A lot of us have niggling bodily pains. A bum knee, a tight hip, an achy back. My guest would say that the cause of those maladies, as well as their cure, can likely be traced to a common source: your posture.
His name is Vinh Pham and he’s a physical therapist and the author of Sit Up Straight: Future-Proof Your Body Against Chronic Pain with 12 Simple Movements. Today on the show, Vinh explains the problems that can arise when we don’t stand and sit properly, and simply sit too much in general, and how those problems can be prevented by practicing good posture. He explains what good posture looks like when you’re sitting and standing, and the cues that will help keep your body well-aligned. Vinh shares the ideal ratio of sitting to standing to aim for throughout the day, and a better way to hold your phone so you don’t get something called “tech neck.” Vinh then walks us through some exercises you can do to address physical issues you may already have, from tight shoulders and hips to lower back pain.
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Read the Transcript
Brett McKay: Brett McKay here and welcome to another edition of the Art of Manliness podcast. A lot of us have niggling bodily pains, a bump knee, a tight hip, an achy back. My guest would say that the cause of these maladies, as well as the cure can likely be traced to a common source, your posture. His name is Vinh Pham and he’s a physical therapist and the author of Sit Up Straight: Future-Proof Your Body Against Chronic Pain with 12 Simple Movements. Today on the show, Vinh explains the problems that can arise if we don’t stand and sit properly and simply sit too much in general and how these problems can be prevented by practicing good posture. He explains what a good posture looks like when you’re sitting and standing and the cues that will help keep your body well aligned. Vinh shares the ideal ratio of sitting to standing to aim for throughout the day and a better way to hold your phone, so you don’t get something called tech neck. Vinh then walks us through some exercises you can do to address physical issues you may already have, tight shoulders and hips to lower back pain. After the show’s over check out our show notes aom.is/posture.
Alright, Vinh Pham welcome to the show.
Vinh Pham: Hi Brett. How are you?
Brett McKay: Doing good, man.
Vinh Pham: Thanks for having me.
Brett McKay: Well, Hey, it’s a pleasure. So you are a physical therapist and you treat high profile athletes, business people as well. And you got a new book out, Sit Up Straight: Future-Proof Your Body Against Chronic Pain with 12 Simple Movements. What’s your approach to physical therapy like? What are you doing that’s different from, say if someone went to physical therapist, how would your approach be different from a lot of other physical therapists?
Vinh Pham: Yeah, so like a simple analogy I always use is, you know, everybody here understands skin muscle and bones, and also there’s this fourth component called fascia that not a lot of people understand or are even aware of. But for whatever reason in the industry, they split up the rehab industry and skin muscle bones. So skin is massage therapist. Bone is chiropractor and muscle is physical therapist. And then in terms of fascia, no one even, there’s no profession that really specifically focuses on the fascia and we can talk about the fascia later. But so, if you have an issue, when, let’s say you have knee pain or you have low back pain, most of the time it’s a composite, actually not all the time, it’s a composite situation. It’s like, is your issue 30% skin, 30% bone, 10% fascia or is it 50% muscle, 10% this, 10% that, you get what I mean?
Brett McKay: Yeah.
Vinh Pham: So then, because it’s like a composite situation, but we’re only trained in one domain in the industry. So as a physical therapist growing up, every issue that I would encounter, I would always try to either strengthen it or stretch it. So I would always be focused on the muscle because that’s how they were training me. And if I was a chiropractor, I would probably approach that same issue with, manipulations, joint manipulations or bone manipulations.
And if I was a massage therapist, I would just basically try to, “rub the pain away.” So just growing up in the physical industry, seeing tons of tons of patients, I started realizing like, “hey, if the person was dominantly a muscle issue, I would be the greatest solve ever. But if it was anything remotely out of my domain, I would have no idea how to fix it.” But I always knew there was a way to fix it, so in that process, what I would say did different, but to me was just common sense is I essentially just went to train with different chiros. I went to train with different massage therapists. I went to train with obviously other physical therapists and I just started learning about just the whole art of healing in general. And I just dove myself in that whole field and in the process, I essentially created my own version of therapy, which is kind of just like mixed martial rehab, you know?
Brett McKay: Alright. So, you’re taking things from different domains and applying in an all in one thing, depending on what the person needs, right? So it’s like if you, they come to you.
Vinh Pham: Yes. Exactly.
Brett McKay: Yeah. They come to you, it’s a muscle issue, okay. We’re gonna do some strengthening if it’s a joint issue. We’ll do something else with that.
Vinh Pham: Yes.
Brett McKay: Well, we’ll talk about the fascia ’cause I think that’s really interesting. I wanna bring that, circle that up. But I wanna talk about, let’s get into your book. Because this book Sit Up Straight seems like it was written in response to the pandemic because with the pandemic, people started, a lot of people started working from home and you started noticing people coming to you with different issues that you hadn’t seen before. Maybe you had seen before, but not as frequently. How did the pandemic affect people’s bodies? And like what type of ailments did you see more of in your clinics?
Vinh Pham: Yeah. In general, the crazy stat is the average desk worker sits about on average 15 hours a day. So from sitting at work to sitting at home, watching TV or hanging out on the couch, which is insane if you think about it. And then during the pandemic, they sat two hours longer than that. So people on average were sitting 17 hours a day. So, if you’re sleeping seven hours, that’s pretty much your whole day [chuckle], you know? So that’s actually, so it is crazy how much people were physically inactive during COVID as well. So that exacerbated a lot of issues like back pain, neck pain, I would say were the two main ones that showed up even more. And also because at their office, they had really good setups, at home they were working from seats that were too low or slumped on the couch or working on in their bed. And this caused all these issues to show up in their bodies.
Brett McKay: Okay. So you had a lot of things going on. First, people were just sitting poorly because they didn’t have an ergonomic setup at home. They were just making do with what they had. I know, you know, I work from home and sometimes I’ll be on the couch and I’ll kind of be slumped over and I’m like, “this is not good for me.” They’re doing that a lot more but also just being inactive, likely weakened muscles that we use to support ourselves. And so you probably, that’s why you saw more back issues ’cause people’s backs were weak ’cause they weren’t using them.
Vinh Pham: Mm-hmm. Absolutely.
Brett McKay: So, okay. The pandemic’s got a lot… People got a lot of issues and what you do with what’s kinda interest with your practice is when someone comes to you for a physical therapy visit, the first thing you do is you ask them, well, let me look at your posture. A lot of times when you go to physical therapists office, they just wanna know like, “what’s hurting?” And then they just look at the thing that’s hurting, right? So if you have a knee issue, they’re gonna look at your knee right away. You do, you’re gonna get to the knee but the first thing you’re gonna do is like, “well, I wanna look… Just stand up, let me see how you stand.” Why look at the posture? How can looking at someone’s posture help you figure out what’s causing pain downstream?
Vinh Pham: Yeah. I mean, Brett, if you walk into a room and you see there’s water on the ground, do you necessarily just… Okay, sure, you’re gonna clean the water on the ground, but then what are you looking at next? You’re gonna be like, “Where did the water come from?” And then, next thing you know, you’re gonna look up at the ceiling, then you’re gonna start looking in the pipes, and you’re gonna start tracing back where the water came from. You don’t just scrub the water away and then wait there, and then two hours later, there’s more water again. And you keep scrubbing the water non-stop and you just stop there. [chuckle] Next thing you know, there’s definitely a pipe that’s broken in the room somewhere and that’s causing water to build up at this area that you keep cleaning.
I look at pain the same way. Someone comes in, their knee hurts. To tell you the truth, most of the time when their knee hurts, it’s probably the last thing I look at. If it’s not like a acute, like a traumatic injury, if someone didn’t hit your knee, I probably wouldn’t look at your knee first. If you came in from like, “Hey, listen, I’ve been running for a while and my knee hurts.” I probably start looking at your foot or start looking at your hip, because your knee’s probably doing too much. It’s probably taking the brunt of the load because it’s the only thing that’s operating properly. And that’s what a lot of people don’t think about. And I always use this analogy when… Back in the days when I was in high school or even grade school, I would be… Were you ever part of group projects, Brett?
Brett McKay: Yeah. Sure.
Vinh Pham: Yeah. So group… You’re part of a group project. You get assigned a team and then there’s always one guy doing more work than everyone else, yeah?
Brett McKay: Right.
Vinh Pham: [chuckle] There’s one guy doing more work and there’s one guy that’s slacking and there’s maybe like two people that’s… Let’s say mid-range. Let’s say there’s four people. Essentially, the person who works the most is essentially the one who gets the most trauma and stress on his body. Agreed?
Brett McKay: Agreed. Yeah, yeah, yeah.
Vinh Pham: Yeah, exactly. So, because he has the most workload versus the other people that are not doing as much work, you need… In order, for example, let’s say the person who does the most workload is the knee, so then the hip and ankle are not operating properly. In order for me to solve your issue, I don’t strengthen the guy who does the most work. I go to the other lazy guys, the slackers, and I go, “Hey, wake up. It’s time to contribute to the team.” And that’s, honestly has helped me solve so many issues, just thinking like that.
Brett McKay: Well, so let’s say someone’s got bad posture, what are some typical ways you see the body compensate for that bad posture? And how does that create problems?
Vinh Pham: Yeah. Posture is just… When I look at someone’s posture, essentially it just tells me where you spend most of your time. It’s where you’re most comfortable. If you like to slouch a lot over time, as you keep slouching, as you’re sitting for 15 hours a day, that slouch posture is gonna translate into you walking slouched. It’s gonna start translating to you modifying your center of mass more forward, for example. So all of these little things, when I look at your body, I can start seeing how you like to use your body. So, let’s say, for example, you like to sit more on the left side, on left butt cheek, over time, your ribcage is gonna start tilting to the right. So you’re gonna start getting squished in the right side of your body, because you’re always leaning into your right… Leaning into the right side of your body, but like, putting all your weight in your left butt cheek. So if you stand up, you’re naturally gonna have a scrunched appearance on the right side of your ribcage. So imagine if you carry that into when you’re squatting and you’re loading your body, that’s gonna start creating issues in your lower back, because your ribcage is gonna be tilted, because of all this time you’ve been spending sitting down on the couch a certain way and it starts translating into your exercises. Does that make sense?
Brett McKay: Yeah, that makes sense. I know like with shoulders, a lot of times people have their shoulders rounded and that just causes things to get tight in your back, and even in your chest. Your chest muscles are gonna be kind of scrunched forward and it’s just gonna get used to that. And so a lot of people get problems with their, a pec tear when they’re doing a bench press, because pretty much all day they got their shoulders slumped forward.
Vinh Pham: Absolutely. And then even the shoulders slumped forward, to add a little bit nuance to that, it’s essentially, a lot of times, not only is it from the shoulder, but it’s also from this place called the thoracic spine, which is your mid-back. And from slouching all the time, naturally your thoracic spine, the middle part of your back, starts bending forward, flexing forward, and that starts locking up your shoulder in that position. So in order to fix rounded shoulders it’s not only important to work on the shoulders, but also important to realign your thoracic spine.
Brett McKay: Well, another issue when you talk about bad posture, oftentimes when people have that sort of rounded upper back, kinda slumped like a caveman, that causes your hips to go forward as well. So you kinda have that out of alignment as well, and that can cause problems when you’re walking or running.
Vinh Pham: Yeah, absolutely. Well, just for you to understand simple mechanics, like when you’re sitting, you’re essentially posterior tilting your pelvis, which is essentially, it’s like you’re tucking your pelvis under you. And then that in turn will cause your thoracic spine to slouch, that in turn will cause your head to come forward. And also, from a foot perspective, it’ll naturally cause your foot to supinate, which is essentially crunched. Go into a higher arch position. So all of those things start giving you that Hunchback of Notre Dame look that we all don’t want. [chuckle]
Brett McKay: Right, right. No, and then… But yeah, it looks bad, but also it can cause a lot of problems if you’re physically active.
Vinh Pham: Of course.
Brett McKay: That’s why you might… You start running and you’re like, “Man, my hip feels out of whack.” Well, it’s probably because your posture’s been bad all day.
Vinh Pham: Of course, because you’re loading in an unaligned position and that causes compensation patterns, because you still wanna get from point A to point B. And if you’re mentally tough, you push yourself through the pain, and next thing you know you have plantar fasciitis, you have hip issues, you have neck issues, all these things.
Brett McKay: Well, another thing that’s contributed, probably has caused different problems that didn’t exist, I mean, they existed, but not as frequently 25, 30 years ago, was with smartphones. People have this thing that you call tech neck. What’s tech neck?
Vinh Pham: Well, tech neck is just simply this thing called forward head posture, which essentially over time your chin just starts to drift forward and you start developing this bump in the back of your neck. And you essentially are moving… You start rotating and moving your neck from the top part of your spine and not having any motion in the lower part of your spine. In your neck… Or, sorry, lower cervical, which is the lower part of your neck. So that causes a lot of issues, headaches, can cause nerve irritation, that can also cause so many, so many, so many issues. Your neck can cramp when you’re driving, let’s say you’re checking your blind spot and you’re stuck in a tech neck position. And when you rotate, because it’s not optimal rotation, you can start pulling on your muscles of the neck. So many things can happen from tech neck. So definitely something to work on overall.
Brett McKay: Okay. So generally people have bad posture. There’s slump forward. That can cause issues in your shoulders, your neck, your middle of your back, lower back pain as well. Cause issue in your hips. That’s so that’s like why you look at just when someone comes to you, like, let me see, just stand. Let me see how you sit because that bad posture can cause your body to compensate in ways that is unhealthy. Let’s talk about this. What does good posture look like then? Like if someone, ’cause I think when people typically think like good posture, they think like, you’re like military straight, but it’s not that right?
Vinh Pham: Yeah. I think good posture is essentially just effortless movement. Even when I talk about posture, I talk about like, I don’t really believe that there’s static posture is essentially, everything’s just dynamic. Even when you’re standing still “still”, there’s always a shift that’s happening where you’re your muscles are constantly holding you in that “still” position. So even when you’re sitting is dynamic, even if you’re trying to be as still as possible. So good posture to me is like making sure that you can move well, giving your current body and you can move pain free and you have to be aligned. So you have to be essentially, you know, when you’re sitting, for example, sit at a 90 to 110 degree angle with your eyesights like being able to look forward and not necessarily down or up.
Brett McKay: Let’s say you’re at your workspace. Your head should be in line with your shoulder and body. There should be no rounding of the shoulders. Your chin should not be poked out. Your elbow should be give or take at 90 degrees. So you don’t end up having irritation in your ulnar nerve. And you know, your feet should be making contact with the ground. And one of the main things about, “good posture” is over time, I want you to be able to sit up straight. Sit up straight is almost like the pinnacle that you wanna work towards. And obviously for most people trying to sit up straight is going to be effortful for them. So because of very, you know, maybe they’re not strong enough to do it. Maybe they’re too tight. Maybe they’re not trained well enough. Maybe their body won’t allow them to. And they’re naturally more comfortable in the slouching position and that’s okay. But over time we want to eventually make you be able to attain those positions. And when it comes to like movement and good posture in general, like everyone can generally tell. You ever watch the Olympics, Brett?
Brett McKay: Of course.
Vinh Pham: Yeah, exactly. So you ever seen really good athletes move or gymnasts move. There’s so much effortlessness in their movement, in how they stand, in they move their arms, move their legs, you know, do back flips and stuff like that. And that just comes with good training. And it’s the same thing for sitting like you should be, over time, you should be training to sit properly. It’s not about like, oh, all of a sudden you just have to be aware of it and then your body will allow to sit up straight. It doesn’t work that way.
Brett McKay: No. Yeah. You lay out some cues for a good posture generally. And there’s some good ones you can just follow here. Your ears are align over your shoulders. So you don’t have like the tech neck thing going on, your shoulders are aligned above your hips. And when you’re sitting down, you wanna be looking straight forward, not down at your monitor. This means you might have to elevate your monitor with some books or a stand of some sort. And you get this nice cue too. If you feel like you just want to become aware of your posture, roll back your shoulders, ’cause that will get rid of that slump you have, and you don’t have to be super tight about it. Just kinda just a simple rollback. And I’ve been doing that. I’ll just throughout the day, I’ll be like, I’m gonna roll, my shoulders crunch forward. Yes. Just roll back that shoulders. And that does a lot to just open things up.
Vinh Pham: Yeah. And also this is like a little simple trick. You should also watch out where your elbows are or where your wrist are because sometimes if your wrist are kind of bent backwards in extension, because of like your workspace, then you end up getting like carpal tunnel.
Brett McKay: No. Yeah. You got to be careful of this work station. I had last, I’m gonna say September through, I’m still, it’s almost cleared up. I had the worst case of tennis elbow ever.
Vinh Pham: Oh no.
Brett McKay: And it was in both elbows. So it started off in my left and then a month later, my right. And I was like, what is going on here? And I think it was just how I had my arms rested on my desk. Like it was just there… Something was off. And I think it just, it caused it’s like that sort of repetitive strain. My elbows were on extension a lot and it just caused the tennis elbow. And it stunk, it was not fun.
Vinh Pham: Yeah. Definitely not fun. And yet the way that you were leaning your elbows on your desk were probably just irritating the nerve in your elbow.
Brett McKay: We’re gonna take a quick break for a word from our sponsors. And now back to the show. Okay. So general posture you want to just, you don’t have to be like military straight, but it’s just kind of everything in alignment, whether you’re standing or sitting. If you’re sitting, you wanna make sure your feet are flat on the floor. Knees are 90 degrees. ‘Cause if you’re not sitting right, not only do you worry about the back stuff, but you have to worry about the hip issues as well. Like what happens, how does the way we sit all day affect our hips?
Vinh Pham: Yeah. I mean, if you’re sitting all day, your hips are always in a flex position. So therefore you start to lose the ability to extend your hip. And you know, when you’re doing anything, [laughter] you need good hip extension. You know, whether you’re doing a hip thrust at the gym or you’re running, walking is all about having good hip extension, running is all about having good hip extension. Anything when it comes to sports, you need good hip extension. So imagine if you’re spending 15, 17 hours during COVID hip flex over time, your body starts losing that extension. And that’s just in the, this thing called the Sagittal plane, which is like front to back. If you’re sitting and you’re slouching to one side, you’re leaning to one side that starts causing issues side to side, you start losing your ability to bend sideways. So yeah, that’s definitely can affect how you perform in sports or how you walk around how you run, how you do anything.
Brett McKay: So there’s been a lot of talk lately about sitting being the new smoking and that people need… And I think people went out and they bought standing desk or treadmill desk. And so they’re just standing the entire day. They’re walking while they’re working, but you make the case that… Okay, yeah, standing while working is good for you, but standing all the time, probably not, what’s going on there?
Vinh Pham: Yeah. It’s the same thing. The key to everything is just movement. You gotta move a lot. Ideally this is obviously in a perfect world and it will never happen, but ideally you should only be sitting for like 30 minutes at a time. So in a typical eight hour Workday, you should be sitting for four hours and walking for four hours and essentially breaking up the sitting and standing every 30 minutes, that’s essentially in a perfect world, but similar to sitting if you’re standing all day, it’s the same thing. Because naturally when you stand, you’re gonna start, A, being immobile, two, you’re gonna start leaning more to one leg or more to the other. And you’re gonna essentially develop these standing… These versions of standing slouching that you will naturally start to do. Standing leaning, actually, I should say. And I remember… I forget exactly the study, but I remember reading a study where they said the ideal ratio of standing to sitting should be give or take, for every hour sitting, you should do one to three hours of standing, which is essentially what I was saying earlier, which is, yeah, you should be sitting for max half your day.
Brett McKay: Okay. So I guess, so you wanna alternate, so maybe sit for 30 minutes and then move to a standing position for 30 minutes and then…
Vinh Pham: Yes.
Brett McKay: Sit 30.
Vinh Pham: Exactly.
Brett McKay: Yeah. The standing all day thing. If you stand all the time, you develop imbalances as well. I’m thinking back to when I was a waiter and you’re on your feet all day, and you’re walking and when it’s busy, you’re moving a lot. But I remember doing like when it was dead, you just… I’d find these weird positions to lean.
Vinh Pham: Yeah, totally.
Brett McKay: And I just… It would just, my lower back would hurt. It was not pleasant.
Vinh Pham: Yeah. Yeah, ’cause you would probably just lean more on one leg, and then lean into your hip and then you would just contort or you would like lean against the table probably when you’re standing, or let’s say you’re at the hostess bar or not sorry, the hostess the front desk situation, you’d probably put your elbows on it and just lean and then figure out new ways to be more “comfortable.” And you do that for, again, eight hours standing or sitting. It’s the same thing.
Brett McKay: With the standing desk. You also recommend to set up things where you can kind of rest your foot so you can lift up your leg a bit. So you put your… You’re resting your foot on a stack of books, for example.
Vinh Pham: Yes yes.
Brett McKay: What’s going on there, and why do that?
Vinh Pham: Yeah. So the whole point is if you wanna stand properly, you wanna just level your pelvis. So you don’t want to allow a side to side dip. So when you put your foot up on a stack of books, it automatically levels your pelvis and doesn’t allow you to essentially cheat and slouch in that position.
Brett McKay: Gotcha.
Vinh Pham: So yeah. So similarly, if you’re sitting down and you want to make sure that your pelvis doesn’t roll back and forth, or for you to assume a slouch position, having a bottle of water put in the back of your chair while you’re sitting or a lumbar support is great.
Brett McKay: Okay. So to recap here for the standing desk, don’t wanna stand all the time, alternate between sitting and standing while you’re doing that maintain good posture. So ears above shoulders, shoulders above hips. It should be comfortable if you’re first starting out, trying to correct your posture, it’s gonna be uncomfortable because you’re not used to it, but you wanna get to the point where it just feels… It feels natural. Another thing I wanna talk about, okay, let’s talk about the tech neck. So people, when they’re looking at their smartphone, a lot of times people are spending time on their smartphone or a tablet, is there a better way to hold your phone when you’re looking at it so you don’t get that tech neck?
Vinh Pham: Yeah, I would say essentially, just, if you can’t avoid looking down at your phone, which is kind of hard, you can essentially put the phone in front of you, like hold it right in front of you at eye level. It looks a little bit crazy when you do it in a group of people, but it’ll definitely be way better for your neck. And then, or if you want to keep looking down at your phone, what you want to do is maybe every 15 minutes that you do that you wanna maybe reset and just do a few chin tucks or just like move your neck around to kind of like oil it up, essentially.
Brett McKay: What about the way you hold your phone. I know a lot of people, they get like smartphone thumb or their wrist pain because they just… They hold their phone in a weird way and it just causes pain. Anything there? Have you…
Vinh Pham: Yes.
Brett McKay: Had you had that… Have you seen that issue?
Vinh Pham: Yeah, but I think it’s more with people who either buy phones that are too big for them.
Brett McKay: Okay.
Vinh Pham: So they kind of have to twist their arm a certain way to type in the phone. And then also in terms of a tip for you, where you were saying, I think a lot of people, they use one hand, I think using two hands is way easier for your thumb, for like thumb health. So cradling your phone with two hands and then using your two thumbs to type is probably the best way versus typing with one hand.
Brett McKay: Right. And maybe just use your phone less. [chuckle] That’ll probably help. Yeah.
Vinh Pham: Yeah, yeah. Exactly or maybe use your phone… Yeah, maybe just use your phone less. Absolutely.
Brett McKay: Yeah. Okay. So moving more, moving from a sitting position to a standing position throughout the day, practicing good posture. This will go a long way to helping people future-proof their bodies. But some people, because of years of just sitting improperly, being immobile, they need a few extra exercises to help correct those years of bad posture. And you highlight 12 of them in your book and it’s all about… And they’re about increasing mobility, not necessarily flexibility. What’s the difference between mobility and flexibility?
Vinh Pham: Mobility is how much like your muscles can move in that given range under your control. So right now, if you’re laying down on your back and you bring your knee up to your chest without using your hands, you’re gonna go only as far. That’s essentially mobility because you’re using your muscles to bring your knee to your chest. But then if you use your hands and you start pulling your knee to your chest, you probably can go further. And that’s your full range of motion, which is that’s your flexibility. Does that make sense?
Brett McKay: Yeah, that makes sense. What role does fascia play in mobility? Let’s circle back to fascia.
Vinh Pham: Yeah. So fascia is the wrapping. So let’s say you cut an orange in half. You cut an orange in half and then you look at the slices, what delineates those slices is this white part. So white part is essentially the fascia. If you were to take all that white stuff out, the slices would just fall over and just not be stuck together. So a lot of people call fascia the organ of structure, because it essentially gives you structure. It helps you organize and delineate your muscles in your body. And it’s also used for force transmission. So as you’re moving your arms and stuff like that, the force gets transmitted through the fascia. And essentially the fascia is, if the fascia gets “tight,” it starts to… It’s a wrapping around your body. And then that now stops you from moving to your ranges of the motion, because imagine you’re just in a tight wetsuit. Like you can’t move as well, or like a straight jacket. That’s kind of how it feels over time as your fascia hardens because you sit for too long in a certain position, for example.
Brett McKay: Okay. And so what these mobility exercises do, it helps kind of keeps everything greased up.
Vinh Pham: Yes, essentially. Yeah. It helps keep everything greased up. Fascia is a living tissue. So as you move through motion, it starts unwinding it and then it starts “loosening it.”
Brett McKay: Well, let’s talk about some of these mobility exercises, like you said, there’s 12 of them. Let’s highlight a few. Let’s say, someone’s got some… A serious case of tech neck. So, they’re all the time, even if they’re not looking at their phone, they’re… They have got sort of the chin forward. It just doesn’t look good. And they have got some neck issues. Is there a good exercise for that that can help correct that?
Vinh Pham: Yeah. So I would say the most simple one is called a chin tuck. So I’m really bad at explaining. [laughter]
Brett McKay: Yeah. Just walk me through. Imagine I’m here with you. Like, I’m gonna do the chin tuck.
Vinh Pham: Okay, perfect. So you’re gonna be sitting up straight.
Brett McKay: Right.
Vinh Pham: Shoulders align with your pelvis, your feet firmly flat against the floor. And what you’re gonna do is you are going to retract your chin. So someone’s trying to touch your chin and you’re basically doing like a turtle and you’re just retracting your…
Brett McKay: Gotcha.
Vinh Pham: You’re moving your chin away from them.
Brett McKay: Yeah. I’m doing that.
Vinh Pham: So you’re giving yourself a double chin.
Brett McKay: Yeah, no, yeah. I can feel it in the back of my neck.
Vinh Pham: Exactly. So that’s essentially stretching out the top part of your neck out.
Brett McKay: Okay. And so like how often do you just… Do you hold it? Is it like a typical stretch or are you actually doing a full range of motion?
Vinh Pham: Yeah. So I would probably do full range of motion. I would probably stop for like a two to three second hold and then repeat that like five times. You can do that kind of every hour. Five reps, keep it easy.
Brett McKay: Okay. I like that. What about movements to help with the tight shoulders so they, you know… Someone’s been sitting down all day and they’ve got the… I’m really bad at this. I’ve got really tight shoulders and it affects my weight lifting, ’cause it… When I do a bench press, my chest is really tight. Getting under the bar for a squat, it’s really tight ’cause my shoulders are slumped forward all the time. Any exercises to help open up those tight shoulders?
Vinh Pham: Yeah. So when it comes to the shoulders, I would always also target the thoracic spine, which is your mid back. So what I would do is, I would take my arms. Okay, imagine you’re sitting. So these are all for sitting.
Brett McKay: Okay.
Vinh Pham: So you’re sitting down. Right? And then you’re gonna take your hands and you’re gonna basically put your arms out in like a cross position.
Brett McKay: Okay.
Vinh Pham: Like as if you’re in a cross position.
Brett McKay: Yeah. I got it.
Vinh Pham: And your palms are gonna be pointed upwards to the ceiling.
Brett McKay: Got it.
Vinh Pham: Right? So it’s like, “Hey.” Someone’s trying to come hug you. You’re like, “Hey, my arms are out.”
Brett McKay: Right.
Vinh Pham: Okay? And from here, what you’re gonna do is, you’re gonna start trying to… You’re gonna try to point your palms towards the back of the wall behind you.
Brett McKay: Oh, okay. Yeah.
Vinh Pham: So you’re gonna rotate your palms back. Right? And then you’re gonna have your palms face the wall behind you. And naturally when you do that, you’re gonna notice that your thoracic spine starts lifting up.
Brett McKay: Right.
Vinh Pham: Do you notice that?
Brett McKay: Yeah. I’m noticing that. Yeah.
Vinh Pham: Exactly. So then if… And if you rotate your palms downwards towards the ground, right? You’re gonna notice that naturally it’s gonna start… You’re gonna start going in a slouching position.
Brett McKay: Okay, I’m doing that right now.
Vinh Pham: So yes, exactly. So you’re gonna do that back and forth. So you’re going from a slouch position with your arms internally rotated and you’re gonna externally rotate your arms and then you’re gonna start extending your spine.
Brett McKay: That’s nice. So how many reps do you do that for?
Vinh Pham: Same thing. I would say, five reps. Keep it easy.
Brett McKay: Okay.
Vinh Pham: A lot of these things, it’s just more about adding movement in your life versus like trying to exercise. It’s not like a three sets of 10.
Brett McKay: Okay. Okay. So this is something you can just do throughout the day. Like, you’re like, “I need some movement. I’m gonna do this.”
Vinh Pham: Yeah. Think about it like movement snacks.
Brett McKay: Okay.
Vinh Pham: Your body just craves movement.
Brett McKay: I like that.
Vinh Pham: So you’re giving it a little snack here. Just move a little bit.
Brett McKay: I like that. I like movement. Here’s my movement snack. I’m doing that right now. Okay. Let’s talk about tight hips. So a lot of people get tight hips ’cause they sit down often, usually poorly. Any movements to alleviate tight hips when you’re working?
Vinh Pham: Yeah. So, for this one, I would say you definitely need to stand up.
Brett McKay: Okay. I’m standing.
Vinh Pham: Okay. So as you’re standing, so what you wanna do is you wanna go in a split stance.
Brett McKay: Got it.
Vinh Pham: Okay. So you’re in a split stance. And from here you want to… Which leg is back, Brett?
Brett McKay: My left leg is back.
Vinh Pham: Okay. Your left leg is back. Great. So now we’re gonna… If your left leg is back, it means we’re working on your left hip flexor.
Brett McKay: Okay.
Vinh Pham: Okay? And then from here, what you’re gonna do is you are going to work on shifting your weight forward and back. So you’re gonna be bending your right knee.
Brett McKay: Oh, okay.
Vinh Pham: And as you’re bending your right knee, you’re gonna be shifting your weight forward. You feel that?
Brett McKay: I can feel that. Yeah.
Vinh Pham: Great. And then you wanna try to keep your left foot on the ground planted.
Brett McKay: Should I feel a little bit of like calf stretch in the left?
Vinh Pham: Yes. Absolutely.
Brett McKay: Okay.
Vinh Pham: You’re gonna feel a little bit of a calf stretch as well.
Brett McKay: Great.
Vinh Pham: And now what you’re gonna do is you’re gonna take your left hand and you’re gonna reach for the ceiling.
Brett McKay: Oh man. Okay.
Vinh Pham: Yeah. So as you’re shifting your weight back and forth, you’re trying to reach for the ceiling with your left hand and you’re gonna feel a huge stretch. A mix of your calf and also your front hip flexor.
Brett McKay: Yeah. I’m feeling that. That’s nice.
Vinh Pham: Yeah. Yeah. And if you want to let go of the… You know, if you wanna go on the ball of your foot, it’s gonna start focusing more on your hip flexors only.
Brett McKay: Let me see if I can try that. Oh yeah. Okay. Okay. That’s good. I like that.
Vinh Pham: Yes, exactly. And you wanna keep that leg, that back leg straight at all times as much as possible.
Brett McKay: Okay. So that’s for the hips and again, this is something you could do like, “Yeah, okay, I need a little snack break. I need a movement snack. I’m gonna do this.”
Vinh Pham: Yep. Yes, absolutely.
Brett McKay: And you might get funny looks from your colleagues, but you can just, they might actually, “Oh, that actually looks good. I’m gonna join you.”
Vinh Pham: Yeah. I think… I actually think people will be like, “Oh my God, that sounds like a great idea. [laughter] I look like I need that.”
Brett McKay: What about… A lot of people have lower back pain, any movements there to help with the lower back pain?
Vinh Pham: Yeah. So for lower back pain, you can definitely do… So, same position. So you’re in a split stance.
Brett McKay: Right.
Vinh Pham: And what you’re gonna do is… Whenever people have lower back pain, I always look to the hip first. So they probably have tight hips generally.
Brett McKay: Right.
Vinh Pham: So from here, you’re in the split stance. So let’s say you retain that same position. You have your left leg back, right leg forward in a split stance. What I want you to do is, as you’re shifting your weight forward, you’re gonna be pushing your right glute towards the wall away from you.
Brett McKay: Oh, okay. Yeah.
Vinh Pham: Right?
Brett McKay: Yeah. Yeah.
Vinh Pham: And then you’re gonna take that your right hand and you’re gonna try to reach for the left side of the wall. Sorry. The opposite side.
Brett McKay: Right, right.
Vinh Pham: Away from your glute, right?
Brett McKay: Yeah.
Vinh Pham: So that naturally is gonna start…
Brett McKay: Oh yeah.
Vinh Pham: Pushing your hips towards the wall. You’re gonna naturally start feeling a huge stretch in your right glute.
Brett McKay: That’s nice. I like that a lot. That feels good. That’s a good one. Okay. So those are like just three. And again, I like how it is. You don’t have to… A lot of times people think when they have to do rehab or pre-rehab, they think they have to set aside an hour to make this happen. And you’re saying, “No, you don’t have to do that. Just do this throughout your day.”
Vinh Pham: Yeah, exactly. Let’s say you’re sitting, let’s say you’re sitting for an hour. You’re probably doing this for like a good five minutes in total and that then you’re good. That’s it?
Brett McKay: That’s good.
Vinh Pham: Yeah.
Brett McKay: Beyond these movements. Okay. Let’s say you wanna set aside some time, right? Where you wanna work on future proofing your body. What’s something that someone could do, I don’t know, for 15 minutes after a workout that can help, that can go a long way to preventing some of these issues that come from bad posture.
Vinh Pham: I have the whole routine set out in my book. So like you would be doing that routine once a day or twice a day. The entire 12 exercise sequence is gonna take you about like 10 to 15 minutes if you’re doing one set per exercise.
Brett McKay: Got you.
Vinh Pham: And if you’re really busy, I would say actually the three exercises that I gave you, are probably the main three I would do, very simple.
Brett McKay: That’s nice. What about foam rolling? What’s you take on foam rolling? Is that useful?
Vinh Pham: Yeah. Foam rolling is good. It definitely warms up your nervous system and yeah, it just allows like transient. It gives you a period of time where you can move better and then in that period of time, you can access more range of motion and it just helps you. It’s a good warm up, I would say.
Brett McKay: Yeah. So you do do foam rolling as a warm up?
Vinh Pham: Yes, absolutely. As a warm up for sure.
Brett McKay: Okay. And as you said this stuff isn’t rocket science. If you just, okay. You, again, work on moving more, focus on your posture, do some of these corrective exercises throughout the day and it’s not gonna, it could be overnight, but it’s gonna be one of those things as you do this more and more, you’re gonna start seeing the benefits come to you. It just has to become part of your routine.
Vinh Pham: Absolutely. It’s just when it comes to dental hygiene, you don’t… How do you get nice teeth over time? You gotta brush your teeth every day. You don’t automatically assume, “I’m gonna have to just brush my teeth one time and never have to do it again.” [chuckle]
Brett McKay: Right. I wish it was that way.
Vinh Pham: When it comes to like resetting the level of dirt in your body, it’s the same thing you shower every day. Hopefully. [chuckle]
Brett McKay: Hopefully. Well, a lot of people didn’t do that during the pandemic either. They just… I guess they went to go… I hear it was called Goblin mode where you just kind of not bathe and just wear your sweatpants.
Vinh Pham: Totally.
Brett McKay: Well, Vinh, this has been a great conversation. Where can people go to learn more about the book and your work?
Vinh Pham: Yeah. So they can go to myodetox.com, which is my brand of clinics, or they can go to my IG, which is Vinnie Rehab. V-I-N-N-I-E R-E-H-A-B. And they can also pick up my book, Sit Up Straight, which is in stores now and Amazon and everywhere.
Brett McKay: Fantastic. Well Vinh Pham thanks for your time. It’s been a pleasure.
Vinh Pham: Thank you so much, Brett.
Brett McKay: My guest today was Vinh Pham. He’s the author of the book, Sit Up Straight, it’s available on amazon.com and bookstores everywhere. Check out our show notes at aom.is/posture, where you can find links to our resources and we delve deeper into this topic.
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