Rehab for kyphosis/forward head

Hi

does anyone know what would be the best re-hab movements for kyphosis/forward head? I find wall extensions with the back of the head pressed into the wall somewhat effective. The reason I ask is that when I am practicing wall handstands, my neck seems out of alignment from the rest of my body. I think the problem is with my upper spine/thoracic/shoulder area and neck

thanks

I use a kitchen timer set to 15 min to address postural bad habits: when it rings, I adjust my posture and reset the timer!

other than that, you could maybe try stargazing? :roll:

Kit Laughlin's material comes very highly recommended. I will be purchasing his head and neck book, which includes shoulders and upper back, but that's what you need as well.

Coach is actually changing the way his guys stretch based on what Kit showed them, so it has to be pretty good. Cory Fair has also told me privately that he has experienced excellent results with Kit's work, so I really think that it is a good way to go in general, but especially with your particular issue (which I have as well).

therock, this is Kit's website: http://www.kitlaughlin.com/

Joshua Naterman said:

Kit Laughlin's material comes very highly recommended. I will be purchasing his head and neck book, which includes shoulders and upper back, but that's what you need as well.

Patrick Smith said:

therock, this is Kit's website: http://www.kitlaughlin.com/

Is this the exact item in question?

http://pandf.com.au/store/cart.php?m=pr ... etail&p=49

Joshua Naterman said:

Coach is actually changing the way his guys stretch based on what Kit showed them, so it has to be pretty good.

Would Coach be referring to something like this DVD or is it some other one listed on the website?

http://pandf.com.au/store/cart.php?m=pr ... etail&p=54

One more question, for both these items, there are 2 DVDs listed. A regular one and an UPDATE version. Do we need to order both?

These are the two ones I am planning on buying, as soon as you confirm they are the right ones. If their are additional ones, please let me know, and I`ll add more items to my shopping cart.

I would buy the 'update' version. It's probably the same thing as the other material but.... updated.

I think it's like a 2nd edition.

Hello all,

Only in the interested of clarification (I don't want this to sound like a hard sell):

There are two main books, each with their own DVD Updates (the slowness of standard publishing models means that DVD Updates are the most efficient way to distribute new material). Note that both DVD Updates are shot in 16:9 HD video, and distributed on NTSC standard definition DVDs.

1. Overcome neck & back pain; in the spirit of Coach's acronyms, let's refer to this as "ONBP".

This is now in its 4th edition, which now includes a new chapter, and includes our approach to hand, arm, and shoulder pain (so a bunch of exercises for all these parts). Key to understand in respect of the OP's question is the role the hip flexors play in whole-spine mechanics—very often this spinal shape can be rapidly improved by ONLY stretching the hip flexors. The reasons are many, and I will elaborate below for the OP.

The DVD Update for ONBP has all the essential exercises for us (GB) folk, in respect of hip flexors, hamstrings (essential for decent pike), spinal flexibility in all planes, all shoulder and arm ROM, and so on.

All the ONBP exercises are available in DVD form for those who learn better this way; there are four of these. Various combination packs are available from the shop on my site.

2. Stretching & Flexibility; from here, "S&F".

This is available in two different covers, but the contents are identical and there is no benefit in getting the later printing.

The DVD Update for this book, like ONBP above, has all the latest versions, new versions, and additional exercises you need, but the focus of this book is the whole body, and optimisation of function is the explicit objective (rather than overcoming pain/dysfunction).

As well as the S&F DVD Update, there is another DVD (dual layer, 3.25 hours, standard definition video, 4:3 format) called Stretching & Flexibility, which has all 96 exercises from this book. If the straddle position, or full side splits is your goal, all the necessary hip abduction exercises are found there. Exercises that supersede any in the original DVD (as with our new approach to working the hip flexors) are found in the S&F DVD Update.

So, for clarity, there are two main books, ONBP and S&F, each with their own DVD Update, as well as the various other DVDs.

We are discounting the postage for all GB seminar attendees, too; I believe that Coach will be emailing attendees with the code that is entered in its own window when checking out.

Finally, before I make another post to directly answer the OP, we have over 50 Youtube clips available free, and many of the exercises GB folk need will be found there. The channel is HERE.

Re. kyphosis/head-forward posture:

Short perspective is that this benefits from being corrected before specific shoulder pre-hab/rehab is attempted, in my view, because trying to get shoulder ROM from the joint, rather than re-aligning the shoulder and arm on the rib cage (which has to include improving middle and upper back extension) is doomed to failure in my experience (and the MAIN reasons for shoulder pain in folk attempting to do the intermediate GB work).

The reason this spinal alignment is so often seen these days is the work we do: the computer era, with forced immobility and undesirable laptop/iPad ergonomics, slowly changes the shape of the thoracic spine, shortens pec. minor in particular, and virtually guarantees short hip flexors. How many hours a day do we spend at the keyboard? This time we spend in these positions tells the brain/proprioceptive system that we privilege this shape.

The solution is to

Next is to learn how to do

Next is to use the

You will need a partner to get the best/fastest results, but all of these exercises have their solo versions, too.

There are many more, but this will be a good start. cheers, kl

Thanks for the replies Kit

kit laughlin said:

So, for clarity, there are two main books, ONBP and S&F, each with their own DVD Update, as well as the various other DVDs.

I`ll be ordering these two combos when I get my next pay cheque

http://pandf.com.au/store/cart.php?m=pr ... etail&p=30

http://pandf.com.au/store/cart.php?m=pr ... etail&p=25

kit laughlin said:

You will need a partner to get the best/fastest results, but all of these exercises have their solo versions, too.

These solo versions are found in the books and dvd packages referenced above?

kit laughlin said:

The reason this spinal alignment is so often seen these days is the work we do: the computer era

Absolutely, but hard to avoid. I`m gonna try buying a standing work station. My forward head is no where as bad as some other people i know, but nevertheless, it needs to be addressed.

kit laughlin said:

The solution is to stretch the hip flexors first

kit laughlin said:

Next is to learn how to do passive back bends over a support

kit laughlin said:

There are many more, but this will be a good start.

Thanks, I`ll be trying out all those, as well as the others on your Youtube channel. I just have a few questions regarding this though. Steve Maxwell, who I think you probably know, said on his website somewhere that a static wall facing squat also helps with this problem as well as certain back bends such as the classic locust pose shown below. I haven`t tried those yet, but has this also been your experience? I always assumed the focus of the locust was active lower back flexibility, but recently read somewhere that the focus is on the shoulder girdle, upper thoracic area.

Classic Locust Pose - courtesy of RegianeYoga

Trust me on this: anyone who is a flexible as this girl has perfect spinal alignment. Unless you are already very flexible, I would regard the locust as one of the least efficient ways to getting this way, and your point about the major focus focus being the lumbar spine is spot on—unless you are already this flexible (just because in the majority the lumbar and cervical spines are the most flexible in the untrained).

An aside: all solo versions of exercises are shown in both books. I disagree strongly with the experts who claim that parter stretches are either inefficient or dangerous. I follow the Mel Siff line: "There are no dangerous exercises, only dangerous ways of doing exercises." In my experience, a single iteration of the right stretch for a problem area will open the body immediately—and then you can feel how to do this by yourself. It is perfectly possible to become completely flexible by yourself, but it's a much longer road. Why wait?

And what follows are the deeper reasons behind my recommendations: unless the HFs are loose, any back bend will have its emphasis in the lumbar spine, because in the chain of HF > lumbar >thoracic > cervical, the loosest link is where you will bend—and this is the least efficient way of getting HF flexibility (and HF flexibility is what controls leg extension.

So: if you want to be a bit scientific about this, have a friend take a picture of you (side view) standing relaxed before you start. Then begin with HF, do the passive back bends (pay close attention to where you have the maximum bending point; try a number of positions) or the chest opening partner stick stretch, and once you are done, take another picture while standing completely relaxed. Please post!

kit laughlin said:

Trust me on this: anyone who is a flexible as this girl has perfect spinal alignment. Unless you are already very flexible, I would regard the locust as one of the least efficient ways to getting this way, and your point about the major focus focus being the lumbar spine is spot on—unless you are already this flexible (just because in the majority the lumbar and cervical spines are the most flexible in the untrained).

An aside: all solo versions of exercises are shown in both books. I disagree strongly with the experts who claim that parter stretches are either inefficient or dangerous. I follow the Mel Siff line: "There are no dangerous exercises, only dangerous ways of doing exercises." In my experience, a single iteration of the right stretch for a problem area will open the body immediately—and then you can feel how to do this by yourself. It is perfectly possible to become completely flexible by yourself, but it's a much longer road. Why wait?

And what follows are the deeper reasons behind my recommendations: unless the HFs are loose, any back bend will have its emphasis in the lumbar spine, because in the chain of HF > lumbar >thoracic > cervical, the loosest link is where you will bend—and this is the least efficient way of getting HF flexibility (and HF flexibility is what controls leg extension.

So: if you want to be a bit scientific about this, have a friend take a picture of you (side view) standing relaxed before you start. Then begin with HF, do the passive back bends (pay close attention to where you have the maximum bending point; try a number of positions) or the chest opening partner stick stretch, and once you are done, take another picture while standing completely relaxed. Please post!

+100

I didn't even want to comment on the locust position... that is clearly an advanced position that took a long time and/or naturally good whole spine mobility to achieve. Things like that typically show off excellent mobility, as opposed to your work which actually develops it.

Kit has well outlined the essentials of good backbending.

I particularly appreciate Kit's mentioning passive backbends which I have also found to be very effective. I think backbending movements are among the best responders to passive work.

Locust position is absolutely wonderful and terrible at the same time. Do NOT attempt this if you are not already very comfortable with bridging in its many variations. Based on the nature of your post this is not you.

In general as Kit mentioned, backbends are especially prone to falling into the weak link of the lumbar or sacrum. When working with kyphosis this is even more likely to happen.

It's very hard to figure out how to get the upper back moving, there aren't as many nerves there, so there isn't as much sensitivity as say your finger tips. But with practice it can come. The passive work, and exercises like Kit showed are wonderful for bringing this sensitivity to life.

On the active side, things like spinal waves are excellent http://yoga-horizons.com/2011/04/keep-y ... nal-waves/ In general you want to be able to feel that you can actively draw your thoracic spine into the body a bit at will. When you get there just do it from time to time throughout the day.

Some good active poses would be Cobra and shoulder bridge working to get the chest towards the chin.

I'm not sure what Maxwell is talking about but if you do it back on the wall and try keep you shoulders and the back of your head on the wall and 'suck' the thoracic spine off, that's a great exercise.

Finally I'll end with something a bit controversial, but I'm now convinced it's true. In general having good resting posture is over rated. Many PT's I follow support this believe it or not. So if you are trying to fix your posture for the sake of fixing it, you may be wasting your time. However we do want to have a good deal of movement potential, if you can't create movement in your thoracic spine at will, then that's something worth doing but that doesn't mean you have to stand 24 hours a day like the perfect Victorian gentleman.

Coincidentally a friend and I were having a conversation on this topic and he brought this interesting quote from Mel Siff up.

"The concept of long lasting static posture runs contrary to how the body functions. Speeded up video studies have shown that our bodies are always indulging in subtle or gross movements to ensure that one precise posture is NOT held for prolonged periods, thereby ensuring that stresses are not imposed upon the same physical structures in exactly the same way. Even in sporting and other complex movement situations, the same external movement pattern may be produced by different musculoskeletal and neuromuscular strategies, so that the idea of an invariant, highly stable single posture is misleading."

"Is it not possible that no posture which deviates moderately from the ‘norm’ really will cause any problems provided that it is not held for too long or subjected to prolonged or excessive loading in any given direction? After all, the body is in constant motion, even during sleep, which may well be the body’s natural way of preventing any given structure from being excessivelyor inappropriately loaded.

So, if we move around regularly from one posture to another, no matter how poor each may appear to be, are we not then minimising the occurrence of any dysfunction – as long as we don’t load the spine excessively or hold the same posture for too long in any one state? Is it only when we forget to shift around regularly in seated and other positions that problems begin to emerge?

Is the prevalence of back pain and dysfunction more a consequence of lack of

adequate postural variation than any single ‘correct’ posture? Though our models of optimal spinal functioning may well be quite accurate, is it that essential to implement them so precisely, when regular shifting from one position to another may tend to offset most of the alleged risks of imprecise spinal usage? Does this then imply that many of the popular therapies and methods of spinal use and rehabilitation are undulyprescriptive and in many cases, redundant?"

The lady doing locust in the photo looks quite healthy, I imagine she is, but don't let a photo of someone doing something like that lead you to believe they must be have perfect spines etc. I know plenty of yoga people with plenty of aches and pains. In fact since yogis have to pretend that yoga is only about a healthy pain free life, they can't even mention the fact they are in pain.

My own experience with locust was interesting, and it does very much activate the thoracic spine. The first time I did it and had someone assisting me to get there touching my toes to my head, I could feel my spine pressing into my lungs and drive the air out. It scared the bejesus out of me, but then I got used to it and loved to do the pose. I'm also fairly certain that contributed to the asthmatic condition I later developed and also damaged my voice box. But we do the things we do for love of our art. Thankfully now that I'm out of that world I can say, hey it was fun, I'm not so sure it was as healthy as 'gurus' wanted me to believe.

"Finally I'll end with something a bit controversial, but I'm now convinced it's true. In general having good resting posture is over rated. Many PT's I follow support this believe it or not. So if you are trying to fix your posture for the sake of fixing it, you may be wasting your time. However we do want to have a good deal of movement potential, if you can't create movement in your thoracic spine at will, then that's something worth doing but that doesn't mean you have to stand 24 hours a day like the perfect Victorian gentleman."

@Cole: I am very interested in this subject as I am planning on becoming a physical therapist. It is interesting that you mention the fact that proper movement is more important than proper static posture without the proper movement. Would this be why some athletes, say chinese gymnasts or some gymnasts in general, can compete at such a high level with what appears to be poor static posture (kyphosis/forward head/protracted shoulders) because they have the ability to move the different parts of their body at will properly?

But, I also wonder, when an athlete or person has achieved good range of motion, the ability to stabilize and control and move in and out of various ranges of motion with control, and proper movement as well as neuromuscular coordination, would it not still be beneficial to further strengthen and stiffen (so to speak) the weak and overly under-stimulated areas and bring the body back into a more balanced static position or posture/s?

What makes me think that this would be worth attaining is the fact that infants/little children do not start out with and don't naturally develop kyphosis/forward head/ internally rotated and protracted shoulders/everted feet/excessively pronated ankles etc. So if we have a young child that not only has proper movement and activation patterns, but a much more balanced and stable static posture, would an older athlete/person not also benefit from working long term to bring their bodies into an even greater balance, such as they might have been as a child before all of the years of one-sided sports, physical inactivity, computer, video games/tv?

An example that comes to mind is take a blacksmith. This blacksmith has spent his entire adult life (lets assume a career of say forty years) swinging a hammer to shape and forge iron. This blacksmith (through the years of flexing, no finger/hand/wrist extension, and gripping) has developed a hand or hands that have become permanently closed/gripped/tight. Let's assume that maybe he can't fully extend his fingers because of chronically tight finger flexors, and chronically weak, undeveloped finger extensors. So this blacksmith is put through some therapy. Any scar tissue or adhesions that he may have are broken up and worked free. His tissues are gradually made soft and supple. His fingers and hands are stretched out slowly and progressively until he has full, healthy range of motion. Then his finger/hand extensors are activated/stimulated/retrained so that he can actively extend his fingers through a full range of motion.

Now, this man's hands left as they are are most likely plenty flexible, mobile, healthy, supple, and can move much more properly now that he is done with therapy and as long as he continues to do some basic daily prehab. But, his hands are still in a flexed position just because of how dominant his finger flexors are. Would it not lead to even greater hand/finger health if his finger/hand extensors were slowly and progressively made even more strong/developed/dominant to the point that when his hands were totally relaxed his fingers rested in a more open/balanced position, as opposed to the possibly functional, but still flexed state?

It just seems to me that bringing the body back into an even greater balance would provide even more structural health benefits in the long run. Any thoughts?

The balance in structure you're referring to is something we try to evaluate and to an extent recover and maintain through FMS. Long term wise it is certainly beneficial, now to have good proper movement does not require good posture doing all things. Often we end up in position that have become comfortable, the body has adapted to it. In the case of the desk worker whose posture is leading to dysfunction symptoms we definitely aim to correct it as a priority. For the high end athlete things get a bit more complicated. We do try and correct to a certain base point and maintain that but as higher levels of competition get close you have to "give" a bit as their preparation might take away from it. After it we will attempt to move back to a base line.

These baselines are through conscious movement, not by observing static posture. Just postural analysis by itself cannot show dysfunction, just a poor habit. Balance movement with movement. In many that will cause them to show better posture. Most of us are just too lazy or too comfortable with our poor positions. Good example is a lot of military personnel. Look at them in civilian clothes, their posture is not so great. I was guilty of this but once in uniform, especially "dress" everything is nice and straight. The athlete can demonstrate excellent static positions in situation where they want/need to. It is often just the choice not to.

I cannot comment on Kit's books/dvd's as I have not had the chance to look through the material though it is on my list to get.

This is all very true.

Past a certain point you can't recover original resting posture because of physical changes to vertebral structure, but that doesn't mean you can't recover full active mobility.

Those are two very separate things. If I had to pick one, it would be the ability to move easily through a full range of motion along with actually using proper movement when applying force.

Cody H this is an important question particularly if you are considering embarking on a career in physical therapy.

As a long time yoga teacher, the importance of good posture was throughly engrained in me. I was taught that bad posture WILL lead to pain problems and the the cure to pain problems was good posture.

However after many years I noticed that fixing posture only sometimes helped. In fact there were cases the more I worked on correcting 'bad' posture and increasing 'limited' ROM the worse the person symptoms would be. Stretching for many seemed to be a moral imperative, but I would consistently see all that stretching only causing more problems for the person.

I also had begun to develop some issue with my hips and sacrum towards the end of my career and again the more I tried to correct it via the better posture route the worse it got.

It was only when I stopped trying to be so 'perfect' that I began to find a route out of that pain, which is now completely gone.

Perhaps there is such a thing as perfect posture, but if there is it most likely not a rigid think, but fluid.

As it is, if there were such as thing, who is to define it. I know from years of studying Easter movement arts that there is actually no real agreement on what it is. In fact in being open to all the different viewpoints I found that they all worked together. In other words that the body likes variety, it thrives on it. If one of the many ways of being didn't work, I tried another and gradually built an open picture of possible movements rather than a Cartesian fixed one true way of moving.

Later I was lucky that an online acquaintance pointed me to a loose collective of PTs that had also figured this out and more. Then the understanding that pain is really a product of the brain which takes into account the various inputs from the peripheral nervous system, past and present experience etc before 'deciding' to produce the pain signal. This concept really helped me understand why correcting posture doesn't always work.

Melzack, one of the leaders in the revolution to understanding pain, postulated what is now fairly accepted, the Neuromatrix theory of pain. The name sounds like new age voodoo, which is unfortunate because it is pure research science.

Read more on it here. I now consider this essential reading -

http://ipcoregon.com/pdf/pain_and_the_n ... _brain.pdf

Here is a link to one thread an this very topic that may help on the road to understanding this mysterious topic.

http://www.somasimple.com/forums/showthread.php?t=13096