The Sitting Solution, 2014 SittingSolution.com

A BILLION-DOLLAR problem, back pain is the most disabling con-dition out of all 291 conditions in the Global Burden of Disease 2010 Study. Either you have already experienced back pain or you most likely will in the future. Indeed, 8 out of 10 people will experience back pain at some point in their lives.

The root of back pain is often ignored as the majority of the population attempts to address it with pills, injec-tions, and marginally effective surger-ies. These short-term solutions rarely get us where we want to bepain-free and feeling good long-term!

We must uncover the root of the prob-lem. By becoming aware of how we sit, stand, and move as well as how to restore balance to the musculoskele-tal system, we can often avoidand solvethe back pain dilemma.

The truth about back pain is it is prev-alent, disabling, expensive, and usual-ly avoidableif we know what to do about it!

Most back pain doesnt result from traumatic incidents but from remain-

ing in poor positions over time and habitually performing poor movement patterns.

You have in your possession The Sit-ting Solution: How to Save Your Spine, Body, and Life. As you already know, chronic sitting increases your risk for developing acute and chronic back painamong other disease condi-tions.

Implementing the knowledge present-ed in The Sitting Solution is the first step toward addressing (and avoiding) back pain. The exercises address the common musculoskeletal imbalances

by Brenda Walding, DPT, FDN & Chad Walding, DPT, OPT L1, RKC

TH

E Truth AboutBACK PAIN(& How to Solve It)

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that develop in a culture where people chronically sit and slouch, which often leads to back pain. Watch the videos and learn the best ways to sit, stand, and move.

In addition to offering The Sitting Solution Program, we want to teach you the most beneficial exercises for preventingand in many cases, treat-inglow back pain. Weve success-fully used these exercises with our patients to eradicate unwanted back pain. We incorporate these exercises into our personal exercise regimes to keep our backs strong and pain-free. We suggest you do the same!

Please read these exercises carefully and take your time to ensure you are performing them correctly.

Note: If you have any doubts about your technique with these exercises, experience increased pain as a re-sult of these exercises, or feel severe back pain and/or radicular symptoms (numbness, radiating pain down the leg(s)), we advise you to seek out a qualified healthcare practitioner to help you design a more individualized treat-ment prescription.

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Press-UpsSTEP 1. Lie on your stomach with your hands directly under your shoul-ders.

STEP 2. Using your hands, press yourself up. Keep your hips on the ground and glutes relaxed. Attempt to straighten your elbows as much as

possible to achieve the full available lumbar extension range of motion.

STEP 3. Inhale on the way up and exhale at the top. Use the exhale to consciously relax your glutes.

STEP 4. Return to the starting posi-tion.

STEP 5. Repeat for the desired num-ber of repetitions.

BridgesSTEP 1. Lie on your back with your knees bent and feet flat on the floor. Your feet should be hip-width apart.

STEP 2. Initiate the movement by posteriorly tilting your pelvis (pull your bellybutton toward the floor, en-gage your lower abdominals, and lift your glutes slightly off the ground).

STEP 3. Continue to lift your glutes off the ground as you peel your spine off the ground, one vertebra at a time.

STEP 4. Hold at the top position and squeeze your glutes for 3 seconds.

STEP 5. Return to the starting po-sition the same way you came up, attempting to place each vertebra on the ground in the opposite direction until your glutes return to the floor.

STEP 6. Repeat for the desired num-ber of repetitions.

Note: Go slowly and with control for both directions to enjoy maximal benefit.

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Hip Flexor Stretch STEP 1. Position yourself in a half-kneeling position (front leg bent and foot flat on the floor; back leg bent

with knee on the floor and lower leg behind you). Place a towel or cushion under the knee on the floor if needed.

STEP 2. Find an erect posture by reaching through the top of your head and gently tucking your chin.

STEP 3. Squeeze your glutes and engage your midline to keep the pel-vis in neutral and avoid tilting it forward.

STEP 4. Translate your pelvis forward while keeping an erect posture (avoid tilting the pelvis forward). Hold to stretch your hip flexor.

STEP 5. You should feel stretching around the front hip region on the kneeling leg.

STEP 6. To progress this stretch, place your arms overhead and lean to the side opposite the knee on the ground.

STEP 7. Hold 30 to 120 seconds.

STEP 8. Switch sides and perform the desired number of repetitions.

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Bird DogsSTEP 1. Begin in a quadruped position (on all fours). Make sure your hands are directly under your shoulders and your knees directly under your hips. Keep your spine long and your neck in a neutral posi-tion (you should be look-ing toward the floor).

STEP 2. Engage your midline by drawing your bellybutton toward your spine. Keep your midline engaged throughout the movement.

STEP 3. Lift the oppo-site arm and leg simul-taneously. Keep this leg straight, driving through your heel with your foot flexed and toes pointed toward the ground. Keep your elbow straight and make a tight fist as your arm reaches forward.

STEP 4. Hold 3 to 5 seconds, keeping your midline engaged. Return your arm and leg to their starting positions.

STEP 5. Switch sides and repeat for the de-sired number of repeti-tions.

Note: As you lift your arm and leg, keep your pelvis and hips level. If you cannot maintain your balance while lifting your arm and leg simultaneously, prac-tice first lifting your arm and setting it down and then lifting the leg and setting it down. Then repeat on the opposite side.

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PlanksSTEP 1. Begin in a Plank position propped up on your elbows (forearms flat on the ground). Make sure your elbows are directly under your shoul-ders and your body is straight. Keep your neck in a neutral position and your feet together.

STEP 2. Ensure a stable midline by squeezing your glutes, tightening your abdominals, and locking your legs straight.

STEP 3. Avoid letting your hips sink down or sticking your butt in the air.

STEP 4. Pull your elbows toward your feet without actually moving to maximally engage your abdominals.

STEP 5. Hold for the specified time and reps.

Note: Dont hold your breath. If a full Plank is too challenging and your hips are sinking down or your butt is stick-ing the air, then modify. Drop down on your knees with your arms in the same position. Keep a straight line from your knees to the top of your head. Keep your abdominals and glutes engaged.

Figure 4 StretchSTEP 1. Lie on your back with your knees bent and feet flat on the floor.

STEP 2. Cross your left ankle over your right thigh, creating an up-side-down 4 figure with your legs.

STEP 3. Next, grab your right knee with both hands by threading your left arm through the space created by the bent left leg and bringing your arm around the outside of your right leg.

STEP 4. Use both hands to pull your knee toward you.

STEP 5. Hold 30 to 120 seconds.

STEP 6. Switch sides and perform the desired number of repetitions.

Note: You should feel a deep stretch in your buttocks, specifically in the area where your jean pocket would be. Keep your head and neck relaxed.

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Hamstring Stretch (with strap)STEP 1. Lie on your back and posi-tion the strap or belt loop around your foot.

STEP 2. Hold the strap in both hands and use it to pull your leg toward you while keeping the opposite leg on the ground and knee straight.

STEP 3. Pull the strap or belt until you feel a moderate stretch in the hamstrings.

STEP 4. Hold 30 to 120 seconds.

STEP 5. Perform this stretch at dif-ferent angles (45 degrees inward and outward) to stretch different parts of the hamstring muscle.

STEP 6. Switch sides and perform the desired number of repetitions.

Note: A yoga strap works nicely here, or you can use a belt. A cloth robe belt also works well.

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Lumbar RotationsSTEP 1. Begin by lying on your back with your knees bent and feet flat on the floor. Your knees and feet should be right next to each other, touching. Place your arms flat on the floor next to your sides, with your palms facing downward.

STEP 2. Rock your knees to one side, keep-ing your upper body still and your shoulders from lifting off the ground.

STEP 3. Next, bring your knees to the op-posite side. Initiate the movement by using your abdominals to first pull the side of your pelvis opposite the knees to-ward the floor, followed by your knees as you twist to the opposite side.

STEP 4. Continue to move back and forth in this fashion for the desired number of rep-etitions. Remember to initiate the movement by using the abdominals to pull your pelvis toward the floor; your knees will follow directly after.

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A1. Press-ups x 10; rest 10 seconds

A2. Lumbar Rotations x 1 minute; rest 30 seconds x 23 sets

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B1. Bridges x 20; rest 10 seconds

B2. Bird Dogs x 10; rest 10 seconds

B3. Plank x 30 sec; rest 1 minute x 24 sets

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C1. Figure 4 Stretch Left x 30120 seconds; rest 10 seconds

C2. Figure 4 Stretch Right x 30120 seconds; rest 10 seconds x 23 sets

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D1. Hamstring Stretch Left x 30120 seconds; rest 10 seconds

D2. Hamstring Stretch Right x 30120 seconds; rest 10 seconds x 23 sets

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E1. Hip Flexor Stretch Left x 30120 seconds; rest 10 seconds

E2. Hip Flexor Stretch Right 30120 seconds; rest 10 seconds x 23 sets

All Together NowNOW THAT youre familiar with the movements, lets organize them into a routine. We recommend doing this three to five times a week if youre suffering

from back pain and one to three times a week for mainte-nance and preven-tion. You can also perform the move-ments indi-vidually as needed.

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HOW TO READ ALL THIS

START WITH the following section, which is focused on spinal mobility.

A1. Press-ups x 10; rest 10 seconds

A2. Lumbar Rotations x 1 min; rest 30 seconds x 23 sets

What this means is you will start by performing 10 Press-ups. Be sure to press up to the top, keep your hips on the ground, and exhale at the top.

Once you have completed 10 Press-ups, take a 10-second transition pe-riod by rolling onto your back and performing 1 minute of Lumbar Rota-tions. We recommend keeping a watch or clock in view. You have now com-pleted 1 set. Take a 30-second break

and roll back onto your stomach to begin your second set, starting with 10 more Press-ups. You will complete 2 to 3 sets total, depending on how you feel and how much time you have available.

A short break is indicat-ed with a +. Get up, move around, and get some blood flowing.

The next section is focused on improving stability in the low back:

B1. Bridges x 20; rest 10 seconds

B2. Bird Dogs x 10; rest 10 seconds

B3. Plank x 30 sec; rest 1 minute x 24 sets

Start by performing 20 Bridges and then resting

for 10 seconds. Then you will flip over and perform 10 Bird Dogs. Each time one of your arms moves forward and one of your legs moves back, thats 1 rep. Then rest for 10 seconds before moving into a Plank for a 30-second hold. You have now completed 1 set.

Take 1 minute to rest and shake your body out before beginning another set. You will repeat 2 to 4 sets total. We recommend starting with 2 sets. As you feel you are getting stronger and more familiar with the movements, start adding more volume by working your way up to 3 and then 4 sets total. This can turn into quite a workout!

Take another short break before mov-ing into the cool-down stretches.

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Note: People with back pain often have tightness in their hips and hamstrings from chronic sitting.

Heres the next part:

C1. Figure 4 Stretch Left x 30120 sec-onds; rest 10 seconds

C2. Figure 4 Stretch R x 30120 seconds; rest 10 seconds x 23 sets

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D1. Hamstring Stretch Left x 30120 seconds; rest 10 seconds

D2. Hamstring Stretch Right x 30120 seconds; rest 10 seconds x 23 sets

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E1. Hip Flexor Stretch Left x 30120 seconds; rest 10 seconds

E2. Hip Flexor Stretch Right x 30120 seconds; rest 10 seconds x 23 sets

In all of these stretches, you will start on the left side and perform that stretch for 30 seconds up to 2 minutes. To get the most out of these stretches, shoot for a longer duration as it takes time for the body to get settled into a stretch. Because the body needs to relax, the focus should be placed on

breathing. For most people, it takes around 2 minutes to see true change in muscle length. We realize, however, many people are short on time. If 30 seconds is all you have, then lets start there.

Take no more than 10 seconds be-tween each stretch and set so you are using your time efficiently. We rec-ommend performing at least 2 sets, even if you are doing the stretches for a two-minute duration. If you are only performing them for 30 seconds, we recommend performing 3 sets.

Complete all of the sets for the Figure 4 Stretch before beginning the Ham-string Stretch. Complete all of the sets for the Hamstring Stretch before mov-ing on to the Hip Flexor Stretch.

Note: If you are still in pain after per-forming these exercises, we strongly recommend seeking out a certified McKenzie practitioner in your area. You can find one by going here.