Don’t Run with (open) Scissors

by Mitch Hauschildt, MA, ATC, CSCS

“Don’t run with scissors!”

That was something that we all learned from our parents when we were kids, right? The thought of tripping and impaling someone with a sharp metal object is pretty scary as both a child and adult. I was curious, so I did a quick search and I did find a study published back in 2003 that concluded that scissors were a major cause of eye injuries in children below the age of 6. So, I guess there’s something to some of the things our parents harped on over the years.

Enough about the actual scissors that cut people. I’m interested in the classic open scissor posture.

This past weekend, I had the privilege of teaching an FMT Basic course in San Antonio. One of the postural corrections that we talk about in the course is the open scissor posture. I don’t have a ton of time to talk about it in the course, so I thought maybe I should be into a little more depth about it here. I was further encouraged to write about it when one of our collegiate football players, who presents with a classic open scissor posture, came in today with a hamstring strain he sustained while running a sprint workout.

What is an open scissor posture?

The classic open scissor posture is when a patient stands with an anterior pelvic tilt (the bottom side of the scissors) and a rib flair (the top side of the scissors). This person typically has all of the signs of Janda’s lower cross syndrome, including shortened and overactive hip flexors and lumbar extensors, as well as lengthened and under-active lower abs and glutes. Then when you couple this with a dysfunctional diaphragm and poor core function (the top side of the scissors), you get a classic open scissor posture.

Why is it a problem?

When combining both some of the research that exists with years of clinical experience, the open scissor posture can be associated with the following (I’m sure there are more, but this is a good starting list):

• Foot pronation and pain
• ACL Tears
• Hamstring Strains
• Hip Flexor Strains
• Low Back Pain
• Shoulder Dysfunction
• Poor running mechanics

To take the football player that I mentioned earlier as a classic example, in his typical walking and standing posture, his hamstrings are always on stretch. Because of the origin of the hamstrings being on the Ischial Tuberosity, when the pelvis rotates anteriorly, the hamstrings get stretched out. When you combine that with poor pelvic control due to a lack of inner unit trunk stabilization, you have a recipe for a hamstring strain (or anything else on that list that happens to be the weak link that day). For him, that weak link today was his hamstrings. But, tomorrow it may be low back pain or it might be a shoulder issue. They all come back to the underlying postural issue. This is why we never want to just treat the injury sight. We have to get to the true cause of the dysfunction.

How does it happen?

I find that it typically happens over a period of time (several years) and can happen in both athletes and sedentary people. Athletes who spend a lot of time squatting, deadlifting and sprinting are more likely to present with it than other athletes are (i.e. distance runners, swimmers, etc). I tend to see open scissor posture in women’s track sprinters, football players, and high performing cross fitters, although it can happen with a lot of other athletes who compete in other sports.

The athletes who compete in the aforementioned sports tend spend a lot of training time with their pelvis in an anteriorly rotated position and they tend to do things that encourage low back dominance. If they don’t train against it and get control of their breathing, over time their posture will decline.

Sedentary individuals with open scissor posture typically don’t have much by the way of core and trunk stability. Because they have low tone and neuro control in that area, they rely on the bony structures of their lumbar spine for stability. This is pain and injury waiting to happen.

Regardless of whether they are athletic or not, the underlying problem usually begins with a lack of stability and which then leads to a mobility issue. The dysfunctional mobility – stability relationship then begins to perpetuate itself and the longer it goes on, the harder it is to fix.

How do you fix it?

There are a number of strategies to fixing it. I recommend that you start with working on the mobility issues that exist. Go after the hip flexors and lumbar extensors. They are also likely restricted in their thoracic spine and their diaphragm, so they need to be released as well.

Remember to always train mobility before stability. Use manual or instrument assisted work to decrease tone and then perform mobilizations, stretches or whatever other tools you prefer to improve mobility. But, don’t stop there. Remember, they are immobile because of their underlying lack of stability. If you never address the stability problem, they will get better in the short term, but they will end up right back in your facility a few weeks down the road with the next weak link.

So, after you work on the mobility portion, the real work begins. I prefer to start right where a lot of their issues begin…breathing. We perform a lot of diaphragmatic breathing work. If they can’t control their diaphragm, they will never have true inner unit stabilization. As they get better with breathing and their thoracic rotation improves, then we move on to rolling patterns. This is another way to promote core and trunk control.

Once we can demonstrate basic control with those movements, I like to move into some more demanding postural positions. You can do a number of things here…work in tall kneeling, planks, farmers carries and so on, but the key with all of them is that they have to close the scissors and keep them closed. I tell my athletes to pull their lower ribs close to their ASIS. If you’ve done things well up to this point, they should be able to work on breathing in all of those various postural positions.

From there, correcting the open scissor posture is a matter of continuing to progress and challenge them in new positions and gravitational environments with the scissors closed until they can do it consistently all of the time.

Overall, there are larger health risks than an open scissor posture. But, open scissors does expose your patients to some pretty significant musculoskeletal injuries and performance problems. Will it kill you to run with open scissors? Not likely, but it certainly isn’t recommended.

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