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Fredrickson Health Solutions

Nirvana Flow 4 min Prehab and Warm Up

anatomy· chiropractic· exercise· physical therapy· warm up

22 Mar

At Cornell University Department of Ergonomics, researchers found that up to 90% more pressure is applied to your lower back when you sit versus when you stand.

According to the National Institute of Arthritis/ MSK and Skin Diseases, back pain is one of the American’s most common health problems, with 1 out of 4 people experiencing back pain 1 day out of every 3 months.

From my experience with treating patients with various neck and low back conditions, a lot of these patients also had bad posture. And guess what? Poor posture can be prevented!

 

As, you can see from the picture above, having better posture while lifting and doing everyday activity like sitting can have dramatic impacts on the amount of pressure we exert on our lumbar discs. This leads me to a couple of conditions that I would like to discuss regarding poor posture:  

 

Lower Cross and Upper Cross 

 


 

 

Upper Cross and Lower Cross Syndrome basically refer to a movement pattern in our body where one side becomes too tight (from posture, activity, etc) and the other side then becomes weak in comparison. 

 

In Upper Cross Syndrome, we generally have extremely tight pectoral and upper trapezius muscles with weakened rhomboids, lower trapezius, and deep neck flexors.

 

In Lower Cross Syndrome, we almost always see a combination of tight hip flexors (psoas, iliopsoas), with a weak glute and subsequent weak abdominal muscles and tight low back muscles (erector spinae).

 

What does this mean? 

 

In upper cross you will see someone with a slumped or rounded mid back and  a head that juts out forward. This not only makes you shorter, but it also puts more pressure on your discs and the nerves around your neck! Did you know that for every inch your head translates forward, your head subsequently weighs 10lbs heavier! So if your head translates two inches anteriorly, that’s 20lbs of extra stress on your cervical spine. 

 

Lower Cross Syndrome typically causes anteriorly rotated pelvis. See the diagram below: 

Now this image might seem like an exaggeration, but some degree of this type of posture is seen very often and it can contribute to low back pain. With an anterior pelvic tilt, which we can often contribute to prolonged sitting or a more sedentary lifestyle, is a result in the hip flexor pulling our pelvis forward (anteriorly) and our glutes and core not being strong enough to compensate for the pulling. This posture can stress the hip joints and lumbar vertebrae, as well as make it difficult to stabilize our core, further subjecting us to an increased chance of injury. The forward rotation of the pelvis can also cause more tightening in the hamstrings, which can cause further strain on the low back.

 

Now that we have a basic understanding of some of the most common postural faults and the impacts they can have, this warm up below should mean more.

 

I have been doing this warm up for the past 6 months. I created this because let’s be honest, when we get older we have less time, and when we have less time we are typically going to neglect things like a warm up and/or cool down in an effort to get a quick workout in.

In my opinion, we  need to warm up even more as we age because our soft tissues are becoming less elastic. To increase compliance, we need to find some ways to maximize time and efficiency as we warm up. Thus, this warm up flow was designed to quickly remove some of the postural faults we discussed previously and warm up our bodies for the workout or activity at hand. Once you know the movements, you can go through the entire sequence in 5 min or less.

 

As a side note, there are hundreds of rehab movements I could have included in this sequence, but I hand-picked these for maximum efficiency. For example the superman exercise can target groups of weakened muscles in both upper and lower cross scenarios (rhomboids, glutes, and hamstrings). The reason I call this a flow, is because the exercises are picked to easily and fluidly be transitioned one from the next, creating maximum efficiency.

 

I chose the name NIRVANA FLOW because these exercises and prehab movements are meant to flow easily without pain,while flowing between mobility and stability creating total peace within the body with minimal equipment. If you don’t have a foam roller or PVC pipe there are simple modifications below. ** If you feel pain, self evaluate the movement that is causing discomfort and modify the exercise to your comfort level.

 

Alright that’s enough reading, let go over the movements. You can also find the whole video at my instagram account. Click here

 

Nirvana Flow

 

  1. PVC pipe arm raises (no pvc? Do overhead arm raises 10x)
  2. Foam roll calves, hamstrings, anything that else that might sore
  3. T spine mobilization w/ 30 sec hold on foam roller
  4. Dynamic lunge stretch 1 min (30 seconds each  side) arm overhead optional
  5. Downward dog with alternating legs 
  6. Cat cow 5 reps
  7. Bird Dog’s 10 reps
  8. Spiderman lunge with T Spine Rotation (Featured Picture)
  9. 5-10 Mckenzies Extensions (if early in morning and stiff, modify these! We have the most pressure on the discs upon waking, so if this is painful just hold a half cobra stretch on your elbows for 20 seconds) Remember to exhale on the way down. For more info click here
  10. Superman 20 reps. For a video click tutorial here
  11. Side lying abduction: left leg 10 up and down, 5 side to side, 5 circles each way. Advanced: Side plank while doing these
  12. 30 sec plank (in between side leg raises)
  13. Side lying abduction: right leg10 up and down, 5 side to side, 5 circles each way
  14. 30 sec deep squat hold with 3 deep breaths 3 sec 3 sec out 
  15. Single-leg modified hip hinge 5-10 reps each side- video link here

 

Okay that’s it! Seems like alot of paper, but it’s really not.. The total time for me usually- 5 mins. I have been doing this for a while, and my body is comfortable with the movements. The key isn’t to race, take your time and work on quality movement while breathing intentionally. Again, watch a shortened version on instagram here.

 

Like this flow? Let me know if the comments? Have a question? Send us a message! Also be sure to follow us on facebook & IG at @FredricksonHealthSolutions.

 

 

References

Structure and Function of the Vertebral Column

Paul Jackson Mansfield DPT, BS, MS, Donald A. Neumann PhD, PT, FAPTA, in Essentials of Kinesiology for the Physical Therapist Assistant (Third Edition), 2019

https://www.sciencedirect.com/topics/nursing-and-health-professions/anterior-pelvic-tilt

 

Mean Body Weight, Height, Waist Circumference, and Body Mass Index Among Adults: United States, 1999–2000 Through 2015–2016 

https://www.cdc.gov/nchs/data/nhsr/nhsr122-508.pdf

 

Column: What Americans’ declining height has to say about the economy

https://www.pbs.org/newshour/nation/the-shocking

How Your Chair May Be Hurting You

https://www.startstanding.org/sitting-new-smoking/

In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems.

https://www.ncbi.nlm.nih.gov/pubmed/10626309

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