The impact of office working on the body: alleviating …...The impact of office working on the body: alleviating upper crossed syndrome through Pilates Ali MacLennan 4 April 2017

The impact of office working on the body:

alleviating upper crossed syndrome

through Pilates

Ali MacLennan

4 April 2017

CTTC Guildford 2016

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Abstract

It is a well-documented fact that, more often than not, people in the

UK today are spending too much time sitting down, hunched over a

computer screen and not dedicating enough time to their physical

wellbeing. A recent report by the British Heart Foundation stated that

more than 20 million adults in the UK are physically inactive, with

women being 36% more likely than men to be classified in that way.

The report also found that the average man spends a fifth of his life

sitting – equivalent to 78 days per year as opposed to 74 days per year

for the average woman.

Spending hours on end at a desk or behind the wheel of a car, for

example, can take its toll on the body in many ways such as poor

posture, aching, rounded shoulders and a stiff, forward-stooping neck.

Other serious health problems can be associated with a sedentary

lifestyle such as heart disease, obesity and diabetes. Mental wellbeing

can also be affected as well.

Adopting a healthier lifestyle and making an effort to increase physical

exercise can do wonders to counter the effects of working in today’s

deskbound society. Pilates can play a really important role in

addressing some of the postural, physical and mental issues mentioned

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above and this paper demonstrates through a real-life example how

this can be achieved.

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Table of Contents

Contents Anatomical Description ................................................................................................................. 5

Case Study ........................................................................................................................................... 9

Conditioning Programme for Lucy Smith ............................................................................ 11

Conclusion ....................................................................................................................................... 14

Bibliography.................................................................................................................................... 15

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Anatomical Description

The diagram below shows the 5 regions of the spine:

Image 1: regions and curves of the spine

As the diagram above demonstrates, the spine is not a straight line but

has a series of curves: the cervical and lumbar regions are curved such

that they are concave to the back, while the remaining regions are

concave to the front. The exact form of these curvatures varies

between people.

If we focus on the upper extremities, the muscles affected by upper

crossed syndrome are shown in the following diagrams:

Images 2 & 3: Major muscles of the upper extremities 2) front view 3) back view

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In a well-balanced body in side view, it is possible to effectively draw a

‘Plumb Line’ from the ear lobe through the middle tip of the shoulder,

midway through the trunk, the greater trochanter, the area just in front

of the middle of the knee, right down to the area just in front of the

ankle:

Image 4: The Plumb Line

Upper crossed syndrome is associated with the shoulders, arms and

chest (the ‘upper-cross’ muscles). It is essentially a muscle imbalance

as a result of poor posture and is characterised by tightness of the

upper trapezius and levator scapula on the back, crossing with

tightness of the pectoralis major and minor. Weakness of the deep

cervical flexors on the front of the body crosses with weakness of the

middle and lower trapezius. This pulls the shoulders and head forward

and encourages the upper back to curve more giving the upper body

a slouched appearance. The upper back, shoulders and neck start to

develop muscle tension / stress, which causes a dull aching pain.

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Image 5: Upper Crossed Syndrome

Postural changes associated with upper crossed syndrome include:

Forward head posture

Image 6: forward head posture

Increased cervical

lordosis and kyphosis –

the hunchback

Image 7: lordosis & kyphosis

Elevated and

protracted shoulders

Image 8: protracted shoulders

Rotation or abduction

and winging of the

scapula

Image 9: winging scapula

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Upper crossed syndrome is typically found in individuals who sit for long

periods of time, perhaps hunched over a computer, and who

continually exhibit poor posture.

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Case Study

Name: Lucy Smith Age: 42

Like many others, Lucy is a busy professional who spends the majority of

her day in front of a computer. She travels extensively with her work,

driving for several hours at a time around the country as well as

regularly taking long-haul flights for business. Lucy works in a very

pressured environment and, as a result, also works long hours and has a

high level of stress in her working life. As a result of this, she admits that

she hasn’t previously found the time or energy to exercise regularly and

describes herself as ‘unfit and out of condition’.

Increased tension and aching in her shoulders and lower cervical spine

as well as a general desire to take better care of her body has

prompted Lucy to take up Pilates. She has done mat Pilates in the past

but not for a long time and has never tried equipment Pilates.

Lucy has recently taken a 6-month sabbatical from work and is looking

to concentrate on her health and wellbeing during this period. She has

signed up for private equipment Pilates lessons twice a week. Lucy has

confirmed that she has no specific injuries and is looking for a

programme that will help to improve her posture and alleviate some of

the aches and pains she currently feels. We have agreed to focus

initially on releasing the tension in her shoulders, opening up and

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stretching her pectorals, as well as strengthening her back extensors. In

addition, however, focus will also be given to building strength

generally, increasing flexibility and stretching the entire body.

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Conditioning Programme for Lucy Smith I created a programme (see following page) that specifically

incorporated a number of exercises designed to open up and

strengthen Lucy’s shoulders, upper back and arms. By its nature, the

BASI Block System® is designed to ensure that every part of the body is

conditioned in turn and so, whilst specific focus was given to alleviating

the upper-crossed syndrome, each session was holistic in terms of

strengthening and toning the entire body. The programme also

includes progressively more complex or challenging exercises to act as

a motivating factor so that Lucy could see and feel the improvements

in her body and so that the sessions did not become monotonous. I

included other exercises in some of the sessions from week 11 onwards

but the programme shown was typical of the regime for Lucy.

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Weeks 1-10 Weeks 11-20 Weeks 21 +

Pre-session Roll Down Roll Down Roll Down

Warm up Pelvic Curl

Spine Twist Supine

Chest Lift

Chest Lift w/ Rotation

Pelvic Curl

Spine Twist Supine

Chest Lift

Chest Lift w/ Rotation

Leg Lifts / Leg

Changes

Leg Circles

Pelvic Curl

Spine Twist Supine

Double Leg Stretch

Single Leg Stretch

Criss Cross

Foot Work Reformer:

Parallel Heels

Parallel Toes

V Position Toes

Open V Heels

Open V Toes

Calf Raises

Prances

Single Leg Heel

Single Leg Toe

Chair:

Parallel Heels

Parallel Toes

V Position Toes

Open V Heels

Open V Toes

Calf Raises

Single Leg Heel

Single Leg Toes

Cadillac:

Parallel Heels

Parallel Toes

V Position Toes

Open V Heels

Open V Toes

Calf Raises

Prances

Single Leg Heel

Single Leg Toe

Hip Opener

Abdominal

Work

Step Barrel:

Chest Lift

Reach

Reformer:

Hundred Prep

Hundred

Co-ordination (to be

added in from week 15)

Cadillac:

Breathing with Push

Through Bar

Bottom Lift with Roll

Up Bar

Hip Work Reformer:

Frog

Circles (Down, Up)

Openings

Cadillac:

Basic Leg Springs

Frog

Circles (Down, Up)

Walking

Bicycle & Bicycle

Reverse

Step Barrel:

Supine Leg Series

Scissors

Bicycle & Bicycle

Revers

Openings

Helicopter

Spinal

Articulation

Reformer:

Bottom Lift (to be attempted from

week 5 onwards)

Cadillac:

Monkey Original

Or

Tower Prep

Reformer:

Short Spine

Or

Long Spine

Stretches Ladder Barrel

Shoulder Stretch 1

Shoulder Stretch 2

Or

Step Barrel:

Shoulder Stretch Lying

Side

Reformer:

Standing Lunge

Ladder Barrel

Gluteals

Hamstrings

Hip Flexors

Or

Reformer:

Kneeling Lunge

Full Body

Integration

Reformer:

Scooter

Upstretch 1

Reformer:

Elephant

Upstretch 1

Upstretch 2

Cadillac:

Sitting Forward

Side Reach

Kneeling Cat Stretch

Arm Work Reformer:

Arms supine series

Extension

Adduction

Circles (Up, Down)

Reformer:

Arms sitting series

Chest Expansion

Biceps

Rhomboids

Reformer:

Shoulder Push

Shoulder Push Single

Arm

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Triceps Hug-a-tree

Salute

Leg Work Chair:

Leg Press Standing

Reformer:

Single Leg Skating

Chair:

Frog Front

Lateral Flexion /

Rotation

Chair:

Side Stretch

Ladder Barrel:

Side Over Prep

Reformer:

Side Over on Box

Back Extension Chair:

Swan Basic

Ladder Barrel:

Swan Prep

Reformer:

Breaststroke Prep

(leading to)

Breaststroke

Post-session Roll Down Roll Down Roll Down

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Conclusion Lucy was able to maintain the ongoing commitment to two sessions a

week for the duration of her sabbatical. Initially in the first few weeks,

she found some of the shoulder stretches were quite uncomfortable

due to the tightness in her shoulders and pectorals, however as the

weeks progressed her discomfort noticeably reduced. Her overall

flexibility and strength improved significantly and by the end of the 20th

week, Lucy stated that the aches and tension in her shoulders had

almost completely disappeared. She also found the sessions to be very

valuable, not only in terms of her physical wellbeing but mentally as

well, stating that it was ‘an hour of escapism and was incredibly stress-

relieving’, so much so that she has now returned to work but continues

to attend regular sessions to maintain her new-found level of wellbeing.

It is commonly known that regularly sitting at a desk, driving for long

periods and / or taking long haul flights takes its toll on the body,

tightening muscles and can cause stiffness and pain. However, by

regularly undertaking a Pilates regime (either mat or equipment), the

effects can be substantially reduced or even eliminated.

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Bibliography Books

1. Isacowitz, Rael. Study Guide: Comprehensive Course. Costa

Mesa, California: Body Arts and Science International, 2013.

2. Isacowitz, Rael, Clippinger, Karen. Pilates Anatomy. Human

Kinetics, 2011.

3. Calais-Germain, Blandine. Anatomy of Movement. Eastland

Press, 1993.

Websites

1. More than 20 million Britons ‘physically inactive’

http://www.bbc.co.uk/news/health-39457993

2. Upper Cross Syndrome.

http://www.chelseaosteopaths.co.uk/upper-cross-syndrome/

3. Identifying Upper Cross Syndrome for Dummies (part 1)

https://www.crossfitinvictus.com/blog/identifying-upper-cross-

syndrome-for-dummies-part-1/

4. Upper Crossed Syndrome Part 1

http://drfranksessa.com/2013/07/upper-crossed-syndrome-part-i/

5. Winged Scapula Syndrome

http://www.paindoctorfortlauderdale.com/winged-scapula-

syndrome/

6. Training your back muscles properly

http://relentlessgains.com/training-your-back-muscles-properly/

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7. Lumbar lordosis – the deep curve in your lower back

http://www.lower-back-pain-toolkit.com/lordosis.html

8. Forward head posture and what you can do about it

http://www.losethebackpain.com/conditions/forward-head-

posture/