Watch your back!

“Let’s face it”, I told my sister earlier this year. “At the rate your shoulders have been elevating, they will be past your ears by graduation.”

“Not fair”, she retaliated. “I’ve been working hard. Med school is no cakewalk!”

No one says that the path to becoming a doctor is easy. So those of us who work in the movement world often worry about our friends in the medical arena. As Matt McCulloch, a Master Pilates Trainer in New York City, says: Watching students progress through medical school calls to mind a “reverse evolution,” as their thoracic spines become increasingly rounded and the students subsequently lose a few centimeters in height (and he should know, he met his wife while she was in med school!). Between studying, heavy pockets on white coats, and leaning over hospital beds, White Coat Kyphosis has become today’s norm.

There is a solution: watch your back.

I put this solution to the test earlier this year. I gave my sister 3 simple tasks to do to ensure that her spine remained erect, and that her shoulders stopped rising like lava bubbling out of a volcano. The tasks involved paying attention to 3 parts of the body:

1. Your Head. When you’re at the hospital, pause for a minute, clasp your hands together, and place your interlocked palms behind your head, at the level of your occipital bone. Gently tug your skull to raise it up towards the ceiling (also known as cervical traction). You should feel some relief on your cervical spine. Now try it again, but this time—as you gently tug your head— also depress your scapulae. In other words, imagine you have two zippers on your back, one on each shoulder blade. Picture you are pulling the zippers down towards your back pockets.

2. Your Shoulder Blades. During a break between rounds, try this exercise from  Pilates pioneer Kelly Kane. Stand with your back against a wall. See if you can place your thoracic spine (the area behind your heart) against the wall. Now retract your scapulae, by squeezing your shoulder blades together like you are trying to hold a nut between them. Repeat it one more time— standing with posterior thorax against the wall and scapulae retracted— and now depress your scapulae. In other words, draw your shoulder blades together and down your back. Once you are able to retract and depress your scapulae, take a deep breath in and, as you breathe out, extend your thoracic spine by lifting your heart towards the ceiling.

3. Your Spine. This one is the simplest one for everyone who hunches over. All it takes is 2 minutes at night to undo this pattern: Get yourself a foam roller, and lie down on it every night. To enter into this position, sit down on one end, and slowly lie all the way down, so your head is near the other end. (You know you’re doing it right when: the foam roller is vertically aligned, paralleling your vertebral column, and you have full contact with it—from tailbone to skull). From this position, take your arms wide to the side, like the letter “T” by horizontally abducting them. Feel your pectoral muscles open up, then take your arms towards the ceiling, right above your chest by horizontally adducting them, then back down by your by horizontally abducting them and returning them to a “T” shape. This should help open them up even more. Allow your spine to melt into the roller, realign, and repeat.

My sister followed this regimen, and is looking pretty fly these days with great posture, including an un-hunched thoracic spine, and shoulders where they should be (e.g. away from her ears!). She told me that being made aware of her shoulders was great: now, as she works in research or at the hospital, she is conscious of how she stands, where her shoulders are placed, how much stuff she is carrying in her white coat pockets, and how heavy the purse on her shoulder is. I can’t wait to see her next year at graduation, standing tall!


About the author

Priti Radhakrishnan is a Pilates teacher at Kinected, in New York city. In addition to her journey as a Pilates teacher, Priti has worked for nearly a decade as an attorney fighting for access to affordable medicines for patients living in poverty in the developing world. She loves to combine therapeutic Pilates with her experience working in clinical and low-income settings: her dream is to ensure that Pilates is available to everyone, regardless of economic status.

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