Managing Your Posture in PT School

Name: Joshua Holland

Undergrad: Idaho State University

Hometown: Centennial, Colorado

Fun fact: Before PT school, I worked at a BBQ restaurant in Missoula, MT called Notorious P.I.G.

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Last week, I was editing my Biomechanics skills video when I noticed a curly-haired DPT student in my video with fairly poor posture. I was far from excited when I realized that student was me. I knew my posture wasn’t the greatest after years of asymmetrical shoulder position from college pole vaulting and poor lifting mechanics, but I had no idea it was THAT bad! My shoulders were protracted with my head in a significantly forward position. My initial thought was, “man, I am about to be a PT soon…how am I going to teach posture when my own posture is so poor?!”

An average day for PT students involves a heavy dose of lectures, studying, and an even heavier dose of sitting. Often a PT student may be seated in lectures for 8 hours a day. By the end of the day, professors may start to notice students performing many combinations of wiggling, shifting, and slouching, with many students standing up in the back of the class.

The field of physical therapy involves movement for rehabilitation and we often hear, “exercise is good!” However, within school, sometimes we neglect our own movement in order to remain studious. The intention of this blog post is to initiate the thought of posture and provide some quick exercises that DPT students can use throughout their day. As future clinicians, we are role models to many of our patients, so it is important that we recognize our own posture and work to preserve good body mechanics within ourselves in order to have long-lasting careers and fully help our patients.

I couldn’t sleep after seeing my poor posture! So, I set out the next day to find ways to correct and maintain posture and decided to share them with you all. In this blog post, I interviewed Dr. Alice Davis, an expert on the spine, and fellow first year DPT student, Sarah Spivey, a certified pilates instructor since 2007, to provide some tricks on improving posture!

 

Question and Answer Interview with Dr. Alice Davis

Q: Often our posture is poor in class, we tend to slump over to write down our notes, what are some cues we can use in class to correct this?

A: Make sure your feet are flat on the floor and use the back of the chair to support you. You are becoming kinesthetically aware of your body in space as PT students, so try to be aware of the weight on your ischial tuberosities as you sit. Try to make each ischial tuberosity level. The overuse of repetitive poor posture is what creates problems over time, so start to realize your body position while you sit in class.

Q: While we sit in class it feels like we roll our shoulders forward and lean forward to pay closer attention or write on our devices, what are some cues to get those shoulders back with a neutral head?

A: Because you are sitting at computers for most of the days, you tend to have some upper cervical extension and increased flexion in the lower cervical spine. Imagine there is a rope going straight through your head and down to your seat, try to make that rope as straight as possible. A quick exercise you can do in class is move your shoulders up an inch, back an inch, and down an inch, then hold this for ten seconds, and relax. Try to do 10 reps for 10 seconds of this exercise.

Q: For the anatomy nerds out there, what are some of the muscles that are affected by this forward leaning posture/slumped position?

A: The upper cervical spine is extended in this forward posture position. Suboccipitals are a major component in this and often called the headache muscles because it can result in cervicogenic headache. A cervicogenic headache is when the pain begins in the back of the neck first before it goes up to the skull. This can be posture and stress related. Other muscles that play into extensor moment of the upper-cervical spine are the splenius and semispinalis muscles.

Q: Is there any other tips and tricks we can use in the classroom and out of the classroom to help with posture?

A:  

  • Foam rollers are great! You can put the foam roller vertically along your spine with the head and sacrum supported. Using your arms, do some snow angels for pectoralis major and minor.
  • If you are feeling uncomfortable and wiggly, your body is telling you to move – get up and move around.
  • Do something during lunch time. Eating is important, but try not to study if you don’t have to. Give 30 minutes during lunch for your body and mind.
  • Breathing is important. Moving the body and getting the diaphragm to move through breathing helps those muscles that support the thorax. Watch your breathing pattern, especially when you are stressed. Try to do some slow inhales and exhales.
  • Try a simple nodding of your head, as if you’re saying yes. This lengthens the longus colli and capitis muscles that can help with postural support. You can even do this when you’re driving! Rest your occiput on the headrest and perform a little nod. Try to hold the nod for 10 seconds with 10 repetitions.

 

Here are some techniques and exercises for managing posture in graduate school (or any career environment!) brought to you by our very own DPT first year, Sarah Spivey!

 

Sit on deflated Gertie ball.

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This will allow you to sit up on your ischial tuberosities (IT) to encourage a more natural lordotic curve while also eliminating the pressure on the ITs. By sitting on a relatively unstable surface you will also increase the use of your postural stabilizers. Try to incorporate five minutes per hour of sitting.

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Another technique is to use the Gertie ball between your lumbar spine and your chair. Find your ideal posture by allowing yourself to slump in your chair. Now, move into a full anterior tilt of your pelvis until you feel pressure in your lower back. Now, ease off until you feel the pressure disappear. Scoot back toward the back of your chair and place the ball at the level of the lumbar spine. The ball will help you maintain your neutral posture during sitting.

Head nods/nose circles on Gertie ball.

Lie in supine on a firm surface. Bend your knees and place your feet at the distance of your ASIS. Allow your sacrum to feel heavy and equally distributed on the floor/mat. Take a few breaths and notice if you have excessive space between your thoracic spine and the floor. If so, on an exhale, allow your t-spine to sink toward the floor. This should limit any rib flare. Place a 1/3 – ½ inflated Gertie ball (or folded towel) under your head. You should feel pressure evenly distributed near your occipital protuberance – this will insure you are lengthening your cervical extensors (especially for those of use with a forward head!). Take a few breaths and allow your head to feel heavy on the ball. Imagine a one-inch line on the ceiling and slowly trace this line down with your nose. Return to your starting position making sure to avoid moving into extension. Repeat this 8-10 times. Now draw slow circles with your nose around your one-inch line. Keep your circles small and controlled. Perform 6-8 in each direction.

Wall sit pelvic curls.

While sitting in class, if you start to feel your low back tighten up, try this stretch! Stand against a wall with your feet about 12 inches in front of the wall and hip distance apart. Try to feel contact of your sacrum, rib cage and the back of your head on the wall. You should have a very small space between your lumbar spine and the wall. As you exhale, draw your abdominals in and curl your pubic bone up toward your nose. You should feel your lumbar spine flatter against the wall. As you inhale, slowly allow your ischial tuberosities to widen until you are back in a neutral position. Repeat 10-12 times.

 Seated neck stretch – sitting on hand.

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Feeling tension in your neck during class? Scoot forward so your back is away from the chair and sit tall on your ischial tuberosities. Imagine lengthening your cervical spine and then gently tuck your chin toward your chest. Try not to flex your cervical spine! Now allow one ear to fall toward your shoulder. You should feel a stretch on the opposite side. If you would like to increase your stretch, you can sit on the hand of the side you are stretching. For example, if you are feeling the stretch on the right side, sit on your right hand. This will bring your shoulder down and away from your ear.

 

Overall, I hope  this post helped you become more aware of how important it is that we practice good posture while in school, or with any lifestyle! Do you have favorite exercises or tips to remind you to practice posture? Feel free to share with us in a comment below!

Finals Week: A Beautiful Struggle

It’s that time of the year again…

No, we’re not talking about the holidays.

It’s Finals Week, the crescendo of each physical therapy (PT) school semester.

If you haven’t experienced a finals week in PT school, then here are a few ideas of what Regis students encounter during this time each semester.

  1. …but first, Practicals Week

Gone are the days of “dead weeks” leading up to final exams. Practical Exam Week is usually the week prior to all of the written final exams. This is where the skills you have acquired over the entire semester are put to the test to see how you are able to apply them in a real-life situation. During the days leading up to these exams, you will often see students crowding into room PCH 409 to practice their skills and drill each other on the specific times to use them. Study sessions can extend late into the night for some students (Pssst…PT school secret: often these practicals require knowing information that will also be on the written final, so it’s like studying for two exams at once…now that’s a deal!)

  1. Review Sessions

It is not uncommon for faculty members to hold review sessions discussing what to expect on the final written exam. These are often a great help in refining study strategies (PT school pearl of wisdom: take advantage of these sessions!)

  1. Finals Week Schedules

Each class takes 4-5 exams the entire week, with one exam per day and each one for 2 hours. You can find last minute study sessions dispersed across Claver Hall in the hours leading up to the exams to review any lingering questions or fill any remaining knowledge gaps. And hey, after one exam is over, students have 22 hours to study for the next test…what an ample amount of time!

  1. Work-Life Balance

In the words of The Great Tom McPoil, “take a day for yourself every week.” This may be hard to remember during these challenging weeks, but still very relevant. Students usually make modifications to Tom’s “day” suggestion during finals week, and instead take a few hours to relax and meditate with various types of exercise (or naps) – whatever takes the mind off studying for a few moments.

  1. The Triumph of Completing a Semester of PT School

At the end of each finals week, you will find students celebrating another semester down and another job well done! It’s a time to look back at the terrific accomplishments with pride and relish in the fact that your hard work got you here

– Courtney Backward

Check out this video of first and second year students studying (and relaxing) for their finals!

 

Video Credit: Janki Patel

 

Welcome, Zuma!

The newest addition to our DPT program has arrived! Zuma will be trained by our service dog team of students.  We’re looking forward to seeing her learn and grow; she has a big vest to fill!

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…Oh, and isn’t she ADORABLE?!

Move Forward 5K/10K Recap

Move Forward 2016 (September 17, 2016) was a huge success! We had 261 runners signed up for the event and raised over $7,000 for Canine for Companions and The Foundation for Physical Therapy. A sincere thank you to all of our volunteers, runners, and sponsors for making this event amazing.  If you have any questions, suggestions, or would like to be involved in next year’s race please email us at moveforward5k.10k@gmail.com.

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Our beautiful sign made by Lauren Hill and Jenna Carlson!

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Fastest Faculty Awards go to Andy and Amy.

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Our service dog Takia, making sure we don’t forget who we are raising money for…

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A few racers/volunteers enjoying some yoga after the race.

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Post-Run Fun!

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Our Couch to 5K team did amazing this year! Next year, maybe a 5K to 10K team?

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No one asked Matt (Class of 2017) to dress up, but that is just how great this man is…

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Class of 2017’s Move Forward Team; great job, everyone! The Class of 2018 has some big shoes to fill…

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We can’t wait for the start of next year’s race!

 

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Ryan Bourdo, co-director of Move Forward, graduated The University of Oregon with B.S. Degrees in Biology and Human Physiology in 2010. Originally thinking of medical school (never mind the fact that medical school rejected him twice), he soon fell in love with physical therapy, thanks to an amazing therapist in Portland, Vince Blaney, MSPT. Vince showed him everything he originally wanted to be as a physician: using anatomy and physiology to help those with injuries. He soon worked as a physical therapist aide for two years and is currently at Regis University completing a Doctor of Physical Therapy. In his free time, Ryan likes to run, hike, and cook. You can find Ryan at www.ryanbourdo.com, or on Twitter @RyanBourdo.

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PT School: No longer a pain in the neck

Sitting, studying, stress:  we’ve all felt tense around the shoulders and neck before.  First years, in particular, would attest to some serious cramping after so many hours of studying first semester.

Luckily, one of our second semester classes focuses on the biomechanics of the spine.  And, with that, we get to learn how to test ligaments and facilitate movement between spinal segments.

In our lab yesterday, we focused on the lower cervical spine and were trying to incorporate concepts of biomechanics with learning how to work gently and professionally with other people’s necks.

Although we had to understand the proper movement of each vertebrae, I think the most important take-away from this first exposure was learning how to be comfortable and confident when handling someone else’s head.  I think we all enjoyed taking turns getting different segments of our neck isolated; it felt like a massage after all that sitting!

Blogger: Carol Passarelli