LisaAnn McCall responds to an article published in The Washington Post on December 21st titled: “As Millennials flock to high-intensity workouts, hip pain follows” (see full article).
LET’S LOOK AT STRUCTURE
High intensity. Burst. Interval. This type of training is definitely “hot” right now and whenever that happens, injuries often follow. But what is the REAL CULPRIT in the breakdown of the hips of these millennials? The previous article states the problem possibly lies in a combination of lack of flexibility, neuromuscular imbalances, form and/or high intensity workouts.
LET’S DIG A LITTLE DEEPER
Let’s look at FORM from the perspective of bones and how they are stacked. Form is often viewed as what muscles should be working. Addressing muscles before bones is getting the cart before the horse. We’re one step ahead of where we should start. We must address the whole skeleton, not just a simple adjustment of the hips and shoulders before lifting a weight. It’s much more detailed than that.
OK, back to the basics of physiology for a moment. There is an old saying that “structure governs function” which has shown to be true over the ages. So let’s start with this idea of “structure.”
If the structure is lined up with gravity (always bring gravity into the picture…. that’s very important) then the muscles can do their job stabilizing and moving the body well. So what is the correct structural alignment what makes up Optimal Posture?
Optimal posture is much more than standing, sitting or moving well. A different and more useful way to define it is: standing, sitting or lying with as little muscle activity as possible, then moving correctly to create a natural transfer of weight. Think of it as moving from Point A to Point B with the least amount of effort.
Research consistently supports the theory when standing or sitting the least amount of work needed to maintain the upright position is the most ideal or optimal. For instance, whether you are stationary or moving, it should take the least amount of muscular activity to keep your bones in balance.1 Further, the less work the neuromuscular system must do in static positions, the better. In other words, the less your body has to work, the more the parts are in place. 2
LET’S BREAK IT ALL DOWN AND REBUILD IT
Imagine disassembling the skeleton and rebuilding the bones as children do with their Legos — stacking them up one at a time from the feet all the way up. We would stack the bones so the greatest amount of surface area would be in place with each bone with gravity so that it would stand strong. And the posture you would create would look much differently from the one promoted in the fitness/medical world.
Without getting too technical, let’s just look at the woman carrying the load and way the woman is carrying the load on her head. Is she relaxed? Yes, look at her face. Is she stacking a lot of weight on her body yes? People do this naturally in many countries that do not rely on cars to get around and they do it all their lives well into old age.
Now let’s bring this concept into our reality. Looking at the picture from my book on page 61 as you can see the pelvic bone is more aligned with gravity and able to carry a load better when the pubic bone has a greater surface area to sit on. The greater the surface area to sit on, the fewer breakdowns occur.
Your pubic bone is closer to the horizontal plane, which makes it an ideal bone to sit on. When you sit in the center of the basin (remember “pelvis” is the Latin word for basin), you allow your spine to balance your weight, allowing your muscles to perform a minimum amount of work.
By tilting the pelvis backward (tucking the buttocks), the center of gravity shifts forward. Notice the forward position of my shoulders and head. And look how little bone I’m sitting on.
Also much less “work” is needed by the muscles because with great “form” comes greater quality of movement. In sports like swimming or baseball, if the athlete has good form (they are moving their bones well) they are relaxed and they have great skill in their movement.
COMPARE TO OTHER PARTS OF THE WORLD
Research has shown that African women have low rates of hip fractures of the femoral head. They bend and stoop more than U.S. women. The African women walk carefully placing one foot in front of another, often balancing large parcels on their head. 3
So with greater balance, there’s less work and less improper stress on the joints and tissue.
These women who carry heavy loads on their heads their entire lives don’t seem to have hips breaking down….yet the hips of our young American population are breaking down before the age of 30. That’s a head scratcher, right???
MY CLINICAL EXPERIENCE
I’ve seen this problem of hip pain for years (more than 25) as a physical therapist. I have great results with helping people with this problem by relaxing and stacking the bones and guiding the body back into its natural alignment. The medical community and fitness experts claim “good posture” results from tightening or pulling in the abdominal area and “dropping” the tailbone to protect the spine, creating “core stability.” This is MORE work and MORE strain on the hips and spine not less. Remember the less your body has to work, the more the parts are in place.* As we rely on computers and cars to keep our lives going, our bodies get left behind. We forget there IS an innate knowing and body wisdom about how to move. Let’s remember how strong, relaxed and upright we naturally are built and move our energy and focus in THAT direction.
References: 1. Brownstein and S. Bronner (eds.) Functional Movement in Orthopaedic & Sports and Physical Therapy: Evaluation, Treatment & Outcomes, ed. Churchill Livingstone Inc. New York, 1997, p.149. 2. L.A. McCall, The McCall Body Balance Method, Simple Concepts for Ageless Movement, Brown Books ,Dallas Tx., 2001 p. 43. 3. R. A. Bloow and H. Pogrund, “Humeral Cortical Thickness is Female Bantu “Its Relationship to the Incidence of Femoral Neck Fracture.” Skeletal Radiology (1982), 8:59-62.
LisaAnn McCall, Physical Therapist
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Lisa Ann McCall is a physical therapist with 27+ years experience in orthopedic dysfunction. During that time in private practice, she’s worked with professional athletes,physicians and surgeons, as well as patients suffering from arthritis, joint disease and chronic pain. McCall worked three years as a physical therapist in clinical settings before starting her private practice in 1991.
LisaAnn McCall, Physical Therapist, Creator and Author of the The McCall Body Balance Method