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Imagery - An innovative way to improve your posture

Poor posture can lead to headache, neck pain, shoulder pain, low back pain, and fatigue.  Good posture projects confidence!  So, here are some images to help you improve your posture:

Images to help you improve your posture:

  • Sit or stand as if someone is gently pulling you up by your ears
  • Stand on your feet as if they each are tripods - there should be equal weight on the two sides of the balls of your feet and on your heels
  • Stand as if your body is a helium balloon and your feet are anchoring you to the ground
  • Sit as if your seat is a rocket ship and your heading for the moon
  • Pretend you have videocameras filming from the front of your shoulders and out your chest bone and you’re filming the scene in front of you
  • Spread your collar bones outward as if they are smiling
  • Pretend your knee caps are flashlights and they are shining forward
  • Pretend your pelvis is a bowl filled with water, maintain the alignment of your pelvis such that the water doesn’t spill forward or backward

Common misconceptions about posture:

  1. The spine should be flat and without any curves - Actually, there are natural curves in the spine.  Your vertebrae that support your neck and low back curve forward and the vertebrae that support your mid-back and sacrum curve backward.
  2. You should stand with your shoulders back, chest forward, and chin up (think military posture).  - Actually, your ears should be directly in line with the middle of your shoulders, your front ribs should not be flared open, and the tip of your nose should point straight in front of you.  
  3. Your posture is fixed and you cannot improve - It’s true that the muscles that support your posture are endurance muscles and they take time to train, but they can get stronger and support a new posture!  With some stretching, self-awareness, and persistence, you can improve your posture.  

Some tips for the desk jockeys

  • Take a 10 second break every 20 minutes.  During those 10 seconds, do one of the following: 
    • Roll your wrists
    • Change the focus of your eyes
    • Roll your shoulders backwards
    • Stretch your arms above your head or horizontally in front and behind you
    • Gently tilt your head side to side
    • Stand up 
    • Stretch one of your legs behind you (staying seated)
    • Gently twist your trunk in your chair
    • Touch your toes
    • Get some water

Post this guideline at your work station as a reminder!  

Written by Dr. Alyssa Herrera-Set, Physical Therapist -


Book of Mormon!

I’m currently working with The Book of Mormon performers at the Orpheum in San Francisco. Finally saw the show last night and it was hilarious!

I’m currently working with The Book of Mormon performers at the Orpheum in San Francisco. Finally saw the show last night and it was hilarious!

ACL Injury Prevention

The Anterior Cruciate Ligament (ACL) is one of 4 ligaments that provide stability to the knee joint. More than 200,000 people per year experience ACL injuries. Non- contact ACL injuries usually occur with sudden stopping, awkward landing from a jump, or pivoting with the foot planted on the ground. The consequences of an ACL injury potentially include surgical repair, a long rehabilitation period before returning to sports, and in the long run, a higher risk for knee arthritis.

! The good news is that recent studies suggest that certain exercises decrease the chance of ACL injury. Athletes should be examined by a health professional such as a physical therapist to assess strength, flexibility, and mechanics. Itʼs best when these exercises are started with young athletes before poor technique becomes a difficult habit to break. With the help of a coach, trainer, or therapist, an athlete can implement an exercise program to prevent the chances of ACL injury.

Exercises you can do at home to prevent ACL injury:

  1. 1)  Squats - Lower into a mini squat by bending at your knees and hips. Make sure that

    your knees go straight forward (in the same direction as your feet) and they stay behind the front edge of your toes. Maintain the space under the inner arches of your feet and draw in your abs to make sure your spine stays neutral. At the bottom of your squat, your shoulders should be in line with your knees and toes and the side of your hip should stay in line with your heels.

  2. 2)  Single leg heel raises - This exercise is to improve balance, core strength, and leg strength. With very little or no hand support, stand one foot and rise up to the balls of your feet. Make sure your ankle stays in alignment with your foot and leg, your spine stays neutral, your hips stay even, and your knee stays straight.

  3. 3)  Jumping- with feet about 4” apart, use the squat technique and heel raise technique from above to launch your jump. Try jumping in place, forward, backward, and side to side and turning. With every jump, make sure that the alignment described in the first two exercises is maintained. Your knees should stay 4” apart just like your feet.

Remember, the most important aspect of these exercises is to perform them correctly - not to feel the “burn” or push until you canʼt do more. Start by doing them in front of a mirror and then take these techniques to the field, gym, or dance studio!

Written by Alyssa Herrera-Set, DPT

The Core of It: It’s More than Just the Six Pack

We’ve all heard how important it is to “strengthen your core”. Having a strong core is said to improve your sports performance, prevent low back pain, and trim your waistline.

What is The Core? Most people would answer this by putting a hand on top of their mid-section. Or, they simply grab their abdominal fat and look up with a guilty smile. The core, the magical muscle whose strength is said to fulfill all of the aforementioned promises, is actually comprised of multiple muscles including the transverse abdominis, the obliques, and the multifidus. At the top of the core is your diaphragm which attaches to your ribs and lumbar spine. At the bottom of your core are the pelvic floor (aka kegel) muscles. There are more muscles in the trunk, but the abdominal and back muscles that protect your spine, the true core, have multiple short distance attachments to the spine and pelvis. They tighten just enough to stabilize the center of your body allowing your extremities to work from a stable base. Some consider the gluteal muscles as part of your core because their attachment to the pelvis and the legs are important in keeping your pelvis in alignment when you’re standing.

How does the core protect the spine? The core muscles are like an internal corset. They protect your spine and the spinal nerves because they wrap around your trunk and draw the contents of your abdomen inward. They keep your vertebrae stacked on top of each other and maintain the integrity of the 4 natural curves of the spine.

What about the Six Pack Muscle? The most famous abdominal muscle, the rectus abdominis or “six pack” muscle, has very little to do with protecting the spine. The action of the rectus abdominis is to flex your trunk forward. It spans multiple segments of the spine and cannot prevent excess shearing or twisting of the spine. When done correctly, the exercises used to strengthen the rectus abdominis can challenge the true core muscles, but, performed incorrectly can increase back pain and perpetuate a hunched posture. The erector spinae of the back help extend the trunk and maintain posture but their long distance attachments spanning multiple vertebrae don’t add strength to your body’s internal corset.

Check back next month for tips on how to strengthen the core!

If you can’t wait, you can contact me with questions or requests for future articles: Alyssa Herrera-Set, DPT at