Chapter 17

Flexibility, Corrective Exercises, and Posture

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I say with humor – if you haven’t figured it out already, this book is not like other books out there. Part four, especially follows an order of interventions that is likely counterintuitive for many movement professionals.

Here is my logic around this – and centers around people with PD who are reading this book:

• We want the person with PD to start moving better as quickly as possible

• Chapter 13 and 14 focus on increasing sensory input to wake up the nervous system and brain. This will help to improve movement faster than a more traditional approach of doing flexibility and posture related exercises first

• Chapter 13 focuses on vibration which can usually be self-administered

• Chapter 14 focuses on kinesiology taping. While taping is seldom self-administered, you do not have to be a movement specialist to learn how to apply taping. A caregiver can easily acquire tape, read chapter 14, watch videos on the support website, and administer

• If the person with PD tends to fall, chapter 15 goes deep into foundational movement patterns that teach how to leverage the body to navigate back to safety. This builds strength in a unique and functional way

• Once the person with PD is up and moving again, chapter 16 covers material related to improving gait and reducing the risk of falling With that said, we will now move forward and discuss posture and flexibility and corrective exercises and movements that will work towards improving posture.

Posture

Over the course of time, a combination of lifestyle and disease pathology cause many with PD to have a forward posture. While forward posture is common in today’s society, it tends to be more pronounced in the PD population.

Kinesiology taping, barefoot stimulation, and postural exercises (our focus for this chapter) will help to improve posture.

Why is posture so important? Optimal posture makes for optimal movement. Compromised posture leads to movement compensation patterns, pain, compromised movement, and increased fall risk.

Corrective Exercise (and Flexibility)

Corrective Exercise is defined as a technique that leverages an understanding of anatomy, kinesiology, and biomechanics to address and fix movement compensations and imbalances to improve the overall quality of movement during workouts and in everyday life.

Corrective Exercise is used to help assess and determine the root cause of imbalances and faulty movement patterns that lead to issues with posture, balance, and total body coordination. (NASM, n.d.)

We will use several corrective exercises to work towards improving posture.
Important notes:

• General corrective exercise concepts will be covered in this chapter
• Detailed corrective exercise instruction can be found on the support website
• The person with PD who has a forward posture has likely adjusted to a new forward center of gravity
• Standing up straight too quickly may cause a disorientation, increasing the risk of falling backwards!
• Our postural corrective exercises will focus on attaining an improved posture.
Movement specialists:

As with any patient or client, base your corrective exercise programming on client assessments

Use your knowledge and experience combined with information from this book to design your client programming and intervention strategy. We teach what we generally find to be most helpful. Be safe but be creative and think outside the box. That’s usually where the magic happens that helps people to move better.

Parkinson’s Posture

A stooped forward posture is common in the Parkinson’s population. Figure 17a portrays what we often see.

Figure 17a (Anderson, n.d.)
The anterior chain is in a flexed position while the posterior chain is on slack. Our postural corrective exercise intervention will involve releasing and stretching the anterior (flexed) muscles and strengthening the posterior chain.

Important note: We will cover a general postural exercise intervention in this chapter. To learn the detailed intervention process, visit the support website at www.thepdbook.org
Flexed muscles (release and stretch)

Tight or flexed muscles are in a shortened state and generally include:

  • Levator scapulae
  • Suboccipital muscles
  • Pectoralis minor
  • Latissimus dorsi
  • Hip flexors
  • Hamstrings
  • Lateral gastrocnemius

Other tight muscles may include:

  • Hand flexors
  • Bicep brachii long and short heads
  • Peroneus longus
  • Peroneus brevis
  • Vastus lateralis
    These muscles typically need to be released and stretched.
    On the book support website, visit the Corrective Exercise tab and from the dropdown menu, visit SMR (self-myofascial release) tab first. You will learn release techniques for every muscle listed above. Next, from the Corrective Exercise tab dropdown, select the Stretches tab to learn stretches for all the muscles you just released.
    On the support website, in addition to release and stretching techniques, you will find several videos on the BIG MOVEMENTS tab. Big and exaggerated movements are highly beneficial when battling rigidity and working to improve posture. They are an especially important part of exercise programming and best of all, can be done anywhere!Elongated muscles (activate and strengthen)
    Elongated or weakened muscles generally include:
    • Deep cervical flexors • Erector spinae • Middle trapezius • Rhomboids
    Other elongated or weak muscles may include:
    • Gluteus maximus • Gluteus medius • Tibialis anterior • Tibialis posterior

These muscles typically need to be activated and strengthened.

Chapter Summary

Poor posture leads to poor movement, an increased risk of falling, and is commonly accompanied by pain.

Using the information in this chapter in addition to sensory input tools (Naboso products, RockTape, vibration therapy) and videos on the support website, you will be able to take steps every day to improve posture and optimize movement