Mobilization Optimization

The third component of the POW protocol. Learn simple and easy mobilizations to mitigate the compromising positions of daily tasks and sedentary work environments.

Mobility

Good mobility has three components:

1. Proper positioning: be in a good position as much as possible.  This includes having a braced-neutral spine, torque at the hips and shoulders, proper footwear, and proper workstation set-up.
2. Joint range of motion: put your joints through full ranges of motion as much as possible.  Squat all the way down, move your ankles, wrists, neck, and shoulders through their full range daily.  Apply the addedge, “If you don’t move/use it, you lose it.”  
3. Soft tissue quality: if you are unable to move joints through a full range of motion, or already have pain, you must address your soft tissue quality.  Massage, self-myofascial release (SMR)/foam rolling helps to restore suppleness to muscles and tendons.  Always release above or below an area of pain.  For example, if your knees hurt, SMR your shins, feet, or quads.  To mobilize a joint system, SMR locally.

We’ve covered component 1, proper positioning.  Here are component 2,  joint-range-of motion exercises you should perform each day:

Above: “Heads will Roll” 1-6: Slowly bring head and neck through a full rotation in each direction, several times.

Above: “Clock Arms.” 1-9: Bring each shoulder/arm through a full revolution, both directions, several times.

1&2: Make fists and circle your wrists. 3: Spread your fingers and make big, exaggerated wrist circles. 4: Interlace your fingers and flip your palms. 5&6: Bend your wrists forward, and back, palm-to-palm, and knuckle-to-knuckle. 7: Orient your palm facing out, fingertips down, pull up on thumb with opposite hand.

1&2: Make a ‘4’ with your legs.  First, simultaneously pull up on your foot and push your knee away.  Next, cradle your top leg, and try to pull it up towards your chest while maintaining a 90 degree hip and knee angle. 3: Grab onto a chair, desk, or wall, pull chest down and push hips back.  You should feel a stretch by your armpits, in your glutes, hamstrings, and calves. 4&5: First, stand in a tall lunge, scoop abs in, squeeze your butt.  You should feel a stretch in your hip and quad (on the side of your back leg).  To intensify the stretch, bend the back knee.

The following mobility techniques are to improve soft tissue quality and help your joints go through more complete ranges of motion.  If you have pain or immobility, use these techniques above or below the area of concern.  For example, if you have knee pain, use a joint-range-of-motion exercise to open up your hip, and a soft-tissue technique to work on your ankles and lower leg.

These techniques require a lacrosse or mobility ball.  Find a sensitive area above or below the area of concern.  Apply pressure with your mobily tool.  Oscillate joint back and forth to move muscles and tendons under the tool.  The duration of these techniques is as long (or as soon) as it takes to feel or see a change in your mobility or pain.  If performing these techniques for maintenance, one minute per area should suffice.

Start with your mobility tool slightly in front of your heel, and work through your arch.   Flex and point your toes and ankle as you go.

Start with your mobility tool at the top of your tibialis muscle (the tendinous area behind your shin bone, in front of your calf).  Flex and point your ankle as you work your mobility tool down your lower leg.

Place your mobility tool on your medial glute area (the fleshy area between your sacrum and your hip bone).  Bend and straighten your hip and knee, and make tiny hip circles.

Start with your mobility tool at the bottom edge of your shoulder blade, next to your spine.  Punch your arm forward to move your shoulder blade out of the way.  Pressing up against a wall, move the tool up towards your trapezius, stopping at any “trigger points” along the way.  Switch sides, and repeat.

Workstation Optimization

Part deux in the POW Protocol.  Here you will learn how to set-up and interact with your workstation properly.

WORKSTATION OPTIMIZATION

Office Set-Up

Computer Monitor: Top of screen in line with eyes. 18”-30” away from your face.  Your screen should be directly in front of you, not off to one side.  If need be, tilt your screen up slightly, so that you can see all of it with one glance.

Keyboard and Mouse: Directly under hands when forearms are parallel to the ground/elbows are approximately 90 degrees. Mouse should be next to keyboard.

Laptops: Ideally should be used on a laptop stand with an external keyboard and mouse.  If additional hardware is not available, mitigate by placing laptop at chest height.

Standing Desk: The ideal desk height allows you to position your monitor and keyboard according to the specifications listed above.  

Standing Desk Stool: You should have a hard, tall stool (seat should be at butt height) available for changing positions throughout the day.  Here are the main positions you should assume while operating a standing desk:

Slant board or kickstand: Having a slant board, box, block, or step to place one or both feet on is crucial for stabilizing your pelvis and hips.  Here are additional positions for operating a standing desk:

Sitting Desk: The ideal desk height allows you to position your monitor and keyboard according to the specifications listed above.

Sitting Desk Chair: The ideal sitting desk chair is sturdy wood or metal, has no arms or back rest.  The sturdiness allows you to keep your braced-neutral spine, the armlessness allows more versatility with keyboard and desk placement.  If you do have a chair with a back, or even a cushy chair, you can still do your best to be in a good position.  Here are some sitting pointers:

• Always go through the bracing sequence before sitting and before changing positions.
• Attempt to sit near the edge of your chair on your sitz bones.
• Always have your feet on a hard, stable surface.  This is an overlooked and crucial point.  If your feet are dangling or unstabilized, your calves will shorten, and your knees and lower back will ache.  If your feet do not reach the floor, a slant board, box, or blocks should be used under your desk.
• Change positions every 30 minutes.  Each time you change, stand up, brace and enter a new seated position.  Here are some ideas for changing positions:

Sitting on the floor: This is the best possible option for sitting for several reasons.  1) Sitting on the floor balances weight over your pelvis and allows you to stack and brace your spine.  2) Sitting on the floor requires you to get up and down off the floor, a skill that is often lost to immobility and weakness. 3) Sitting on the ground is custom-fit to your body, no need to size-up the perfect chair!  

The ideal sitting position for the ground is the lotus posture, a cross-legged position where each foot is placed on the opposite thigh.  If you have difficulty getting into this position, sit cross-legged, and work on your hip mobility.  Here are several other sitting positions that are suitable for the floor:

Body Optimization

Unit One of POSITIONAL OPTIMIZATION at WORK

Take a deep breath

Proper breathing is the foundation for creating stability in the midline.   A deep, productive breath should be slow and through the nose, making the lower ribs (diaphragm) expand. It should look like a tiny person behind your navel just opened an umbrella inside you.  If you put your hands around the bottom of your ribs, you should feel them expand.  

1. Lie supine, feet up on a wall or box, knees and hips bent 90 degrees.
2. Place hands on lower abdomen or bottom of ribs.
3. Inhale through the nose, as if to smell a scent.  If this is challenging, an essential oil, such as peppermint, may be applied under the nose to assist.  Pretending to smell an odor, such as coffee, may help if oils are not available.
4. Exhale slowly, through the mouth.  Imagine attempting to blow on hot food at the beginning of the exhale, and trying to blow out a trick birthday candle during the end of the exhale.

Brace yourself

Movement happens from core to extremity.  This means that the stability in your spine leads to mobility and power in your hips and shoulders.  If your spine isn't braced during performance and physical tasks, you are at risk for spinal injury and you are not being as powerful or as mobile as you could be.  The following is the bracing sequence you should go though before movement or changing positions:

1. Begin with feet facing forward.  Squeeze your butt.
2. Pull your rib cage down using your abdominals.
3. Flex your abs and breathe into the tight container you've made of them.
4. Externally rotate your shoulders by screwing your shoulders down and out (palms face up).
5. Set your head in a neutral position by tucking your chin and elongating the back of your head.

1&2: Squeeze butt, 3&4: Pull ribcage down, 5: Flex your abs and breathe into the tight container you've made of them, 6&7: Externally rotate your shoulders (palms face up), 8&9: Set your head in a neutral position.

This bracing sequence applies to almost all exercises.  The greater the load, the more intense and important the bracing sequence is.  Even when you are just standing around, there should be some semblance of bracing happening.  If you sit or stand all day, make sure that your butt is squeezed and your abs are “on.”  It is also important for your shoulders to be depressed (down) and externally rotated (rotated out).  Having your shoulders rolled in, abdominals soft, or standing on one hip will eventually come back to haunt you in the form of pain, injury, or decreased strength and power.

Keep your spine together

As stated earlier, the bracing sequence above applies to movement.  It is a way to keep your spine from moving under load.  This means the way your back looks at the beginning of an exercise is the way it should look at the end of an exercise.  When performing movements, you should only be changing the angles of your hips, shoulders, and appendage joints (like knees and elbows).  It is an error for any part of your spine to flex or extend locally during a movement.  

Torquing

At this point you should understand that the spine should be in a braced and neutral position during activity.  Having a braced-neutral spine will give you the stability needed to create force through your hips and shoulders.  Symbiotically, if you generate enough tension and force (torque) in your extremities, you  have a better chance of  maintaining a braced spine.  Generating tension in your hips and shoulders is crucial for optimal force, power, and stability during movement.  The following cues should be part of your bracing sequence and movement prep:

• Screw your feet into the ground.
• Spread the floor.
• Push your knees out.
• Activate the arch in your foot.
• Break the bar.
• Preferate an imaginary paper towel on the floor, with your hands.
• Fondle the floor.
• Pull the bar apart (like a magician's scarf).
• Hide your armpits (for pull-ups)
• Armpits forward (for overhead pressing).
• Elbow pits forward (for push-ups and dips).

When you rotate your hips and shoulders into an 'on' position, they become powerful and stable.  If you create torque before you move, you can get away with missing a small bit of flexion or extension range of motion.  For example, if you don't have great hip flexion, but have excellent hip rotation/torque you will be able to lift an object safely and productively.  If you are missing shoulder or hip rotation, stabilizing your spine and generating force becomes exceedingly difficult.  

1: Go through bracing sequence. 2: Initiate descent by shoving hips back and leaning forward. 3-4: Continue to load hamstrings and glutes by driving hips back. Do not shift weight back.  Stay centered over mid-foot the entire time. 5: Lower hips and bend knees while keeping a relatively vertical shin.  Aim to sit on your sitz bones, near the edge of the chair.  6-7: Assume a braced, neutral sitting position. 8-9: Reverse the process to stand.  Lean forward and lift butt until tension is felt in hamstrings. 10-11: Continue to straighten hips, knees, and shins until you are in a standing position.

Movement inventory

Now it is time for you to take inventory and responsibility for your movements.  Good positioning looks like this:

• Breathing diaphragmatically
• Spine braced and neutral
• Torque at hips and shoulders
• Feet and hands forward

Poor movement and positioning signs:

• Chest breathing
• Local extension or flexion in spine
• Hips or shoulders internally rotated
• Feet and hands spiraled out or in
• Knees in, elbows flared

A note on footwear

When walking, exercising, sitting, or standing, you should always attempt to have your feet as straight forward as possible.  This allows maximum torque to be generated at the hip and provides maximum stability in the knees and spine.

The shoes you wear all day greatly affect your ability to maintain forward-facing feet, whole-body mobility, and stability.  Without stable feet, it is impossible to generate torque at the hips or have a stable spine.  Even if you sit all day, your feet should be in a shoe that allows you to be in a braced-neutral sitting position.  Good footwear is:

• Form fitting: your foot should not slide around or be pinched.
• Flat: your shoe should have a uniform sole with no heels, heel cups or major orthotics.
• Flexible: your shoe should allow you to articulate through your whole foot.
• Feel-good: your shoe should be comfortable and easy to walk in.

Fallen Arches

A fallen arch is basically the weakened state of the muscles and ligaments in your feet.  Most children have healthy, archie arches.  These arches flatten out when an individual starts wearing supportive or inflexible shoes.  That's right; flat feet are caused by supportive shoes and insoles!  Arches (geometrically and anatomically) get stronger when they are top loaded and weaker when they are bottom loaded.  This means that putting weight (your body) on top of an unsupported arch will make it stronger while 'supporting' your arch will make it weaker.

The best way to get your arches back is to get rid of your insoles and work towards wearing minimally supportive shoes.  You can work your way down since going from very supportive shoes to minimally supportive shoes can cause muscular pain (those arches working and getting stronger) if done too hastily.

How to Text or Read:

1: Shoulders rounded, elbows out, hands in are recipes for carpal tunnel, shoulder, and neck pain. 2-4: Palms up, elbows, and shoulders down is the way to go for pain-free texting and reading.

Introducing POW

I will be releasing different components of my Positional Optimization at Work protocol over the next few entries. POW is a systematic approach to alleviating musculoskeletal pain associated with poor positioning in activities of daily living.

The Origin of (Wo)Man’s Pain

Since my beginnings in the fitness industry, I have searched for a missing link in my clients’ lives.  The short amount of time I spent with clients in the gym was not enough to make a lasting impact on their health and fitness.  Many clients came to me with pain and mobility issues that we had to mitigate before getting to our scheduled strength programming.  

I became savvy about effective mobilization techniques.  These techniques worked wonders short-term.  My clients were grateful, but I wasn’t satisfied.  Even my most diligent clients, the ones who purchased mobility tools and mobilized daily, still had chronic pain.  Mobilization techniques decreased pain and gave my clients a sense of control over their symptoms but did not provide a long-term solution.

I then looked to the exercises used in my programming.  I took every measure to make sure my clients’ form was spotless, hoping this would provide lasting pain relief.  

Finally, I began to take a holistic approach to addressing client’s pain and mobility.  I began to look at their lifestyle and daily positions.  I asked my clients what positions they spent the most amount of time in, especially what their position at work looked like.

It turned out, this was the elusive missing link.  I discovered that the positions one spends the most amount of time in have the biggest impact on pain, mobility, and injury potential.  If movement is poor and positions are sub-optimal, no amount of mobilizing will last or resolve chronic pain.

What causes pain in your life?

Positions of daily tasks (PDT) are the leading causes of chronic pain and immobility.  The reason for this is the amount of time spent in them.  Many office workers are not aware of the posturally sound positions they should be in until they already have pain.  Once pain is experienced, most look to surgeons or begin complicated physical therapy regimens that serve only to mask the symptoms of pain.  

Positional Optimization at Work (POW) is the solution. POW reduces chronic pain and increases mobility at the source.  

The POW protocol begins with body optimization, where we cover the basics of postural alignment, spinal bracing, and breathing.  Many ergonomics courses only offer suggestions for new office furniture and never address an individual’s isolated position or posture.  The fanciest, most expensive equipment will not help if you don’t understand the guidelines for creating a neutral spine, being in mechanically sound positions, and breathing effectively.

The next step in the POW protocol is workstation optimization.  Workstation optimization covers how to set up your workstation in the optimal way for your dimensions, daily tasks, and resources. You will learn the optimal sitting and standing positions for daily tasks, and how to operate your workstation in the optimal way for reduced pain and increased mobility.  Whether you have the newest ergonomic equipment or a classic office set up, the POW protocol is adaptable to your work environment.

Finally, in mobility optimization, you will learn simple and effective mobility techniques to address current pain and prevent future pain.  These techniques can easily be performed daily, in the office or at home.  They provide relief for common mobility and pain issues associated with sedentary jobs.

Quality movement is the first component of mobility.  If movement is poor and positions are sub-optimal, no amount of mobilizing will help.  Here, I will teach you how to be in the best position for everyday life. Know this: if you are out of position for repeated or long bouts you will eventually have pain.  The idea is to get in a good position before pain is created.  If you already have pain, you must address your position to make any mobilization techniques stick.

Stagnation Mode

Has your fat loss plateaued despite your dedicated efforts?  Do you feel like it gets increasingly difficult to achieve fat loss the harder you work?  Are you afraid that your body has gone into 'starvation mode,' or that you've ruined your metabolism?
Fear not!  Chronic dieting does not permanently damage metabolism, nor does it alter the physics of how your body processes food.  I know, your FitBit says you're burning 2000 some-odd calories and you're down to eating 1000 calories, why no fat loss?  Your body doesn't need an upgrade or a re-boot, your information about fat loss and energy balance does.    

Let's begin with the information most receive when starting a diet:

• In order to lose fat, you must be in a calorie deficit. This means you must eat fewer calories than you burn or burn more calories than you eat.  
• All foods have calories, all activities you do burn calories.  
• Your body will either have a neutral (no change in weight), negative (losing weight) or positive (gaining weight) energy balance based on your caloric intake and output.  Simplistically, as long as you're in a calorie deficit, you will lose weight.

These guidelines are summed up by this familiar energy balance equation:

Precision Nutrition 

This equation never stops working.  The laws of physics do not change, no matter how long you've been dieting.  The issue is the energy balance equation is more complex than presented.  Not every calorie eaten and burned can be accounted for through labels, logging and tracking.  It is either impossible or very expensive to know your exact calories in/out each day.

Calorie intake is affected by the following:

• Nutritional labeling discrepancies:  calorimetry is not fool-proof.  Nutritional labels and calorie values can be off by up to 25%.  
• Measuring discrepancies: think you're super slim-savvy using a measuring cup?  Think again.  Caloric values are always in terms of weight, not volume.  For example, a tablespoon of peanut butter is supposed to weigh about 15g.  If you scoop out an amount of peanut butter with a tablespoon and weigh it on a food scale, its weight is often closer to 30g (double the serving you think you're getting).  Using a food scale is far superior to using volume based measurements when tracking food.
• Digestibility of food: calorie labels state how much energy is in a food, not how much you absorb from that food.  You absorb more calories from foods that are cooked or processed.  For example, you will most likely absorb 100% of calories from a serving of almond butter, but only absorb about 70% of calories from a serving of raw almonds.  The more processed or cooked a food is, the more readily available its nutrients and calories are to your body.
• Gut bacteria:  the environment in your gut is a major player in your ability to absorb nutrients and breakdown food.  If food is not broken down properly and nutrients are not absorbed, your body may increase its calorie absorption in an attempt to receive more nutrients.  On an individual level, calorie absorption can vary by up to 25%

Considering the factors above, the 'energy in' portion of the energy balance equation will now look like this:

Precision Nutrition

There are also a multitude of factors affecting the calories you burn:

• Resting metabolic rate: 60% of the calories you burn each day are used just to sustain basic functions of living.  This number depends on body composition, age, sex, genetics, weight and gut bacteria.  RMR is usually higher in larger or leaner individuals.  RMR can vary up to 15% even among individuals with seemly identical characteristics.  For example, in a room full of 35-year-old, 200lb males, RMR can vary among subjects anywhere from 1,900 calories to 2,300 calories.
• Thermic effect of eating: 5-10% of your daily calorie burn comes from processing and digesting food.  The more food you eat, the more you burn.  You burn more calories digesting protein and minimally processed foods.  You will never out-burn the amount you eat through eating, though...nice try.  
• Physical activity: this one seems like a no-brainer, exercise burns calories.  Larger or leaner individuals will burn more calories than smaller or fatter individuals (muscle burns calories, fat does not).  However, the more you perform a specific exercise, the more you will adapt to it.  This means you will burn fewer calories each time you perform a specific exercise.  This is one reason why strength training is crucial to fat loss.  Strength training is adaptable and progressive over time.  Cardiovascular based activities have fewer variables to increase as your body adapts to them.  Read- you don't burn 500 calories every time you take spin class.
• Non-exercise activity thermogenesis:  NEAT is the calories you burn through standing, fidgeting, pacing, cleaning, etc.  NEAT varies from person to person and from day to day.

Considering the factors above, the 'energy out' portion of the energy balance equation will now look like this:

Precision Nutrition

Remember that cute, little 'energy in = energy out' equation from before?  Look how big s/he got:

 Precision Nutrition

Energy balance is even more complicated than this beefier equation.  Any of the variables above will affect other variables when increased or decreased.  Let's take a look at what happens when an individual decides to diet:

Eating less decreases calories in-->Thermic effect of eating decreases because less food is eaten-->RMR and exercise calories decrease if weight loss occurs-->NEAT calories decrease due to weight loss or lowered energy levels-->Nutrient absorption increases as weight loss occurs.

 Here is a real-world application of the above:

Mike is a 35-year-old, sedentary, 5'10, 200lb male.  His FitBit calculates that he burns about 2,500 calories each day.  He decides to eat 2,000 calories each day, creating a deficit of 500 calories.  Since there are 3,500 calories in a pound, he should lose 1 pound a week.

Mike begins to eat fewer calories-->Thermic effect of eating is lowered.  Mike loses 5 lbs in the first month of his plan-->RMR is lowered since he weighs less.Mike has not been strength training, so he loses some muscle along with his fat-->RMR is lowered.Mike lowers his calories more to keep losing weight, this makes him hungry and lethargic-->NEAT decreases.

After two months, Mike has still only lost 5lbs.  If he keeps decreasing calories, he will continue to burn fewer calories, especially if he loses more weight.
 The takeaway point here is: dieting doesn't cause your metabolism to self-destruct, the nature of creating a calorie deficit lowers metabolism right off the bat.  Individuals who have dieted down to a certain weight have adaptively slower metabolisms than individuals who started at that weight.

Before you get all doom-and-gloom, there are ways to keep your metabolism as high as possible during and after a diet.  Don't worry, grapefruit eating and sauna sitting are not on this list.

• Boost Thermic Effect of Eating: eat more protein, unprocessed foods and fibrous vegetables.  Instead of reducing calories when a plateau hits, try increasing protein and lowering carbohydrates to boost TEE.  
• Keep RMR from plummeting: add strength training to your routine 2-5 times a week and eat adequate protein to maintain or build muscle.
• Increase NEAT: add more walking and standing into your daily routine.  Take the stairs, clean your house, stop asking mom to do your laundry.  Track your steps, aim for at least 10,000/day.
• Increase physical activity: listen to Nike.
• Balance your gut: take a probiotic with at least 30 billion cultures (Garden of Life, Dotfit make good ones), eat yogurt and other fermented products like kombucha and kimchi.  Eat fruits and vegetables from a local garden, they contain prebiotics (gut substrate) from the soil.
• Decrease measuring discrepancies: This one is the most important!  The most common reason for fat loss plateaus is lack of diet adherence.  Log and weigh your food for at least 3 days to make sure you are actually eating the amount you're supposed to. 
• After you've reached your goal: slowly increase your calories each week to bring yourself back to maintenance calories.  Let's say you were eating 1,200 calories/day during your diet.  Start by increasing to 1,300/day and increase each week until you're at maintenance.  This method of 'reverse dieting' is crucial to ensure that you don't regain the fat you lost.  It is also an important method of boosting your metabolism (mainly through TEE) after a diet.

As you can see, fat loss is a complicated and non-linear process, understand what it will actually take for you to achieve your goals.  Remember, self deception causes more plateaus than so-called 'starvation mode.'  If your progress has stalled, review your information, check your methods and tighten up your plan before blaming your body.