Pain Free Performance — Posture Alignment Therapy

Posture Alignment Therapists, Graduates of Egoscue University

Pain relief

Misalignment leads to Neck & TMJ Pain

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Our head is the center and peak of our body. When the head and neck are out of alignment, the weight of our head increases the load on our neck by 10 pounds per every inch that our head is forward. As our culture continues to become tech focused, the root of neck pain and jaw pain are due to our misaligned necks and forward heads. 

 

Our neck is made up of the top part of our spine: the cervical spine. The cervical spine is a slightly concave curve that develops during the first three months of life as infants learn to lift and turn their head. The curve of our neck allows for enhanced mobility of our head. This is why we can turn our head to see something without rotating or turning our spine and shoulders. 

 

Throughout the past 20 years our culture’s behavior has changed. We no longer turn our head to look for cars behind us while driving because our rear cameras alert us when someone is there. Work days have shifted to being predominantly at the computer. The average time an adult spends on their phone is more than three hours per day. The decrease in movement of our neck and increased forward head has led to a loss of the concave cervical curve.  Without the cervical curve of our neck to support our head, our skeletal system shifts and leads to increased tension in the muscles that connect our neck to our shoulders and jaw misalignment.  

 

Within the past few years at our practice, we have seen this increase in clients presenting with neck pain and temporomandibular joints (TMJ) pain.  As the head becomes more flexed forward, the joints that connect our jaw to our head begin to shift in response to the misaligned spine of our neck. The misaligned jaw often is identified by “clicking” or pain from overuse of chewing/talking in a misaligned joint positioning. Often clients with forward head positioning and jaw misalignment present with headaches in conjugation to neck pain and TMJ pain. Forward head positioning leads to decreased blood flow to the brain from poor alignment. It might sound unusual that headaches and jaw pain are connected to your alignment, but as the head shifts forward the cervical spine becomes more flexed, decreasing blood flow to the brain, enhancing strain on the muscles around the neck, and often creating shifts within the jaw.

 

At our practice, we treat the misalignment of the head positioning that creates TMJ pain and neck pain by addressing the body as a unit. We focus to align the body vertically and reduce the flexion of the neck. One example of this would be aligning the body against a wall and placing a block between the knees with active pressure. This position allows the feedback of the wall against the head, shoulders, hips, and ankles. When holding this positioning daily, the muscles of the neck and shoulders begin to relax and have reduced tension and muscular compensation. Overtime, we are able to see a reduction in the flexed position of the head, correct curvature within the spine, and the jaw becomes more aligned.

 

Our goal during a postural alignment therapy evaluation is to identify what is driving the forward head position and jaw misalignment. Through a complete health assessment, functional testing, and gait analysis we can begin to understand the muscular imbalances in a client’s body. This will allow us to identify the muscles that need to be strengthened or released to bring the body into alignment. We do this through corrective exercises that will be done daily at home in the order to address the misaligned neck, forward shoulders, and jaw positioning. Once the body is aligned and the forward head position and shoulders are less rounded, the pain will subside and our clients are able to live a functional pain free life.

A look into Knee Pain

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As postural alignment specialists and graduates of Egoscue University, our focus is on the position of the client’s load bearing joints. Our shoulders, hips, knees, and ankles bear the weight of our body when standing and moving upright. When we look at our client’s joint position, many of our client’s are surprised by their knee position. 

The load bearing joints of the shoulders, hips, knees, and ankles should align.

Try this:
Stand in front of the mirror
Look at the middle of your thigh bone that is named the femur. Then look at the middle of your knee cap.
Draw an imaginary line from the center of the thigh bone to the middle of the knee cap.
Does the knee turn to the outside of the body or does the knee roll toward the middle of the body?

If the center of your thigh and center of your knee cap are not in line, the rest of your load bearing joints are picking up the work for the uneven load. This uneven load leads to knee pain, arthritis in the knee joint, bursitis, and torn ligaments!

When knees turn out or roll toward the middle of the body, there is significant wear and tear on the knee joint. Imagine going up and down the stairs with the knee cap pointing outward. The friction and demand on the uneven knee joint will lead to knee pain. Over time to avoid the knee pain we begin to sell our house to live on one level or we take the escalator to avoid the movement that leads to pain. This avoidance of triggers will decrease the feeling of the knee pain, but does not address the cause of the knee pain.

Oftentimes the exercise we do to be healthy and support our heart, aggravates our knees and we begin to wonder why. If your knees turn outwards and you cycle or run for 30 minutes, that is 30 minutes that your knee joint is impacted and inflamed. Frequent wear and tear from a misaligned knee exercising on the elliptical, bike, or treadmill will lead to arthritis of the knee and the need for a knee replacement. The exercise is not the enemy, but the position of the knee cap in relation to the thigh bone and pelvis. 

How do we avoid knee replacements, ligament tears, and arthritis? We must consider the muscles that support the thigh bone (femur) and knee cap (patella). Through a postural alignment assessment, we will identify what is off in your body and which muscles need to be activated to bring your body into alignment. By correcting and supporting the position of the lower legs, you will continue to be able to tackle stairs and maintain your heart healthy cardio!

Painful Hip Flexors

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It’s not uncommon for us to hear our clients mention waking up with tight, sore hip flexors. Hip tightness can occur for many reasons. Excessive sitting can cause the muscles to relax and deactivate becoming progressively weaker and shorter, creating pain.

Poor posture habits can create a structural imbalance which will cause an uneven pulling of muscles.  No matter the reason, tightness in the hip flexors will lead to decreased movement in the hip and change the way we walk, stand and sit. Our pelvic position will be out of line because the hip flexors are pulling the pelvis forward. This changes the load of our body and creates instability in our gait. Over time, the uneven load and misalignment leads to inflammation, arthritis and other degenerative changes causing pain.  What to do?

At Pain Free we will evaluate you individually to see what is going on with your body that’s creating the issue.  Part of the prescribed plan will retrain those hip flexors to let go, get back to their intended length and tension to eventually re-establish the entire body’s alignment restoring proper gait.  All of that equals being pain free!

Try this and see if you are able to notice a release:

Stand with your back against the wall. When your hips are touching the wall, your thighs and kneecaps will begin to release. If your thighs want to engage, stay in this position for 2-5 minutes until your thighs release and the backs of your legs begin to work.

What’s Causing Your Back Pain??

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When it comes to back pain, there is no classic case. Clients come to us with different reasons for their back pain including: muscle spasms, fusions, herniated discs, impinged nerves, spondylolysis, or scoliosis. All of these medical diagnoses are a result of a muscular imbalance. Although everyone’s back pain does not look the same, many of these patients have a something in common: a misaligned pelvis.

When the body is misaligned, it is forced to adapt just to function. This means that parts of our body are doing jobs that they were never meant to do. When the pelvis is tilted (anterior, posterior, elevated or rotated) it changes the curve of our spine. This is important because the curves of our spine are designed to absorb shock and prevent us from feeling pain!

So how do we fix this? By providing the body with the exercise or stimulus it needs, the alignment of the pelvis will slowly be restored. This will allow your pelvis to be balanced again in a neutral and functional position which restores the curve of the spine.

Getting your pelvis in the correct position is not where we stop. We have to train the muscles around the pelvis to continue to hold the correct position. If your pelvis is misaligned, it’s likely that your gluteal muscles, (those big muscles in your behind) are not working the way they were designed. By retraining those muscles to work as they were intended, we can help restore the stability to your pelvis, realign the spine and get rid of the back pain.

The beauty in restoring alignment and function to the body utilizing the Egoscue Method, is that it is lasting and preventative. As Egoscue therapists, we know that we are providing our clients with the tools they need to not only get out of pain, but also to prevent future issues!

 

The Whole Picture of Being Pain Free

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As Egoscue certified therapists, when we look at the body, we do not isolate it into individual bones or parts. We hear our clients when they identify the quality and site of their pain whether it’s knee pain, back pain, hip pain, or foot pain. This information is used as a tool to provide appropriate care for our client, but we continue to treat the whole body. In order to eliminate pain long term, we must work to correct the imbalance of the body as a whole unit.

When our client’s come to Pain Free Performance, we encourage them to “listen to their bodies”. This means to acknowledge when they have pain, to not complete exercises that bring on pain, and identify changes within their body after completing a musculoskeletal exercise.

In an Egoscue therapy session, we might encourage our client to stand with their backs against the wall and have their heels, hips, shoulders, and head touching the wall for two minutes. For some clients, not all of their body parts will be able to touch the wall in the beginning. During these two minutes, a client could feel that their body is falling forward, that the muscles behind their knee could be stretching, or they could notice that their head is forward. After two minutes of holding this exercise, we watch the client walk and ask them to consider if anything in their gait is different which could include:

Are they lighter on their feet?

Are they standing straighter?

Has their knee pain decreased?

Do they feel equal weight bear in both feet?

As therapists, we are looking for a change in the function of their body. We are assessing whether the exercise restored the client’s ankle function or created a lighter load in the client’s steps. In the beginning pain level or quality might not change, but it is through restored function of the musculoskeletal system that our clients will not only have improved posture, but improved quality of life without limitations. Balance and restored function of the musculoskeletal system are the key to becoming pain free.

 

Moving Toward Being Pain Free

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We often work with clients experiencing significant changes in their quality of life due to pain. Many are having pain for the first time and don’t understand why. They progressively and reluctantly remove the activities they love that seem to increase pain. Ironically this leads to no longer being able to sit, stand or move without discomfort. The catch is, even in pain, our bodies are meant to move. Ultimately, the body moves the way you move it or, doesn’t move because you don’t move it.

If you have been a cardio-queen, spending an hour doing the elliptical every morning and then go off to work sitting for eight hours, that’s a problem. Perhaps you’re a jogger and pound the pavement on the weekends but lay low during the week. Both of these scenarios can cause pain over time. Parts of your body and muscles are deprived of oxygen for all that time you are sitting or sedentary. Most people are out of alignment and can unwittingly create more dysfunction with activity. It creeps up on you and then one day, as our clients describe above, you are in pain for the first time. You have back pain, hip pain, foot pain, neck pain or shoulder pain and you don’t know what to do! You hurt, so you stop the morning exercise, the running, the elliptical. Inactivity is not the answer, but the right activity to correct your alignment is key to healing your pain.

At Pain Free, our job is to evaluate each client’s body, to diagnose what is truly causing the pain and reintroduce appropriate movement. This prescribed movement restores alignment, naturally removing pain which reunites people with the activities they enjoy! Let us join you on this journey back to moving well and doing the things you love to do.

Arthritis and Aging

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Many of us assume that as we age, there will be a certain amount of pain to endure. We think arthritis is a sure thing.  Or, is it?  And if so, is age really the only culprit?

First of all, what is arthritis?     It means “Inflammation, etiology unknown”.  Where does the inflammation come from?  There is the implied theory that we’ve just worn out our joints because we’ve lived so long!  If that were true, then everyone over a certain age would have arthritis or worn joints.  We know that knee pain, shoulder pain, hip pain, back pain comes from wear and tear.

Well, most often patients present with one side or the other hurting –I hear it all the time “thank goodness my other knee feels great!” This phenomenon alone debunks the theory that time on earth is dictating joint wear and pain.  While joint compression from age can be a factor would we really only have knee pain, shoulder pain, hip pain, and back pain on one side if pain was caused just by longevity?  No, both sides would have arthritis pain.

As Posture Alignment Specialists certified by Egoscue University, we evaluate bodies in pain all day every day– young and old, all sizes, shapes, injuries, surgeries, abilities and disabilities and condition levels. Most people come to us because they want pain relief – with knee pain, shoulder pain, hip pain, back pain, and ankle pain.  The simple and amazing thing is that they all have the same problem – their bodies are not properly aligned.  What your body needs is not youth but alignment… the way it was intended.  The earlier one understands the importance of alignment, the less arthritis has a chance!

joint alignment

Notice the alignment showing the ankles, knees, hips, and shoulders vertically and horizontally aligned, the pelvis is neutral, the spine has an s-curve, and the knees and feet point straight ahead. When this isn’t what is happening in our bodies – for whatever reason (accident, surgery, work posture) – some muscles begin doing too much and some not enough.  That is when bones are pulled out of alignment because of the compensation and then joints begin to wear unevenly.  This is true no matter what your age, however, the more years it goes uncorrected the more work one must do to unravel the compensations.

We need alignment so that our joints are properly “loaded” while we participate in as much weight bearing movement as we can handle, keep our range of motion in all joints full and active!  It’s not age, its alignment.  No matter what your age, we can help you retrain your body to be straighter and more functional without all the pain!

 

Getting Back to Exercise

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Often when clients are feeling better, they want to get back to their exercise routine. In order to create a change in posture, we ask that people hold off on weight lifting or repetitive exercise in the beginning so as not to strengthen any unresolved dysfunction. We completely understand that when the body is becoming aligned and pain has decreased, you are eager to get back to a more physical and active lifestyle.

So the question is: how do you exercise and remain pain free?

If there is an activity you love and want to get back to, you should try it! Listen to your body while doing the activity. If you have concerns about what you feel, acknowledge it. Your body will give you a signal if it is resisting, like pain or restricted range of motion. Our rule of thumb is to complete your Egoscue menu first, in order to align your body the best you can prior to your workout. Always follow up your activity or workout with a few exercises that your therapist recommends for your body or even repeat your menu. This will allow you to the live the life you love and remain pain free.

Remember, the best exercise equipment is your own body. Just walking puts your body in dynamic motion and allows your 200 bones, 230 joints, and 600 muscles to become energized! Not only will walking increase your aerobic response and nourish your joints, but it will maintain something called the “cross crawl pattern” within the brain that’s necessary for maintaining balance.

If you have any questions about getting back to your active lifestyle and remaining pain free, our Egoscue Certified Posture Alignment Specialists at Pain Free Performance will keep you on the right path!