Low Back Pain – The Price of Poor Posture

Do you remember when your fifth-grade teacher scolded you for slouching?  “Stand up straight, young man – and take your hands out of your pockets.”

Sounds like she was giving you some good, therapeutic advice.  If she were a physical therapist, she might have said, “Flatten out that kyphotic-lordotic curve, adduct those shoulders and, while you’re at it, add some posterior tilt to your pelvis.”  If you had followed that advice, it might have helped you avoid many episodes of painful, low back pain. 

There’s no doubt that faulty posture is a significant cause of low back pain.  Thankfully, it’s a condition that can be corrected with a few special exercises and some new, postural habits.

Ideal Posture

In the ideal posture, viewed from the side (A), the normal spine assumes a gradual, S-shaped curve – convex at the top (kyphosis) and concave at the bottom (lordosis).  The head is centered over the cervical spine and not tilted or rotated in any way.  Remember, the position of your head and neck will be affected by the conformation of your upper back.  If you allow your upper back to slump into a rounded, “hunched” position, your head will be thrust forward and downward into an increasingly uncomfortable position (B). 

The pelvis is in a neutral position – crest of the ilium directly positioned over the hip joint.  The forward part of the ilium is in vertical alignment with the pubic symphysis (A).  

Kyphotic-Lordotic Posture

In B, the S-shaped curve is exaggerated.  The kyphotic curve of the upper back is pronounced and the head and neck are forced forward.  Weakened abdominal and spinal muscles allow the pelvis to tip forward and increase the lordotic curvature. This adds strain to the lower back.

Corrective Exercises

Add the following exercises to your daily routine. If you’re overweight, modify your diet. Excess body weight tends to increase lordotic curvature and add considerable strain to the lumbosacral joint.

Upper Body

• Mild stretching and then strengthening of the muscles behind the neck (extensors) will help you establish a more erect position of the head.
• Strengthen the thoracic spine extensors (upper back) to elevate the chest.
• Add deep breathing exercises to your daily routine.  This will help stretch the intercostals and expand the chest.
• Stretch the adductor muscles of the shoulder and pectoralis minor to help bring the shoulders back to a more normal position.

Lower Body

• Strengthen the muscles of the low back.
• Strengthen abdominal musculature with posterior, pelvic tilt exercises.
• Avoid sit-ups.  They shorten the hip flexors and increase lordosis.
• Temporary use of a corset or brace can relieve the strain on abdominal muscles as you train yourself to stand, walk and sit in a more erect position.

The trainer at your gym should be able to show you the proper exercises to achieve these goals.