Part 2. Velma: Mesomorphic? Asthmatic? geek

As a geek, Velma takes herself and solving problems seriously. Her apparently short neck and raised shoulder posture are typical of mesomorphic body types and also of long-term asthma sufferers. Velma is likely to take her health seriously – her seriousness lends itself to being a supersleuth!

What is the CAUSE? Velma’s poor posture

Velma’s posture is seriously upright (what we often think of as ‘good posture). This is both compensation for a serious need to exhale during asthma attacks (by recruiting her ‘accessory muscles of respiration’ such as scalenes) and trying to grow taller when standing next to lanky best friend Shaggy.

As a mesomorph, daily recruitment of her postural extensor muscles (trapezius, erector spinae, quadratus lumborum) has shortened her back muscles so much that her posture mimics that of uncorrected spondylolisthesis (a defect in the spine causing instability and excessive muscle tension) although she’s probably just hyperlordotic. Check out her running posture – rigidly flexed at the hip (contracted psoas), rigidly extended at the back (lumbar erector spinae and quadratus lumborum).

Sustained muscle tension means she’s STIFF. She can’t relax and although she doesn’t necessarily have stiff joints prolonged muscle contraction makes her feel like she can’t bend anything. She has never been able to touch her toes. Although she doesn’t obviously have poor posture, she really needs to learn how to stretch and relax.

What is the CONSEQUENCE? Velma’s symptoms

Velma doesn’t know what relaxing muscles can feel like. She has constant tension headaches manifesting as persistent pain at the back of her head and around her hat band area. In her 30s she may develop migraine without aura.

Because she doesn’t easily relax, her trapezius and levator scapulae muscles are short and bulky (disguised by her cool rollneck jumper). She gets dull shoulder and neck pain which usually feels bruised, but periodically causes burning shoulder pain that prevents her from working at her computer.

When she goes to bed at night she may experience dull, low back pain – common to hyperlordosis posture – that doesn’t resolve and often wakes up with back pain (particularly if she has uncorrected spondylolisthesis). She feels better after exercise but this threatens to trigger her asthma so she doesn’t relish running (except in pursuit of villains with the team) or conditioning.

What’s the best treatment? 

Velma’s fatigued shoulder and back muscles need outside help to relax. She is the sort of person who benefits from and probably loves deep tissue massage. She probably craves sports massages (but probably finds them painful!).

She’ll benefit from any treatment that assists relaxation: traditional Chinese acupuncture and gentle osteopathic manipulation and cranial osteopathy that focus on joint movement and progressively lengthening passive and active muscle stretching to help her body recover a sense of space and softness.

Spinal manipulation demonstrably helps people relax the muscles around the manipulated joint. If Velma’s muscles are acutely painful and feel like they’re burning (which we term ischaemic muscle pain), spinal manipulation combined with stretching and MET can create a lot of helpful release that doesn’t further irritate the muscle (allowing it to be massaged later on to stimulate vascularisation).

FUTURE: Short-, medium- and long-term management

Velma urgently needs to stretch her short, tight extensor chain musculature and integrate it into muscle recruitment using her entire body. A good strength and condition coach, Pilates, or yoga instructor can guide her to effective active stretching. Like a lot of people with short tight muscles (often men), she may find stretching particularly difficult or painful.

People with very busy minds also worry they’ll find yoga boring, so reformer Pilates can be very helpful to condition adrenaline junkies and Alpha type personalities into disciplined whole-body workouts.

Some breathing disciplines such as Buteyko, physiological exhalation and ujjai breathing that focus on prolonged exhalation will help her condition her muscles of respiration that will improve her breath control in all circumstances.

Desk posture

When she works at a desk Velma needs to be aware of the following

• Laptop at eye level (use laptop support if needed)
• Forearms supported by the desk for their entire length to the elbow – so desk depth is very important
• Chair height allowing 90 degrees of flexion at both hip and knee
• Don’t rely on chair back support all the time (a good ratio is 30 min off/30 min on)
• Velma may also benefit from sitting on a Swissball instead of a chair to let her tilt her pelvis in all directions to relax her low back muscles
• Velma could lie in bed looking at screens for short periods if it helped her muscles relax!