Rebuilding You: Part II

Part II: Spinal Stability and Positioning
Written by: Dr. Elizabeth Chamis, DPT

​Do you have back pain? If so stay tuned…

In the previous article we discussed foot and lower limb positioning during the squat to prevent injury to the feet, knees and ankles, therefore strengthening the lower limbs. If you’ve practiced this, then you are ready to consider your spine.

Creating a stable spine during movement and under load is one of the most important things we can do to prevent spinal injury. Since everyone performs squat-like movements on a daily basis, i.e., picking up that cooler for the BBQ, picking your child up off the floor, etc., then it is essential to create a stable spine when moving from a squat-to-stand .position.  This serves to prevent disc, muscle, and ligament injuries of the spine.

How to protect your back...
1. Exhale. Breathe out purposefully with pursed lips when moving from your squat-to-stand. When you exhale as such, you automatically contract the rectus abdominis, internal and external obliques, transversus abdominus and the internal intercostal muscles. When these muscles are activated, they act as a corset around your spine, serving as a natural back brace, which lessen your chance of back injury.

2. Neutral Spine. You’ve probably heard this term before, perhaps at a Pilates, yoga, or at an abdominal exercise class at your local gym. Basically, what you need to know is how to keep a neutral spine. Instead of the age old thought of “sticking your butt out” to perform a lift or squat, or even worse, letting your back round out like the hunchback of Notre-dame, you need to understand how to keep it neutral by engaging your abdominals. Start in standing, exhale and pull your belly button to your spine, tighten your glutes. As you squat down send your hips back as a whole unit instead of initiating the movement by arching your low back. Neutral spine also applies to the neck, or cervical spine. Your neck should also be in a straight line from your tailbone to the top of your head. Keep that chin tucked and your gaze ahead, not up. By looking up when you don’t have the mobility in your thoracic spine (mid-back), you are putting your cervical spine at risk for disc injury and nerve compression. (see photo 1 & 2).

3. Set Your Shoulders. Now that you know where the feet, knees, and spine go…where do you put your arms? Since your arms are linked to your torso it is important that your shoulders are active and not rolling forward. Gently squeeze your mid-back together to avoid dumping the shoulder forward. Your shoulders should be in an active position in order to accept weight on top of an engaged and active spine.

4. Thumbs Up!  Sometimes,  existing shoulder injuries or repetitive stress can be aggravated if the thumbs are placed in a down position.  Keep the thumbs up during movement to help avoid impingement-like symptoms. By having your thumbs up when reaching overhead, you create space in the shoulder girdle and alleviate the pinching sensation or repetitive stress that can occur in the shoulder. (see photo 3 & 4) .