Pre-Ski Routine!

Winter is in full swing and so is ski and snowboard season. For those of you who are hitting the slopes over the next few months, it’s time to take your body as seriously as your skiing. It’s also time to make sure your body is balanced and ready to go before bombing down the hill and weaving through the bumps.

Many people feel they turn better to one side. This is because turning to the left requires you to transfer your weight to the inside of your right ski. Your ability to transfer your weight from your left, accept it on your right, and keep the edge on your ski depends entirely on the function of your hips. Hip imbalance and uneven weight distribution results in both poor weight transfer and loading response, which ultimately leads to not very good skiing!

Try these exercises before you ski and you’ll notice a major difference in how you feel on the mountain. With better balance and hip function you reduce your chance of injury and you’ll tear it up out there!

Sitting Knee Pillow Squeezes

Sit on the edge of a chair with your feet pointed straight ahead and a pillow between your knees.  Roll your hips forward to make an arch in your lower back and then squeeze and release the pillow with your knees.  Do 3 sets of 20 repetitions.

Static Extension

Kneel on a large block or chair with your hands on the floor in front of you, with your shoulders directly above your wrists and hips above the knees.  The hands should be place shoulder width apart with the palms flat on the ground and the fingers pointed straight ahead.  Walk your hands forward about 6 inches and shift your upper body so that your shoulders are again over your hands.  Your arms should be straight with your elbows locked and your hips in front of your knees.  Relax your low back and allow it to arch by tilting your pelvis and collapse your shoulder blades together while dropping your head down.  If your low back begins to hurt, bring your hips back so they are closer to the knees.  Hold this position for 3 minutes.

Upper Spinal Floor Twist

Lie on your side with your shoulder underneath you, your knees and ankles stacked together, and bend your hips and knees at 90 degrees. Keeping the knees together, bring your top arm up and over towards the floor as you rotate your torso in the opposite direction of your knees. Breathe deeply and hold. Let your hand and shoulder continue to drop towards the floor. Turn your head towards your open arm as far as is comfortable. Hold for 1-2 minutes and then switch sides.

Floor Block

Lie on your stomach with your forehead and nose flat on the floor and the tops of your feet on the floor with your big toes touching and heels dropped out.  Place your hands on some pillows or books that are about 6 inches high directly above your shoulders and lock your elbows and point your thumbs toward each other in a golfer’s grip.  Rotate your thumbs to point at the ceiling with the movement coming from your shoulders and hold this position for 1 minute.  Move your arms, while keeping them rotated, out to a 45 degree angle from your shoulders and hold this position for 1 minute.  Next, move your arms out to a 90 degree angle from your shoulders, while maintaining the rotation in the arms from the shoulder, and hold for 1 minute.

Free Squat

Stand with your feet pointed straight ahead and hip width apart.  Raise your arms straight out so they are level with your shoulders and your palms are down.  Stick our butt back to place an arch in your lower back and bend your knees to lower yourself down while keeping your upper body straight.  Hold this position for 1 minute.

Neck Pain

If I had a nickel for every client I see with neck pain, I’d be buying the Warriors. It’s way too common and very misunderstood. We blame sitting at our computers, carrying our kids, riding our bikes, and everything other than the real culprit: Our posture.

Head Position
The head weighs roughly 10-12lbs and is designed to sit directly over our shoulders. When a head is correctly positioned, the muscles of the shoulders, upper back and neck work efficiently with minimal effort to keep it aligned. If the head moves forward, even if it’s just an inch from our shoulders, all the neck and upper back muscles go into overdrive to keep it from falling further. Leave it forward for hours, days, or in many cases, years, and you’ve got a situation where the neck muscles will tell you they’ve had enough.
Furthermore, when the head sits habitually forward, the cervical spine is no longer compressed evenly from top to bottom. This leads to excessive stress on the lower cervical vertebrae resulting in all the symptoms you’ve heard of before: degenerative and herniated discs, cervical stenosis, and pain.

Posture Check
A really easy way to check for a forward head is to stand with your heels, butt and shoulder blades against the wall. Your head should be able to easily rest against the wall without exerting any effort to keep it there. If there is any effort, strain or even pain involved in trying to bring it to the wall, then your head and neck are no longer in line with your shoulders, hips, knees and ankles and you have a posture problem!
Your head and neck don’t move forward and out of position by themselves. Since the body is a unit, you have to look at the bigger picture. They are attached to a spine, which also connects your shoulders and your hips. Therefore, to fix the forward head and neck you really need to restore the position of the entire spine by addressing the dysfunctional muscles from the pelvic girdle on up.

The Fix
These exercises will begin to restore the position of your major load bearing joints in order to bring your head back over your shoulders without you consciously thinking about it.

Static Extension Position
Start on your hands and knees with your hands directly under your shoulders and your hips about 3” forward of your knees. Let your stomach relax and your back sway to create an arch throughout your entire back. Let your shoulder blades come together and drop your head. Keep your elbows straight and hold for 2 minutes.

Upper Spinal Floor Twist
Lie on your side with your shoulder underneath you, your knees and ankles stacked together, and bend your hips and knees at 90 degrees. Keeping the knees together, bring your top arm up and over towards the floor as you rotate your torso in the opposite direction of your knees. Breathe deeply and hold. Let your hand and shoulder continue to drop towards the floor. Turn your head towards your open arm as far as is comfortable. Hold for 1-2 minutes and then switch sides.

Static Wall
Lie on your back with your arms out to your sides and your legs up the wall. Contract your thighs and push your knees towards the wall. Keep your knees and feet pointing straight ahead rather than turned out to the side. Flex your feet back towards you and hold for 3 minutes. Get as close to the wall as possible while keeping your butt down on the ground. There should be medium to no stretch in the back of your legs, so if it’s too much then scoot back until it’s more comfortable. Relax your upper back and shoulders!

I recommend doing these exercises every day for 2 weeks. Once you’ve restored the alignment and function of your hips and shoulders your head and neck will go back to where they belong.

Got Tennis Elbow?

Tennis elbow, also called lateral epicondylitis (inflammation of the tendon that attaches to the outside bony part of the elbow), is common to over 1/3 of all tennis players at some point in their lives. Typical symptoms are pain in the outside of the elbow when grasping things (shaking hands), or cocking the wrist back. You might feel it during any stroke, but especially a forehand due to the position of the wrist and the stress on the lateral part of the forearm. Typical treatment for the symptom is rest, ice, and anti-inflammatory pain-killers. I highlight the word symptom, because that’s exactly what it is, a reflection of a larger problem. The cause, is not the elbow, or the tendon across the elbow, or your tennis racket, or your age. It’s the position and function of your shoulder.

The shoulder is an anatomical thing of genius. It’s flexible enough to move in all directions and in all planes, yet stable enough to allow you to walk on your hands and swing from trees and not break your neck (at least, that’s how it’s designed). Yet, if the shoulder is out of position in any way, the entire chain of muscles, bones and tendons throughout the arm, hand, and wrist, are compromised. To see what I mean, take a look at your shoulder and arm in the mirror from the front. Chances are, your hand is sitting in front of your body, rather than at the side, and you’re looking more at the back of your hand than just the thumb and pointer finger (internal rotation of your upper arm bone). Your tennis playing shoulder might also be lower than the other. From the side you will see that shoulder, or both shoulders, rounding slightly forward, meaning the shoulder blade and shoulder joint are out of position, and stuck in flexion. If any, or all, of these postural imbalances are present, then you have a shoulder dysfunction. When it comes time for you to hit a tennis ball, instead of your shoulder doing its job of rotating, stabilizing, flexing and extending, the elbow and wrist substitute for those tasks. The shoulder limitation then forces the wrist and elbow to become the major sources of force production, which is a job they aren’t designed to do. Hit like this for a few hours, days, or even weeks and now those muscles and tendons, which attach directly into that elbow, get awfully sore, and tired and they tell you with pain.

The short-term solution, of course, is to continue to rest and ice, but to permanently solve your elbow pain you need to change the position of the shoulder. Here are some exercises that will help restore the position, and function of the shoulder, and relieve the pressure off the wrist and the elbow.

Standing Arm Circles: This exercise restores the ball and socket function of the shoulder that is lost when a shoulder is stuck in flexion (rounded forward). It will also begin to ask the muscles of the wrist, elbow and shoulder to work together again as a unit.

To do this exercise: Stand with your head up, feet squared, and arms at your sides; put your hands in the golfer’s grip, with fingers curled, knuckles flexed, and thumbs extended.  Raise your arms to your sides, keeping your elbows straight, palms down, and thumbs pointing forward.  Lift your arms until they are level with the shoulders.  If one shoulder wants to wobble forward or pop up, lower both until they stay level.  Now squeeze the shoulder blades together slightly, and rotate the arms forward (in the direction your thumbs are pointing) in a six inch diameter circle.  Do it twenty-five times.  Reverse the circles by turning the palms up and thumbs back.  Repeat for a total of fifty times in each direction.

Standing elbow curls: The shoulder is a hinge joint as well as a ball and socket, and this exercise restores that function. It also restores the function and motion of the shoulder blades.

To do this exercise: Using both hands and the golfer’s grip (see Arm Circles), raise the palm-out so that the flat area between the first and second knuckle joints of the index and middle fingers rests on the temples in front of the ears; the thumbs are extended downward, parallel with the cheeks.  Draw the elbows back evenly and in line with the shoulders.  From this starting position, slowly swing the elbows forward until they touch in the front.  Keep the knuckles in contact with the temples, the thumbs fully extended and the head erect.  If the head moves back and forth, stand up against a wall, slow down, and breathe deeply.  Do twenty-five Elbow Curls.

One Arm Circumduction: This exercise restores the normal glide function within the shoulder joint.

To do this exercise: You will need a low bench that will allow you to stand beside it with one leg straight and the other bent at 90 degrees while resting on the surface of the bench.  Bend at the waist, placing the hand that is opposite to the straight leg palm-down on the bench for support.  Position a five-pound weight under the free hand, where you can reach down and pick it up.  The weight should be in a vertical position so that you can grasp its head.  Hold the weight lightly – don’t clench your hand or throw your arm muscles into a hard contraction – as you gently swing the fully extended arm in a small circle.  Your arm isn’t “windmilling” up and over the head and around; it is inscribing small, easy circles on the floor.  Circle twenty times clockwise, and twenty times counter clockwise, then repeat on the other side.

Upper Spinal Floor Twist: This exercise restores rotation to the spine and puts the arms and shoulders back in the same plane.  To do this exercise: Lie on one side in the fetal position with your arms straight out ahead of you on the floor.  Open the top arm to the other side and look in the same direction.  Do NOT let your knees come apart while moving the arm to the other side.  You can take your bottom arm over to hold the knees together.  HOLD this position for one minute and allow your body to open up.

Gravity Drop: This exercise gets the shoulders, hips, knees and ankles to reconnect under vertical load.

To do this exercise: Wearing rubber soled shoes for traction stand on a step or stairway as though you were climbing upward.  Feet are parallel, and hip width apart.  With one hand or both, hold onto a railing or other object for support.  Edge your feet backward until the heels are off the stairs and your feet are hanging onto the stair with the balls of your feet.  Make sure feet remain pointed straight ahead.  Let the weight of your body drop your heels off the stair.  You will feel a great stretch in your low leg musculature.  The key is to keep your hips over your heels and your shoulders in line with them as well.  Hold for three minutes.

Barefoot Running

Check out this article on barefoot running.. At Egoscue we’ve been telling people for years to go barefoot as much as possible. The muscles of your foot and ankle need stimulus to maintain their strength and function. If you’re wearing shoes all day, especially shoes with “extra support and stability” your foot and ankle muscles just get weaker because the shoe is doing the stabilizing work for them.  Here’s an excerpt from Pete’s book The Egoscue Method of Health Through Motion..”The shoe manufacturers are selling shoes for dysfunctional feet- feet that are pronating, supinating, bearing weight improperly. The shoe design masks the symptoms of dysfunction-or attempts to- and those symptoms move into the ankle, the lower leg (shin splints), the knee, and the hip.”

Barefoot walking and running allows the foot to regain its strength, stability and function. Take it one step at a time though and make sure you allow your foot to get used to the new stimulus. In other words, walk before you run!


Egoscue is a process, we all know this… but do we REALLY know it?  We always remind our clients that the onset of pain is rarely instantaneous, and therefore the path to becoming pain free will take time.

Although I discuss the fact that it takes time to become pain free with the majority of our clients, I am completely guilty of having those moments of frustration where I just want a quick fix.  These moments tend to sound something like this:

David:  Yes?
Me: My hip/knee hurts.
David: Did you do your menu today?

From here, we have two possible scenarios…

Scenario #1

Me: Yes, and I feel better than before I did it, but there’s still some pain.
David:  How long have you been in pain and how many surgeries have you had?
Me: 13 years and 7 surgeries
David: So, your body has been out of alignment for over a decade and you’re currently experiencing some pain, but nothing like before?
Me: Yes… and the pain lessens when I do my menu.  So I should remember that my body has been through a lot and that it’s not going to get better after doing a menu one time.  And whatever pain I’m experiencing is just a part of the process of my body coming back into alignment?
David: YES!

Scenario #2

Me: No.
David: Why not?
Me: Because I’m frustrated.  Because, logically, I get it- my body has been “messed up” for years now and it’s silly for me to think that my body is magically going to be fixed this instant, but I am so sick of being broken and having to do menus everyday…
David: But you aren’t broken and the menus help.  What can you do now, that you couldn’t do a month ago?
Me: I can do lunges the length of the clinic.
David: Right.  And what can you do that you couldn’t do six months ago?
Me: Go on a six mile walk through the city and not be in any pain- during or after.
David: The fact that you can do these things is showing you that the menus help, not matter how frustrated you feel.  Menus mean change and progress, and you KNOW that.
Me: Right.  I’m going to go do my menu now….

I think we all have those moments where we lose our objectivity about our bodies and pure emotion takes over.  Pain is frustrating, and it would be ridiculous for me to pretend otherwise.  But if you can put your pain into the larger context of your life, you’re more likely to see the progress you are making and remember that becoming pain free is a PROCESS!

Rethinking Soda

This is a great article on soda and it’s unhealthy role in our society!

Thanks to Brian Bradley in San Diego for reminding us about this issue!


A very cool article about Anterior Hip Replacements, which are less invasive than the standard approach.