The Revolutionary Bone that No One Talks About

It was a beautiful sunny day, not too hot with a nice cool breeze. As I jogged along the trail that passes through the meadow by my house, taking in the thousands of bright blue chicory flowers, I reflected on how lucky I am to live in such a beautiful place, to have a healthy body…. OUCH!

My knee was bugging me again, as it sometimes does when I’ve been running a lot without much cross training. Not that long ago I may have endured it, knowing that I would do some manual therapy or soft tissue work when I got home to try and coax my body back into a better alignment. Maybe I would have checked out my running form-making sure my core was engaged, and that my cadence was just right.

But today I know more. Thanks to the postural restoration institute, or PRI for short, I have such a deeper understanding of how so many things affect our movement and anatomy. I knew that the best thing I could do was just be more aware of the left side of the trail as it whizzed past. As I did that, my knee instantly felt much better.

Wait whaaaat??? Yup. Seriously. I simply became more aware of my left peripheral vision, which made my knee feel better.

Little disclaimer here…this is not to say that everyone who goes running will instantly be painfree by looking to the left, everyone has unique needs and nuances.

That said… it is a good idea to be aware of your peripheral vision when running and in general…more on that later.

But WHY??? Why would what I’m doing with my eyes affect my knee pain?

It’s all because of this special bone at the center of our head called the sphenoid.

Before we get into what this could possibly have to do with my knee, we should first ask ourselves…

Why Is the Sphenoid Bone So Special?

Here are just a few reasons…

The sphenoid bone attaches to our jaw, our eyes, and our ears.
The nerves that tell us to rest or digest or fight or flee or freeze pass through this bone.
The main arteries that supply blood flow to your brain pass through this bone.
The position of this bone determines the amount of pressure on your brainstem, which contains the apparatus to help your body organize movement.
The pituitary gland, which performs life-sustaining functions, nestles nicely into a tiny protective saddle in the sphenoid bone.

I could keep going, but I think you get the point. This bone is responsible for a lot of important stuff!

Even just a tiny tweak in the position of the sphenoid could cause all sorts of repurcussions, many of which seem completely unrelated.

What Might Tweak a Sphenoid’s Position?

The way your teeth touch matters big time to your sphenoid.
- The sphenoid interacts with your top and bottom teeth via muscles and nerve endings, but even the bony position of your jaw and maxilla (the bone that holds your top teeth) push against the sphenoid in certain ways. Not to mention, the periodontal ligament is HIGHLY sensitive to pressure and gives you lots of reference as to where you are in space. This neural information is then processed by your BRAINSTEM (remember that guy?) And what’s between your teeth and your brainstem? The sphenoid.
- Have you ever had dental work done and had the position of your tooth end up just a little higher or lower? If you have, you know it. Your body knows it. Everything feels off, you can’t relax until that tooth is back to where you like it! That’s the sensitivity of the periodontal ligament and the sphenoid position at play.
Head injuries and concussions.
- I don’t think I really need to explain why a blow to the head can affect sphenoid position and surrounding function. But what most people don’t realize is that you don’t have to hit your head to get a concussion. Whiplash, blast exposure, falls, all these things can result in jostling the contents of the skull.
How you use your eyes.
- Remember, the muscles that move your eyes around attach to your sphenoid. If you use your eyes the same way most of the time (like staring at a screen, for example), this can pull on the sphenoid.
The neck.
- The poor head is at the whim of what the neck is doing. And the neck is at the whim of what the body is doing underneath it! Think of a house that is built on clay. When first built, everything is nice and level. But then, after a big rainstorm, different parts of the clay expand at different rates due to the moisture, and the foundation starts to shift and become unlevel. Of course everything above the foundation will also become unlevel. Similarly, if your body is imbalanced below your sphenoid, you will likely also have imbalance above.

Of course there are other situations where certain visual or dental changes (surgical or otherwise) can affect how you hold your body below, because, unlike a house, the body’s roof (the cranium) has just as much of an effect of where the foundation (rest of the body) sits due to all the sensory input we get from our head telling us where we are in space.

Don’t believe me? try standing on one foot. Got it? Good. Now try doing that with your eyes closed. Little harder? That’s because you’re getting information about where you are relative to the ground from your eyes, not just your feet.

Also, I have to say that if you had a head injury or dental work or vision work, this does not doom you to a life of a crooked sphenoid! It can certainly have an effect, but in most people it is manageable with the right program of manual therapy and movement techniques.

So back to my knee. Why did being aware of my left visual field help my knee?

At a purely structural level, there is some effect of letting my eye position change to pull on my sphenoid in a different way.

On a deeper, subtler, neurological level, being aware of the left does several powerful things.

Firstly, it reminds my body to become centered instead of pulling to the right, which I do (and most people do) because of our anatomy and the way our brains are wired. This is especially important for me since I have had a head injury which included broken facial bones.

Secondly, it opens up my left peripheral vision, which creates a sense of expansiveness in my body, thus allowing the sphenoid and surrounding bones to spread and widen. This takes pressure off of all those neural and vascular structures, and lets my body relax out of a state of tension.

When our bodies are held in a tense and protective state, we can’t rotate well through our torso. A side to side alternating activity like running absolutely requires the ability to rotate. If you can’t rotate at your trunk, your body will do it somewhere else. For me, it was my knee.

As soon as I let my left visual field soften and open, my body got a signal (or many signals, rather) to reposition itself into a more optimal position, subconsciously. I could rotate better, breathe better, and didn’t need to put any extra torque on my knee.

Well, I know this is a pretty heady conversation (get it? Heady? Skull? Ok I know, too punny) but it is one worth having.

Because sometimes you do all the right things and still aren’t feeling better or where you want to be with your sport, your breathing, your health, or your ability to do the things you want to do.

When that’s happening, it’s time to look at what’s happening from the neck up to determine if something there could be inhibiting your progress.

Here’s a simple but powerful technique to try that will help with restoring sphenoid position.

May 1, 2020May 1, 2020

Reduce Pain by Changing Your Outlook

If you know me, you know I love to look at research studies. Sure, they have their limitations, but it’s really cool to see things we intuitively know are good for us proven under the scrutiny of the scientific method!

Take, for example, a recent review of the literature that studies the role of a positive outlook on pain. This study is from the Clinical Psychological Society in the Netherlands.

They found that a positive outlook significantly reduces pain, and reduces sensitivity to painful events.

For people with chronic pain or other painful conditions, they found that positivity can also optimize the effectiveness of other treatments.

Wow! That is pretty amazing. But if you’re anything like me, you’re thinking,

“Well, it’s pretty hard to be happy-go-lucky when you’re in pain! How am I supposed to do that?”

This is especially true if you have chronic pain that you’ve been dealing with for a long time. It’s hard to not let that get you down, and understandably so.

So how can we use this research to make change in our pain and our lives?

My prescription for you is this:

decide, right now, that you are your own first priority.

Yup, that’s right. Before you start thinking of reasons to put yourself second (or third, or fourth…or last), consider this:

When you get on a plane, don’t they tell you to put your own oxygen mask on before helping other people? That’s because you’re not much good to anyone if you’re passed out in the aisle!

Taking care of yourself is like putting your oxygen mask on. You need to be okay before you can be there for other people in a meaningful way. Otherwise, you will end up resentful to those you intended to help, and/or you will burn out. If you REALLY want to be there for the people you love and the causes you care about, you MUST take care of yourself first.

There are so many simple, quick and effective ways to reduce your levels of daily stress, and thereby improve your mood and your outlook.

Some of the things you can do to boost your mood are quick reminders that you can include easily in your day on the fly, and others you have to plan for. Let’s take a look at both.

On the Fly Mood Boosters

I’m gonna give you some daily, stress-busting reminders to try.

Your job is to pick one or two that you can really do over the next week.

Write the one you pick on a post-it and stick it on a mirror, the refrigerator, your desk, or anywhere else you know you’ll see it a lot. You can even post reminders in more than just one place!

After a week, take a moment to notice if anything has shifted in you since you started this practice.

You might keep up with it as it is, change your reminder, or just modify yours a little. It’s your daily ritual, make it how you like it!

List of Reminders For Your Post-It:

“Breathe” (long slow inhales, longer slower exhales)
Be willing to not have all the answers.
When you’re feeling stressed, ask yourself, “what is the most important thing right now?”
Pick a different energy- whimsy, joy, playfulness, or one of your own choosing- and call it into your mind and heart.
Remove extra minor stressors when you find them (e.g. driving just a little too fast…it’s weirdly stressful!).
Be willing to ask for help when you need it.
If you’re pushing yourself to complete a self-imposed task, ask yourself, “will this matter in a year?”
Take several slow, deep breaths before each meal.
Remind yourself to “slow down” more often.
Pretend that you’re at your “vacation job” or your “vacation home,” or in your “vacation car.” How would you act differently if this was exactly what you wanted to be doing, where you wanted to be? If you CHOSE this?

Plan Your Relaxation Time

While it’s good to have little reminders in the day, nothing can match the power of actually scheduling time in your day to do something to take care of you. And, for most of us, if you don’t schedule it in your calendar, it won’t get done.

So grab your favorite pen, your planner, and block out some time for yummy self care!

Here are some ideas you can choose from, or you can come up with your own self soothing experience 🙂

Planned Ways to Reduce Stress

Practice this Active Rest Pose for 5 minutes, a few days a week.
Practice self empathy for a few minutes, especially if you are feeling down.
Take a nap!
Go for a walk outside. If possible, try not to look at your phone (or not bring it if you can!).
Buy yourself some flowers.
Leave early for an appointment and enjoy the journey getting there.
Go for a walk with your dog or child, and let them lead the way. Stop where they stop, notice if you feel impatient, and let them teach you how to slow down and savor the moment.
Use all your paid time off!
Read a book (that’s not related to work or self-improvement!)
Eat your lunch outside, and JUST eat. (try not to look at your phone, read, or listen to something).
Plan a “frump day” where you stay home all day in your comfy, frumpy clothes and do whatever you feel like. Watch movies, do some stretching, bake some cookies, take a bath.
Write a handwritten letter to someone you care for and haven’t seen in a while. Use special stationary that you like.
Lie on the couch for a few minutes. Not to listen to a podcast, sleep, or text. Just be there.
Take a 5 minute stretch break at work- make sure you’re breathing!

Not all of these may appeal to you, but I’m sure some of them do! Incorporating some spontaneous and some planned relaxation into your day can make a huge difference in your outlook, your pain, and your overall experience of life.

After all, what’s the point of all this if you’re not enjoying some of it along the way, right?

Keep taking care of yourself, and the world will reward you.

May you find ease in your body! I’ll be there rooting for you the whole way.

– Dr. Derya

April 23, 2020May 4, 2020

Listening to Your Body: Why It’s So Hard!

I wasn’t always an active person. In fact, growing up I was a total bookworm. I hated sports, I was the slowest person in gym class, and I spent most afternoons curled up with a book or watching TV.

In high school I started working out and watching my diet, and it felt really good! I was also getting more attention from classmates, the cool girls and guys who had never noticed me before were striking up conversations and inviting me to hang out. I even joined some sports teams.

Naturally, I became very attached to my great liberator, exercise. How could I not? It made me feel great, bolstered my social life, gave me energy, and all the other merits that we constantly hear about exercise.

But, there was also a dark side to this life changing health decision.

Exercise and Attachment

This last month I have been sick. Not terribly ill, but definitely not able to run and workout like I want to. And I think I have prolonged my illness to some degree by still pushing myself more than I should have. For me, I am so attached to the boost I get from exercise, that when I don’t have that in my life I start to get really down on myself. I have a good base in meditation and mindfulness practice, but I am still human and I still have my attachments. It takes quite a bit of work for me to “take it easy” and “listen to my body.” And how do you even “listen to your body” anyway?

woman feeling exhausted at work — Do I need a break, or should I keep pushing? (hint: you probably need a break!)

I hear it all the time, “listen to your body, if you need to rest, rest.” But then I also hear the opposite, “push yourself, when you are feeling tired, that’s the time to push even harder!” And, to be honest, I mostly end up just following the advice that suits my mood in the moment, but that’s not always the healthiest choice.

For example, in this recent bout of illness, my body was telling me to slow down, nap, drink tea and CHILL. But I hate the feeling of being unproductive, and when I don’t workout I feel that inner child bookworm creeping up. Or rather, I could say that I am attached to the feeling of being productive, and instead of asking how I could console this inner child that is struggling, I am pushing her away.

It doesn’t sound so good when I put it that way. But that’s the reality of it. To really understand how to actually listen to our bodies, we have to first talk about wanting vs attachment.

Getting Past the “Shoulds”

When I am really listening to my body, most of the time I still want to work out. I love the way it makes me feel, the health benefits I get, and the joy of moving my body in the great outdoors. The difference is that I am not attached to working out, because I can tune in and listen to my sensations and trust my intuition. So, if I get signals from my body that I need to rest, nap, take more time to relax, I can listen to that instead of shaming myself out of it. This is the goal, but that takes practice.

The most common way we disregard what our bodies are trying to tell is by shaming ourselves. My favorite guilt trip is, “Wow, you are being so lazy. You had so much you were going to get done today, and you’re just going to nap? How dare you! When everyone else in the world is out there working!”

Pretty mean, huh? If I talked that way to my friends, I probably wouldn’t have any. But it is not uncommon for us to talk to ourselves in this way. How can we allow for that? It stems from attachment, to the way we think we should act, should look, should engage with our world.

In order to be able to connect with our intuition, a.k.a. be able to “listen to my body,” we have to learn how to let go. To let go of the “shoulds” and get back to our sensations in the present moment.

Learning to Let Go: Two Versions of the Self

Letting go is hard. It’s hard because we feel like we are going to fall apart without the things that hold us together. For me, working out on a regular routine is one of those things. Part of me feels that if I skip a week or two of working out, I’m going to be horribly out of shape, feel awful, and be a hypocrite (because a lot of my job as a physical therapist is teaching people about exercise!). This is the part of me I call the Fear Self. But there’s another part of me that knows I’m going to be okay. This second part is what I call the Rational Self. She looks at the big picture, and knows that I will get back to working out when I am better, that by taking a real break I will heal faster and get back to my routine faster. The rational self is rooted in truth and fact instead of fear and worry.

At first, the fear self is always louder. She comes up with all sorts of reasons to be concerned, sad, and frustrated. She is small minded and short term focused.

The rational self is quieter, she’s always there but needs to be called upon to speak up. By seeing the long term results and the reality of the situation, she can make good decisions without being influenced by self imposed “shoulds.”

How To Quiet the Fear Self

To connect with your rational self means to listen to your body, in a real and non-superficial way. In order to do this, we need to first identify our fear self. By naming our fears and worries, we can clearly see how irrational and unhelpful they are. The next time you find yourself criticizing yourself, acknowledge that this is the Fear Self. Tell her that you see her, and you appreciate her concern for you, but you’ve got this one under control.

Here’s an example:

Fear self: “You are not even sick, you are just being lazy. You have all this time to be working on projects and getting fit and you’re not using it! You’ll never get this opportunity again!” (hint: all-or-nothing words like “never” are a clear sign that the fear self is talking).

Me: “Okay, I see you, Fear Self. Thank you for looking out for me, but I am doing what is best for me right now.”

It doesn’t help to get mad at or blame your Fear Self. That will just have the opposite effect. Instead, think of your Fear Self as a scared child, who needs comforting and consolation, not to be yelled at or scolded.

*Remember: listening to your body starts with being kind to yourself.

Of course, you won’t be able to catch every critical comment, but whenever you are able to go through the process of calling out the Fear Self, you are developing new neural connections that make it easier to do the next time. It is a skill to cultivate and hone.

Once you’ve identified the fear self, she loses her power. Just by naming it, you begin to see the fears and worries for what they are: intangible ways of keeping us stagnant in our old patterns. To move forward, to grow and expand as a human being, we need to connect with the rational self.

How to Connect with the Rational Self

Once the fear self is quiet, the rational self can emerge. Let’s stick with the example above.

Fear self: “You are not even sick, you are just being lazy. You have all this time to be working on projects and getting fit and you’re not using it! You’ll never get this opportunity again!” (hint, all-or-nothing words like “never” are a clear sign that the fear self is talking.

Me: “Okay, I see you, Fear Self. Thank you for looking out for me, but I am doing what is best for me right now.”

Connecting with your rational self and listening to your body

From this point, I can ask the Rational Self, “what do I really need to do right now? Am I being lazy, or am I actually sick?” Then I focus on the area of my belly or chest, and wait until I get an answer. This also takes some practice, but really it doesn’t work if you over think it. Just ask, focus on the center of your chest, and see what comes up. For me, the answer way, “Girl, you are actually sick! Rest up!” And when I heard that my thought was, “Duh! How have I been ignoring this obvious advice?”

The harder part is actually listening to that advice. And I promise you, if you continue to not listen, your body will make you listen. In the past, I’ve pushed myself to the point where I HAD to lay in bed for a while. That is my old pattern, to keep pushing and ignore those signals to slow down. I’m not perfect, that’s for sure, and it takes effort for me to change this pattern. Of course, doing the things the way we’ve always done them is easier. It’s an inertia, you’ll keep going the way you were always going unless some effort is applied in another direction.

So, as for me, I’m still working on taking it easy, and listening to those signals from my body. Sometimes I don’t want to listen, and I give in to the Fear Self. But I keep trying, and I’m getting better.

With all the latest diets, pain “cures” and workouts at our finger tips, it can be really hard to decide what works for you and what doesn’t. But the more you can connect with your Rational Self, your True Self, the easier you will be able to navigate decisions about what is best for you.

Have you ever struggled with the Fear Self, or had trouble listening to your body? I’d love to hear your story. Share your story by leaving a comments below.

May you find ease in your body.

Derya

April 21, 2020April 22, 2020

Whiplash, Pain, and the Brain.

Earlier this week it snowed a lot. Then it melted, and froze overnight. And when I took my dog out for her morning walk, well, you can probably guess what happened. I didn’t make it 20 feet from my door before my feet slid out from under me on a patch of ice and I landed hard on my butt, with my head being painfully snapped back. I was, of course, a little stunned and went back to my house to survey the damage. No broken bones, just some bruises. Over the next few days I monitored myself for signs of concussion, which , thankfully, there were none, but what I did have was a painful stiffness and ache in my neck when I tried to move my head. “Oh great,” I thought. Whiplash.

When I first walked into my house after slipping on the ice, these were the thoughts in my head, “oh no, you have a delicate neck. This is going to be so bad. You are going to be dealing with this for months. What if you have another concussion? That’s going to really mess you up…” and on and on.

Luckily, I had the knowledge and training to know that these thoughts would be the most significant factor in my speed and completeness of my recovery. Even though it was hard, I started to change my self talk. I said to myself, “this is not that bad. You’ll get over it soon with a couple days for your strained muscles to heal. You didn’t hit your head, and there are no signs that anything is seriously wrong. You’re going to be ok.”

At first, I didn’t believe these words I told myself, but I kept up with it. And, over the course of the day, I started believing a little bit of it. But more importantly, my body felt less tense and guarded. Now, three days later, my neck pain is almost completely gone. I didn’t have to go to a chiropractor or have needles stuck in my neck. I didn’t have to do any special exercises except some breathing to calm my nervous system. I didn’t even have to change my daily activities and still did what I would usually do, including exercise.

Of course, it’s not always that easy, and it has not always been the case for me to get over neck pain that quickly. I have had many neck injuries of varying severity, and the pain of them has plagued me for many years of my life. I tried everything, acupuncture, chiropractic, and of course several physical therapists. Those all helped, but my neck pain never really went away until I changed the way I thought about my pain. I know, I know, it sounds like I’m saying, “it’s all in your head.” Which is just not true. But, it is true that a lot of it is in how your head and your body talk to each other.

Pain and the Brain

You see, the brain determines levels of threat, and sends signals to our body on what to do accordingly. When your brain perceives high threat, it starts emitting neurotransmitters that tell your body to tense, to breathe more shallowly, and halt healing processes.

This is actually really good. For example, let’s say you’re a wild human and you get attacked by a tiger. You find yourself bleeding and injured, and your brain knows that it needs to get your muscles tensed and ready to go so that you can hoof it back to your village before you die in the middle of the prairie. (Do tiger’s even live on prairies? Anyway, you get the idea). Your brain, in that moment, is not worried about healing. Healing occurs when you get back to the village and your wounds can be tended, you are safe.

But what if you never get to the village? What if the stress of getting attacked by a tiger is replaced with the stress and worry that’s associated with chronic neck pain, the fear that you will never get better, the threat of having to deal with a stiff neck on top of all the other things you are having to deal with in your life right now?

In this scenario, your body never gets a signal to relax, to soften your tensed muscles, to release a cascade of neurochemical transmitters that promote healing. You become caught in a troublesome feedback loop: your muscles get’s tense, which causes your brain to percieve threat. As a result of that percieved threat, your body get’s more tense. And on and on, until you find yourself dealing with months to years of pain with no one able to explain to you why it won’t go away.

Getting out of the Cycle of Pain

I have been there, in that loop. I have a tendency to go back there, maybe it’s just how I’m wired. I have to actively, consciously, change the way I think about my body and pain in order to subvert that loop. And it works. I also use relaxation techniques and mindfulness meditation practices to assist me in this process. But what has been so fascinating to me is that this is the missing link in healing from chronic pain, and, perhaps more importantly, preventing it in the first place.

This is not news to the medical community; there have been plenty of studies linking a patient’s outlook on recovery to how well they actually recover. This mind body connection is starting to become more popular in pain management, but in most cases it is not emphasized or even acknowledged in our healthcare system. Certainly, there are appropriate times to seek invasive modalities or even surgery, but shouldn’t we start with an intervention that is very low risk and potentially very high reward in regards to resolution of symptoms?

I have created some resources to help you manage your pain and to prevent yourself from developing chronic pain syndromes. It starts with being able to sense and feel your body, in a non-threatening way. This will allow your brain and body to get out of the cycle of threat and pain and back into fluid, alternating, reciprocating motion.

Getting Back in Your Body

A great place to start getting back in your body is with this simple 5 minute Guided Body Awareness Technique. (You should try it, it’s really relaxing!)

Five Minute Body Awareness Exercise.

Remember, pain is not just in your body, and it’s not just in your brain. Whoever says that mind and body are two separate things is just wrong. You can’t treat one and not the other and expect to change the patterns that we live in. If you find yourself in chronic pain, be kind and gentle with yourself. Reconnecting with the sensations in your body is the first step to letting go of these stuck patterns.

May you find ease in your body.

– Dr. Derya

April 16, 2020August 19, 2020

How do I Release Tension From My Body? 3 Quick And Easy Ways to Relax

It was my second year of physical therapy school, and I was sitting in the white and beige lecture hall. The room emulated the newness and grandeur of the medical campus, but lacked character or color. The course title, “Musculoskeletal 101,” was stamped in the top right of the slides, and today’s topic was Managing Dysfunction of the Cervical Spine. I was bent awkwardly over my desk, furiously taking notes when I had to take a break because my neck was just killing me.

The irony of this was not lost on me.

Even though in physical therapy school I was learning about all the cool ways to crack joints and push and pull on muscles, the tension in my neck was inescapable. I was seeing a physical therapist myself, who would stick needles in my ropey neck tissue, and I was spending my precious study time rolling all around on tennis balls and stretching in all the right directions to “loosen up” my neck. While these things helped for a short while (and some not at all)

I couldn’t help wondering if there was another reason I was getting so tense.

Did I mention that physical therapy school is one of the most stressful things I have ever done in my life? Long commutes, sleep deprivation, assignments that took longer than the hours I had to finish them, projects and social dynamics, constant testing, hours of note taking, clinical rotations with high expectations… you get the picture. I don’t regret any of it, it was an invaluable experience. But I DO regret not having the tools to help me manage my stress levels, because it was taking a huge toll on my body.

Why Do We Get Tense?

We tense our bodies as a way to protect ourselves. It just so happens that high stress levels cause your body to perceive threat and therefore seek protection. Another reason we get tense in our necks, lower backs and hips is to hold ourselves up when our core is not functioning well. Guess what? Stress triggers us to shunt blood away from our core and to our arms and legs (because if there’s a threat, you better be ready to run!)

This is what I call the stress-tension one-two punch.

It’s the double whammy that stress has on causing tension in our bodies. The first blow is the initial tension you get directly from the stress hormones in your body that are readying you to fight or flee. The second comes from the compensatory way your body carries itself when in a stress state.

Hold on a sec! My stressful scenario wasn’t one where I had to fight or flee, I was just bent over my computer hacking away at a keyboard like a madwoman on a diet of coffee and energy bars. Why would my body have to ready itself for anything?

Tension and Stress

The thing is that your body doesn’t know the difference between the stress of being chased by a mountain lion or the stress of your boss adding an extra pile of work to your already overflowing inbox.

Stress is stress! The same hormones are released, and the same responses occur.

Our systems to manage stress are a primal instinct, present since we were “wild humans,” if you will, and the threat of having to fight or flee for your life was a more common occurrence. The steady drip of minor stressors (emails, traffic, alarm clocks, board meetings) did not even exist yet.

We are designed to manage a stressor that is an immediate threat – it is something that we deal with and then it’s over.

You either get away from the saber toothed tiger chasing you down, or you kill it, or you die. Done. Your system takes a few minutes to an hour to return to relaxed muscles, deeper breathing, and an active core. You can rest, digest, and hold yourself up properly.

When we have that steady drip of stress, however, our body doesn’t know how to get back to that baseline “rest and digest” state anymore.

We’re constantly juiced with stress hormones that make our body tense, despite how many physical therapists or chiropractors poke our muscles or push on our backs. To get rid of that tension, we have to get to the source.

We have to help our nervous system relax.

A Nervous System Reset

Even though we can’t always change the world around us, we can certainly change ourselves. You may not be able to change your work situation, your commute, or your other stressors.

But you CAN take small actions that reprogram your nervous system to quickly get back to that place of calm, and by doing so let go of tension in your body.

There are lots of ways to reset your nervous system. Below are three of my favorites because they are:

Easy to do
Fast
Effective

One way is by balancing the right and left sides of the body with your breath.

Balancing Breath:

sit comfortably. Bring your right hand index and middle fingers down, leaving the right thumb, ring and small fingers up (see video below if this is tricky for you!)
Cover your right nostril with your thumb, and exhale completely through your left nostril.
Pause for a 4 count, then inhale through your left nostril.
Cover your left nostril with your ring finger, pause for a 4 count, then exhale completely through the right nostril.
Pause for a 4 count, then inhale through the right nostril.
Pause for a 4 count, then cover the right nostril with your right thumb and exhale completely through the left nostril.
Continue with this sequence for about 6 breath cycles. Then rest.
Do this 1-2x/day.

Alternate Nostril Breath: a simple way to balance the body

Notice how you feel before and after doing this exercise. With some practice you can do this quickly and easily to help your body relax and release tension.

Cupping the Eyes

Did you know that how you see the world affects how tense your body gets? No wonder most people who work at a computer all day develop back or neck pain (or both)!

By letting our eyes relax, our nervous system gets an immediate signal that we are safe, and our bodies relax as a result.

Here’s how to do it:

Lean your elbows on a desk or table. Place your head in your hands so that the perimeter of your palm rests on the orbit (boney part around the eye). You don’t want any pressure directly on your eye.
Close your eyes, and stare into the darkness behind your eyes.
Try to make your field of vision very wide, like you are trying to take in as much of the view behind your eyes as possible.
Notice the gradations of light behind your eyelids. You will notice that it is not all black, but rather that there are different grades of blackness and lightness.
Focus on the darkest areas, see if they get bigger.
Tip: if you don’t notice any different gradation of blackness, just keep focusing on the wide view behind your eyelids.
Stay for 2-5 minutes, then come back by lifting your head and slowly opening your eyes.
Do this 1-2x/day.

How to do it: Cupping the Eyes to Help your Body Relax

Notice how you feel after. Try to connect with and remember in that feeling of relaxation in your body.

Breathe!

When we are stressed, our breathing becomes shallow and rapid. Chances are, if you’ve been stressed for a while, you haven’t taken a full breath in a looooong time. And when I say a full breath, I don’t mean getting a lot of air in, I mean getting air OUT!

That’s right, when we are breathing shallowly, it’s the lack of complete exhales that prevents us from getting new, oxygen rich air to our brain and other tissues. If you can’t get the old stuff out, you can’t make space for something new (that’s a good metaphor for life, too)!

Here’s how to do it:

Sit comfortably.
Place one hand on your lower front ribs.
Inhale quietly through your nose.
Exhale completely through your mouth, making an “ahhhhh” sound.
Pause 1-3 seconds at the bottom of your exhale before inhaling again quietly through your nose.
Repeat 4 breaths. Rest and repeat 4 more cycles of 4 breaths.
Do this 1-2x/day.

Like I said, I wish I had known these ways to de-stress when I was in physical therapy school. I knew stress mattered, but I didn’t realize the incredible impact it was having on my body!

I hope this article prevents you from having to endure chronic tension in your body, and from having to constantly seek ways to release tension. If you can find the wellspring of calm and ease within, the body will follow.

January 18, 2020February 18, 2020

Find Your Wings: 3 Things You Should Know About Your Shoulder Blades

We all have them, the big broad bones that fold onto the back of your ribcage like wings. But what do we really know about them?

To understand the function of the shoulderblade, or “scapula,” we must first understand their form.

1. The only bone to bone attachment of the scapula to your trunk is a tiny joint where your collarbone meets the top tip of the scapula.

This joint, called the acromioclavicular joint, or AC joint, is about as secure as if you put the tips of your two index fingers together head on, i.e. it’s pretty flimsy.

picture of two hands with the tip of the index finger touching. This represents the AC joint. — *The joint between your shoulderblade and the rest of your body* is about as secure as the joining of two fingertips.

The crazy thing is that the arm bone attaches to the scapula bone via a shallow concavity, and the scapula is attached to the rest of your body via the above mentioned AC joint. Literally the only bony attachment of your arm to your torso is via a tiny, flimsy joint.

Small attachment of scapula to torso via the acromioclavicular joint, aka the AC joint. — The acromio-clavicular joint, or AC joint, is the only connection between the scapula and the rest of your torso.

So, you’re probably wondering at this point, “how is my arm not falling off?” It is pretty amazing that our arms not only stay attached, but that we are able to climb, crawl, draw, reach, swim, etc with such precision and stability.

2. It is mostly muscle that holds our arm onto the rest of our body.

This is an amazing design because it allows for a huge degree of mobility in the shoulder, which is necessary to do all the precise tasks and vast ranges of motion required of our arms.

However, this can also create a lot of problems. Muscles change their function based on their position, and repetitive, habitual movement patterns can place muscles in suboptimal positions. If we always sit at the same desk, with our phone on the same side, or we always sit the same way in the car, or always throw a ball with one hand, we are slowly but surely ingraining one-sided patterns into our bodies.

When this occurs in the shoulder and shoulderblade regions it is especially impactful due to the heavy reliance of the shoulder on muscles for stability. This is why shoulder injuries often have little to do with the shoulder, unless it was due to a direct trauma. Usually it is a muscle imbalance or aberrant positioning around the scapula that is the issue, even if the pain is felt in the shoulder.

3. Our shoulderblades are concave in shape

Even though at first glance it seems that are shoulderblades are flat, they actually have a concave shape. This allows for the shoulderblade to sit on the ribcage, which is egg-shaped.

Shoulder blade (Scapula) shown from the side. It has a concave shape. — Side view of a shoulderblade showing the concave surface that touches the ribcage.

However, many of us tend to change the shape of our ribcage by changing the way we breathe. For example, a common pathological breathing pattern is pushing the front lower ribs up in order to get air in without completely exhaling. This is a common breathing pattern when we are stressed- it is a shallow, more rapid breath. If we are a little stressed most of the time, our breathing will reflect that, and over time the shape of our ribcage will reflect that as well.

What this “stress breathing” pattern does is create a flattened ribcage in the back, so now we have a concave shoulderblade trying to sit on a flat surface. At this point the muscle activity cannot be restored because it is the structure underneath that is the issue, and must be corrected before the shoulder can start to move better and feel better.

The shoulderblade is often overlooked when we think about how we move our bodies, but its position and function is vital to our arms being able to move well and without pain. Keeping the muscles around your shoulderblade strong and in an optimal position, as well as keeping your ribcage well positioned with proper breathing, will preserve the life of your shoulders and make for a much happier and painfree shoulder complex.

January 14, 2020February 18, 2020

How to find Stability in your Yoga Practice

With the exponential growth of yoga in the last few years, class sizes are getting bigger, and the content more imaginative. It is wonderful that more people are exposed to yoga. As a physical therapist, what concerns me is the lack of emphasis on internal stabilization. This stability comes from deep muscle activation, in sanskrit called bandha, which translates to “Lock.”

In our fast-paced lifestyle, we are often tempted to put ourselves in a position of compromise to “just get things done.” We skip the part where we find our sense of center, and we forget to return to it repeatedly. This is what the practice of bandha teaches us. Developing the bandhas takes effort to build strength, vigilance to maintain, and patience to master. However, once the bandhas are in place, all the other aspects of yoga practice become more accessible, fluid, and enjoyable.

Bandhas stabilize the body during dynamic movement. Some yoga postures can even be damaging if done repeatedly without this awareness. Sure, a teacher might now and then mention a bandha, or advise students to “engage the pelvic floor.” . The problem is that many people have never been taught how to access the bandhas in the first place.

yoga on a mountain top representing internal and external stability — Yoga and the bandhas can apply to every day life.

What are bandhas, and how do we access them?

In yoga there are essentially three bandhas in the body. The main two we will discuss today are “mula bandha” and “uddhiyana bandha,” which represent the pelvic floor muscles and the transversus abdominus muscle, respectively. These are the deep stabilizers of the trunk and pelvis. The third bandha is “jhalandara bandha,” which involves the core muscles of the neck and head known as the deep neck flexors (longus colli and longus capitus muscles).

Mula Bandha (Pelvic Lock)

Let’s start with mula bandha, the root lock, or the pelvic floor. In physical therapy practice we often teach patients to engage their pelvic floor if they have hip, back, and leg pain. I even now teach pelvic floor exercises to help patients who have neck pain, because the pelvic floor is the “foundation of the house.” If the head and neck are the roof of the house, you can imagine how a poor foundation would result in an unstable roof.

In my experience working with patients, these muscles are inherently difficult to engage for several reasons. The first is that they are “postural muscles.” Unlike big mover muscles, like the thigh muscles that bend the knee, the postural muscles are under subconscious control. This makes it difficult to fire them at will, and they are harder to feel. The thing that makes pelvic floor muscles really hard to access is the fact that we can’t see them, and many people have never even heard of them.

How to access Mula bandha

As mentioned above the pelvic floor is hard to access, but visualization can be helpful.

Sit on a firm chair with knees and hips at 90 degrees and feet flat on the floor.
Sitting up straight, hinge forward and back from the pelvis until to feel ventered on your sit bones (the boney protrusions at the base of the pelvis).
From here, draw the sit bones closer together, without tightening your gluteal muscles.
Keep this as you visualize the sit bones pressing down into the chair, as the space between them moves up (this is the doming up/activation of the pelvic floor muscles that make mula banda).
If you can achieve this lifting sensation, you can try maintaining that while visualizing your coccyx (the tailbone) and the pubic symphysis (the very front of your pelvis) also moving towards each other.
These four points (the sits bones, coccyx, and pubic symphysis) all are moving towards a central point.
Even if you feel nothing initially, with continued visualization you will begin to feel something. It is a process.

Uddhiyana Bandha (Navel Lock)

Also known as “flying up” bandha, this is the place between your navel and your pubic bone that wraps around your waist. It creates lightness and lift, and stabilizes the trunk and pelvis during movement and during static standing and sitting. A long, flat sheath of muscle, this bandha is made up primarily by the transversus abdominus and the internal oblique muscles.

The transversus abdominus muscle which activates navel lock, or uddhiyana bandha — The transversus abdominus muscles that make up uddhiyana bhanda.

How to access Uddhiyana Bandha

One accessible way to feel uddhiyana bandha is by activating the leg muscles strongly.

Stand with your feet hip width apart, feet parallel.
Draw up through the inner arches of the feet, while rooting the base of the big toe, base of the pinky toe, and straight down through the heel. You may feel something light up in your core with just this! If not, no worries, keep going.
Imagine you are drawing all the musculature of your legs up towards your pelvis.
Maintain that as you tighten the front and back of the thighs simultaneously.
At this point you should feel the area below your navel turning on. That is uddhiyana bandha.
Now see if you can relax your legs somewhat while keeping the activation in your abdomen.

Jalandhara bandha (Throat Lock)

While the full expression of Jalandhara Bandha is more applicable during breathwork, a sense of this lock can help with asana practice as well.

Due to our lifestyle that now frequently involves sitting, the head tends to come forward with the chin protruding. Then, when it comes time to practice yoga on the mat, we carry this poor posture with us.

Jalandhara bhanda can mitigate this effect by teaching us to draw the head back over our spine. In the full expression of the bhanda, the chin is nestled in the nook of the breast bone between the collar bones, called the sternal notch. This can be a good release of the fascia along the back of the neck, but is impractical for asana practice and may cause strain for some individuals.

A lighter version of Jalandhara bhanda can help us find a neutral and stable position of the head and neck by recruiting the muscles that make the “core of the throat.” These deep muscles return the head to a neutral position.

How to access Jalandhara bandha (throat lock)

Sit in a firm chair, feeling your sit bones.
Exhale completely through your mouth as you let your neck and shoulders relax and your front lower ribs move down and in (for more info about the importance of the ribs here, see my other post “the posture myth”)
Now, draw your head straight back so that it sits atop the rest of your spine.
Maintain a relaxed posture of your neck and shoulders as you draw slightly nod your head down as if you are holding a small orange between your chin and the space between your collarbones.
Imagine the base of your skull floating up as your chin drops slightly, lengthening the back of your neck.
Check to see that your shoulders are still relaxed. If not, take another exhale and let them drop.
Stay here a few breaths, inhaling to lengthen through the back of the neck, exhaling to settle the shoulders and the front lower ribs.

Yoga and Injury

As a physical therapist, the most common yoga injuries I see are in people who are naturally flexible (usually young to middle-aged women, which happens to be the largest demographic of yoga practitioners). These individuals can put themselves in many challenging postures but lack the deep stabilization of the bandhas. I also see stronger men and women who are able to muscle through arm balances but end up with neck and shoulder pain because really it is the deep connections of the bandhas that create a sense of levity in arm balances, not the arms. Practicing poses with correct activation of the deep stabilizing muscles may mean that you have to approach the pose in a new way, and you may not be able to make the pose look as good initially. This is where the yoga really happens- when we shift our focus from what the pose looks like to what it feels like, when we move from place of integrity and patience.

It can take time to develop a keen awareness of the bandhas and to incorporate them into practice. However, by learning to engage the bandhas, yoga injuries can be prevented and healed by practicing with increased awareness, intention, and patience.

December 18, 2019June 24, 2021

The Illusion of Symmetry

From the outside we look symmetrical. Left to right, it seems that if you drew a line down our center we would get two equal parts. Most anatomical drawings present the human body in this way.

When we dig a little deeper, it turns out that right to left we are quite different, and these differences can have a profound effect on our physical functioning.

Often I have patients ask questions like, “why is it that only my right knee hurts with running?”

Good question! Some may say that this is due to handedness, with most of us being right handed. But have we ever stopped to ask why it is that most of us end up being naturally right handed? I don’t intend to get into a debate about handedness, but it certainly hints that there is something else at play, some asymmetry inherently present in all of us. These asymmetries are normal and natural. However, these asymmetries can become problematic when they become unbalanced.

This can occur due to external or internal circumstances. For example, your life requires that you do repetitive tasks to one side only, like reaching for the phone on the right, or getting in and out of the driver’s side of your car. It may also be something intrinsic to you, such as an injury. If you had an injury to your left leg, you felt more stable on your right leg as you were healing. That is helpful while you heal, but that patterning of preferring the right leg to stand on can remain long after the tissues have healed.

The Postural Restoration Institute has a deep understanding of these asymmetries and how they affect us. This institute is unique in that it addresses these complexities of being a human when creating a treatment plan, which I have not seen in literally any other course or training for physical therapists, even when I was in my doctorate program this was glossed over at best.

Let’s Talk Asymmetries.

The primary source of these asymmetries is the center of our body, the trunk. It is the generator of motion in our limbs and it is our center of stability. At the center of our trunk (the “core of the core,” if you will) lies the diaphragm, which is dramatically impacted by the asymmetries of our organ and lung placement.

The diaphragm on the right tends to be more domed due to:

lower attachments of the diaphragm onto the right side of the spine compared to the left.
The central tendon (which makes the dome of the diaphragm) is thicker and stronger on the right than the left.
The right diaphragm has the support of the liver underneath.
The presence of three lung lobes on the right and only two on the left to make space for the heart.

Radiograph showing the right diaphragm (left side of picture) being higher than the left. This is normal human patterning.

All these things cause the right rib cage to be in an “exhale” position with the ribs dropping down and into the body, and the ribs on the left to be in an “inhale,” an elevated and expanded position. Think of the left lung as a big balloon pushing on the smaller balloon on the right. This causes an orientation of our ribcage to the left. The attachments of the diaphragm on the spine cause the spine to turn right.

The Postural Restoration Institute has recognized this natural asymmetry and incorporates this anatomical variance into their training of physical therapists and therefore the treatment of our patients. When I first heard that everyone is biased one way, it was news to me. When I was in my doctoral physical therapy program, we learned all the asymmetries of the vital organs, however the influence of this asymmetry was not applied to physical function. Furthermore, the asymmetrical structure and pull of the diaphragm was hardly mentioned, if at all. I find this surprising now as the diaphragm is a muscle that we use all day, every day, and it has profound impacts on how we move and interact with our world.

So what’s the big deal about the diaphragm?

The diaphragm is huge! It attaches to our lower back spine and interfaces with our abdominals, low back muscles, and hip flexors. After I took my first postural restoration course, I was pleasantly surprised at the emphasis on diaphragmatic function and it’s role as a driver of human movement. I was also surprised at how “belly breathing,” which I taught and practiced myself, was actually detrimental to harnessing the power of the diaphragm. The inherent asymmetries within our diaphragm drive the initiation of human movement, specifically walking. Essentially, the stability of the right diaphragm supports right stance phase of gait (standing on your right leg and left leg swinging).

walking still shot in Right stance phase with left swing phase

The problem occurs when we go to stand on our left leg, but we are still in right stance with our supporting muscles. The left diaphragm is not able to support our body in this position, and our right leg does not adequately recruit muscles to swing the right leg. This occurs not just in walking but also during day to day tasks. This can create all kinds of issues, knee pain on one side being just one of them. Fortunately, this asymmetry can be addressed with specific exercise that is asymmetrical, and therefore corrective. These exercises incorporate the breath to achieve diaphragm function.

Once again, I want to reiterate that this asymmetry is not a bad thing inherently. It is in fact a wonderful thing as it initiates the walking cycle and allows us to begin rotating through our trunk and pelvis. Asymmetry becomes a problem when we get stuck on one side, and are not able to get over to the other side. Relearning how to transition from right to left, and then back from left to right, is how we get balanced again.

Are you transitioning well from right to left stance?

You may have difficulty transitioning from side to side if you:

Tend to always have tightness in one hip more than the other
Always cross one leg over the other (usually the left one over the right)
One leg feels longer than the other
You notice different wear patterns on your shoes or bike saddle

Try this simple exercise to test your asymmetry:

Stand with toes pointed straight forward (feet not turned in or out). Keep this foot alignment as you transition to standing on one leg. You can touch a counter in front for support. Now, turn your pelvis so that the zipper of your pants comes over your right big toe. Try the same thing standing on the left leg, toes pointed forward, knee slightly bent. This time, try to turn the zipper over your left big toe. Notice if you can do this on one side, but not the other.

If you find one side to be challenging, but not the other, that indicates you may have trouble shifting to one side. Because of our natural human pattern, it is usually harder to do this standing on the left leg. That doesn’t mean you can’t stand on that leg at all, but it means that when you are standing you aren’t using the correct chains of muscles, which results in pain and dysfunction. To address this issue, come see me or a PRI trained therapist near you to get properly screened and the tools to find better ease and balance in your body.

November 6, 2019August 29, 2021

The Posture Myth: Why Straighter is not Better

Most of us remember being told to “sit up straight!” or “shoulders back, chin up!” as a child or maybe more so as a teen. While this advice was given with the best intentions, it may not have been that helpful. Don’t get me wrong, I’m not advocating the slumped computer posture with shoulders rounded and head poking forward.

This is certainly not a biomechanically sound posture and can lead to all sorts of dysfunction and pain. In an effort to avoid this unsightly slump, we may find ourselves in a position I call “reverse slumping.” This is the tendency to pull the front lower ribs up and push the chest forward. While this may look more upright, it is an overcorrection, and can be more problematic than helpful.

The Problem

So what’s wrong with a lifted chest and elevated front lower ribs? The problems that arise are largely due to how we breathe, and the important relationship between the ribcage and the pelvis. The Postural Restoration Institute has defined the relationship between the breath and function. Below is my meager take on their extensive understanding of the topic. For more information check out https://www.posturalrestoration.com/.

1. Poor oxygenation. If our front lower ribs are “flared” up and out, the mid-upper back is essentially closed off and becomes flat. This causes many problems, one of which is poor oxygenation. The human body is designed to breathe into the back mid and lower ribs, not just the front. These back middle and lower regions of the lungs have the largest area of lung tissue, and the highest blood flow to lung tissue ratio. This means that this area is very important for getting oxygen from your lungs to the rest of your body. When this is closed off (by pushing front ribs up) we are forced to breathe shallowly into our front upper chest, which may recruit neck muscles to help inhale and result in increased neck tension (among other issues). Further, it is harder to get air out because the chest is in a hyper-inflated state. This means less new, oxygen-full air in. Theoretically, if you improve the expansion of your mid back, you will use oxygen more efficiently and fatigue less quickly with sport and daily living.

2. Altered neck and shoulder mechanics. The spine is not meant to be straight, rather it has natural curves that allow a springy quality for shock absorption. When the front ribs are pushed up, the upper back spine becomes flat. This destabilizes the shoulders, as the shoulderblades are designed to function on an egg-shaped surface, not a flat one. As a result, the muscles that manage the shoulderblade cannot function optimally, thereby changing the mechanics of the shoulder in an adverse way. Many of the muscles that attach to the shoulderblades also attach to the neck spine and can create increased tension in the neck area if they are not functioning well.

The muscles that attach to your shoulderblades, back, and neck can become strained and painful with poor posture.

A flat upper back also burdens the point where the upper back spine meets the neck spine. The neck spine is naturally curved and is designed to follow the curve of the upper back. However, if the upper back is now flat, the spring-like shock absorbing factor is lost. Furthermore, the juncture from upper back spine to neck spine becomes vulnerable due to a sharp corner instead of a nice smooth curve between the vertebrae. This can create pain and sensations of tension in this area.

3. Increased stress levels. When we are stressed, that really means our body is entering a “fight or flight” state, which means that there is some imminent threat, and we need to either fight or get away. Blood is shunted away from the core and immune function and digestion are halted as the body prepares to fight or flee. This threat could be anything from being chased by a mountain lion to a steady drip of small daily stressors, like traffic, aches and pains, worrying about money, etc. Our body simply does not distinguish what the cause of the stress is, the same pathways and neurotransmitters are stimulated in the case of a lion attack or spilled coffee. The “fight or flight state” has its purpose, however it is not healthy to remain in this state for prolonged periods of time.

The part of our nervous system that promotes our “rest and digest” state is governed by the vagus nerve which passes from the brain to the abdomen through the ribcage. This state allows the body to be calm and relaxed, allowing for sleep, healing, and digestion. When we are in this state, our breathing is full and deep, with the diaphragm moving through its full range of motion.(1) This is the state that we should be in most of the time.

So what does this have to do with posture? Well, if we push the front ribs up and close off the back of the ribcage, the sympathetic ganglia (the nerves that promote a “fight or flight” state and live along the upper back spine) become overly stimulated due to compression. Furthermore, with the front ribs elevated, the body is in a constant state of shallow inhales and exhales, which is correlated with higher stress levels and promotes release of stress hormones in the body.(2) What’s really amazing about our bodies is that this system works both ways. That is, just as the state of our nervous system causes our breathing patterns to change, we can similarly alter our nervous system by modifying the way we breathe.

4. Poor recruitment of deep abdominals, especially upon inhale. Even if you have six pack abs, that doesn’t necessarily mean you are using the abdominals in the way they are meant to be used. Deep to the well known “six pack” of the abdominals are deeper muscles that create a cylinder around the center of the body. These are breathing muscles. They attach to the lower rim of the ribcage and the upper rim of the pelvis. They create stability and order within the body as well as reduce pressure on the lower back spine and associated nerves. They allow us to be both stable and mobile when they function correctly.

When the front ribs are excessively elevated, the front of the pelvis is often tipped forward as a counterbalance. This places the deep abdominal muscles in the front of your body in a state of excessive length. Our muscles do not function very well (or hardly at all) from their most lengthened state. It’s like trying to pick up a heavy bag of groceries with your arm totally straight instead of slightly bent. It just doesn’t work as well.

A deep stabilizing muscle, called the transversus abdominus, helps us maintain neutral posture.

So then what is good posture?

Essentially, your rib cage should be egg shaped, and sit atop your level pelvis. The spine should be lengthened while maintaining its natural curves. In sitting, you can achieve this by:

Sit in a firm chair with your feet flat, knees and hips at 90 degrees.
Feel your sit bones (the boney protrusions at the base of your pelvis). You may need to lean forward and back a few times to find where you feel them most. When you are most aware of your sit bones pressing into the seat, this indicates that your pelvis is level. It may feel like your pelvis is slightly “rolled under.”
With a long, relaxed exhale breath through your mouth, allow your front lower ribs to drop down slightly. Pause a few seconds at the bottom of the exhale. There should be a sense of your front lower ribs coming down to the front top rim of your pelvis.
Maintain this position as you imagine your lower back ribs expanding with each inhale, and your lower front ribs moving down and back towards your spine with each exhale. Hint: pausing after your exhales for 3 seconds will make it easier to feel back ribs expanding.
Below is a video on finding a neutral sitting posture.

And there you are! If you are used to pushing your chest up, it probably feels like you are slouching when you come into a correct posture. To assure yourself that you are still sitting straight, you can use a mirror to see that you are indeed not slouching. If you can see yourself from the side in the mirror you may also notice that now you have a little more expansion in your lower back ribs. Good job!

References:

1. Russo MA, Santarelli DM, O’Rourke D. The physiological effects of slow breathing in the healthy human. Breathe (Sheff). 2017;13(4):298-309.
2. Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci. 2015;8(3):143-52.
3. Tenney, R., KL Boyle, A DeBord. Influence of Hamstring and Abdominal Muscle Activation on a Positive Ober’s Test in People with Lumbopelvic Pain H. Posturalrestoration.com. Accessed January 26, 2019.