Why Adults Need "Tummy Time"

When babies develop in utero, they do so in a flexed fetal position.  When the baby is born, you will observe spontaneous kicking and punching of the air, along with some significant crying.  This is the baby's way of stretching out for the first time in this newly discovered universe of space.  What a relief it must be!

Parents are instructed on many "do's" and "don'ts" regarding the care of their newborns.  We know that we should not place our children on their abdomens (prone) to sleep, for concern of SIDS.  However, we are also told to make sure that our babies get some "tummy time" each day.  This entails placing our babies on their abdomens so that they can practice lifting their heads and working on their back extensor muscles.  There was no room for these muscles to get worked on in the womb.  Therefore, we want to allow our kids to start working on the muscles that will provide them with strong upright posture and mobility one day.  It's a pretty cool process to watch develop.

A couple of weeks ago, I was looking around at people on the LIRR.  Virtually everybody was focused on some sort of device, such as their smart phone or ipad.  What struck me was the posture that people assume to use these great toys of modern life.  If you want to use a Blackberry or iphone to send a text, presumably you have to hold it in front of you so that you can use both thumbs to peck away.  In addition, since the screen is so small, usually people are forced to lean their head forward.  Now you're in that forward head, rounded shoulders posture that can lead to neck and back pain.  And this is occurring on your down time!  Odds are, these people I was observing had spent 8-10 hours at a desk, where they likely craned their necks forward looking at a computer screen all day.

Desk jobs and mobile devices are not going away any time soon.  They're a fact of modern life.  My point in writing about this is to remind you to give yourself the equivalent of "tummy time" by stretching out your chest and shoulders and engaging the muscles in your back, particularly between your shoulder blades.  At the very least, try standing up once an hour at your desk, raising your arms overhead, and squeezing your shoulder blades together as you lower you arms back down towards your sides.  Think of making a snow angel.  Doing this or other similar exercises will help you maintain the back strength that your parents helped you build up years ago by placing you on your bellies.  Don't let your gadgets draw you back into the womb.

I need to clarify one point.  I am not suggesting counteracting flexed postures by sleeping on your abdomen.  This is NOT an ideal way to sleep.  Besides, that would only passively stretch your front but do nothing to actively engage your back extensors.

As always, feel free to call me if you want some pointers on how to stretch and strengthen for good posture.  Good luck!

James W. Horn, MSPT

Owner/Director

Chelsea Physical Therapy & Rehabilitation, LLP

119 W. 23rd Street, Suite 1002

New York, NY 10011

(212) 675-3447 (W)

(212) 243-5213 (F)

@Manhattan Spine & Sports Medicine

300 E. 56th Street

New York, NY 10022

(212) 935-1700 (W)

(212) 753-9856 (F)

chelseapt.com

Fix the "Stick"

Have you ever experienced a pulled muscle?  The chances are that you have, whether through some sports endeavor or just an every day task such as bending over to tight you shoe.  If you have, then you're familiar with the pain and functional limitation associated with it.  For mild (grade 1) strains, some simple rest, ice and ibruprofen will do the trick, and you'll be feeling better within a few days.  But that can lead to a false sense of security.  The reality is that you may be more prone to re-injuring yourself in the near future.  Here's why.

When you strain a muscle or tendon (you sTrain a muscle/tendon, you sPrain a ligament), microtears occur in the tissue.  Your body responds accordingly by beginning a cascade of repair responses.  Fluids rush to the site with all sorts of tools to begin the repair.  It's similar to an emergency response team rushing to a collapsed construction site.  This rush of "first responders" to your injury site is what causes swelling in the area.  This is when we ice, not to completely shut down the repair process, but rather to control it so as to avoid compression injuries to nerves in the area.  As part of this process, the body begins to lay down scar tissue to repair the damage.  And here's the key to long-term management of a muscle strain.

Think of that scar tissue adhesion as "glue" in your muscle belly.  Muscles rely on the smooth gliding of fibers over one another as they contract and release.  Now picture a spot in that smooth gliding mechanism that won't move.  It's stuck.  If left alone, the next time that muscle is put under a rapid change and stressed, the muscle is likely to re-tear near that "stuck" point.  The same healing cascade effect will begin all over again, with more scar tissue being laid down.  Without proper treatment, this can become a chronic condition.

Many of you have probably been taught that once your strained muscle feels better, then you should begin some light stretching of that muscle.  Not a bad idea, but that's only half the picture.  Let's say I strained my hamstring (muscles in the back of my thigh).  Two week later, I might have no pain and pretty close to normal function.  I may begin to diligently but cautiously work on my hamstrings with slow, static stretching.  That's great for all the muscle fibers that are still smoothly gliding over one another. But what about that stuck, "gluey" adhesion?  That area is not getting stretched!

The solution?  I highly recommend seeking help from somebody who can teach you how to "release" that adhesion.  I'm not just talking about your typical Swedish massage, which will bring much needed blood flow to the area but won't necessarily break up the adhesion.  There are techniques that are VERY effective in undoing these adhesions, and the good news is that they work fairly quickly.  The technique involves finding the "hot" spot (you can typically feel the area of restriction by palpating with your fingers), applying pressure, and lengthening the involved muscle through it's range.  Picture dragging knotty hair through a hairbrush that is held static.  

So, don't let those muscular sore spots turn into a chronic problem.  Learn how to "free up" your muscles after injury (or even restricted spots due to chronically poor posture) so that they can move correctly and reduce you chances of re-injury.  As always, feel free to call me with any questions!

James W. Horn, MSPT

Owner/Director

Chelsea Physical Therapy & Rehabilitation, LLP

119 W. 23rd Street, Suite 1002

New York, NY 10011

(212) 675-3447 (W)

(212) 243-5213 (F)

@Manhattan Spine & Sports Medicine

300 E. 56th Street

New York, NY 10022

(212) 935-1700 (W)

(212) 753-9856 (F)

chelseapt.com