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Planning Retirement Online

Home Exercise and Rehab

March/April 2014


Gina John

Gina John is a Pilates Practitioner and Registered Osteopath who has spent many years offering help and advice, especially to the over 50 age group.

She is founder of The Osprey Clinic in the St. Johns Wood area of London and now specialises in Home Exercise and Rehabilitation Programmes. For further advice on exercising safely, and a selection of exercise films for general fitness and medical conditions, visit the website:



This month: Improving posture to resolve upper back pain.

Q: I often feel terribly stiff between my shoulder blades, when sitting for long periods. My shoulders and upper arms will also start to feel weak unless I start to walk about. Can this problem be resolved by improving my posture or exercise?

A:The body has evolved to facilitate movement. So, we may not cope well with the demands of contemporary living; such as with long periods of computer use, or being seated at the theatre or cinema.

Our postural muscles work at around 25-30% of maximum contraction when functioning efficiently. We contract muscles around the hips, abdomen, pelvic floor, spinal column and shoulders to maintain the sitting posture. Conversely, the muscles which create movement are activated by up to 100% of maximum contraction during activities, depending on whether we are walking, running or dancing.

Our postural muscles start to fatigue when we sit for protracted periods and the body makes compensations to be able to maintain posture, such as poking the chin forwards, or rounding the shoulders and low back. This modus operandi is the body’s way of acquiring additional postural support, by recruiting the mobilizing muscles. Since the fibre composition of mobilizing muscles is designed for short periods of activity rather than prolonged postural support, fatigue and muscle pain ensues.

Sitting with a slouched posture, weakens the muscles between the shoulder blades, called the Rhomboids and the Trapezius muscles, as well as the Serratus muscles located beneath the shoulder blades. When these muscles are inefficient the upper back and shoulders may start to feel tight and painful, and the upper arms may feel heavy and weak.

Degenerative changes and arthritis in joints of the neck (cervical spine) may also contribute to back, shoulder and arm pain and weakness. When the joints in the neck become inflamed, pain may be referred to the upper back and over the shoulders. Muscle imbalance of the neck and shoulders is often associated with degenerative changes and may irritate or compress the nerves which run from the neck to the shoulder and arm muscles. Treatment by a Physiotherapist or Osteopath will be helpful to rebalance the muscles, and your GP may prescribe anti- inflammatory drugs.

If upper back pain is intense and there are associated arm or chest symptoms which are aggravated by physical activities, it is important to consult your GP. These may be symptoms of serious cardiovascular problems and must be investigated promptly.
A daily programme of strengthening exercises and gentle stretches will help to improve symptoms which are associated with poor posture.


Diamond Press
Lie face down on the floor or a firm bed and place a pillow under your abdomen.
Start by placing your hands beneath your forehead with your elbows pointing out to the sides. Draw back your abdominal muscles firmly, by scooping in the navel towards the spine. Exhale as you lift your head from your hands, while trying to squeeze your shoulder blades towards the back of your waist. Inhale to hold the lifted position and exhale as you lower your forehead back to your hand again. Repeat up to 15 times.

Chair Twist
It’s a good idea to do this exercise, to take a break from the computer every 15 minutes! Sit upright, and draw back the abdominal muscles, scooping the navel towards the spine. Twist your body to the right, taking the right arm behind the back of the chair while the left hand assists in holding the rotated position by pressing onto the right thigh. Hold the position and take 3 deep breaths, while pressing the shoulders blades down towards the back or your waist. Then repeat the exercise, turning your body to the left.

Front of Arm Stretch
Stand about a foot away from the wall with the right side of the body facing the wall. Place the palm of the right hand on the wall behind you, with the elbow stretched out. Turn the body away from the wall, to feel the stretch at the front of the shoulder and along the front of your arm. Hold the stretch for around 20 seconds and then repeat on the left shoulder and arm. .


See all Gina's Home Exercise and Rehab features

Please send your questions for Gina John to answer in next month’s column to:

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