T Nation

Hobbling in my 20's

Hi T-Nation,

I hope this is the right spot to post this thread in. I’ve been coming to the site on and off since about 2004. I was a teenager back then in high school. The forums have been very helpful to me in the past, so I figured I’d see if anyone here had any advice.

I’m 23 years old and suffering from severe problems with my neck, back, hips, knees and to a lesser extent my shoulders, ankles and elbows. I think the problem is kyphosis… when I google pictures of kyphosis, it’s like what I see when I look in the mirror. I have a definite anterior pelvic tilt.

I’ve been to my family doctor, who seems to refuse to consider any health problem exists unless he can prescribe some sort of drug therapy for it… all he wants to do is give me painkillers. He laughed at me when I said I went to physiotherapists, saying that ‘you look like you’re fit, you don’t need physiotherapy’. I’ve been to numerous physiotherapists, sports medicine MDs, chiropractors, massage therapists and even acupuncturists for this problem, but all I get is the same stupid cookie cutter routine they photocopy for me. I have a collection of them sitting in my desk.

The exercises just don’t help me. It’s mostly made up of static stretches, bridges, crunch variations and planks. And for the glute stuff… I can’t even get my glutes to activate in any exercise I do, it’s like they’ve shut off. My butt has literally become flat like a pancake… it’s just bone and fat at this point, and no matter how much I try to squat or deadlift, it feels like the only thing that’s being worked is my back - painfully.

My posture is terrible, but there seems to be little I can do about it. I try to hide it in public, but it makes talking to people incredibly awkward. I am hunched forward all the time, and despite my best efforts, it feels like my body is very heavy, and I’m compelled to lean forward.

I don’t believe I have any sort of underlying genetic or skeletal condition, but I do think the problem is a result of strain. Over the past two years I’ve shed almost 100 pounds of fat through cardio and lifting, and this is when the problem seemed to begin. I think I may have been overtraining… being tired all the time, hunched over a treadmill, the best I can gather is that perhaps my hip flexors became dominant and forced my glutes to sit on the sidelines? I’m not sure. I’m not a professional, but unfortunately, the professionals I’ve sought out have not helped me. I just wish I could find some definitive answers so I knew how and where to apply effort.

At 23, I’ve just, as of last week, dropped out of university. I can no longer function normally. My social life is practically non-existent now, I’ve lost my girlfriend, and I’ve reached the point where I can’t even carry my groceries home from the grocery store.

I’ve read every article on this site I thought might be relevant to my problem, and I’ve learned a lot, but I’m not an expert, and I need help. Does anyone know what I could possibly do from this point on?

I’d really like to have a life again.

soft tissue work, foam rolling and stretching. Plus strengthening the weak muscle groups

Send BBB a PM and ask him to visit this thread…

This post was flagged by the community and is temporarily hidden.

I am currently having somewhat similar problems like the OP. I would like to hear your take BBB on how we can prevent poor posture to begin with. I know the question needs to be more specific, but in loose terms what things should we avoid in order to further good posture?

Here is my current combat plan:

Pre-Workout on Lower Body Days:
Acute Corrective Exercises:
A1. Rectus Femoris Stretch
A2. Glute Bridges/Hip Thrusts
B1. Piriformis Stretch
B2. Lying Clams/Lying Abduction
C. Birddogs/Fire Hydrants

Mobility Work:
Knee hugs, Pull-back butt kicks, warrior lunges, running butt kicks, cross over reverse lunges, cradle walks, leg swings, roll over into v-seats, fire hydrant circles, mountain climbers, groiners, planks, bird dogs, prone scorpions, walking spidermans, Single-leg RDLs

Thanks for the detailed reply,

Not sure how to quote using the forum code, so I’ll just do it the old fashioned way:

Kyphosis is excessive thoracic curvature. An APT (ant pelvic tilt) results in excessive lumbar curvature which is called hyperlordosis. It is quite possible (and not unusual) to have both conditions in one patient. Sometimes they are referred to as upper and lower crossed syndromes. Upper being the kyphosis and lower being the hyperlordiosis.

I have had diagnoses of both. I have the beginnings of the distinct kyphotic ‘hump’, but also the exaggerated curve in my low back.

You seem to know a lot about kinesiology, so here’s another detail that is probably relevant. My hips have begun to stick out at funny angles… I don’t know how or why this is related. All I know is that when I lay down on my stomach, I feel my hips digging into the bed in a way they never did before. There was a T-Nation article a while back called ‘How not to warm up’. For convenience, here is a link to the article: http://www.tmuscle.com/article/most_recent/how_not_to_warm_up The reason this article stood out to me was that these are the positions I naturally gravitate towards in bed when I’m sleeping. I’ll often wake up in a position that resembles the ‘windshield wiper’, or ‘scorpion twist’. It feels like it’s related to my hips. If it matters, I have the same similar sort of distortion with my knees.

Shame, but not unusual. I need more detail of their treatment modalities, etc. Surely ONE of them must have offered you some degree of improvement or relief???

Well…

The only positive benefit I’ve noticed is that from the added core work, I’m more stable doing pushups. That’s about it. There has been absolutely zero reduction of pain or postural abnormality… in fact, most of what I’ve done has made me feel worse. The last physiotherapist I went to was doing something to my spine… immobilization through manual manipulation (I think it was vertebra T8), I think he said? It’s felt like my posture has been worse ever since.

You MUST persist with the exercises that do offer some relief.

If I can figure out something that works, I’ll do it until the cows come home, then call it from a mountain.

There is a thread in CTs subforum called ‘blasting lrdosis and pelvic tilt’

I found it and read it. I can’t say I fully understand it, but what I can tell you is that I’ve tried corrective exercises in conjunction with concentrating on contracting my glutes. They’re on strike, man. I can’t even activate them when I try mind-muscle connection. I’ve worked with chiropractors in the past, and I’m planning to try a new ART guy on Wednesday, but there’s no way I can find to stimulate my glutes. What is a PIR stretch?

tape a big, fuckoff ‘X’ across your upper back and shoulders

Sadly, I’ve tried this. It doesn’t help. It’s not a matter of bad habit… it’s that I simply can’t maintain correct posture, no matter how much I try. I eventually lose the battle and am forced to either slouch or lie down to rest. I’ve reaped no benefit from doing it repetitively either.

It sounds like we need to figure out how to get my glutes firing?

Quick update,

Just had another physiotherapy session. Instead of having him go through his stupid cookie cutter routine, I explained to him I needed help firing my glutes. Unfortunately, he didn’t even know any free weight glute exercises, so we basically spent half an hour on a selectorized leg press machine trying different foot positions.

I was able to fire my right gltue on a single-leg leg press, but I was unable to reproduce the effect in my left glute. My foot was in the symmetrically correct opposite position of where my right foot was, but I couldn’t feel my glute working.

What’s this mean? Hip problem?

I don’t know if it will help but reverse hypers might help as they decompress the spine which may in turn loosen up your glutes and get them firing again.

This post was flagged by the community and is temporarily hidden.

This post was flagged by the community and is temporarily hidden.

This post was flagged by the community and is temporarily hidden.

Anterior, Posterior and pictures of both sides may help us out here. I know you have described your posture in depth, but visualizing it is always better. When you take the pics, stay as relaxed as possible so that we can see the posture you normally gravitate to. Your problem is very common as I see kypho/lordo and no glute activation in most of my patients.

@BBB,

If you can suggest to me how to direct my care with the next physiotherapist, that might be the best solution short of a trans-Atlantic flight… it seems like unless I can tell them exactly what to do, I’m just going to get another cookie cutter printout to add to my pile.

@jflagg,

I’ve held off on posting for a day because I’ve been trying to get a hold of a digital camera, but I haven’t been able to. All I can do is describe my body:

-My head posture is forward
-I have a kyphotic ‘bump’ in that telltale spot just below my neck on my upper back
-I look like I’m tilted forward, like I’m leaning over to sort through a file cabinet
-My Sternocleidomastoid (I admit, I copy pasted that from EXRX) is massively overdeveloped, and I can’t even feel the muscles on the back of my neck anymore
-My hip bones feel like they’re protruding at unnatural angles, like they’ve changed position somehow

-I feel a constant urge to lean to one side or the other, and I usually lean to my left side while it feels natural. In fact, when I ‘reset’ myself to a neutral position, I feel like I’m leaning to the right side instead of neutral
-Same thing as above but with my pelvis
-Can’t turn over in bed properly… I have to sort of use my arms and legs to flip myself over, like a jiu jitsu move. It feels like I can’t use my ab muscles unless I contract my bowels (!) like I’m trying to defecate

-Sorry, I know the last one must have been embarrassing to read. It was to type, too
-I can’t really make low back contact sitting in chairs anymore, even orthopedic ones. My upper back always touches the back of the chair instead of my lower back, and it causes my torso to sort of be diagonal on the chair
-For that matter, I frequently feel like I’m sliding off even seated on the most stable chair, and find myself doing ‘bodyweight dips’ on the arms of the chair to pull myself back up

-My quadriceps are massively overdeveloped, and I can feel that my glutes and hamstrings feel like they’ve shrunk to the point where I can’t even feel them unless I flex them as hard as I can.
-I don’t know if it’s one of the heads of my quads or the actual hip flexor muscles, but the point of greatest development of my quads is closest to the hip

-My knees, elbows and ankles look like they’re bent out of shape, although it’s not nearly as noticeable since I’ve gained about 20 pounds from inactivity as of late. If I wasn’t taking a ton of MSM I’d be in agony

I went on Google Images and tried to find a pic that resembled my posture. This is the closest I could find, complete with rounded back: http://images.drtereo.com/local/361/poorposture_1_.jpg

When I look at my physique in the mirror, it looks almost like the front of my lower body (quads, hips) is supporting the back (hams, glutes), rather than the back supporting the front. Does that make any sense or is that crazy?

I appreciate anyone who’s taken the time to read this.

Wow, you seriously messed your body up losing all that weight. I’m convinced that this kind of thing happens more often than you think because of bad advice given by non-professionals like in bodybuilding magazines or at the gym. Obviously, BBB is a professional. You can tell his advice is different than the “big guy” in the gym.

I think I read this entire thread, but I may have missed something so correct me if this has already been said. My two cents would be to add plenty of pulling movements for upper back, glutes and hamstrings. Seated rows or dumbbell rows are a great option to help you with scapular retraction - sounds like that’s a problem. You may want to read up on scap retraction so you’re focusing on the right stuff. I’d also try to hip isolation stuff like hip extension with a band to get your glute firing. You can also try glute/ham raises, 45 degree back extensions, RDL, ball leg curls, ball bridges, etc. You can’t do those exercises without firing the glutes. Even if you don’t feel your glutes firing, you’re still going to get some work in. I’d stay completely away from quad exercises for the time being as well. I don’t think stretching is going to help that much, but like BBB suggested, you need to hold your posture in place over and over again until you can support it yourself. You claim that it doesn’t help and that you get tired. That’s the point. You need to push through that and keep doing it. You only started this thread a few days ago, so how can you say you’ve been donig it and that it doesn’t work. This stuff takes time, man. You’re going to need to work on posture (holding yourself in place, probably using some considerable effort) over and over again for a couple of months at least. You messed yourself up bad over time and it’s going to take time to fix this. Don’t stop doing an exercise after two days. that’s not how this works. Give it two months, then decide if it’s working or not. You’re not going to find relief immediately.

[quote]Asoss wrote:
Here is my current combat plan:

Pre-Workout on Lower Body Days:
Acute Corrective Exercises:
A1. Rectus Femoris Stretch
A2. Glute Bridges/Hip Thrusts
B1. Piriformis Stretch
B2. Lying Clams/Lying Abduction
C. Birddogs/Fire Hydrants

[/quote]

This is great. But for those with truly shutdown glutes, the hammies and lower back tend to take over the work. BBB suggested to lay face down, bend the knee 90 degrees and lift your heel towards the ceiling, one leg at a lime. I’ve done this and think it works better than glute bridges, or done before glute bridges makes them more effective at placing stress where it should be.

[quote]ucallthatbass wrote:
Asoss wrote:
Here is my current combat plan:

Pre-Workout on Lower Body Days:
Acute Corrective Exercises:
A1. Rectus Femoris Stretch
A2. Glute Bridges/Hip Thrusts
B1. Piriformis Stretch
B2. Lying Clams/Lying Abduction
C. Birddogs/Fire Hydrants

This is great. But for those with truly shutdown glutes, the hammies and lower back tend to take over the work. BBB suggested to lay face down, bend the knee 90 degrees and lift your heel towards the ceiling, one leg at a lime. I’ve done this and think it works better than glute bridges, or done before glute bridges makes them more effective at placing stress where it should be.[/quote]

You are absolutely right. This is a very well studied concept of “pre firing” a muscle before getting to a more difficult exercise. The OP needs to get the glute firing at lease minimally first which, through his description, sounds as though he is not able to do. The glute max MMT that BBB has described is the best course of action to start off with. Another strategy that you can use Galium to get the glute firing is to do the exercise BBB has outlined and have some one press into your glute max with their finger. This is a form of biofeedback that can help you contract the muscle. Good luck.

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Gallium, it sounds as though you have become an internet physician, able to self-diagnose simply by googling. You say that you have been to multiple PT’s and chiro’s, and they just don’t understand. Let me guess…they are all incompetent, right? Tell me now, on a scale from 1 to 10, what your pain level is.

NOW, was the pain level a whole number, or did it include a fraction? IMHO, if the pain level includes a fraction, no matter how low(even a 1 and a half), thou art a pain in the ass.

You will be a high-maintenance patient that over-analyzes to the point of paralysis. No health-care practitioner would want to take you on. For good reason. Just do the damn exercises and get your formerly fat ass outside, off the treadmill.

Gallium -

From my experience, kyphosis is mainly a structural issue with the spine, which typically happens over an extended period of time or through growing. It sounds to me like your problems were created through lifting - which leads me to believe that your issue is muscle imbalance more than permanent spinal curvature.

Here’s a run down what I suspect is causing your problems and why static stretching and simple PT exercises aren’t working - then below - a few easy and painless exercises:

  1. Your pectorials are too tight - especially pec minor - pulling your shoulders into internal rotation. Your SCM is constantly being worked to hold your head in an upright position, which accounts for your forward head carriage.

  2. All of this forward pull is over stretching all of the muscles in your back. An over stretched muscle is like an over stretched rubber band - it does not return to it’s proper resting position.

When you force your shoulders back (like into a downward dog position, bottom of a push up or the Y of YMCA) you probably feel a cramp like pain. This is because the muscle is being forced into a shorter position than it is able to contract - it just jams up.

  1. These two muscle groups work together - similar to your bicep and tricep - when one shortens the other lengthens. What happens when your traps are unable to shorten? Your pecs are unable to lengthen. That means that without regaining elasticity in these muscles - NO amount of static or dynamic stretching will release your pecs and stop them from pulling your forward.

There is an answer - it comes through eccentric training (resistance stretching) with 3 specific exercises. Try to get to 4-5 reps, but never push through pain - only go as far into the stretch as feels good.

  1. Traps - I’m attaching promo video I did a while back - I absolutely hate it - but it’s the exact stretch you need. http://www.youtube.com/watch?v=hQRL6kbIb8k

  2. Pec Minor - Raise your arms into a simple Y position chest opener in a doorway - but keep resistance on your hands the entire time to push you back out of the door and to slow you down on the way in.

  3. Pec Major - try a push up - but focus on the lowering stage. Slowly come as close to the floor as you can to stretch out your pecs.

Repeat this 3 times.

Good Luck!

[quote]BennyHayes wrote:
Gallium, it sounds as though you have become an internet physician, able to self-diagnose simply by googling. You say that you have been to multiple PT’s and chiro’s, and they just don’t understand. Let me guess…they are all incompetent, right? Tell me now, on a scale from 1 to 10, what your pain level is.

NOW, was the pain level a whole number, or did it include a fraction? IMHO, if the pain level includes a fraction, no matter how low(even a 1 and a half), thou art a pain in the ass.

You will be a high-maintenance patient that over-analyzes to the point of paralysis. No health-care practitioner would want to take you on. For good reason. Just do the damn exercises and get your formerly fat ass outside, off the treadmill. [/quote]

I don’t know how things are where you live but I know exactly what the OP is talking about.

When it comes to physical issues, most of the doctors where I live are of one of two types:

  1. The old school doctors who accept our insurance, have to get us in and out of their offices in 15 minutes, and who frown on “experimental” treatments (anything that doesn’t involve pharmaceuticals, which they pass out like M & Ms. We may get a referral from them but That Guy usually does a quicky exam and hands us a generic sheet of exercises while wishing us good luck and not recommending any follow-up. That’s the start of the cycle wherein the patient visits doctor after doctor, none of whom work together to see the big picture. And like you, they smirk and tell themselves their patients are all just a bunch of spoiled whiners which, of course, lets them off the hook.

  2. Then there’s the guy who really knows his shit, like BBB. Things may be different in Wales, but here in the U.S.A., guys like him only deal with high level athletes (the pros, college, maybe a high school footballer with a big future) because THAT’s where the big bucks are. He doesn’t accept insurance and really doesn’t want to deal with Joe Blue Collar. I mean, Cressey may be a great guy but I bet he doesn’t have time for a factory worker with Blue Cross/Blue Shield. Nobody with that kind of knowledge and experience does.

The idea that the ordinary guy/gal has somewhere they can go where they’ll be examined head-to-toe, inside-and-out to find out what’s really wrong and freakin’ fix it is a fantasy for anyone who’s not getting a big signing bonus.