Deane Juhan uses the expression “muscular armour” when describing a body’s reaction to stress. The original “stress” can be in the form of physical or emotional injury but no matter what form, the body, Juhan describes has to physically compensate and over time these areas in the body develop a kind of soft tissue “armour.” Originally it’s the body’s way of surviving, but over time if not “processed” becomes still, dense, tight, and often painful.

In one of his most comprehensive pieces of writing, titled “Jobs Body”, Juhan goes into intricate detail about soft tissue (muscle,fascia,nerve) and the potential affects of stress on them. The book takes you on an amazing journey starting at the cellular level and describes the physical and emotional merits of manual therapy; his particular expertise being therapeutic massage. It’s an amazing read but very dense so you may want to read a section at a time – there is way too much to absorb!

I find myself reading sections repeatedly over the years – for example, reading about the cellular makeup of fascia is not only miraculous but gives me a cognitive representation of the facial matrix which can be very helpful when working on an area that needs to be released. Juhan even has photographic images of facial orientation, and what happens when it is “stressed”, and then how the body attempts to repair it. It’s very enlightening and really gives me a fresh perspective.

So, I will leave you with these thoughts and also with a quote I came across the other evening while listening to my daughter, Lucy, fiddle with her bluegrass musician friends in Frankfort, KY.

“…….the body’s mischiefs, as Plato proves, proceed from the soul; and if the mind not be first satisfied, the body can never be cured.”
– Richard Burton, “The Anatomy of Melancholy”

So lets talk about those pits……..! The armpits or what is called the axillar region is riddled with difficulties – by nature the anatomy of the shoulder and the surrounding region is tenuous – on one hand we are thankful;  it’s extremely mobile and capable of  a multitude of planes of movement. Not so thankfully it’s the nature of this tenuous joint to become the culprit of poor posture, muscle strains, and often a ever-growing decrease in strength as we age. I could go on and on about the shoulder joint but tonight I want to talk about those armpits! Commonly I see people trying to harness more strength in the upper body by literally squeezing their shoulders into their armpit reegion. I think it’s an attempt to access the scapulae and the area between the scapulae; a way of “engaging” that ever-so-hard- to- reach region. We’ve all heard it or said it: “gently press your shoulders down, feel those shoulder blades coming together, gently try to push those shoulder blades down.” So it isn’t surprising that the outcome is people trying too hard to “feel” what we suggest and literally squeeze into their armpit region to “hold” on. The consequence of this is potentially very limiting if not interesting to observe. Suddenly the arms are somewhat limited in their freedom of movement and if one attempts an exercise that requires true upper body strength, it isn’t there! Without compensating by squeezing into their armpits the exercise can’t be done. It becomes a habit and ultimately develops a malalignment in the bony structure and a possible accompanying tight mid back. More holding, less breathing, and certainly a stress on that region of the spine.

So lets try this: sit on the floor/mat and have your legs long out in front of you or slightly bent if those good ‘ol hamstrings are too tight – don’t stress out your lower back! Now place your hands along your sides to the back portion of your hips. Hands on the floor with the fingers facing forward. Air out those pits! That means take a moment and open up the axilla and feel a sense of air and lightness in them. Now, while keeping this sense of lightness and freedom in the axilla, gently (there’s that word again :), lift your sternum, and think about broadening the length across your upper chest. Sense how the shoulders gently drop down and back. Sense how the scapulae rotate downward and inward. Hold this position for  about 5 seconds and then let it go and relax. Try it again and this time after you find the position take five more seconds to engage your lower abdominals. Relax. Try it again and the third time, if your legs are long out in front of you, try gently squeezing them together sensing how the lower body engagement can support the upper body work. Keep the chin down, jaw relaxed and a sense of length behind the neck.

Working on this daily has an a huge effect on how one learns to “wake up” that lower upper back without tensing up the shoulders and lats. Fun! Well actually its hard work but the results are quite immediate in a neuromuscular sense – the habits here can be unlearned quite quickly. Awareness of this armpit tension is almost immediate.

Later on try performing various upper body exercises (pull backs with the straps on the reformer, bicep curls, the roll down with the bar — and be aware of this habit. (you may wonder why I mention the roll down but watch: see how when folks are halfway down or up from performing the roll down how many literally squeeze their shoulders into their trunk for stability – ask them not to do this and watch how they realize they haven’t really been using their mid to upper abs…………..) Wow! You will feel new muscles working and not too soon after that you should start to feel that mid-back easing up its hold and tension. The scapulae start to settle back into their proper position (further down the back and more closely approximated to each other). It is here that all upper body work should be done and if done correctly puts no stress or strain on the actual shoulder joint.  It is an “aha” moment for many of us and I challenge you to try it!  “Air out” those armpits and feel a new sense of strength and ease in the upper body.

One last point: remember that when sitting or standing with “proper” bony alignment, the sternum is higher than the base of the scapulae. Notice when people have a more forward shoulder posture you see scapulae that are riding too high and suddenly the mid aspect of the sternum (or really the sternal angle) is literally at the same height of the base of the scapulae! Whoa! This is not anatomically correct and puts unusal strain on the mid back – increasing the kyphosis in the mid-back. Take two minutes and look at a picture of the human skeleton (preferably a side-view) and see what I am suggesting. Sometimes thinking about the bones is very helpful and a nice change of perspective from always working from the images of our soft tissues.

In Pilates we talk a lot about “working from the inside out.” You know – awakening and deepening our core stabilizers so we can stop “holding” and managing our bodies from the outside. Less tension and more deep inner strength. It makes sense that as we age many folks become less mobile, breath more shallow, and that over time our inner strength is neglected and we develop compensatory ways of literally “holding ourselves together.” It’s that outer “muscular armour” of sorts — tight, shortened soft tissue that eventually starts to hurt. Over time the pain results in decreased mobility and suddenly we are feeling tired, “heavy”, and less interested in moving. Today I stood a client upright to look at her standing posture — I wanted to see how she managed standing in what I assumed was her “everyday working posture.” The obvious will often stand out – some forward shoulder tendencies, the ever-familiar anterior tilt of the pelvis and resulting increased lordosis – but what stood out to me today was her “knock-kneed” tendency. Again – not so out of the ordinary; lots of females have this alignment; place them with their feet parallel about 4-5 inches apart and the inner aspect of their knees touch. So I decided to see how she would fare in the classic Pilates stance – the “v” position. I encouraged her to move her heels closer together (but not necessarily touching) and the toes angled slightly outward. She was stunned! She could not stand in this position without holding on to something as her feet automatically lifted off the floor –  almost the entire inner aspect of her feet and also her forefeet were lifting off the floor. Wow! I suddenly felt like I could see her “story!” We have been working for over three months as she came to me complaining of a very sore low back and upper trap/neck. We have done the basics – conscious breathing, ribcage mobility and of course deep core awareness. We’ve worked on correct pelvic placement, hamstring length and also learning to move what I call more “economically” ; trying not to give 50 pounds of effort for a five-pound effort movement. As we started working today I felt as if she has progressed (and we are both thrilled about her new deep core awareness) but there was still an innordinate amount of tension and decreased flexibility in her mid back region. Humph. So we did a lot today – flexion, extension, rotation and a combination of the latter – I wanted to get this back moving! Still something seemed missing………….. something isn’t connecting. Something she is doing everyday is not budging! So I get her to stand like I described above and suddenly I “see” it all – those outside forces wreaking havoc on her body – literally the entire outside of her body fighting to keep her from falling over with this small adjustment in alignment – the “v” position. The valgus tendency in her leg alignment literally pulls her inward but at a cost – as the hip muscles weaken due to this skeletal alignment (over time) the body has to compensate for this and is desperately holding on for balance and stability. Those outside forces keep those knees inward and there is automatically an emphasis on weakness in the joint and a coupled tightness in the soft tissues. Putting her in the “v” position made her realize that her inner plumb line/center line of gravity is just not present. I asked her to hold on to my cabinet and think about pulling up and lifting along the inner aspect of the legs. I gently stood on her forefeet to help ground her and for a brief second or two I could see something different. The pelvis relaxed, her tail dropped down, she had more weight in the center of her feet and she seemed “lighter.” As soon as it appeared it disappeared and she lost her balance, looked at me as if I had introduced some “zany” exercise and wondered what the heck that was all about. Wonderful! I suddenly realized this is the path into her work – increasing her central “line” and dissipating those outward forces.  

So that’s a very long way of saying – don’t forget the simple stuff – like standing. Alignment is very different in different positions – supine, sidelying, prone, sitting, and of course standing. Also –  never underestimate the power of gravity! Over time it can really cause havoc on the body if we don’t stay strong and supple. 

So I guess I am on a “what comes first” theme. When I think about movement these are places my mind goes; what is causing the immediate discomfort or disruption in movement? Is it some kind of compensatory action? How has this person adapted to their pain or decreased range of motion? The body is amazing in how it adapts; the trouble lies in when this “adaptation” becomes habit. Compensatory motion is the cause of a lot of pain and discomfort.

So I wanted to talk about shoulders today. So many people are coming through the studio with shoulder pain and limited range of motion only to say that it’s been that way for awhile and they have just decided there is nothing they can do about it. Needless to say people are frustrated and wonder if they will have these limitations forever.

One basic fact we need to remember is that the arms are attached to the trunk. There is a beautiful set-up here; when properly aligned the trunk is the structural “base” that lends itself to all the range we require and desire of the arms. When the trunk is not properly aligned then the arms are encouraged to work beyond their intended “scope” and they get stressed; sometimes this stress causes joint problems and other times soft tissue strain.

Once this balance is disrupted we must “back up” and revisit some of the trunk basics; open up the upper chest, get the ribs moving well, stretch out tight muscles (probably the pecs!) and allow the bones to realign. The shoulder joint is “special”; it’s a very loose and accommodating joint. That’s why we can do all the wonderful things we ask of it; reaching long across the trunk, reaching high above the trunk, reaching behind our trunk. But if the trunk itself is limited in motion then it all becomes stressful for the arms. Think about it for a moment; the arms move in a beautifully choreographed rhythm; the scapula glide across our rib cage; up, down, across,  and then the arm (the humerus) can then go where it pleases. If the trunk is “stiff” (not enough rotation or extension) then scapular movement is limited and strain is put on the actual arm/shoulder to make up for the lack of movement; the rhythm is “off.”

So here comes the part about stability before mobility. Lie on your back and most likely all of us have shoulders that are way too forward — it’s a postural thing. When we stand our sternum is dropped, our shoulders are forward, and some of us eventually have the head and neck too forward. Exaggerate this and then try to move your arm(s). Feel the limited range of motion, feel the strain on the shoulder joint. Now stand more erect and lift your sternum up allowing your shoulders to broaden and go back and the head and neck to settle more directly above your spine. Now try moving your arms — aha! Much more movement and much less strain. Now this is hard to see/do when standing because for many this is years of accumulated poor posture — sitting at a desk, pouring over notes, etc. So for most we need to start on our backs.

Lying down we can use whatever props we need to support opening of the upper chest and eventual release of the shoulders more posterior. Strengthening the mid and upper back muscles will help support this posture. This takes time – you just can’t force a joint to realign too quickly but its worth it — once proper alignment is reinstated, movement and strengthening of the arms and shoulders happens quickly.

So we reinstate mobility in the trunk, then the trunk becomes a flowing breathing entity; it provides that dynamic stability which supports the movement of the arms and shoulders. Mobility begets the proper stability which results in mobility. That’s what it is all about!

After deliberating about it for much too long I am starting a blog to write about my work with the body; healing through movement. My work is based in the Pilates Method and then ten years ago I also went back to school to get my Masters in physical therapy.  Now I work with a wide variety of clients helping them learn about their bodies, alleviate pain, and reacquaint themselves with the joy of movement. Some clients are moving for the first time in many years, some have continued to move but with pain, others are just disappointed with the outcomes of traditional rehabilitative exercise.

Last week I had the privilege to visit a studio run by my friend, Jennifer Anzelmo. Her studio, Transformotion, offers private and group Pilates work, Spin, and several cardio-based exercise classes. Jennifer and I worked together (last year) in the Passing the Torch program run by Balanced Body paying homage to the Pilates Elders. The Pilates Elder that we had the privilege of working with was Mary Bowen. Mary was my original teacher and mentor in Pilates Method which I began studying in the early 1980’s.

So back to Chicago: I offered two workshops on Saturday; the first focused on the upper body and postural influences and in the afternoon I talked about the lower body;  pelvic position, the importance of bony alignment in the legs, and how to keep our feet flexible and strong. Both workshops wrapped up with a brief discussion about what I like to call moving more “economically”; learning how not to give fifty pounds of effort for a five-pound effort movement, and how our habitual patterns of moving are not always in our best interest.

Okay – so now to today’s topic; tension versus strength. For almost every client that I met in Chicago, strength was an issue; either the client was strong but still had a great deal of pain, or the client was in pain and strength was eluding them. Immediately this is what came to my mind:  Strength is different from tension. Tension is stiff, unyielding, unaccommodating, and perhaps most importantly, limited. Strength is the exact opposite; it breathes, it is pliable, it accommodates.  This mandates that we start with re-introducing the breath. As we know, conscious breathing has the potential to reduce soft tissue tension, quiet the mind, and perhaps most importantly help us to move more economically. I like to start with the ribcage helping the client understand the basics of “normal” ribcage movement; sensing how the ribs expand and travel upward on the inhale, and then travel back down and towards each other on the exhale. I was surprised by the general lack of ribcage movement –in fact I always am. Without consciously focusing on the ribs moving during the inhale and exhale, the ribcage becomes more rigid and our breaths become more shallow. So after guiding the new clients to breath more directly into their ribcage on the inhale, I then gently assisted their exhale (manually) encouraging the downward movement of the ribs, helping them to expel air more effectively, and simultaneously lengthening their intercostal muscles (muscles between the ribs).  Pleasant expressions on their faces ensued – as well as lots of sighs, yawns, and smiles. Almost like their bodies were trying to acknowledge how important it is to have this pliable, breathing trunk. When you first start working on ribcage mobility you may not have much movement (especially on the descent), but practiced daily you will be amazed at how quickly the ribcage will respond. The ribs will start to descend more freely, you will be more efficient at expelling your breath, and your mind will start to focus and relax. Anatomically its important to know that when the ribs are mobile their attachment at the spine provides needed mobility and support for the vertebrae – almost like a massage for the spine as they gently pivot back and forth. The ribs also provide support for the spine giving it needed traction to keep the vertebrae less compressed.

Next take a few additional minutes and focus your breath into the sternal region. Inhale as you allow the sternum to rise up towards the ceiling, exhale and just let it fall back down. Sometimes I imagine a balloon of sorts behind the sternum and when I inhale I picture it inflating; gently pushing the sternum out and up. On the exhale just allow the “balloon” to deflate. Practice this in different positions – even standing – and feel how this area craves the breath and greatly affects our posture. The other image is to breathe into the sternum and let the breath travel up and out along each clavicle (collar bone) so not only do you feel a lift in the sternum but a sense of breadth across the upper chest. It’s empowering!

So this is where we begin; decreasing tension in the body, discovering areas of tension in the body and then strengthening exercises. Building strength on top of tension is potentially harmful; adding a degree of effort into the body that is unhealthy. This is how people hurt themselves. Also the strength will be limited; you won’t get the full benefit of finding your true much deeper inner core of strength. This is acquired only by “melting” those outer layers of tension away, freeing the muscles and fascia to let go of their grip on the bones and allowing your skeleton to gently realign and prepare for strength work. It’s worth the extra time to introduce the breath! You can practice this in a formal Pilates session but also throughout the day – seated in a car at a traffic light, at the dinner table, reading a book, standing in line, etc. Once a person has a better understanding of their habitual expressions of tension (basically where they hold their stress), then they can learn to lessen it through “conscious breathing” before they strengthen; reaping the benefits of “true” strength.

Okay – that’s today’s topic. I realize that this was ridiculously long but something about it being the first entry just mandated that! Next entry will be about improving arm and shoulder range of motion by increasing awareness and mobility in the trunk.

Be well, and breathe, breathe, breathe!!!