Downhill skiing is a fun and exhilarating sport that millions of Americans (including me and my family) enjoy each winter. But traveling down a snowy and often icy mountain at speeds exceeding 25mph comes with risks. Head injuries, broken legs, twisted knees.  Over the last 10 years, the introduction and increased use of ski helmets has reduced the incidence of head injuries while skiing by 25%. But the rate of knee injuries including Anterior Cruciate Ligament (ACL) tears has remained steady over the same time period despite improvements in skis, bindings, and lessons. 

Michael Decker, a biomechanical engineer at the University of Denver, said that asymmetry between the left and right leg may be a factor in ACL injuries. 

​“You are seeing big differences in right and left legs,” Decker said. “What we are finding is the non-dominant leg has been injured, especially the ACL, much more than the dominant. Females have two times the rate as males of the non-dominant leg.”

Postural imbalance causing knee injuries including ACL tears is something I have talked about before and think is the number one factor in why these injuries happen.

Look at the image above left which shows a woman with good postural alignment and balanced leg strength. You can see that both her feet point straight ahead as do her knees and her hips and shoulders are level. This means when she repeatedly squats while skiing, her ankles, knees, and hips will work together as a team distributing workload throughout all the lower body muscles and avoiding excessive strain on any ligaments, cartilage, or other connective tissues in her body. This means she is very unlikely to tear her ACL while skiing. 

Now look at the image above on the right. Notice how her feet turn out at different angles. Her knees also point in different directions and her hips and shoulders are not level. Since we know that how we stand is how we move and bad posture equals bad form, there is no way her body will move or ski in a balanced and even way. She will end up overloading her dominate side while collapsing on her non-dominate side. This is a recipe for injury including an ACL tear - whether it happens while she's alpine skiing, playing soccer, returning a tennis serve, or jumping up and down during a bootcamp workout. 

If you have a dominant or stronger leg or notice your feet or knees don't both point straight ahead I would highly recommend you seek professional help in correcting these imbalances from an Egoscue University certified Postural Alignment Therapist and Advanced Exercise Therapist to address your imbalances before you get in injury. As they say, an ounce of prevention is worth a pound of cure. 

​I would be happy to offer anyone who is seriously interested in correcting their imbalances to prevent injury a free posture evaluation and consultation. I would also offer the same to anyone who has suffered a torn ACL or other skiing injury and would like help getting back to 100%. 

Hip extension and knee extension. Very important to running. Most of us spend hours and hours sitting each day which teaches our hips and knees to be in a flexed position, and if we aren’t doing anything to remind our legs they can also extend, we are asking for injury – hamstring pulls or tears if we try to sprint, knee and low back pain if we are running long distances, foot and hip pain, the list goes on and on. (The Egoscue Tower is a great e-cise to encourage knee and hip extension while also creating thoracic extension.)

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Yes! Take motion breaks during your day. I suggest getting out of your chair every 30 minutes and do 1 or 2 e-cises that will break your body out of the flexed position. (Besides the above e-cises, here are some other e-cises you can do at work)

If you are interested in a free posture evaluation and gait analysis, contact me today and I'd be happy to help you understand what is limiting your running or athletic performance and what you can do to improve. 

What is “core strength”? The ability to maintain structural integrity of the joints regardless of the position (i.e. standing, sitting, squatting, running, jumping, etc.). Isn’t that the same definition as “good posture”? Yes. They are the same thing. If your posture is compromised you do not have core strength (even if you have a six pack!).

How do we measure it? By looking at your standing posture and then by watching your body in movement. If you can maintain joint position during movement, you have a functionally strong core.

Why do I need core strength? If you don’t have core strength and you try to pick up something heavy, you might injure your back and end up with chronic back pain. If you lack core strength and you go for a run, your knees might hurt later that day. If you are weak in the core you’ll get shoulder and neck tightness and pain from sitting at work.

What are the best exercises to develop core strength? Anything that realigns your posture and teaches your joints to stay lined up while moving (running, golfing, gardening, tennis, etc. ).
I would recommend getting a free postural analysis including functional testing and gait analysis to identify where your imbalances are and then getting a program of exercises to correct your unique muscular and postural imbalances. 

Great video from 1920s that shows children with poor posture and explains the causes of certain postural imbalances and how to correct them. This film, called "Educated Feet: For Correct Posture", was made for the Beverly Hills United Schools to show how important posture education is for young children and how much positive impact it can have in a short time. 

​This video points out that good posture habits should be taught at a very early age just as reading, writing, counting, and math are. By age 5 when most children enter kindergarten, many children are already developing postural imbalances such as forward head posture, abducted and pronated feet, rounded shoulders and internally rotated arms, internal or external femur rotation, valgus or varus knees, anterior or posterior pelvic tilt, and thoracic kyphosis. 

What are the causes of postural alignment imbalances in children as young as 5? 
Many things including:

• wearing stiff or restrictive shoes
• excessive sitting
• too much time spend looking down at electronics like iPads
• limited physical activity
• not enough variety of physical activity
• mimicking posture and movement of adults

​What can we do to help children improve their posture and health?

• encourage children to go barefoot as often as possible
• when shoes are required, make sure they are flat, flexible, and widest at the ends of the toes
• limit sitting and encourage movement often
• limit time spend playing video games or using computers, tablets, and smartphones
• take children on 20+ minute walks daily
• take kids to the playground or park as often as possible for free play
• practice good posture yourself to be a model for your children

Children's fitness levels have been declining with children today being 15% less fit than their parents generation were. There are many factors causing this decline in fitness, but I believe posture imbalances play a significant role. 

​Along with implementing the suggestions above, here are several fun family workouts you can do as a entire family that will boost your fitness levels, improve your posture, and improve your overall health. 

Kids today are less fit than their parents were at the same age. Why? Kids today just don't move as much on a daily basis. We walk less and drive more. We play outside less and play video games more. We exercise more and play less. Movement is supposed to be fun! That's why let's call this play and not exercise. Encourage your kids to play along with this video and then create their own moves. The goal is to get moving by having fun. 

Related videos/articles:
The difference between play and sports training in kids
The kidding around workout
Pete Egoscue on infants and alignment
National walk to school day
The magic of motion: bear crawls!

This video from Sonima.com and created and narrated by Pete Egoscue, in just 7 minutes will give you a quick cardio workout while improving hip function and range of motion, creating thoracic extension, and energizing you for the rest of the day. All you need for the workout is a jump rope and a bench or chair. Hip function is the key to maintaining hamstring flexibility, improving athletic performance, and preventing back pain. The thoracic extension this workout creates counteracts the daily slouching over laptops and cell phones that most of us do. Maintaining good thoracic posture and mobility can prevent "text neck", forward head posture, neck and shoulder pain, headaches, breathing problems, carpal tunnel syndrome, and back pain. Live, play, be...pain free! 

Related videos/articles:
Why you should never pull your stomach in during exercise
Partner workout
Is training your "core" really helping you?
10 design perfections in the human body
​Oregon Exercise Therapy YouTube page

Cats & Dogs is a simple exercise that has been around for thousands of years, but it is still very relevant and effective at creating change in postural alignment, movement patterns, and overall health. Watch Brian Bradley from Egoscue explain how to do Cats & Dogs in the video below:

Question: What does Cats & Dogs do?
Answer: The movement of Cats & Dogs is spinal flexion and extension. The Cat position involves pelvic posterior tilting, spinal flexion, and scapular abduction or protraction. The Dog position involves pelvic anterior tilting, spinal extension, and scapular adduction or retraction. 

Q: What's the purpose of Cats & Dogs?
A: Its essence is to remind the body that it can move through both flexion and extension and to teach both sides of the body to work together and move symmetrically. Many people spend the majority of their lives in spinal flexion and scapular abduction and Cats & Dogs will help reset the body back into a more neutral position. Many of us also have imbalances left to right in our bodies, whether it's torso/hip rotation or shoulder/hip elevation, and Cats & Dogs will help balance the body back out.
​
Q: When should I do Cats & Dogs?
​A: Anytime! Cats & Dogs are a great exercise to do in the morning or before exercise because it will prepare your body for movement by creating more symmetry and balance in the body. Cats & Dogs are also wonderfully effective to do after exercise or at the end of the day to reset your body. Also anytime you have done something that is unilateral, Cats & Dogs are effective that balancing the body again. (Unilateral activities include: tennis, golf, bowling, baseball, twisting stretches, using a computer mouse, painting, or writing.) 

This is a question that can be hard to answer specifically at the time most people ask it, but let's talk about 10 common causes of posture imbalances and what you can do about them. 

1. Slouching while sitting. Slouching typically consists of rounding the spine into flexion. When sitting this usually involves tipping the pelvic posteriorly, losing the normal lumbar extension, creating thoracic kyphosis, rounding the shoulders, and jutting the head forward. 

Chronic slouching causes laxity of spinal ligaments, weakness in spinal extensor muscles and hip flexors, and causes the body to learn that this posture is normal. 

The fix: Focus on sitting up straight with a small arch in your lower back, shoulders back, and head upright. Take frequent breaks from sitting to stand, walk, stretch, and move. Here are some easy stretches that can help and here is a video of some other ones. 

2. Carrying things on one side of your body. Do you always carry groceries or briefcase in the same hand? Do you sling your backpack, laptop bag, or purse over the same shoulder? This overuse of one arm and shoulder will cause one shoulder to drop lower than the other and often rotate forward. This creates imbalances that continue down your spine and into your hips. A recipe for neck, shoulder, back, and hip pain. ​

The fix: Switch arms and shoulders frequently. When you catch yourself using your favorite arm or shoulder to carry something, make yourself switch sides. Also try to carry one bag of groceries in each arm to even yourself out. ​

3. Standing on your dominate leg. Over time most people have developed a dominant leg that is stronger and more stable than the other side and this can cause problems. Do you catch yourself standing on one leg repeatedly? Do you shift your hips to side when standing relaxed? Just as using one arm to carry a heavy bag, using one leg to stand on or shifting your hips has the same affect on your body: throwing it out of balance. 

The fix: Focus on standing on both feet and hips evenly. One trick is to turn your toes in so you feel slightly pigeon toed which will align your hips symmetrically. 

4. Looking down at your cell phone. Cell phones can be wonderful, but looking down consistently at your cell phone can wreck havoc on your posture. Text neck has become a huge phenomenon because of all the looking down at cell phones people do. ​

The fix: Hold your cell phone up in front of you when using it and try to limit overall cell phone use. The less time you spend on your cell phone, the better your posture will be and the better you will feel. ​

The fix: Alternate feet when walking up stairs. Hold onto the handrails to stabilize yourself if needed, but make sure to alternate which foot goes up first to balance your strength and function. For optimal function, point your feet straight ahead, which will feel slightly pigeon toed for most people. 

6. Doing the same thing every day. Doing the same things every day creates monotony in the body and will lead to muscle, joint, and posture imbalances. Here's an example: Let's say this is your daily routine: Get up, take a shower, sit to eat breakfast, drive 45 minutes to work, sit at work for most of the 8 hours except for several walks to talk to coworkers, drive 15 minutes to the gym after work, ride the stationary bike for 30 minutes, do 7 weight lifting machines (sitting chest press, sitting row, sitting leg press, sitting leg extension, sitting leg curl, sitting bicep curl, sitting tricep extension), shower, drive 30 minutes home, sit to eat dinner, sit and watch TV for 2 hours, go to bed. Yes, this person exercised for 60 minutes a day, but all the exercise was done sitting and doing the same exercises every day lead to muscle imbalances. 

The fix: The body is designed for a variety of motion on a daily basis, not the same motions every day. This person would be much better off doing 7 different weight lifting exercises each time they went to the gym and alternating the type of cardio they did (jump rope, running, cross-country ski machine, step-mill or stair climb machine, play basketball, play tennis, etc). ​

7. Wearing shoes. Over 95% of shoes on the market interfere with normal foot movement and posture and wreak havoc on the body. Most shoes have a heel wedge or "drop" - meaning the heel is higher than the front of the shoe. Since the entire human body is supported by the foot, an uneven platform of a shoe causes compensation throughout the rest of the body's joints as seen below:

Most shoes on the market also have toe-spring (meaning the front of the shoe is angled upward deforming the toes), toe-taper (meaning the toe box is widest at the ball of the foot and narrows toward the toes causing the toes to loose their normal wide spacing), and are stiff. Stiff shoes limit the movement of the joints of the foot and weaken the muscles of the foot and lower leg. 

The fix: Go barefoot as much as possible to allow your toes to spread, feet to move naturally, and muscles of the foot to regain their strength. When you must wear shoes, find shoes that are flat, flexible, and widest at the toes. Also check out Correct Toes to help realign your toes to their natural position. 

8. Being sedentary/not moving enough. As infants, we are born with a c-curved spine, bowed legs, and flat feet. Only through movement do we develop s-curved spines, straight legs, and arches in our feet. Fetuses start moving in the womb and continue moving every-which-way they can from the time they are born and all that movement is essential to normal and healthy physical and mental development. We often forget that not only is movement essential to development but also for maintenance of our physical and mental states. A sedentary lifestyle quickly leads to breakdown of our physical bodies and posture imbalances. 

The Fix: Act like a kid: move, explore, run, jump, climb, dance, and play on a daily basis. Do a variety of physical things every day and week to maintain well-rounded strength, flexibility, agility, balance, and physical capacity. The more you move the healthier you become. 

9. Playing just one sport. Let's play a game! You name the sport, I name the imbalance it creates. Swimming: posterior pelvic tilt and rounded shoulders. Tennis: "gorilla arm" or the massive muscle development of one arm (dominate) compared to the other (non-dominate). Golf: elevated shoulder and hip. Cycling: swayback posture and thoracic flexion. Ballet: abducted feet and posterior pelvic tilt. Soccer: externally rotated femurs. Playing the same sport puts repeated and imbalanced demands on the body creating posture imbalance and eventual pain and injury.

The Fix: Play different sports and do different activities. Cross-train. Even if you are in love with (or play professionally) one sport, playing other sports will make you a more well-rounded athlete and less injury prone. If you are a swimmer, running will improve your hip strength and kicking power. If you are a tennis player, playing soccer will improve your footwork for tennis. If you are a golfer, playing basketball will improve your agility, balance, and coordination for golf. ​

10. Your attitude and mental state. Feeling stressed, hopeless, depressed, pessimistic, or skeptical can all lead to posture imbalances. These emotional states all lead to you rounding your shoulders and head forward, collapsing your chest, and closing off your heart from the world. (This Peanuts cartoon shows this perfectly.) Feeling this way also leads to inactivity exacerbating the posture imbalances. Skepticism is slightly different from the other feelings above in how it affects posture. Skepticism is having a doubting and untrusting attitude, which causes the body to twist and contort. This causes torso and hip rotation, uneven shoulders and hips, and unequal loading - all recipes for injury and pain. 

The Fix: Do things that help you find peace of mind, gratitude, hope, optimism, and trust. Meditation has been proven to be very helpful. Mindfulness, acupuncture, massage, journaling, talking with friends, being in nature, and going for a walk or run outside can all help. I also highly recommend the book Pain Free Living by Pete Egoscue and doing Static Back and the Egoscue Tower to realign the body which will create calmness and peace of mind. 

To learn more about your posture, imbalances, injuries, and pain, contact me for a free posture evaluation.