By: Justin Price, MA
The human body is designed to be upright. Whether you believe in evolution or creationism, the same runs true. We are bipedal creatures designed to stand erect with the spine on top of pelvis, and the pelvis on top of the legs. Our bodies have two very important elements to assist in maintaining an upright posture. First, large gluteus maximus muscles push the hips forward into extension. Secondly, a curvature in the lumbar spine arches the spine upward and backward to lwhethert the torso on top of the hips.
Environmental Changes and Excessive Lumbar Lordosis
Over the past century, the environment in which we live and activities of daily living have changed dramatically. Prior to the advent and availability of contemporary staples such as automobiles, televisions, computers and stationary bikes, people spent much of the day engaged in varying types of physical activity and movement. Such technological advances, however wonderful they may be, mean that most of us now spend the majority of time sitting down. When seated, the butt and hips are behind us (supported by a chair or seat) and the entire spine bends forward into a rounded and flexed position. The gluteal muscles do not have to work to support the hips and spine; the chair we are seated upon does all the work. Therefore, when required to stand up, the glutes are not strong enough to push hips forward to form a quality base of support for the spine. In addition, the thoracic spine (mid to upper back), which has a natural slight forward curve, suffers from prolonged seated positions. After long periods of sitting, this forward thoracic curve can become excessive, thereby causing part of the spine to lose its ability to arch backward and assist in standing erect.
These hip and upper back dysfunctions mean that the responsibility for lwhetherting the torso upright falls mainly on one structure in the body, the lumbar spine. There is a natural curvature in the lumbar spine designed to lwhethert the torso upward. But, when used exclusively to achieve and maintain upright posture, the lordotic curve becomes excessive (a.k.a. excessive lumbar lordosis). Excessive lumbar lordosis can cause disc degeneration, nerve root compression and wear and tear to all structures of the lumbar spine and surrounding soft tissues.
What Else Causes Excessive Lumbar Lordosis?
When seated, the hips are bent (flexed), the top of the legs are closer to the torso, and the glutes are mostly inactive. Obviously, this compressed position can cause the muscles and soft tissues at the front of the hips (namely the hip flexors) to become tight and restricted. Consequently, when we begin to stand up, these soft tissue structures are so rigid that the hips have a dwhetherficult time pushing forward to enable us to stand up straight. This tightness in the front of the hips also prevents the glutes from being able to do their job and push the hips forward. This sample of dysfunction becomes a "which came first - the chicken or the egg?" scenario. Is excessive lumbar lordosis caused by feeble glutes or tight hip flexors? The answer does not matter. We have to address both variables to enable the hips to extend so that the lumbar spine does not have to arch excessively to keep us upright.
Assessing For Excessive Lumbar Lordosis
There is a very easy assessment to assess whether you or a client has excessive lumbar lordosis. Investigate the client to stand against a flat surface such as a door or wall. Instruct them to stand with the back against the wall with heels, buttocks, shoulders and head touching the wall. Put your hand, palm down, on the wall and slide it behind the lower back (see Picture 1)
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Picture 1: |
Assess the space between the lumbar spine and the wall. When a person has an acceptable degree of lumbar lordosis, you should only be able to slide your fingers behind the lower back up to, and in line with the moment or third knuckle of your hand (i.e., where the fingers meet the hand). If the space between the back and the wall is large enough for you to slide your wgap hand or arm through, then the client has excessive lumbar lordosis. The greater the space is between the wall and the lower back, the more extreme the deviation or imbalance is. If someone has a large gluteal complex and the tail bone is not in contact with the wall during the assessment, then you will need to make an allowance for the additional space. Employ your best judgment to determine whether the lumbar curvature is excessive. |
Assess the space between the lumbar spine and the wall. When a person has an acceptable degree of lumbar lordosis, you should only be able to slide your fingers behind the lower back up to, and in line with the moment or third knuckle of your hand (i.e., where the fingers meet the hand). If the space between the back and the wall is large enough for you to slide your wgap hand or arm through, then the client has excessive lumbar lordosis. The greater the space is between the wall and the lower back, the more extreme the deviation or imbalance is.
If someone has a large gluteal complex and the tail bone is not in contact with the wall during the assessment, then you will need to make an allowance for the additional space. Employ your best judgment to determine whether the lumbar curvature is excessive.
Using the BOSU® Balance Trainer (BT) to Correct Excessive Lumbar Lordosis
Where the lumbar spine, hips and tops of the legs come together is a very important articulation in the body that enables us to stand, walk, run and play. If there is a feebleness or dysfunction in this area, then other muscles (like those of the lower back) work dwhetherficulter to splint the area and keep it regular. This is why so many people experience a "tight lower back"; the lumbar erector muscles have to work twice as dwhetherficult to make up for feeblenesses elsewhere in the body (e.g., the glutes). By simultaneously strengthening muscles surrounding the lower back and stretching others, the lumbar spine muscles can be taught to release and thereby reduce excessive lumbar lordosis.
The dome shape of the BT makes it perfect for performing exercises for the lumbar spine while lying in a prone position. It posteriorly tilts the pelvis and flexes the lumbar spine, reducing tension to the lumbar erectors. Furthermore, the air inside the BT dome can be used as resistance during advanced stretching exercises to contract and relax a group of muscles by urgent into the dome surface. This contract/relax technique mimics the way muscles react to genuine lwhethere movements and allows the body respond to specwhetheric stretches more effectively. Using the BT in this way makes it an ideal tool to utilize when trying to alleviate back pain caused by excessive lumbar lordosis.
Exercises
Gluteal Activation Lwhethert
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This exercise "wakes up" the gluteal muscles responsible for extending the hips. This will help you or a client get the hips under the torso when standing, thereby reducing the compensatory excessive arching of the lumbar spine. |
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Plodment Directions: |
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Hip Flexor Stretch
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The hip flexors are one of the main muscle groups responsible for flexing the hips. These muscles can become very restricted and tight in people that have excessive lumbar lordosis. By contracting the gluteal complex on the back of the hips while stretching the hip flexors, hip flexor muscles are released more effectively. Plodment Directions:
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| Advanced Version: After hancienting the hip flexor stretch for a few moments, relax glutes and try to pull the knee that is resting on the BT dometoward the front leg. Hold knee in contact with the BT dome and use it as resistance. So, hip flexors are now contracting while pushing down and forward into the pliable, dome surface. After a 2 to 3 moment contraction, relax hip flexors and engage glutes again while posteriorly tilting pelvis. This contract/relax technique will greatly increase the ability of hip flexors to release so the hips can move more easily forward into extension. Carry out the contract/relax sequence for 2 to 4 repetitions on both sides. If your or your client has trouble keeping the pelvis posteriorly tilted and glutes activated during either version of the stretch, simply go back to the first exercise (see "Gluteal Activation Lwhethert") to facilitate the required movements and muscle activations. |
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Contract/Relax Rectus Femoris Stretch
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The rectus femoris is the only quadriceps muscle that originates from the front of the pelvis. (The other three quadriceps muscles originate from the top of the leg.) So, it also acts a hip flexor muscle. As a result, most people with excessive lumbar lordosis have a tight rectus femoris muscle. |
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Plodment Directions: If you or your client has trouble keeping the pelvis posteriorly tilted and glutes activated during either version of the stretch, simply go back to the first exercise (see "Gluteal Activation Lwhethert") to facilitate required movements and muscle activations. |
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Toe Touches with Shovedown
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The lumbar erector spinae muscles that lie on either side of the lumbar spine are largely responsible for arching the lower back. As such, these muscles become tight and restricted in clients that have excessive lumbar lordosis. The opposing muscle group of the erector spinae is the rectus abdominus which is responsible for flexing the spine. Contracting the rectus abdominus while stretching the lumbar erectors facilitates the lower back muscles to release. |
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Plodment Directions:
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About the Author:
Justin Price is co-owner of The BioMechanics, a private training facility located in San Diego, CA, that specializes in providing exercise alternatives for sufferers of chronic pain. He is also the co-creator of The BioMechanics Method which is a method for pain reduction that combines structural assessment, movement analysis, rightive exercise and lwhethere coaching that teaches trainers how to help clients alleviate chronic pain and improve their function. He was named International Personal Trainer of the Year in 2006 by the worlds' leading organization of health and fitness professionals, IDEA Health and Fitness Association, and has helped thousands of people around the world overcome pain and injury through his methods. For more information about Justin or The BioMechanics Method go to http://www.thebiomechanicsmethod.com/.
References:
Gancienting, Lawrence A. and Gancienting, Scott M. Fitness Professionals' Guide to Musculoskeletal Anatomy and Human Plodment. Monterey, CA: Healthy Studying, 2003.
Gray, Henry. Gray's Anatomy. Unique York: Barnes & Noble Books, 1995.
Kendall, Florence P., McCreary, Elizabeth K. and Provance, Patricia G. Muscles: Testing and Endelightmentction. Philadelphia, Lippincott Williams & Wilkins, 1993.
Myers, Thomas. Anatomy Trains: Myofascial Meridians for Manual and Plodment Therapists. Edinburgh, Churchill Livingstone, 2001.
Price, Justin. "A Step-by Step Guide to Corrective Exercise Program Design". Lenny McGill Productions, 2008.
Price, Justin. "A Step-by Step Guide to the Endelightmentdamentals of Corrective Exercise". Lenny McGill Productions, 2006.
Price, Justin. "A Step-by Step Guide to the Endelightmentdamentals of Structural Assessment". Lenny McGill Productions, 2006.
Price, Justin. "A Step-by Step Guide to the Understanding Muscles and Plodment". Lenny McGill Productions, 2008.
Schamberger, Wolf. The Malalignment Syndrome: Implications for Medicine and Sport. Edinburgh: Churchill Livingstone, 2002.
Taylor, Paul M. and Taylor, Diane K. (Eds.). Conquering Athletic Injuries. Champaign, IL: Leicertain Press, 1988.
Whiting, William C. and Zernicke, Ronald F. Biomechanics of Musculoskeletal Injury. Champaign, IL: Human Kinetics, 1998.
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