towel (as shown below) or even a foam roller to promote gentile mobilization of your back. Try extending over your object and holding for 3-5 seconds (repeat 10-15 times per session) after long periods of sitting to aid in back health.

Fix Your Sit1 Fix Your Sit Part II

Placing a rolled towel behind your back can help push the thoracic spine into extension and help restore mobility lost from prolonged use of a flexed position. Sitting will anchor the pelvis and help prevent lumbar motion

Fix Your Sit2 Fix Your Sit Part II

Raising your arms over your head can help increase extension and helps direct extension with right or left rotation to help with recovering rotation of the spine.

Lumbar/Pelvis support – if you found that the stick test suggested a problem with your lumbar or pelvis upon sitting or commonly find yourself in the flexed low back posture after sitting for a few minutes, it is a good idea to add support to your low back/pelvis. One of my favorite ways of doing this is to roll a towel and place it behind your back, at the dimples on your back (these are actually part of the pelvis. Supporting the pelvis is a better idea than just pushing on the low back because it promotes neutral low back posture by repositioning the pelvis rather than using the low back to drag your pelvis along for the ride. Using a smaller version of the rolled towel used for extension, place it at the dimples on your low back which will tip your pelvis forward (check with your fingers as described in Part I).

Piriformis and Glute Mobilization (below) – if you find yourself having trouble holding a neutral position even with support it’s time to get serous about improving the mobility of the hip. Stretching a muscle is a myth, but we’ll get more into that in another post. We prefer thinking about stretching as mobilizing because what you are really doing is making a tissue easier to move so that it doesn’t passively pull you into bad posture. Once the muscles of the back of hip are mobile enough to rest comfortably in the position of sitting, you should find that holding neutral is easier. If they get more stiff over time, repeat the process.

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Placing your ankle on your opposite knee and pulling your leg towards your chest should cause a pulling feeling in the side and back of your hip. If these muscles become tight they will encourage a backward tilting of the pelvis (cause slouching).

Fix Your Sit4 Fix Your Sit Part II

Placing your ankle on your opposite knee and pushing your knee away your chest should cause a pulling feeling in the side and back of your hip. Again, if these muscles become tight they will encourage a backward tilting of the pelvis.

Fix Your Sit5 Fix Your Sit Part II

Placing your shin on a firm flat surface (chair or with your shin on the back of your couch and knee on the seat of your couch) pushing your pelvis pas your knee should cause a pulling of the front of the hip. Reducing the stiffness of these muscles after sitting will help prevent your back from compensating when you get up and walk.

Couch/Thomas Mobilization (above) – After you have finished your marathon excel spreadsheet session at work it’s time for a much over due stand and walk over to get a cup of coffee, right? If you are anything like the rest of us, you will find that things have gotten more tight as you were sitting and now, as you try to stand up, you end up arching your back because your hip just can’t fully extend. Here is a way to make the front of the hip mobile enough to reach that tall position. I recommend this at least once a day after a long period of sitting for all of my desk athletes, about 40 seconds a side and up to a total of about 4-5 minutes (throughout the day) for people with chronic problems in this area.

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Lying on a ball can help apply pressure to the deep hip flexors, getting them to move more easily so they do not dictate motion of the low back when standing up.

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Placement of ball for hip flexor compression

Psoas Smash (above) – Extra credit for those of us who are really bound up in our hip flexors. Applying pressure to a muscle helps force the layers of tissue to slide over one another again. Placing a ball just below your belt line on the front of your hip, roll onto the ball to apply pressure and roll along the muscles. Again, this should not feel like a tool of torture (if it does, reduce the pressure) and if you have any questions talk to a Physical Therapist.

How Often Should I Do This?

Glad you asked. Assessing your posture should be a continual process, especially if you spend more than 30 min seated for work, play (cyclists), driving or any other activity. The mobilizations of the back of the hip and for thoracic extension are usually best done before you start sitting, because they help you hold a safe position with less effort. We recommend revisiting them briefly every about 1/2 hour if you find that they are a common problem with your seated posture. The mobilizations for the front of the hip are best used before you start walking around after a long period of sitting or in the middle of a long period of sitting to help prevent that stiffness in the first place. 30-40 seconds, 2-3 times per day usually gets the job done. You should feel tension build in the target tissues and not in the spine when performing these activities. Get started with these simple suggestions today. If things do not get better, or if they are difficult to do, give us a call so we can help figure out why. Remember, the problem is not that you sit, it’s how you sit.

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