The benefits of hanging
A conversation with Osteopath Pierre Etcheverry
As part of the Hanging Challenge, I sat down for a conversation with Osteopath Pierre Etcheverry to explore the benefits of hanging. I hope you enjoy it! If you have any questions or comments, please post them below or email me here.
SK: By way of introduction, you're an osteopath and you see people at your clinic in London. You work with athletes of different training backgrounds as well as people who just need to see an osteo right?
PE: Yes! I work with everyone, even kids. I have a range of different consultations with clients from lots of different backgrounds in terms of both training and injuries. But for every client, regardless of background, I always take a holistic approach. I try to see if the person’s body is physically well-balanced, or if there is one side that is maybe a bit weaker than the other one that we have to try to rebalance. That’s why osteos always work alongside physiotherapists or coaches to get people stronger and more balanced.
SK: I know that first-hand because you helped me rebalance myself!
So as you know, I recently started my hanging challenge and I asked for your opinion on it. I started the challenge because hanging helped me personally; I used to be very hunched over, and over time regular hanging helped me get a little bit straighter in my posture.
Along the way I realised that the Israeli trainer Ido Portal had created a similar challenge many years ago, but his was a lot more intense - it was seven minutes of hanging a day for 30 days. I actually took part in Ido’s challenge and within it, I was recommended a book by Dr Kirsch, which I bought and read. I mentioned the book to you and you said yes, it's a great book, you should definitely read it!
In the book he basically makes the argument that through his own practice and research, he has discovered that hanging has become a form of rehab for a lot of his patients. He even wrote that in some cases, it helped patients to avoid the need for surgery. Would you mind explaining the basics of this idea to me again?
PE: The book talks about how, in terms of anatomy, hanging causes the shoulder to move and how hanging from a bar passively can bring benefits.
When you raise your arm fully overhead, you create space between the end of your collarbone and the top of your arm and you actually decompress and free up the tendons in that area. This helps with both rehabilitation and strength. It’s interesting because a lot of people think that holding your arms overhead would actually cause the tendons to compress due to the unusual position, but it’s actually the opposite effect.
That’s what’s so interesting about passive hanging from a bar; it brings so many benefits and could help some people avoid surgery further down the line.
SK: Do you ever suggest to your patients to hang more? How do you use hanging pratice as a tool for recovery?
PE: I use hanging in two ways. Firstly, I use it as a test. When you ask people to passively hang from a bar, they give you feedback. They tell you, oh I feel a stretch into my forearm or they say, actually I feel a stretch into my lats or I'm tight on my chest.
So for me as an osteopath and for the other professions as well, it gives us a clue about what to investigate during the consultation. It’s a good indicator to see where there might be some musculoskeletal imbalances or tension.
Secondly, I use hanging as a rehab exercise. I have found that for some people, hanging has some really great benefits, which we're going to talk about later on.
SK: A question that I was asked a couple of times was, how come we don’t hang more these days? Why aren't more people mentioning hanging as an essential part of our training? If it's so beneficial, why aren't we doing it more? Why is it so neglected?
PE: That's a good question. Perhaps there are a few reasons.
Other than the book we talked about that was published a long time ago, there is not a lot of research on it. The only real way that people get to find out about it is from coaches and trainers or surgeons, osteos and physios. It’s shared more by word of mouth.
Secondly, I would say that some people are a bit scared; they don't know if they might damage their joints by hanging on the bar at home. They might also associate hanging from a bar with pull-up practice, and if they can’t do pull-ups they might not think there is much point practising on a bar.
SK: Would you say 100% of the population should be hanging? Or 90%? Who should and shouldn't?
PE: It’s always hard to say who shouldn’t be doing certain things. If you are unsure, you should always ask your health practitioner for advice first before trying anything new.
There are however, a few indications for me where I wouldn't advise doing it:
If you have a dislocated shoulder, or a very unbalanced shoulder, hanging would not be the first thing to do. I would start with other rehab exercises first.
If you have severe osteoporosis as well, so if you have very weak bones, or very damaged cartilage, I would be careful. I wouldn't completely say no but I would do some other overhead exercise tests first before hanging on a bar.
But apart from these conditions, I would say everyone can try hanging. I would always say be careful about the level of pain as well. If there is any pain at any point, don’t carry on.
This is where coaches and trainers are good with helping people build up to a full hang. For example, you could start by using a little step at the start to help progress through to further movements.
SK: Exactly, you can always start with your feet touching the ground and then if you feel comfortable, you can progress to a full-body hang in the air.
And also as you said, if there's pain don't do it. For someone who hasn't had a dislocation, isn't suffering from osteoporosis and has checked it with their physio, if there’s no pain would you say that they are good to go?
PE: Yes, I would say that. Sometimes, pain is very different for every person so I would say be mindful.
Our generation is also very sedentary. The majority of us work sitting in front of a desk without much opportunity to move overhead. So sometimes when you test some people, they feel quite stiff or they don't have the range of motion. There might even already be a bit of pain, so it's about scaling up slowly and progressing at a comfortable rate.
So, key things:
Be aware of any pain and how painful it is
Double-check practicing anything new with your practitioner
And if you don't have any of the ‘severe conditions’ we mentioned before or huge instability, go for it!
SK: What about hanging for kids? Let's say I had a five-year-old child and I am waiting underneath them in case they fall; is it a good thing for children to be practising? I’m asking this as someone who has been used to being hunched over on the computer for years and finding that now, it can be quite difficult to get started. But if we start our kids hanging from a young age, is that a good thing to be doing?
PE: When you watch babies’ movements, one of the first ranges of movement that they explore is actually reaching overhead. It’s a similar story with little kids at the park. They are commonly reaching overhead and pulling themselves up with their knees naturally coming forward. And they’re doing this from instinct.
So hanging is definitely a movement that can be practised by kids and it’s something that they will automatically do. If they don’t practice it, they will do it anyway!
SK: It’s just at some point they stop! I don't know if I ever hung as a kid and I don't remember ever hanging at school. I might have hung from some trees once in a while and on climbing walls. I did do quite a bit of climbing actually! But actual vertical hanging from bars, I never did. I think that’s a bit of a wasted opportunity because the earlier you start, the better.
PE: I think we’ve just lost it as we’ve evolved. We’ve become more accustomed to forward motions and having our shoulders facing forwards. I think just by doing some hanging practice from an early age, we could prevent some back issues.
SK: It's such a pertinent topic right now when so many of us sit down to work and look at a screen or look down at our phones. Something is needed to fix that and hanging seems like the obvious choice. More people like you and me need to tell the world that it's safe and to dispel some of the doubt and insecurity around it.
PE: I really like what you’re doing with your Hanging Challenge and what you're trying to build right now because it makes people realise that hanging can be very beneficial for them. It also helps to spread the word in a fun way as well.
SK: I’ve been quite impressed with my Hanging Challenge group because there are all kinds of people of different ages getting stuck in. People have bought home pull-up bars for the first time, other people have found monkey bars in their neighbourhoods and it proves that if there’s a will, there's a way. Is there anything else that I haven't asked that you feel we should discuss?
PE: I also wanted to talk about some of the benefits of hanging that I've seen with some of my clients.
The first one that many people often felt straight away was spinal decompression, where a bit of space is made between each of your vertebrae and the sensation is felt almost instantly. Then when they release from the bar, they feel like their chest is more open, their shoulders are pushed back and their shoulder blades feel more connected. Overall, this is a good position.
The second one is more grip strength. I saw this more in people who already train a lot. For example, some of my clients who are into CrossFit would tell me, “my grip is not that strong when I deadlift or when I do pull-ups” and would ask, well have you practised just hanging from the bar and seeing how long you can last? And usually, they would say no.
When you start to build up from that simple hanging movement, you start to feel the benefits in your gymnastics and lifting movements.
In terms of more medium to long-term benefits, I would say shoulder flexibility and stability is a really important one. Especially shoulder blade stability and strength, which prevents a lot of shoulder and back injuries later on.
Those are the main benefits but there are some secondary ones as well. For example, if you do a dead hang with your feet forward and engage your core, it becomes a great exercise for core strength. So you’re targeting two areas of the body in one movement, which is always great!
I'm sure there are other benefits too, but those are the key ones that myself and my colleagues have noticed. The benefits are so great from such a simple movement.
SK: I agree with all of those things but the most interesting one for me is when you talk about the decompression of the back as back problems affect so many of us. A lot of people are now seeing a very pronounced S-curve in their backs and hanging is a great opportunity to just stretch it out and get it more in line.
I actually use hanging to decompress my back in between squat sets. I feel like if I’m going to put even more weight on my back I should try and undo the damage a little bit!
The grip strength is also an amazing insight because the one thing that people doing my hanging challenge complain about the most is their grip strength. It seems to be our weakest link, doesn’t it? You can only hang for as long as your grip can keep you there.
I think a lot of people think, but I'm just hanging, I'm not actually doing anything?! It looks like you're not doing anything but you're doing a lot!
PE: Exactly. Also we’re just talking about doing passive hanging. If you do an active hang where you activate your lats and position your shoulder blades in a particular way, then you will start to activate even more muscle, strength and stability. This is a different type of hang with its own benefits.
SK: Hanging is both a stretching and strengthening movement and you can use it as you like. You can just hang and try and get straighter, or you can do active hanging and focus on more strengthening movements to get stronger.
Some people are already able to get perfectly vertical while others are not quite there just yet. That was me six years ago - I couldn't get my elbows to go straight up over my shoulders. Hanging helped me get that into that range and it took a very long time, and I'm still not entirely there, but it just helps bring everything into alignment just because of gravity.
It also helps the shoulder blades slide, doesn’t it?
PE: Yes it does. If you’ve got a good movement in your shoulder blades, then you've also got good movement on your shoulder joints. You can't have great movement on your shoulder if your shoulder blades are not moving properly. It’s all in one movement. So working on your shoulder blade flexibility and strength is going to give you stronger shoulders as well.
SK: Hanging is definitely a much easier movement than pushing. For example, I can passively hang with a 60 kg weight (myself), but I definitely can’t overhead press 60kg! If you had a patient who was quite hunched over and they went away and practised hanging over a long period of time, would they be straighter?
PE: I wish it was that simple! The hanging position might improve some range of motion or some flexibility, but if the person was really hunched forward, they might have another condition that would need other work as well. For example, flexibility work on the thoracic spine, core strength etc.
Hanging is a first step to recovery. Do it, and you will see improvement, but it’s not the be-all and end-all. It will help to a certain extent, but then depending on how severely the back is hunched (kyphosis), they may need other treatments as well.
SK: Looking at the other extreme now, let's say I'm a CrossFit athlete and I do quite a lot of pressing. What is the benefit of focusing on straight arm strength? Either hanging or pressing with straight arms?
PE: CrossFitters have a very high intensity of training and also do a lot of skilled movements whether it's in Olympic lifting or in gymnastics. Incorporating hanging into your routine may help to prevent some injuries and maybe help to open your joints up a bit more.
The problem when you do a sport with very high skill is that your joints and muscles can often tighten up. As you say, hanging provides a good stretch as well and every stretch is beneficial. Whether you're doing a press, an overhead snatch or squats, hanging is just going to help you to maintain healthy shoulders.
When you do a CrossFit class the coach will often get you to warm up by doing a dead hang from the bar, then an active hang and then maybe some kipping as well. These movements are great for both a warm-up and cool-down after a heavy workout on your shoulders. They stimulate the blood flow to the area, to your joints and also stretch all of the tissues out a bit.
Hanging is such a simple movement that you can practice as often as you like.
SK: Thank you so much for your time Pierre!
If you already work with an osteopath, physiotherapist, chiropractor or any physical therapist, wy not ask them about hanging.
If you are looking for a consultation with an osteopath, you can contact Pierre at pierreosteopathy@gmail.com or book a session directly with him here.