SURVIVING SITTING: BRUEGGER'S RELIEF POSITION

When reviewing with patients some of their postural distortion patterns causing or aggravating their existing pain pattern, the triad of anterior head shifting, rounded shoulders, and increase midback kyphosis comes up more often than it does not. And with it the question: why does this happen? The simplest answer is that modern human life involves everything in front of you and below shoulder level, with very few counterbalancing activities. And by far the biggest culprit is sitting, especially sitting at a computer workstation.

The so-called Bruegger's stretch or relief position is a rapid focused counterbalancing posture that emphasizes thoracic lengthening an extension, cervical retraction and extension, external rotation and retraction of the shoulders. I tell patient to do this every 2 hours, for 6 slow breath cycles as a sort of postural reset.

Squatting exercises for knee problems

I frequently run into patients who tell me they have had to give up squatting exercises because of aggravated knee pain. This is extremely unfortunate since squatting is 1 of the best exercises to functionally engage the core, upper gluteal areas, lower back, and squats mimics the type of strength and stability posture we need for real-life activities.

It's all the more unfortunate since there is a pretty easy alternative to do a squat without causing me pain. Notice that you can use a ball of any size including something pretty small or even a foam roller, unlike the large ball that I use for the demonstration video.

https://www.youtube.com/watch?v=1zpZeza8lKU

Home soft tissue treatment for symptoms of carpal tunnel

We finally got around to recording the instructional video for patients using the Armaid tool to control symptoms of carpal tunnel associated with repetitive soft tissue strain of the upper extremity. It's going to be much more effective if we can have a 15 minutes set up time in the office, to make sure that each patient can properly locate the trigger zones, since everyone's primary area of soft tissue entrapment can be a little bit different.

https://studio.youtube.com/video/6dR7TZnJtnM/edit

Properly stretching the scalene muscle

It's pretty routine to incorporate some degree of stretching as part of the patient's treatment plan, including in the cervical spine. Some stretches are pretty easy to remember and pretty straightforward for patients to remember when they get home. However 1 of the stretches that I find patients doing incorrectly high percentage of the time pertains to the scalene's. Doing it correctly is pretty important because failing to do so means you spending a lot of time with no return on investment, at best, and at worst, you can actually make your particular problem worse.

The scalene muscle group is located interior and slightly lateral to the cervical spine, and part of it attaches to the 1st rib. Both of these anatomical location distinctions requires some special positioning, set up, and order in which you incorporate the different directions of the stretch. Scalene muscular dysfunction is often associated not only with anterior cervical discomfort, but overload pain along the left scapula, as well as vague symptoms radiating into the upper arm, since the brachial plexus has to exit through the scalene's. If you're not setting up the stretch correctly you just don't get the results which is frustrating to the patient investing time in stretching.

https://www.youtube.com/watch?v=t6greMAkJLU