SDCCD Optimal Spine Health PDF

DISCOVER YOUR POSTURAL CORE!
OPTIMAL SPINE HEALTH

THROUGH
ALIGNED MOVEMENT TRAINING
Marcia Tassinari, MPT, Physical Therapist

Sara Meeks, PT, MS, GCS, KYT
www.PBFoundation.org (858) 581-0062 PBFoundation.org@gmail.com

If a task has once begun, never leave it til its done.
Be it great or be it small, do it well or not at all.
-Unknown
DEDICATION
To Sara Meeks, PT, MS, GCS, KYT
who inspires, educates, collaborates, and
is a generous mentor to Marcia and thousands of others
All likeness, similarity, and replication of pictures or names of movements
are used by permission of Sara Meeks, PT, MS, GCS, KYT (THE MEEKS METHOD)
Elizabeth Philbin, BA, Pre-DPT

VP of Program Development, Program Assistant
The Tassinari Family (Rusty, Gabriella & Anthony)

Tassinari Physical Therapy, Inc.
David Gough, Artist
Carol & Martin Wilson
COLLABORATIVE CONTRIBUTORS:
San Diego Community College District (SDCCD) Continuing Education
Nicola Salmon, PTA

Emeritus Program
Charlene Schade
Associate Professor
Emeritus Assistant Program Chair, Health/Fitness
PROJECT SUPPORT
Ancillary Funding
SDCCD Continuing Education Program
Brian Ellison
Vice President of Instruction
Emeritus Program
Leslie Shimazaki, Dean
Kim McIntyre, Program Chair
Mary Burns Prine, Associate Professor
TABLE OF CONTENTS
Page
Optimal Spine Health / How Posture Affects Your Spine Health 1

May the Force Be With You: UNLOAD! 2
Body Position and Movement: Which Ones Are Best For Your Back? 3
UNLOAD To Reduce The Force On The Front Of The Spine 3
The Benefits of UNLOADED Backward Bending Exercise 4
Getting Started 5
Dynamic Standing Alignment 6
Dynamic Seated Alignment 7
Standing Realignment Routine: Position 8
Breathing & Shoulder Slide 9
The Lengtheners 10
The Presses Against A Wall Or Door 11
Seated Realignment Routine: Position 12
Breathing & Shoulder Slide 13
The Lengtheners 14
Postural Core Training: Optimal Starting Alignment 15
Level One 16, 17
Level Two 18
Level Three Combinations 19
Deep Abs and Core: Standing 20
Seated 21
Wall Lengthener With Arm Lift 22
Spine Aligner 22
Dynamic Balance: The Cone of Economy 23
Find Your Cone of Balance 23
Dynamic Balance Training 24
Hinge Movement Technique 25
Optimal Alignment For Smooth Walking 25
Guidelines For Movement And Free Weights 26
References 27
Welcome to Optimal Spine Health through Aligned Movement Training. This unique approach is
based on THE MEEKS METHOD and Dynamic Postural Unloading. It is designed to improve your
spine and core strength, balance, posture, control of body movement, and overall health.
EXPERIENCE 3 STEPS to build a stronger back and better posture!

1. UNLOAD and take the weight off of your spine
2. REALIGN your body for effective training
3. STRENGTHEN your core and deep posture muscles
A specific and easy to implement approach:

Develop a stronger body with optimal alignment
Improve your balance, agility, and body mechanics
Learn a specific program you can practice on your own
Implement aligned movement training for everyday activities
HOW POSTURE AFFECTS YOUR SPINE HEALTH

POSTURE is one of the most visible signs of spinal deformity and compromised spine integrity*, which
is often associated with pain, stiffness, weakness, and imbalance. Postural problems have been shown
to significantly effect overall health due to the physical, psychosocial, and economic consequences.
Changes in posture affect spine health by altering the relative orientation of body structures.1,17
This program specifically focuses on eliminating the problems associated with this condition,
which include:
Body Structure Associated Problem or Condition

Vertebrae Osteoporosis, Osteopenia, Stenosis
Joint Degenerative Joint Disease, Arthritis (i.e. Osteoarthritis)
Disc Disc Bulge, Disc Herniation, Degenerative Disc Disease
Pelvis Pelvis and Sacroiliac Dysfunction
Muscle Strains, Weakness, Tightness, Trigger Points
Ligament Sprains, Over-Stretched Ligaments
Rib/Chest Impaired Breathing, Decreased Lung Capacity
These common problems influence how the entire body operates in space, as well as the ability to
control movement. Therefore, the precise manner in which you sit, stand and move could affect your
spine health.1 (*Integrity: The state of being unimpaired; soundness)
www.PBFoundation.org 858 581-0062 PBFoundation.org@gmail.com

Copyright Marcia Tassinari, MPT 2010
1
MAY THE FORCE BE WITH YOU: UNLOAD!
This method applies evidence-based research that demonstrates the benefits of spinal UNLOADING:
removing or decreasing potentially harmful forces or compression from the front of the vertebrae.
Load or force comes from gravity, muscles, body position, and movement. Too much or too little load can
damage the vertebrae; however, just the right amount and type can improve vertebral integrity.
The foundation of this approach is based on optimal spinal UNLOADING. This can be achieved with
posture alignment, body position, specific muscle training, control of movement, and body mechanics.
This program integrates these components to improve spine and overall health.
1. Posture Alignment When the body is in an optimal, lengthened position it can

potentially reduce harmful forces from gravity, muscle, body position, or movement
that could otherwise damage the vertebrae. Improved postural alignment may
strengthen the spine and improve health.
2. Body Position Lying on your back, side, or stomach are

positions that can reduce the force of gravity on the spine. Spinal
UNloading may be achieved with Dynamic Seated or Dynamic
Standing Alignment.
3. Specific Muscle Training The core and deep postural muscles of the ENTIRE
spine (from head to tailbone) are designed to move the body, while keeping it
upright and stable.
4. Control of Movement The central nervous system controls

body speed, direction, and level of movement. Reducing spinal
forces for safer loading can improve the bodys ability to move
with optimal control.
5. Body Mechanics Techniques used to move the body for daily activities,
exercise, work, and recreation can either damage the spine or improve its integrity.
When the body is effectively trained with optimal alignment, it can properly
UNLOAD with all movement to promote a healthier spine.

2
BODY POSITION AND MOVEMENT:
WHICH ONES ARE BEST FOR YOUR BACK?
Posture, body position, movement, and type of exercise affect the health of your spine depending on the
amount, direction, and location of the force placed onto it. The FRONT of the spine (vertebral body) is
soft, spongy and more frequently damaged than the BACK of the spine, which is hard, firm, and stronger.
Bottom Line: UNLOAD the front of the vertebral body!
AMOUNT OF FORCE ONTO SPINE (KG)

HIGH FORCE Harmful Forces
FRONT OF SPINE
REDUCE HARMFUL
FORCES
Healthier
Forces
LOW FORCE
Nachemson et al. 1966

BACK OF SPINE
HEALTHIER
FORCES
UNLOAD TO REDUCE THE FORCE ON THE FRONT OF THE SPINE

Healthier Forces Common Activity or Body Position Harmful Forces
Dynamic Seated Alignment Driving (car seat), Dining (common chair) Seated, knees higher than hips
Standing/Seated Hip Hinge Picking up or putting on shoes/socks Seated, bending forward
Standing Single Hip Hinge Picking up groceries, Laundry Standing, bending forward
Single Kneeling Hinge Gardening, Cleaning Standing, bending forward
Dynamic Seated Alignment Computer work Seated, legs level with hips
Position your body in

DYNAMIC STANDING* OR DYNAMIC SEATED ALIGNMENT**
and move with Hinge Technique to reduce
the load or force on the front of vertebrae.
(page 6* , page 7**, page 25)

3
THE BENEFITS OF UNLOADED BACKWARD BENDING EXERCISE
Effective exercises for the spine are different from loaded (weight bearing) exercises for the arms and
legs. Research demonstrates that specific muscle training for the back performed in an UNLOADED
position (e.g. lying on stomach, side, or back) can improve spine integrity and decrease the chance of
damage and/or fracture.19
The benefits of UNLOADING the front of the spine with backward bending exercise demonstrates the
potential to improve spine integrity AT ANY AGE.
UNLOADED BACKWARD BENDING FORWARD BENDING EXERCISES

EXERCISES CAN REBUILD THE VERTEBRAE! CAN DAMAGE THE VERTEBRAE!
These exercises can:

Improve posture alignment and
lengthen the body These exercises can:
Unload the front of the spine and Cause a curved, compressed spine
improve the shape of the vertebrae Overload the front of the spine and
Improve vertebral strength and cause the vertebrae to fracture
decrease the chance of spine fractures Alter the shape of the spine due to
89% abnormal force onto the vertebrae
Research has shown that

89% of people had vertebral fractures
with forward bending exercises
Sinaki et al. 1984
THE BENEFITS OF A LENGTHENED ALIGNMENT
Look better and feel great!

Eliminate neck and back pain
Strengthen postural core muscles
Improve balance and movement
Expand breathing and lung capacity
Minimize force onto front of spine
where damage usually occurs
Improve the shape of your spine
Develop better spine integrity

4
GETTING STARTED
A LIFETIME OF PRACTICE
This program is designed to be practiced throughout a lifetime. It can improve your postural core, body
alignment, balance, body mechanics, and ultimately help you to achieve optimal spine integrity and
overall health and well-being. The first step is to start.
THINK: Think about it often.
ACT: Take action and practice.
PLAN: Designate specific days of the week or certain times of the day to practice.
PRACTICE: Perfect practice will result in your own optimal health.
KEY POINTS
ALIGNMENT, ALIGNMENT, ALIGNMENT! Achieve your own optimal alignment. Train your body to
move within this aligned position. Each exercise or movement has a specific Optimal Alignment.
KEY Optimal Alignment positions are the following:
Dynamic Standing Alignment page 6
Dynamic Seated Alignment page 7
Standing & Seated Realignment Positions page 8, 12
BE SAFE: LISTEN TO YOUR BODY!

New to the program? Keep EFFORT and STRAIN below 50%
Slowly increase EFFORT and STRAIN in 10% increments. Listen to your body!
EFFORT SCALE STRAIN SCALE

EFFORT:
100% 100%
Maximum 1. Mental or physical energy Maximum
90% Effort Strain 90%
that is exerted to achieve a
80% purpose 80%
70% 2. Attempt to do something 70%
that involves considerable
60% 60%
energy
50% Moderate Moderate 50%
Effort Strain
40% STRAIN: 40%
30% 1. To make a great physical or 30%
20% mental effort in order to do 20%

something
10% Minimal Minimal 10%
2. A pulling or stretching force
0% Effort Strain 0%

5
DYNAMIC STANDING ALIGNMENT
KEY POINTS OF ANATOMY INCORRECT

Base of Head
Back of Neck
X-Bone

Belly Button

Pelvic Headlights
Foot Triangle
Pubic Bone
l l
Foot Triangle Balls of Feet
Outer Border
Center of Heels
THE 5-STEP HOLD

1. Foot Triangle Feet parallel and aligned with Pelvic Headlights
Press into floor with Foot Triangle:
Center of Heel, Outer Border, and Balls of Feet
2. Align Pelvis Place one hand at lower back, palm facing away
Place index finger of other hand at Pubic Bone
Rotate Pubic Bone up, feel lower back flatten
Rotate Pubic Bone down, feel lower back curve
Optimal position will be a slight curve in lower back and
Pubic Bone tipped down slightly
3. Belly In Position palm of hand on abdomen (as shown above)
Use pinky fingertip and draw Belly Button in toward spine to
stabilize pelvis and lower back
4. X-Bone Up Place thumb under base of sternum and lift X-Bone to raise the
chest and lengthen the upper back
5. Head Lift Align neck
Place index fingertips at Base of Head just behind the ears
Lift Base of Head from behind ears and lengthen Back of Neck
Keep nose level, relax jaw

6
DYNAMIC SEATED ALIGNMENT
KEY POINTS OF ANATOMY INCORRECT
Base of Head
Back of Neck
X-Bone

Belly Button

Pelvic Headlights
Pubic Bone
Hip Joint

Foot Triangle
l l
THE 5-STEP HOLD

1. Foot Triangle Feet parallel and aligned with Pelvic Headlights, knees lower than hips
Press into floor with Foot Triangle
Center of Heel, Outer Border, and Balls of Feet
2. Align Pelvis Place one hand at lower back, palm facing away
Place index finger of other hand at Pubic Bone
Rotate Pubic Bone down until there is a slight curve in the lower back
and you are seated equally on both legs at Hip Joint
3. Belly In Position palm of hand on abdomen (as shown above)
Use pinky fingertip and draw Belly Button in toward spine to
stabilize pelvis and lower back
4. X-Bone Up Place thumb under base of sternum and lift X-Bone to raise the
chest and lengthen the upper back
5. Head Lift Align neck
Place index fingertips at Base of Head just behind the ears
Lift Base of Head from behind ears and lengthen Back of Neck
Keep nose level, relax jaw

7
STANDING REALIGNMENT POSITION
Begin with THE 5-STEP HOLD
1. Foot Triangle 2. Align Pelvis 3. Belly In 4. X-Bone Up 5. Head Lift
THE TECHNIQUE
Dynamic Standing Alignment with
THE 5-STEP HOLD (page 6)
Align arms with side of body,
approximately 10-12 inches away

Palms facing forward, elbows and
fingers lengthened
OPTIMAL REALIGNMENT POSITION INCORRECT
Head forward
Nose up
2
-1
10
l l
FOOT TRIANGLE

8
STANDING REALIGNMENT BREATHING & SHOULDER SLIDE
1. BREATHING
Standing Realignment Position with
Initiate breathing from the diaphragm
at lower abdomen
Continue breath by expanding from lower to
upper ribs towards chest
Expand abdomen and ribs with inhalation
Draw belly in toward front of spine with exhalation
Relax jaw
2. SHOULDER SLIDE
Standing Realignment Position 2
-1
with THE 5-STEP HOLD (page 8) 10
Slowly slide shoulder blades together
to activate only upper back and
shoulder muscles
Hold 5-10 counts, 2 times
Breathe, relax jaw

9
STANDING REALIGNMENT ROUTINE: THE LENGTHENERS
THE TECHNIQUE 1
Standing Realignment 2
Position with THE 5-STEP
THE SEQUENCE
HOLD (page 8)
Slide specified foot back 1. SAME SIDE ARM AND LEG
slightly Lengthen right arm, right leg, HOLD
Straighten knee, press heel Repeat same movement with left leg
to floor to lengthen leg and left arm
Lengthen leg, pull hip and
pelvis away from spine
2. OPPOSITE ARM AND LEG
Raise specified arm(s)
alongside head, palm forward Lengthen right arm, left leg, HOLD
Repeat same movement with left
Lengthen specified arm, elbow,
arm and right leg
and fingers, pull shoulder, ribs
and chest away from pelvis
Feel the spine lengthen,
HOLD 5-10 counts
Breathe, relax jaw
3 4
3. BOTH ARMS/ BOTH LEGS
Press both feet to floor
Raise both arms alongside
head palms facing forward,
straighten both knees
Lengthen both arms and legs
at the same time, HOLD
4. COMBINATION
Keep both arms raised and
slide foot back according to
colored arrows
Follow sequence below for
arm/leg position
Lengthen according to
colored arrows
Left arm/Left leg
Right arm/Right leg
Left arm/Right leg
Right arm/Left leg
10
STANDING REALIGNMENT ROUTINE
THE PRESSES AGAINST A WALL OR DOOR
THE TECHNIQUE THE SEQUENCE:

1 1 2
Standing Realignment 1. SAME SIDE ARM AND LEG
Position with THE 5-STEP Shift body alignment onto left 2
HOLD (page 8) Foot Triangle, straighten legs
Position heels against wall Raise right arm, lengthen and
Straighten knees, PRESS PRESS right arm and leg, HOLD
specified heel to wall, HOLD Repeat same sequence with left
Raise and lengthen arm along- arm and left leg
side head, palm facing forward
PRESS to wall with back of hand,
2. OPPOSITE ARM AND LEG
fingers, wrist and shoulder,
Shift body alignment onto right
hold 5-10 counts
Foot Triangle, straighten legs
Breathe, relax jaw Raise right arm, lengthen and
PRESS, right arm and left leg, HOLD
Repeat same sequence with left
3 arm and right leg
1 2
3. BOTH ARMS/BOTH LEGS

Straighten both legs, raise both arms
Follow THE COMBINATION press
sequence (left) for arm/leg position
Lengthen, PRESS arm and leg according
to colored arrows, HOLD
Repeat for each combination
4
4. ARM PRESSES 2
3
3 Arm Positions:
1. Airplane 4
2. 90/90 1
3. V
Lengthen both arms away
from body to Position 1
PRESS into wall with fingers,
THE COMBINATION
back of hand, wrist, shoulder
Follow the colored arrows
Left arm/Left leg
Repeat PRESS for all three
positions
Right arm/Right leg
Left arm/Right leg
Right arm/Left leg
Both arms/Both legs
11
SEATED REALIGNMENT POSITION
THE TECHNIQUE
Dynamic Seated Alignment with
Align arms with side of body,
approximately 10-12 inches away
Palms facing forward, elbows and
fingers lengthened

10-12
l l
FOOT TRIANGLE
COMMON INCORRECT SEAT HEIGHT
KNEES LEVEL WITH HIPS KNEES HIGHER THAN HIPS OPTIMAL SEATED
REALIGNMENT POSITON
KNEES LOWER THAN HIPS

12
SEATED REALIGNMENT BREATHING & SHOULDER SLIDE
1. BREATHING
Seated Realignment Position with
Initiate breathing from the diaphragm
at lower abdomen
Continue breath by expanding from lower to
upper ribs towards chest
Expand abdomen and ribs with inhalation
Draw belly in toward front of spine with exhalation
Relax jaw
2. SHOULDER SLIDE
Seated Realignment Position
with THE 5-STEP HOLD (page 12)
Slowly slide shoulder blades
together to activate only upper back
and shoulder muscles
Hold 5-10 counts, 2 times
Breathe, relax jaw

13
SEATED REALIGNMENT ROUTINE: THE LENGTHENERS
1
THE TECHNIQUE THE SEQUENCE:
2
Seated Realignment Position 1. SAME SIDE ARM AND LEG 1 2
with THE 5-STEP HOLD (page 12) Press into floor with left Foot
PRESS into floor with designated Triangle, raise left arm alongside
Foot Triangle, HOLD head palm forward
Raise arm alongside head, Lengthen, HOLD
palm facing forward Repeat same movement with right
Lengthen arm, elbow, and foot and right arm
fingers upward
Pull shoulder, ribs and chest away 2. OPPOSITE ARM AND LEG
from pelvis to feel the spine Press into floor with right Foot
lengthen, HOLD 5-10 counts Triangle, raise left arm alongside
Breathe, relax jaw head palm forward
Lengthen, HOLD
Repeat same movement with left
foot and right arm
3
3. BOTH ARMS/BOTH LEGS
Press into floor with both feet, raise
both arms alongside head, palms forward 2 1
Follow THE COMBINATION press
sequence (left) for specific arm/leg position
Lengthen arm and press foot according to
colored arrows, HOLD
Repeat for each combination 4
3 2
4. ARM LENGTHENERS
3 Arm Positions:
1. Airplane 1
2. 90/90
3. V
Lengthen both arms away
from body to Position 1, HOLD
Repeat LENGTHENER for
THE COMBINATION all three positions
Follow the colored arrows
Left arm/Left leg
Right arm/Right leg
Left arm/Right leg
Right arm/Left leg
Both arms/Both legs
14
POSTURAL CORE TRAINING
OPTIMAL STARTING ALIGNMENT

1. Foot Triangle Press to floor with center of heel, 5

outer border, an outer border, and balls of feet
2. Align Pelvis Imagine a cushion at abdomen to
maintain stable pelvis and lower back
3. Belly In Draw belly button inward toward spine
4
4. X-Bone Up Lift X-bone to lengthen upper back
5. Head Lift Lift head from top of ears to lengthen
the back of the neck 3

2
Foot Triangle
l l 1
Balls of Feet
Outer Border
Center of Heels
POSTURAL CORE TRAINING

DIAGRAM KEY
Cervical Core
(Step 5)
Example of
Targeted Muscle Area
of Spinal Core
Abdominal Core
(Steps 2,3,4)
Base of Balance
(Step 1)

15
POSTURAL CORE TRAINING: LEVEL ONE
THE TECHNIQUE
Standing Realignment Position with THE 5-STEP HOLD (page 8)
Activate Base of Balance (Step 1)
Activate Abdominal Core (Steps 2,3,4)
Activate Cervical Core (Step 5)
Place arms at instructed position, align with body
Activate deep Spinal Core muscles:
1) Move arms back 1/2 to 1 in specified position
2) Slide shoulder blades together slightly toward
colored area at center of spine
Hold 2 counts each, arm repeats 5-20 times
Breathe, relax jaw
1. Realignment Position 2. W 3. Airplane

Targets low thoracic and upper Targets lower and mid thoracic Targets mid thoracic
lumbar back muscles back muscles back muscles
Align arms with side of body Align arms with side of body Align arms with side of body
Hands 10-14 inches away from Elbows bent, close to body Arms at shoulder height
side of body, palms forward Palms forward Elbows and fingers lengthened
Elbows and fingers lengthened Palms forward

16
POSTURAL CORE TRAINING: LEVEL ONE (Continued)
4. 90/90 5. Row
Targets mid and upper Targets mid thoracic
thoracic back muscles back muscles
Align arms with side Align arms with side of body

of body Arms at shoulder height
Arms at shoulder height Elbows bent and toward back
Fingers lengthened Fingers lengthened,
Elbows bent to 90 palms down
Palms forward
6. Arms Overhead (Single) 7. Arms Overhead (Double)

Targets mid and upper thoracic Targets mid and upper thoracic
back muscles back muscles
Align arms with side of body Align arms with side of body
Lengthen and raise both arms Lengthen and raise both arms
Palms forward Palms forward
One arm repeats Both arm repeats
Switch arms

17
POSTURAL CORE TRAINING: LEVEL TWO
ARM REPEATS WITH LEG LENGTHENED
1. Foot Triangle 2. Align Pelvis 3. Belly In 4. X-Bone Up 5. Head
1. Realignment Position THE TECHNIQUE

Targets low thoracic and upper Standing Realignment Position
lumbar back muscles with THE 5-STEP HOLD (page 8)
Place arm(s) at instructed position,
Align arms with side of body align with body
Hands at side 10-14 away Slide specified foot back slightly,
from legs, palms forward lengthen leg
Elbows and fingers lengthened Press both feet into floor
Arm repeats, 5-30 times
Breathe, relax jaw
2. W Switch leg positions
Targets low and mid thoracic
back muscles
Align arms with side of body

Elbows bent, close to body
Palms forward
3. Airplane 5. Row
Targets mid thoracic Targets mid thoracic
back muscles back muscles
Position arms at shoulder height Arms at shoulder height
Elbows and fingers lengthened Elbows bent and towards back
Palms forward Fingers lengthened,
palms down
4. 90/90 6. Arms Overhead

Targets mid and upper Targets mid and upper thoracic
thoracic back muscles back muscles
Arms at shoulder height Lengthen and raise both arms
Fingers lengthened Single or both arm repeats
Elbows bent to 90 Palms forward
Palms forward

18
POSTURAL CORE TRAINING: LEVEL THREE
COMBINATION ARM REPEATS
1. Arm Overhead
with 90/90
One arm overhead, palm forward
6. Arm Overhead
Other arm at 90/90 position, with Airplane
palm forward One arm overhead, palm forward
Other arm at airplane position,
palm forward
2. Airplane with 90/90

One arm shoulder height,
palm forward
Other arm at 90/90 position,
palm forward
7. Arm Overhead with W
One arm overhead, palm forward
Other arm at W position,
palm forward
3. Realignment with 90/90
One arm 10-12 from side
of body, palm forward
Other arm at 90/90 position,
palm forward
8. Arm Overhead with Row

4. Realignment One arm overhead, palm forward,
align with body
with Airplane
Other arm at row position
One arm 10-12 from side
of body, palm forward
Other arm at shoulder height,
palm forward
5. Realignment with
Arm Overhead
One arm 10-12 from side 9. Arm Overhead
of body, palm forward with Grasshopper
Other arm overhead, One arm overhead, palm forward,
palm forward align with body
Other arm at grasshopper
position

19
STANDING DEEP ABS AND CORE TRAINING
5

THE TECHNIQUE
Standing Realignment Position
4
Hinge only at hip, maintain same

knee and foot angle 3

Repeat 5-20 times
Breathe, relax jaw

2
Stand alongside stable surface and
hold with one hand, if necessary
THE SEQUENCE
A. Leg repeats with 3 arm positions 1
Three arm positions:
1. Realignment (12-18 from side of body)
2. Airplane (at shoulder height)
3. V (hands 12-18 from head) 3
Raise one leg to 90, foot pointing forward
Lower and raise ONE LEG, hinge only at hip
Alternate hip hinge movement with each
arm position
2
B. Leg repeats with combination

Position arms according to colored dots
Realignment
<> Airplane
Realignment <> V
1
Airplane <> V
Raise one leg to 90 or less, foot pointing forward
arm position

20
SEATED DEEP ABS AND CORE TRAINING
THE TECHNIQUE
Seated Realignment Position
4
Hinge only at hip, maintain same 3
knee and foot angle
Repeat 5-20 times 2
Breathe, relax jaw
THE SEQUENCE 1
A. Leg repeats with 3 arm positions

Three arm positions:
1. Realignment (12-18 from side of body)
2. Airplane (at shoulder height)
3. V (hands 12-18 from head)
Raise one leg to 90, foot pointing forward
arm position 3

3
B. Leg repeats with combination
Position arms according to colored dots
Realignment
<> Airplane
Realignment <> V 2

Airplane <> V
Raise one leg to 90 or less, foot pointing forward
1
arm position


21
WALL LENGTHENER WITH ARM LIFT
THE TECHNIQUE 1. SINGLE ARM LIFT

Dynamic Standing Alignment Lift one arm away from wall to align
with THE 5-STEP HOLD (page 6) with side of body, HOLD 2 counts
Place toes at or close to wall Maintain lengthened arm
Position body close to, but not Repeat arm lifts, 5-10 times
touching wall (avoid over-arching Repeat same sequence with other
and straining the lower back) arm

Place arms overhead onto surface
Straighten elbows, lengthen
2. BOTH ARM LIFT
fingers
Lift both arms away from wall to
Press into floor with Foot Triangle
align with side of body, HOLD 2
Lengthen arm(s) with shoulder
counts
and upper back muscles
Repeat arm lifts, 5-10 times
Press X-bone toward wall, HOLD
Maintain alignment with all arm
lift repeats
Breathe, relax jaw
SPINE ALIGNER
THE TECHNIQUE
3 Interlace fingers behind body at tailbone,
palms facing up
1. Gently pull hands toward feet
2. Press hand into glutes at base of
tailbone or buttock, HOLD 10 counts 2
3. Slide shoulder blades together slightly
1 Feel upper back and head lift and lengthen 1
Breathe, relax jaw

22
DYNAMIC BALANCE: THE CONE OF ECONOMY
Periphery Balance is a key requirement for efficient standing and
of Cone function. Research suggests that optimal posture and
standing balance can be viewed in a Cone of
Economy.9
To achieve efficient balance, the trunk of the body

should be centered within the Cone of Economy. This
is a narrow range between which a person can remain
balanced without support.9
Trunk As the trunk of a standing person moves toward the

periphery of the cone, more effort is required to
maintain balance. If the trunk extends in any direction
beyond the cone, the person will fall over unless
supported.11
Feet: Base A standing person maintains a center of balance within

a narrow range of sway relative to the feet. The body
of Support
uses more energy when it is imbalanced, because it has
Conus of Economy (courtesy PR J. Dubousset) to work harder to stay upright. This leads to fatigue,
pain and can result in abnormal forces onto the spine.11
FIND YOUR CONE OF BALANCE
THE TECHNIQUE
1
Dynamic Standing Alignment
2 with THE 5-STEP HOLD (page 6)
8
Hold each position 5 counts
Breathe, relax jaw
THE SEQUENCE
3 Begin with Foot Triangle
7
Shift body in direction indicated
Press into floor with:
l l
1st Balls of both feet
2nd Ball of left foot
4 6 3rd Outer border left heel
4th Center of left heel
5 5th Center of both heels
6th Center of right heel
Balls of Feet
7th Outer border right foot
Outer Border of Feet 8th Ball of right foot
Return to 1st position
Center of Heels Repeat in other direction

23
DYNAMIC BALANCE TRAINING
For balance support, stand ALONGSIDE stable surface and hold with one hand
1. FORWARD LEG LIFT

Dynamic Standing Alignment with THE 5-STEP HOLD (page 6)
Shift body weight onto left leg
Press into floor with left Foot Triangle
Extend right leg forward with heel
Place right heel onto floor
Dip Pubic Bone down slightly
Keep foot forward and knee straight
Lift right heel, hinge at hip, HOLD 2 counts
Leg lift repeats, 10-20 times
Breathe, relax jaw
Repeat with other leg
2. SIDE LEG LIFT

Shift weight onto left leg
Extend right leg to the side
Place ball of right foot onto floor
Lift right foot, hinge at hip, HOLD 2 counts
Breathe, relax jaw
3. BACKWARD LEG LIFT

Shift weight onto left leg
Extend right leg back
Place right ball of foot onto floor
Lift right foot, hinge at hip, HOLD 2 counts
Breathe, relax jaw

24
HINGE MOVEMENT TECHNIQUE
(A.K.A. DIP AND GO WITH THE 5-STEP HOLD)
THE TECHNIQUE
Hinge Movement (Dip & Go):
Press into floor with Foot Triangle Hinge
Dip Pubic Bone down
at
Bend at hips, knees and ankles
hips,
knees,
and
ankles
OPTIMAL ALIGNMENT FOR SMOOTH WALKING
Dynamic Hinge Movement Dynamic Dynamic Balance for Smooth Walking

Seated Technique Standing 1. Extend front leg, heel forward
Alignment with Dip & Go Alignment 2. Step and stride onto Foot Triangle
THE 5-STEP (above) with THE 3. Raise back heel, lengthen leg, straighten knee
HOLD 5-STEP 4. Raise toes off floor to swing leg forward
(page 7) HOLD
(page 6)

25
GUIDELINES FOR MOVEMENT AND FREE WEIGHTS
OPTIMAL: LESS FORCE ON FRONT OF SPINE
Position body in Dynamic Standing* or Dynamic Seated Alignment**
for all movement and weight training (page 6*, page 7**)
Common Free Weights Body Position
Overhead press Dynamic Standing or Seated Realignment
Shoulder flexion/deltoid (forward) Dynamic Standing or Seated Realignment
Shoulder abduction/deltoid (to side) Dynamic Standing or Seated Realignment
Biceps and Triceps Dynamic Standing or Seated Realignment
Sit squat (with or without lunge position) Dynamic Standing Realignment
Wall squat Dynamic Standing Realignment
Seated Realignment Standing Realignment

Position Position
POTENTIALLY HARMFUL FORCE ON FRONT OF SPINE
The following movements can potentially damage the FRONT of the vertebrae
when done in any combination of: forward bending, trunk twisting and/or side bending.
Common Exercise or Movement Body Position

Both knees to chest Lying on back
Toe touches Seated or standing with curved spine
Hamstring stretch Seated or standing with curved spine
Knee extension Seated, knees level with hip curved spine
Forward Bend Seated or standing with curved spine
Abdominals: crunches, sit-ups, roll-ups/downs, abdominal machine

26
REFERENCES
1. Adams, M.A., Dolan, P. Spine biomechanics. Journal of Biomechanics. 2005; 38:1972-1983.
2. Adams, M.A., Pollintine, P., Tobias., J.H., et al. Intervertebral disc degeneration can predispose to anterior vertebral
fractures in the thoracolumbar spine. Journal of Bone and Mineral Research. 2006; 21(9):1409-1416.
3. Ball, J.M., Cagle, P., Johnson, B.E., Lucasey, C., Lukert, B.P. Spinal extension exercises prevent natural progression of
kyphosis. Osteoporosis International. 2009;20:481-489.
4. Bouxsein, M. Bone quality: Where do we go from here? Osteoporosis International. 2003;14:118-127.
5. Briggs, A.M., Greig A.M., Wark J.D., Fazzalari N.L., Bennell K.L. A review of anatomical and mechanical factors affecting
vertebral body integrity. International Journal of Medical Science. 2004;1(3):170-180.
6. Briggs, A.M., Dieen J.H., Wrigley T.V., Greig A.M., Phillips B., Lo S.K., Bennell K.L. Thoracic kyphosis affects spinal load and
trunk muscle force. Physical Therapy. 2007;87(5)595-606.
7. Dolan P., Adams M.A. The relationship between EMG activity and extensor moment generation in the erector spinae
muscles during bending and lifting activities. Journal of Biomechanics. 1993;26(4-5):513-522.
8. Duan, Y.B., Seeman E., Turner C.H. The biomechanical basis of vertebral body fragility in men and women. Journal of
Bone and Mineral Research. 2001;16(12):2276-2283.
9. Dubousset, J. Three-dimensional analysis of the scoliotic deformity. In: Weinsteid SL, ed. The Pediatric Spine: Principles
and Practice. New York: Raven Press, 1994.
10.Eswaran, S.K., Gupta, A., Keaveny, T.M. Locations of bone tissue at high risk of intial failure during compressive
loading of the human vertebral body. Bone. 2007 October; 41(4):733-739.
11.Lafage, V., Schwab, F., Skalli, W., et al. Standing balance and sagittal plane spinal deformity. Spine. 2008;33(14):1572-
1578.
12.Lafage, V., Schwab, F., Patal, A., et al. Pelvic tilt and truncal inclination: Two key radiographic parameters in the
setting of adults with spinal deformity. Spine. 2009;34(17):E599-E606.
13.McGill S.M. Achieving spine stability: blending engineering and clinical approaches. 4th Inter. World Congress On Low
Back & Pelvic Pain. Montreal, Nov. 2001;203-211.
14.Nachemson, A. The load on lumbar disks in different positions of the body. Clinical Orthopaedics and Related
Research: March/April 1966;45:107-122.
15.O'Sullivan, P.B., Grahamslaw, K.M., Ther, M.M., et al. The effect of different standing and sitting postures on trunk
muscle activity in a pain-free population. Spine. 2002;27(11): 1238-1244.
16.Pollintine, P., Dolan, P., Tobias, J.H. et al. Intervertebral disc degeneration can lead to stress-shielding of the anterior
vertebral body a cause of osteoporotic vertebral fracture? Spine. 2004; 29:774-782.
17.Pollintine, P., Luo, J, Offa-Jones, B, Dolan, P., Adams, M. Bone creep can cause progressive vertebral deformity? Bone.
May 2009; 45:466-472.
18.Richardson C.A., Snijders C.J., Hides J.A., Damen L., Pas M.S., Storm J. The relation between the transversus abdominis
muscles, sacroiliac joint mechanics, and low back pain. Spine. 2002; 27(4):399-405.ed. Assoc. Jan 2000 86(1).
Accepted: 2006. Phys Med Rehabil Clin N Am. 2007; 18:593-608.
19.Sinaki M. The role of physical activity in bone health: A new hypothesis to reduce risk of vertebral fracture. Phys
Med Rehab Clin N Am. 2007;18:593-608
20.Sinaki M, Mikkelsen B. Postmenopausal spinal osteoporosis: flexion vs extension exercises. Arch Phys Med Rehabil.
1984;65:593-596.
21. Stokes, I.A.F., Gardner-Morse, M. Muscle activation strategies and symmetry of spinal loading in the lumbar spine
with scoliosis. Spine. 2004; 29(19):2103-2107.
22. Zhao, F., Pollintine, P., Hole, B.D., et al. Discogenic origins of spinal instability. Spine. 2005; 30(23):2621-2630.
23. Webster Dictionary: Definitions of Effort, Strain, Integrity.
27
Marcia Tassinari, MPT
Marcia Tassinari, a physical therapist for the past 16 years, received her Masters in Physical
Therapy from Western University of Health Sciences. Diagnosed with Osteoporosis in
2002, at the age of 37 years old, she devotes all of her work to solving the problems
associated with compromised spine and disc integrity, spinal deformity, postural changes,
Osteopenia, Osteoporosis and spine fractures. Marcia has completed Levels 1 and 2 of THE
MEEKS METHOD Training. She is a frequent guest instructor at the University of St.
Augustine and San Diego Community College. Her programs and classes are currently at
The SHBA Studio in Solana Beach, Tassinari Physical Therapy in Pacific Beach, San Diego
YMCA facilities, San Diego Continuing Education, Orange County, and Santa Fe, New
Mexico. She is currently developing research through her foundation, Posture
Biomechanics Foundation. Marcia and her husband own Tassinari Physical Therapy in San
Diego, California.
Our Mission: To build stronger statures through research and education of effective movement training
and optimal postural alignment, to eliminate disability related to processes of compromised spine and
disc integrity, spinal deformity, Osteoporosis, Osteopenia, and spine fractures, and to improve the
health and well-being of individuals.
Our Purpose:
To develop programs and techniques for effective exercise and movement training which optimally
load the spine to build stronger statures and improve health
To apply this technology and technique to:

perform clinical research
demonstrate objective improvement in postural, neuromuscular and physiological factors
eliminate disability related to processes of compromised spine and disc integrity and spinal deformity
show evidence of improved health and well-being
To implement education and training programs using these proven techniques and bring this
technology to the public through community outreach, collaboration and program expansion
www.PBFoundation.org (858) 581-0062 PBFoundation.org@gmail.com
ENCOURAGING COMMUNITY WELLNESS
4747 Mission Boulevard, Suite 4, San Diego, CA 92109 114 North Rios Avenue
www.PBFoundation.org www.TassPT.com Solana Beach, CA 92075
(858) 581-0062 (858) 581-6900 (858) 581-0062

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DISCOVER YOUR POSTURAL CORE!

OPTIMAL SPINE HEALTH

Marcia Tassinari, MPT, Physical Therapist

www.PBFoundation.org (858) 581-0062 PBFoundation.org@gmail.com

Elizabeth Philbin, BA, Pre-DPT

The Tassinari Family (Rusty, Gabriella & Anthony)

Nicola Salmon, PTA

Optimal Spine Health / How Posture Affects Your Spine Health 1

EXPERIENCE 3 STEPS to build a stronger back and better posture!

A specific and easy to implement approach:

HOW POSTURE AFFECTS YOUR SPINE HEALTH

Body Structure Associated Problem or Condition

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1. Posture Alignment When the body is in an optimal, lengthened position it can

2. Body Position Lying on your back, side, or stomach are

4. Control of Movement The central nervous system controls

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AMOUNT OF FORCE ONTO SPINE (KG)

Nachemson et al. 1966

UNLOAD TO REDUCE THE FORCE ON THE FRONT OF THE SPINE

Position your body in

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UNLOADED BACKWARD BENDING FORWARD BENDING EXERCISES

These exercises can:

Research has shown that

THE BENEFITS OF A LENGTHENED ALIGNMENT

Look better and feel great!

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BE SAFE: LISTEN TO YOUR BODY!

EFFORT SCALE STRAIN SCALE

30% 1. To make a great physical or 30%

20% mental effort in order to do 20%

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KEY POINTS OF ANATOMY INCORRECT

THE 5-STEP HOLD

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THE 5-STEP HOLD

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OPTIMAL REALIGNMENT POSITION INCORRECT

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THE TECHNIQUE THE SEQUENCE:

3. BOTH ARMS/BOTH LEGS

COMMON INCORRECT SEAT HEIGHT

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Begin with THE 5-STEP HOLD

1. Foot Triangle Press to floor with center of heel, 5

POSTURAL CORE TRAINING

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1. Realignment Position 2. W 3. Airplane

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Align arms with side Align arms with side of body

6. Arms Overhead (Single) 7. Arms Overhead (Double)

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1. Realignment Position THE TECHNIQUE

Align arms with side of body

4. 90/90 6. Arms Overhead

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2. Airplane with 90/90

8. Arm Overhead with Row

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