My Journey to a Stronger Core & Better Posture After Stroke

Did you know 80% of Americans suffer from poor posture? [1] These days we have more desk jobs and spend much of the day sitting hunched over at our computers than ever before. This is a health concern already, let alone adding a neurological condition where poor posture is a side effect! After my stroke, I had very little attention from therapy, and I neglected my affected side for years. It has been 12 years since my stroke and since then the effect on my posture is apparent. It is from that disuse of my affected side that inspired my idea for an affected side workout for other survivors.

May is stroke awareness month and we should all know the warning signs of a stroke. I was 25 when I had a stroke and didn't even know what a stroke was. I awoke from a coma to find my left hand curled up against my chest, unable to move it. They told me I had suffered a stroke and had been in a car accident. I spent two months in the ICU followed by several months in a nursing home. I finally returned home 11 months later. Learning to walk, talk, and eat was humbling.

The 12 years since my stroke has taught me so much. I went through the difficulties. I know the long-term effects from learned limb disuse, however, I was able to reverse the effects. I learned the things to focus on so I could make progress. Above all, I have learned the lifelong commitment needed to be a stroke survivor and not a stroke victim.

What is a stroke anyway?

Since we are in stroke awareness month, let’s start from the beginning. A stroke occurs when blood supply is blocked off to part of the brain (ischemic), or a blood vessel in the brain ruptures (hemorrhagic). The brain cells die within minutes due to a lack of oxygen and nutrients.

There are several warning signs of a stroke. Some include:

• trouble speaking or understanding words

• numbness or tingling in the face, arms, or legs

• weakness or paralysis on one side of the body

• and problems seeing or walking [2]

The faster someone receives medical attention usually means the less severe the side effects a person has. Every minute a stroke is untreated, two million brain cells die [3]. Time is of the essence.

The acronym BE FAST is often used to remember the signs to look for:

Someone has a stroke in the United States every 40 seconds. Every 4 minutes someone dies from a stroke. A stroke is the leading cause of long-term disability in the United States [4].

Side effects of a stroke

Side effects tend to differ, depending on the side of the brain the stroke occurred. Some side effects include:

• weakness and/or paralysis on one side of the body

• numbness and tingling

• spasticity of the muscles on the affected side of the body

• the cognitive process can change,

• less aware and cognizant of people and surroundings

• difficulty staying focused or paying attention,

• the way in which we learn can change

• poor judgment

• difficulties swallowing and chewing

• emotional changes and depression are possible

• as well as difficulties remembering things

A stroke occurring on the left side of the brain affects the right side of the body and vice versa; some of the effects above can be experienced regardless of the side of the brain the stroke occurred on, like memory difficulties, swallowing, paying attention/focus, cognition changes, and emotional changes.

Hemiparesis and hemiplegia are probably the most thought of effects of a stroke. They are slightly different. Hemiparesis is a severe or complete loss in strength on one side of the body while hemiplegia is a slight weakness or mild loss in strength. I try not to ever use the word paralyzed because with nerve damage, never say never! With exercise therapy, resiliency, and persistence anything is possible!

I have hemiplegia and over the 12 years since my stroke, I noticed a few things. It was some Bob & Brad YouTube videos that first got me to pay attention to my mechanics a bit more and taught me some basic exercises to incorporate into my daily strength sessions. Up until then my experience, or lack of experience and attention on my left arm in the nursing home and afterward in outpatient therapy left me with the impression improvements were not possible. I honestly felt given up on, so I gave up.

Stroke survivor turned personal trainer

Two years post-stroke I was inspired by some family members to start walking more when visiting them. Honestly, I was surprised by what I could do and how much I was able to work up my endurance. After returning home I kept it up. I was addicted. Thinking back, I remember walking to the nearby gym just to walk some more on the treadmill.

The physical activity was releasing the hormones dopamine and serotonin, among others. Dopamine is sometimes called the "feel good" hormone due to it giving you a mood boost. Besides a boost in mood, there are so many benefits we get from exercise.

Along with walking, about 4 years post-stroke I started strength training. I began to notice my left (affected) arm getting stronger. I also noticed I was dropping the weights less, and my grip strength steadily increased. My gait also got better. I loved the gains I was seeing. I worked on strengthening my stroke-affected side daily. The depression I was experiencing lessened. It wasn't like it disappeared, but I just had a better mood most of the time. I also began to participate in my own life. Exercise was therapeutic, it became my therapy session, both mentally and physically.

Looking back, I feel like I really became my own physical therapist. I tried out different exercises to see what I could do and what helped the most. Exercise gave me focus. It began to give me information that I used to improve the exercises I did on my left side.

Exercise was so important to me that I wanted to help others, especially stroke survivors and those with neurological conditions. The activity became such a pivotal moment in my recovery. I had both mental and physical benefits to my exercising. I wanted to share it with everyone. In fact, I became a certified personal trainer with a specialty in exercise therapy and corrective exercise.

As I studied the body systems, I was amazed at how perfectly the body was designed to support all the different body systems through checks and balances. Specifically with the musculoskeletal system, if one part of the body is out of alignment it is compensated by the other side, creating a misalignment to make up for it. I was in awe of how perfectly structured our bodies are. Studying this got me to slow down and pay attention to my form. Good form allows us to work the muscles we are intending to work. It was this self-study that first brought me to the Bob and Brad YouTube channel. I first saw the videos they made to help stroke survivors as well as how much emphasis they had on posture.

I began to realize how I was sitting every day. I was hunched over, my trunk was leaning inwards, shoulders rolling in. Anything that can be wrong was. Bob and Brad talk about posture a lot. Everyone, not just those that have had a stroke should be aware of their posture. Through my studies and their videos, I realized my posture had really suffered in the last 10+ years since my stroke.

In my personal training class, I learned a posture self-check we can all do.

Here are the steps:

1. Stand with your back facing the wall.

2. Good standing posture will have the back of the head, the upper back, butt, calves, and heels all in contact with the wall.

After doing this self-check, how is your posture? Now you know the things to focus on in your own day to day and exercise regimen.

Sitting at a computer or staring at our phones are big reasons for poor posture. A seated posture self-check I do every time I feel a rounding of my back or my shoulders rolling forward, I sit tall. I tighten the core, not so tight it's uncomfortable and you can't breathe, but tuck the butt in a little, causing us to engage the lower abdominals and we will naturally sit taller. I also push my shoulders back a little like you’re pinching a quarter with your shoulder blades and then release. As you relax, just let them fall into a natural position. Sitting tall like this can feel like hard work, and that's because it is! But the more we sit with good posture, the easier it will become.

As a trainer with my specializations, I am dedicated to helping stroke survivors stay active post stroke and sharing the information I wish I knew 12 years ago.

Improving posture post stroke

The goal of core exercises is to strengthen the entire trunk of the body. This includes the front abdominal, lower abs, internal and external obliques, and all the muscles of the upper and lower back. The front supports the back and vice versa. If you find you have poor posture or back pain, a stronger and more supported core can absolutely help this.

FOR EXAMPLE: My upper back hunches and my shoulders roll forward. To some degree we are all guilty of this, sitting at a desk all day hunched over a computer or looking down at our phones.

To work on these specific areas, I would want to work the chest and upper back, as well as shoulders. If I do my seated posture check, that will naturally involve opening my chest as I sit taller and letting the shoulders rest at neutral.

Sitting tall with your shoulders square and chest up, it feels good, right? This is how your body is anatomically happy!

You may notice your core getting tired, especially keeping the abs engaged, but it will get easier as you get stronger. You will also notice sitting taller allows you to breathe easier because the lungs can fully expand.

With all this focus on my posture, the hunching and rounding forward of my shoulder and upper back that I noticed would always begin with my affected (left) side. Years of disuse and neglect caused me to let the muscles slack in having an upright posture. Bob and Brad's YouTube channel has so many exercises to improve and correct your posture.

Correcting my posture is synonymous with strengthening my core, especially the affected side. Our posture begins and ends with having a strong core, and to improve core strength and in turn, posture, I put together a short five exercise affected side workout to strengthen our core.

All the exercises are ones that focus on one side of the body at a time. It is a perfect workout for someone who has not had a stroke to do; I recommend doing it 3 times through. It is also perfect for a stroke survivor to do because you can isolate strengthening on one side at a time. For the survivor, I recommend doing 2 rounds on both sides as shown in the video, and a third time by strengthening just the affected side. Because my posture stems from a weaker affected side, doing exercises that isolate the strengthening to one side of the body will help the affected si

de get as strong as the unaffected.

Doing posture self-checks gives us the awareness to sit tall. Exercising and improving core strength greatly helps us improve our posture. I love the emphasis on posture Bob & Brad have because whether you have had a stroke or not, good posture and core strength can reduce pain felt over time.

My social channels to help stroke survivors:

I have a YouTube channel, Stroke Strength Support, with videos that are stroke recovery-related. To encourage activity post-stroke, I have exercise videos. I have videos sharing what is currently working for me, I also talk about how to keep a positive mindset in recovery, and how to build the habits that will help in recovery. I am trying to be that person I wish I would have had to talk to after my stroke.

I have a Facebook group: The Stroke Sweat Squad. We share our individual journey, the exercises we do, the ones that could help you, and we help you keep a positive mindset which is so important.

My blog, Stroke Strength Support, is to spread the information everyone needs to know about a stroke, especially other survivors. There are options out there and I want to share all the information I wish I had 12 years ago so others have an easier recovery than mine is.

I also have a separate YouTube channel focused on exercise that is low-impact and would be for anyone, stroke or no stroke at Exercise for Therapy.

I love hearing from others and would love to connect with you! Feel free to send me an email with any comments or questions! Please feel free to email me at michelle@strokestrength.support