Flat Back Syndrome – Diagnosis and Exercises

If you’re over the age of 35 and have spent years either sitting behind a desk, diving, labouring, or otherwise being very physically active, you might have a condition commonly called Flat Back Syndrome.

If you’re over the age of 35 and have spent years either sitting behind a desk, driving, laboring or otherwise being very physically active, you might have a condition commonly called Flatback Syndrome.

What is Flatback Syndrome?

Flatback Syndrome is really not a syndrome as such. I prefer to call it flatback posture or the correct medical term, alordosis.

Lumbar Lordosis is the normal inward curvature in the lower spine. “Alordosis” means “absence of lordosis” – the normal curvature isn’t present, and instead, the lower back is “flat.” The pelvis is usually tipped backward (posterior tilt), associated with or causing the normal spinal curve to flatten. This is Flatback Syndrome

alordosis

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Signs and Symptoms of Flatback Syndrome

  • flat lower back curve
  • forward head  
  • round shoulders
  • low back pain often described as ‘aching.’
  • groin pain
  • leg pain
  • spinal stiffness, especially on waking 

This list is only a guide. You may have many of the signs and symptoms listed, only a few or none of them. The list is to assist you in recognizing whether you have Flatback Syndrome.

What Causes Flatback Posture?

Incorrect Sitting

If you have spent years sitting incorrectly – sitting on your bottom muscles instead of sitting with your back aligned over your hips – you may have developed chronic muscular imbalances – short, tight abdominals, short, tight hamstrings, and weak hip flexors – pulling the pelvis into a tucked-under position (called posterior pelvis).

Slouch Back

Slouch Sitting – copyright Posturo Global Ltd

Disc Degeneration

Incorrect sitting and standing posture, poor nutrition, injuries, athleticism, and manual labor can lead to worn spinal discs and pain in a patient. The lower spinal discs should be wedged-shaped, which gives the lumbar region a healthy inward curve, known as lumbar lordosis.

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Interesting: When people say, ‘I’ve got lordosis in my lumbar spine,’ what they usually mean is that they have hyperlordosis or sway back. The hyper suggests an increase to the normal lumbar curve. We should ideally all have lordosis in our lumbar spine.

If the lumbar curve is exaggerated, it is a hyperlordosis; if it is flat, it’s an alordosis or without a lordosis. Saying you have ‘lumbar lordosis’ is actually saying you are normal. That always makes me laugh – in a kind-hearted doc sort of way.

When our spinal discs degenerate, they lose their natural wedge shape, causing a reduction in natural lordosis. This may result in flatback posture. It may also be common to see spinal curvature.

Herniated Disc

A herniated disc is just a severely degenerated disc, where the gelatinous, toothpaste-like material normally found contained inside the disc has leaked through the outer cartilage rings. This also causes loss of the natural wedge shape, which leads to a change in the normal lordotic curve.

Chronic Muscular Imbalance

Many of the muscles responsible for posture and body movement are found in “pairs.” One muscle (or group of muscles) moves a body part in one direction, while the paired muscle moves the same body part in the opposite direction. The two sides of such a pair are said to be “opposers” since the effort of one side opposes – works in the opposite direction to – the other side.

Both sides of a muscle pair’s efforts may also be exerted simultaneously (when sitting or standing relatively still) to provide the tension and support needed to hold a body part steady in a desired balanced position.

Further Resources: Balance Exercise for Beginners

When one of the muscles of a pair becomes stronger than its opposer, we say that the stronger one has become dominant. Dominant muscles tend to become short, tight, and over-aroused – or facilitated – neurologically. The weaker opposing muscle becomes long and under-aroused or passive.

Although these muscular imbalances are fairly predictable, individual differences do, of course, exist. Muscle imbalances commonly found in people with flatback posture include:

Dominant Short Muscles

  • Abdominals
  • Hip flexors

Passive Long Muscles

  • Hamstrings
  • Gluteals

Because posture and muscular imbalances affect the way we move, problems in one area lead to problems in other areas. Flatback posture often contributes to the development of round shoulders and forward head posture.

Other problems may result from the muscular imbalances found in flatback posture, including:

  • Sciatic leg pain (from inflamed, bulging discs)
  • Chronic lower back pain
  • Acute lower back muscle spasms (often one-sided)
  • Scoliosis
  • Degenerative disc disease
  • Deformity

 

It is not essential to know the exact cause of your flatback syndrome. Still, it suggests some daily posture exercise habit is needed to return mobility and optimal alignment to the spine. Spinal surgery correction or other surgical treatment is not ideal. However, surgery and physical therapy can help you, especially if you have a pinched nerve, neck pain, or other severe pain.

The patient’s objective is to ultimately restore good alignment by establishing healthy posture habits and daily routines. Good posture is a habit and one that you can learn to love. It also helps to avoid spine surgery or other intrusive treatments for the spine.

After Thought – Best Ergonomic Tip

Fully upright posture (90°) is hard on the discs in your low back, so avoid buying the “perfect ergonomic chair” that keeps you bolt-upright. Research has shown that reclining at a 135° angle is the least damaging to our lumbar discs when seated.

Before you jump and adjust your seat angle, recognize that such a position is impractical for working at a computer. You’d be so far back, you’d be straining to reach the keyboard, and you’d almost certainly increase your forward head position.

It seems that 110-120° is about perfect for reducing any forward head posture that could occur if you incline the seat back any further. Personally, I favor 120°, with lumbar back support.

In any event, do remember to keep your head back, nicely inline above your shoulders. Please don’t force it back; allow a gentle lengthening to lift your head back into alignment.

Review the chin tuck exercise for forward head posture if you are unsure.

Inclining your seat 5° downward at the front and using armrests can further reduce lumbar disc pressure.

Happy sitting!

Cervicogenic Headache Exercises

The cervicogenic headache is described as a unilateral or one-sided headache, generally starting in the neck and moving forwards. The headache generally dominates on one side. When the headache is severe however, it may also be felt on the opposite side, but to a lesser extent.

The 5-Step Cervicogenic Headache Protocol

I can’t remember when I had my first headache, but it was sometime in my early 20s. I’ve had a lifetime of headaches. My headaches have been the bane of my life but also my constant companion and gift.

Last Saturday, en route to a barn dance, I had a whopper of a headache. I’m not too fond of perimenopause for the resurgence of headaches in the last two years. However, if it were not for my headaches, I would never have found Dr Brian Sher (Toronto Chiropractor), who provided my first neck adjustment that vanished my headache on the spot and paved the way to Chiropractic college. For that, I am immensely grateful.

Headaches changed the trajectory of my life, for the better.

Here’s the problem that I see with headaches. Most people burdened by headaches can not think clearly enough to take the steps necessary to rid their lives of the misery of chronic pain.

I get it – that was me!

I couldn’t get through the day without a muzzy painful head. I didn’t really know why I was having daily headaches, I just wanted to be like everyone else, who smiled and laughed and went to work and generally just got on with life.

That wasn’t me. I was working for the Sport’s Clubs of Canada at the time. I remember being at my desk, rubbing my head in misery while trying to complete my sales calls. The pain wasn’t particularly dramatic – it just seemed to be there more days than not. It was a burden, a drain, a constant weighing down. Life didn’t feel as good with a headache.

One day, I discovered I didn’t have to live my life with the burden of a headache. That was the moment I had my first Chiropractic adjustment, and that moment changed my life.

Recently, I’m reminded of what it is to have chronic headaches, due to my current hormonal haze of perimenopause. A resurgence of headaches, has me eager to share my knowledge of headache, and how I survive and treat my own headaches successfully – for the most part. I am quite certain this can help you too.

Cervicogenic Headaches

The term “cervicogenic headache” was actually coined in 1983. Although there is long-standing notion that headaches can originate from structures in the neck and can be treated using manual approaches, it is only during the past two decades that the topic of cervicogenic headache has gained attention in mainstream medical literature.

Signs and Symptoms

The cervicogenic headache is described as a unilateral or one-sided headache, generally starting in the neck and moving forwards. The headache generally dominates on one side. When the headache is severe however, it may also be felt on the opposite side, but to a lesser extent.

There are also signs pertaining to the neck, such as reduced range of motion in the neck and mechanical stimulation applied on the affected neck area reproducing the headache symptoms. These strongly suggest cervical involvement in producing the headaches. Sometimes, same side shoulder/arm sensations and even pain have been reported.

People with a cervicogenic headache may report that the pain fluctuates, is continuous, lasts only a very short period of time, begins after long intervals, or starts up upon waking in the morning.

Prevalence

Studies support that cervicogenic headache is common. However, there is a great deal of variation in the perceived prevalence in the general population. For example, prevalence rates seem to range from 0.4% to 80%. It seems the disparity is due to contrasting diagnostic criteria being used in each study. The average affected age is 43,2, and the female/male distribution appears to have more agreement in the literature at 80% female, 20% male.

Resources: 1

Cause

There appear to be three main causes of cervicogenic headache discussed in the literature.

Convergence:

The basic premise of convergence is that when sensory nerves (first-order neuron) detect information about mechanical, thermal, and chemical states of the body and send signals back to the spinal cord, they converge on other nerves (second-order neurons) that carry signals from the spinal cord to the head. Pain signals from the periphery then get perceived as pain in the head and face, where the second-order neurons carry signals to the head (brain).1

Degeneration:

Disc degeneration, or degeneration in the neck’s facet joints, can cause inflammation and lead to irritation of sensory nerve endings for pain, called nociceptors.

Trauma:

In my clinical experience as a Chiropractor, trauma is frequently overlooked and a common cause of cervicogenic headache.  If you have a history of trauma – in particular, a past motor vehicle accident – and a history of chronic headaches, you need a cervical x-ray series to rule out structural changes to your natural neck curve (lordosis). These changes (flat curve – alordosis, or reversed neck curve – kyphosis), lead to degeneration and altered mechanics in the neck, which cause inflammation and irritation of the nerve endings responsible for pain.

The prevalence of joint pain (facet joints in the neck) after whiplash from a car accident has been reported as high as 54%.3

Neck Disability Index

Before you begin my cervicogenic headache protocol, I recommend you measure your starting point regarding self-reported disability. Howard Vernon developed a tool called the Neck Disability Index (NDI) in 1989. The NDI has become one of the standard evaluations for measuring disability due to neck pain and is used by both healthcare professionals and researchers. There are just 10 questions, and answers for each are scored from 0 to 5. The maximum possible score is 50.

You can see a copy of my own NDI report. Note my moderately high frequency of headaches (a recent resurgence since peri-menopause).

Bookmark the link to the Neck Disability Index and complete the evaluation before you begin my headache protocol and every month along the way, to objectively measure your progress in terms of disability.

Cervicogenic Headache Protocol

I’ve created an entire online course to help you treat your own cervicogenic headaches effectively; and I’ve also extracted a mini version for you here, which consists of 5 steps:

  1. Neck Disability Index: Complete the NDI before you progress through this protocol.
  2. Neck X-Rays: Have a cervical series of x-rays taken through your doctor or directly from your Chiropractor. Many Chiropractors have their own on-site digital facility, as I did. The standard series is Cervical AP (front to back) and Cervical Lateral (side view) and often APOM (an open mouth view to visualise the first two vertebrae C1 and C2). If in doubt as to why you need an neck x-ray to proceed, please refer back to the section Cause above and review the third cause, trauma.
  3. Range of Motion: Review the section above on signs and symptoms of cervicogenic headache. Reduced range of motion is almost always present in the neck of someone with cervicogenic headache. Whether or not the lost movement is the cause or the effect isn’t clear, but I stand by the need for increasing your cervical range of motion.
  4. Trigger Points: Myo-fascial trigger points, also known as muscle knots, are painful spots in the fascia (connective tissue) surrounding the muscle. Trigger points in the neck and shoulders are commonly associated with referred pain in the head. Refer back to signs and symptoms above. Recall that manual pressure applied to the affected neck area producing headache strongly suggests cervical involvement. So although self-applied trigger point therapy might initially bring on a headache (please use with caution); the idea is that regular administration, will lead to a reduced frequency and/or severity of cervicogenic headache.
  5. Stretch: After range of motion exercises and trigger point work, it is crucial you stretch your neck to elongate the muscles out to their full length. Although stretching as a treatment is going out of style, I still find it immensely beneficial and stretching often reduces or eliminates my headache on the spot!

It probably works about the same way that stretching out a calf cramp works: you win the tug-of-war with the spasming muscle. Paul Ingraham

If you enroll in my How to Get Rid of Headache and Migraine, I know it will help you. In the course you find out everything I know about headaches and learn the actual exercises and techniques I’ve used so successfully to treat my own chronic headache pain for over two decades. These exercises have the potential to alleviate even the most chronic of headaches. Not only do I cover my top seven self-treatment techniques, but I also teach you how to rule out worrying red flags, give you several ergonomic best practices and share with you the top three researched methods for outsourcing headache treatment.

If you don’t enroll, the Cervicogenic Headache Protocol above will be an excellent place to begin.

Resources:

  1. https://pdfs.semanticscholar.org/6b12/e55353802b0802526da5c55ec153cd95a657.pdf%20art
  2. https://clinicalgate.com/cervicogenic-headache/
  3. https://pdfs.semanticscholar.org/fa07/dac287ce63485bbf4c1b5c7fad5da3d2e458.pdf

Important Test For Brain Health – One Leg Balance | Posture Doctor

An important test for brain health is the ability to balance on one leg. Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with vascular disease in the brain, specifically small areas of tissue death (mini strokes) without symptoms.

I made a new friend recently. She, like me, is 50 (something) and a bit of a tomboy, in that she has been active and sporty all her life. Then just over a year ago, she had a car accident and four days later when trying to answer a question at work, nothing came out of her mouth. She just couldn’t find the words. Moments later, she said to her colleague: I think I’ve hurt my brain.

There is a lot of current online buzz about brain health. Listening to CBC Radio this morning they were talking about particulate matter – from city pollution – and the cognitive impact.

Then I happened upon this study that found that an important test for brain health is the ability to balance on one leg. Yasuharu Tabara, Ph.D., and lead study author and associate professor at the Center for Genomic Medicine says that:

Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline.

The study consisted of 841 women and 546 men, with average age of 67. To measure one-leg standing time, participants stood with their eyes open and raised one leg. They  performed the leg raise twice and the better of the two times was used in the study analysis. Small blood vessel disease of the brain was evaluated using magnetic resonance imaging.

The researchers found that the inability to balance on one leg for longer than 20 seconds was associated with vascular disease in the brain, specifically small areas of tissue death (mini strokes) without symptoms. They noted that:

  • 34.5 % of those with more than two lesions (infarctions) had trouble balancing.
  • 16 % of those with one lesion had trouble balancing.
  • 30 % of those with more than two micro bleeds had trouble balancing.
  • 15.3 % of those with one micro bleed had trouble balancing.

“One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities,” said Tabara.

Although this study is not saying that poor balance causes brain disease and/or cognitive decline, the inability to balance for at least 20 seconds, may suggest brain abnormalities. So poor balance suggests poor brain health, but can improving balance improve our brain health as we age? Now that’s a great research question!

Personally, I like to err on the side of caution with my own health. I’m not comfortable with pill popping and I’m definitely not waiting for signs of aging (other than my quickly greying hair and ever-creasing skin argh). I’ve incorporated balance exercises into my daily posture routine.

Get the balance right


Balance shouldn’t be a concern just for the elderly who are more prone to falls (and the serious complications those falls can cause). Balance training is important for anyone who wants to age well, avoid falls, improve athletic ability, coordination, stamina and overall fitness and health.

If you haven’t thought much about maintaining, or improving your balance, now is a good time to start.

In order to have good balance, we rely on the information given to our brain from three main body systems: our ears, the nerve endings in our muscles, and our eyes (vision).

As children, we develop balance climbing trees (where I spent many hours climbing up, up, up to collect long forgotten bird nests), riding our bikes, walking and running on uneven surfaces and playing sport and games. As adults, we seldom think about balance and rarely practice it.

When was the last time you climbed a jungle gym with your kids, walked along the slim surface of a forest log or tried to balance on one leg whilst brushing your teeth with the opposite hand (I love this one)?

The eyes have it


Your sense of vision is a big part of good balance. Vision works hand in hand with the inner ear to maintain balance. If you move your eyes or take vision out of the equation altogether, it’s harder to balance. You might be surprised how challenging it is to simply stand with your eyes closed. We play around a lot with removing vision during some of the more advanced balance exercises in our posture school.

Better balance means better coordination, POSTURE, core strength, agility and athletic skill. You even burn calories using balance training!

Balance training is good for people of every age, so don’t be afraid to start incorporating balance exercises into your daily workouts. Everyone can benefit from balance training and even better if our ability to balance keeps our brains young, sharp and disease-free!

Try walking off-piste


Lost Your Balance? Try Motor Skills Juggling | Posture Doctor

As children, we develop balance, climbing trees, walking and running on unsteady surfaces, playing sports, games etc. As adults, we seldom think about balance and rarely practice it. When was the last time you climbed a jungle gym, walked over a log or tried to balance on one leg while brushing your teeth?!

Most people don’t spend any time thinking about their balance until it’s too late – when they actually start swaying when they walk; or worse, fall down and injure themselves. But balance isn’t just a concern for the elderly who are more prone to falls. Balance training is important for anyone who wants to age well, avoid future falls, improve athletic ability, coordination, stamina and overall fitness and health.

If you haven’t thought much about maintaining – or improving – your balance, now is a good time to start. Balance is a component of health that you should never overlook. Without it, all of the weight training and exercise in the world won’t help you.

In order to stay upright, constant communication occurs between your brain, eyes, ears and the nerve endings in your muscles.

As children, we develop balance, climbing trees, walking and running on unsteady surfaces, playing sports, games etc. As adults, we seldom think about balance and rarely practice it. When was the last time you climbed a jungle gym, walked over a log or tried to balance on one leg while brushing your teeth?!

Our vision works in tandem with the inner ear to maintain balance. If you take vision out of the equation altogether – by closing your eyes – it’s harder to balance because visual cues from our eyes give us information about where we are in space.

Inside the inner ear is a fluid-filled tube called the semi-circular canal and the movement of fluid within this canal alerts your central nervous system as to the position of your head.

So how is your balance? Let’s find out …

The 30-second balance test


Ideally, find a partner to time you, because your eyes will be closed. It’s also a good idea to have someone close by in case you fall.

  1. Stand barefoot on a hard floor. Now close your eyes.
  2. Bend one knee and lift the foot – if you’re left-handed, stand on your left leg and lift the right foot just 6″ off the floor; do the opposite if you’re right-handed.
  3. Ask the person helping you to time how long you can hold that position without wobbling or opening your eyes. Use the timer on your phone.
  4. Repeat the test 3 times, and then add up your total time and use the average. (For example, if test 1 was 4 seconds, test 2 was 6 seconds, and test 3 was 8 seconds, you’d add up 4+6+8 to get 18. Divide by 3, and your average balance time is 6 seconds.)

It isn’t surprising to see that the number of seconds decreases with age. In the 30-35 year group, for example, the average eyes-closed balance time is 22 seconds. For 50-year-olds, it’s 9 seconds, and 70-year-olds just 4 seconds. That’s because…

Balance declines with age


As we get older, our eyesight tends to diminish. This normal change in the eye’s focusing ability is likely the first step affecting our balance. Our muscles also age, and this atrophy (shrinkage) of muscle tissue makes reaction times slower. But there’s good news, because…

You can improve balance at any age


17 trials involving 4305 participants concluded that regularly engaging in well-designed balance exercise programs, even in the very old and frail, proved to be effective for fall prevention, and there is now ample evidence that this type of program improves balance ability.1

Try this


Practice balancing on one leg every day and several times a day. Brush your teeth on one leg first thing in the morning. Wash your hands at work, balancing on one leg. Wash the dishes on one leg (but please don’t break the dishes). Blow dry your hair balancing on one leg, and have family competitions if you have little ones – who can balance the longest? 


Don’t wait until you notice that you are starting to sway when you walk. Trust me when I say this – if you are over 50, it’s coming. Sigh … isn’t aging fun?!

References

  1. El-Khoury, Fabienne, et al. “The effect of fall prevention exercise programmes on fall incused injuries in community dwelling older adults: systematic review and meta-analysis of randomized controlled trials.” British Medical Journal. 29 October 2013; 347:f6234. Web. http://www.bmj.com/content/347/bmj.f6234 

Why You Should Stop Doing Sit-Ups |Posture Doctor

Many personal trainers are still teaching the wrong position for core exercises – a position that will wear out your discs, cause premature aging and ruin your posture and balance long-term.

Your ‘core’ is comprised of a number of muscles working together to achieve and maintain a stable spine. A strong core and perhaps more importantly, a core with good endurance allow us to move with ease and mechanical advantage; in order to avoid injury!

Your core muscles include: rectus abdominis, internal and external oblique, transversus abdominis, but also – you may be surprised to learn – the quadratus lumborum, and the gluteal muscles.

Your goal when working on your core is to create spinal stability. Stability may be achieved by increasing core strength, but Dr Stuart Mcgill (Professor of Biomechanics at the University of Waterloo) reminds us that improving core endurance may be more important than strength. Endurance provides the ability to maintain a stable spine throughout a variety of activities.


Many therapy approaches have the objectives of strengthening muscle and increasing spine range of motion. This is problematic (Parks et al, 2003) since those who have more motion in their backs have a greater risk of having future back troubles. Strength may, or may not, help a particular individual as strength without control and endurance to repeatedly execute perfect form increases risk. Dr Stuart McGill


McGill goes on to explain that people with ‘troubled backs’ tend to have faulty movement patterns like “gluteal amnesia” and more motion in their backs and less motion in their hips.

With the goal of stability in mind, it would be prudent to strengthen gluteal muscles, increase range of motion in our hips and choose abdominal exercises that do not put unnecessary stress and strain through the low back and discs.

No sit-ups or crunches

It is for this reason, that I will NEVER recommend crunches or sit-ups. Both of these exercises involve repetitive flexion of the lower back (lumbar spine). Repetitive flexion can lead to degeneration of the spinal joints and discs over time.

Effective spinal stabilization should begin with a solid understanding of what stability is. “Stability has little to do with the ability to balance on a gym ball. Sitting on an exercise ball performing movement exercises is generally a poor choice of back exercise until quite late in a therapeutic progression,” says Mcgill. “True spine stability is achieved with a “balanced” stiffening from the entire core musculature.”

Reducing risk of injury

One of the most effective exercises for improving spinal stability is the abdominal brace. Many personal trainers are still teaching the wrong position for core exercises – a position that will wear out your discs, cause premature aging and ruin your posture and balance long-term.

How to Engage Your Core

The abdominal brace is a super little exercise, that teaches you how to engage your core whether you are standing in a line, talking on the phone or simply walking down the street!

Stop Standing Up Straight – Do This Instead |Posture Doctor

If you have been suffering from swayback for many years, tucking the ribcage is likely to make you feel uncomfortably hunched at first. This in turn creates a need to release your rounded shoulders and lengthen the spine from the neck.

When the normal lumbar (lower back) curvature becomes exaggerated and the pelvis tilts forward (anterior pelvic tilt), you have a condition known as hyper-lordosis, or swayback posture. It is frequently the result of long-term efforts to “sit up straight” or “stand up straight.” It can also stem from stresses encountered in extreme physical activities such as gymnastics, ice skating and ballet, and even from some extreme postures found in yoga.

You are at greater risk of swayback posture if you have had multiple pregnancies, if you are overweight, or if you sit for long periods.

The conventional remedy for swayback posture is to intentionally tuck the pelvis – consciously tilt it back, in order to flatten the lower back curve – but this can cause further problems. It is true that tucking the pelvis usually flattens a swayback; it often feels good too, because it stretches out the low back muscles. Unfortunately tucking the pelvis also compresses and compromises the lower spinal discs. 

Learn to tuck your ribs


A better way to address a swayback is to learn how to tuck the ribs. Imagine your ribcage to be a giant vertical egg. Tucking the ribs involves rolling your ribcage (egg) forward, so as to make the lower border of the ribcage sit directly over top of the pelvis. Re-aligning the ribcage lengthens the lower back, causing your swayback curve to flatten to a more normal position.


https://youtu.be/4Inkvyroavo

Unfortunately this rib tuck exercise is usually quite difficult for those who need it most. If you have been suffering from swayback for many years, tucking the ribcage is likely to make you feel uncomfortably hunched at first. This in turn creates a need to release your rounded shoulders and lengthen the spine from the neck. Below is a list of some of the signs and symptoms you may notice if you have swayback posture:

  • weak stomach muscles
  • lower back pain
  • leg and buttock pain
  • tight lower back, groin and hip muscles
  • protruding belly
  • backward-leaning stance

This list is only a guide. You may have many of these signs, or just a few. You may also have signs and symptoms not noted here. The list is simply to assist you in recognizing whether you have  swayback posture.

What causes a swayback?


  1. Muscular imbalances
  2. Loose ligaments
  3. Long-term attempts to maintain extreme postures
  4. Excess body weight

Muscular Imbalances:


Many of the muscles responsible for posture and body movement are found in “pairs”. One muscle (or group of muscles) moves a body part in one direction, while the paired muscle moves the same body part in the opposite direction. The two sides of such a pair are said to be “opposers”, since the effort of one side opposes (works in the opposite direction to) the other side. The efforts of both sides of a muscle pair may also be exerted at the same time, to provide the tension and support needed to hold a body part steady in a desired position.

When one of the muscles of a pair becomes stronger than its opposer, we say that the stronger one has become dominant. Dominant muscles tend to become short, tight and over-aroused – or facilitated – neurologically. The weaker opposing muscle becomes long and under-aroused, or passive. 

The dominant muscles are short, tight and often painful, while the weak muscles may appear prominent (protruding belly and pronounced bottom). Although these muscular imbalances are fairly predictable, individual differences do of course exist.

Because posture and muscular imbalances affect the way we move, problems in one area lead to problems in other areas. Swayback posture often contributes to the development of round shoulders and forward head posture.

Loose Ligaments:


Swayback posture often develops early in life. Multiple factors contribute to development of a hyper-lordosis, including injury, genetics and being born with loose ligaments and joint hyper-mobility.

In a normal body, ligaments (tough tissues that connect bones to other bones) have a natural tightness that restricts movement to within a normal range. This creates good, stable joints. Someone with loose ligaments may easily develop some degree of joint instability, predisposing the body to abnormally extreme movements and postures, and often resulting in injury.

Children with loose ligaments have a greater-than-normal range of movement; as a result, they often make great dancers, gymnasts and figure skaters, where extreme lumbar extension is regularly performed. These extreme postures commonly lead, later in life, to the problems and injuries associated with swayback posture.

Extreme Postures:


Certain sporting activities and exercises encourage over-extension of the lumbar spine, combined with frequent repetition of movements. For example:

  1. some extreme yoga positions
  2. gymnastics
  3. dance
  4. figure skating (which includes many extreme dance positions)
  5. exercises which repeatedly shorten hip muscles (ice skating, sprinting)
  6. sitting for long periods*

* In many ways, sitting works like an extreme exercise. Remaining seated with your hips flexed for hours on end may lead to short, dominant hip muscles and eventually to swayback posture.

Body Weight:


Recall that with swayback posture, the pelvis tips too far forward, and the lumbar curvature becomes exaggerated. Pregnant women (usually in the third trimester) and people who carry excess weight in the abdominal area (pot belly) are at a higher risk for swayback posture.

A pot belly puts more weight in front of the body’s centre of gravity and has the effect of tipping the pelvis too far forward, leading to hyper-lordosis or swayback posture. It goes without saying that managing weight gain is absolutely crucial to preventing the development of a sway back. One of the biggest mistakes I see people make is attempting to correct posture before losing weight. This will only lead to frustration and limited success.

During pregnancy, high levels of progesterone lead to looser ligaments. While these hormones are critical for a successful pregnancy, they also make unintended and uncontrolled extreme movements more likely, putting you at greater risk for sprains, strains and swayback posture. A strong, balanced posture leading up to pregnancy is the best prevention against future posture problems.

Being able to recognize the problems associated with your swayback posture, and practicing exercises tailored to your specific posture needs, is the key to maintaining ideal posture.

Regaining attractive, youthful posture should be the goal of anyone who wants to enjoy a healthy, active life, improve confidence and body image and ultimately slow the effects of aging.

Further Reading: How to Fix a Swayback by Dr Paula Moore

Mini Posturecise – 30 Seconds a Day is all it Takes

So if 30 lectures feels a little overwhelming, or working on your posture for 60 minutes daily, like a mountain to climb, then what you need is a new mini posture habit.

Failure isn’t falling down. Failure is not getting up after you have fallen down. Richard Nixon

Are you exercising daily? Have you enrolled in one of my courses, started out super motivated and then after a week or a couple days or maybe even a day, left it and never returned? Perhaps you are still thinking you need to give your body alignment (posture) some attention, but you just haven’t started.

30 seconds is all it takes

Wherever you are at with your health regime, this post is going to have you finally succeed … but only if you finish reading and actually do what I suggest. AND, I promise, it will only take you 30 seconds.

Are you willing to give 30 seconds a day to improve your posture? Great! I’m guessing 30 seconds is reasonable enough, for even the most persistent procrastinator.

Habits

I love to read. Mostly I love to read non-fiction books on health, success, goals and personal growth – super geek alert!

One of the first books on habit creation I read was The Power of Habit by Charles Duhigg. Basically, he explains that successful habits depend on three things:

  • cue
  • behavior
  • reward

You can use these steps to create a new habit or change an unwanted habit. Duhigg recommends keeping the same cue and simply changing the behavior and seeing which leads to the greatest reward.



As an example, I’m currently working on creating a new habit of getting out of bed 30 minutes earlier. My usual wake time is 7am. 6.30am rising leaves me with more energy (seems counter intuitive, but it’s true), gives me a sense of purpose and I find I’m generally happier. Those are my rewards.

Let’s review the process. The cue is my phone alarm going off at 6.30am – and by the way, I leave the phone in the bathroom, so I have to get up to shut it off! Remember Duhigg suggests only adjusting the behaviors, while keeping the same cue.

These are the different behaviors I have tried so far:

  • Just getting straight up – that resulted in my peeing, and going straight back to bed … sigh
  • Getting up and going right into the shower – This worked quite well, but I prefer showing at night before bed, because I like getting into clean sheets with a clean body; AND I’m always cold in the winter, so love a shower to warm me up before bed.
  • Reading – this one I really enjoy. I have a wee and then I cozy back into my warm bed (with Milo) and read. I did that this morning, but my eyelids were so heavy, I almost fell back to sleep. It also feels like a bit of a cheat!
  • Dry skin brushing – this is my newest behavior choice. I used to skin brush regularly but have got out of the habit. Basically, the theory goes that brushing the skin (our largest organ) helps to rid the body of toxins, improving alertness and overall health. It’s a bit of a shocker first thing, but certainly does the trick waking me up!

It’s early days, so I haven’t chosen the exact behavior I will settle on, but skin brushing is currently a good contender. Which ever one I choose, I already delight in the rewards of 6.30am rising.

Stop saying you’re fine

Recently I read Mel Robbin’s book, Stop Saying You’re Fine. Good book! The first 100 pages are a bit repetitive. You’re never going to feel like it, she says about 1,000 different ways. Then her book gets really good. Here is her book summarized for you in five easy steps:

  1. You’re never going to feel like it
  2. You get motivated from action
  3. Use the 5 second rule
  4. Make a pebble plan
  5. Choose a punishment

Basically, your brain is never going to tell you it’s fun to get up early, or to not eat chocolate cake, or turn off the TV to read, or go to the gym. You’re NEVER going to feel like it, so stop waiting for the right feeling and do it anyway!

Stop waiting to feel motivated! Motivation comes from action. If you are waiting to feel motivated, you may be waiting a long time. Take an action; any action and watch the motivation grow.

When you think of something you know you should do – calling your mother, paying a bill, going to the gym, making healthy soup or walking the dog – use the 5 second rule. Count down from five, four, three, two, one and be sure you begin to act within the five seconds or your brain will convince you not to do it. Act quickly to ride the action wave!

Robbins explains that in order to cross a river, you step pebble to pebble or rock to rock, until you get to the other side. If you have a goal to lose 50 pounds, you need a plan. Grab a big sheet of paper and some colored markers. That is my go-to, when pebble planning.

Write out your goal in the middle of the page – LOSE 50 POUNDS – Now draw 18 pebbles or stones on the paper, nice and large. Fill in all the stones – whatever comes to mind:

  • Get a really good recipe for healthy green breakfast smoothy
  • Call 3 friends and ask them for 3 ideas
  • Walk kids to school 1 day a week
  • Make one healthy crockpot meal (every Sunday)
  • Research weight loss blogs
  • Create a gold star chart for the fridge
  • etc.

Choose a punishment – this is the answer to what if I don’t do it. Choose a pebble a day, or each week and do it! If you don’t do it, you need some sort of retribution. I’ve chosen my buddy Tara – she and I did pebble plans over beers at a Toronto distillery a couple weeks ago. We tell each other which pebble we are doing each week, and so far we are loving it.

Robbin’s suggested reprimand is slightly brutal – but I like it! She suggests throwing $20 dollars out the window, when you are driving. Imagine how much that would hurt. Ouch!

Mini Habits

Currently I’m reading Mini Habits by Stephen Guise. It’s a tiny – read in one day – sort of book. It’s no masterpiece; he isn’t a great writer, but it’s a nice little winner.

I’ve only read 50 pages and basically the science is simple. If exercising (or Posturecising) for an hour every day feels way to tough, then make it ridiculously simple. I’ve been saying this to my patients and students for years!

Make it so silly simple, you can’t possibly fail.

This is how I began Posturecising and creating a healthy daily habit for life. I now Posturecise without fail, every morning. If I miss a day, it’s no biggy, because I’ve neurologically wired it into my brain; so it’s easy to simply pick up again.

Mini Posturecise

Have you been struggling to create your own daily posture exercise routine? If you’ve already enrolled on one of my courses, great. At least you won’t waste time thinking about which exercise to do and in what order.

So if 30 lectures feels a little overwhelming, or working on your posture for 60 minutes daily, like a mountain to climb, then what you need is a new mini posture habit.

A mini habit is just that – a super small, stupidly simply task. One you can not fail to complete.

Tasks

File all my business receipts (a task I despise)

mini task – file one receipt a day

Learn to do chin ups (a goal I’ve been talking about for years)

mini task – hang from bar 5
sec daily

Eat 5+ servings of veg daily

mini task – eat one radish a day 

Get 6-pack abs

mini task – do a 5 second plank daily

I’m guessing all of you could do the four mini tasks I listed above.

Posturecise Task

You want to have good looking posture, am I right? Let’s break it down. Ideally I’d have you each completing my Posturecise program daily.

Further Resources: Posturecise (Level 1) – How to create a healthy habit for life

But you’re struggling, or I’m guessing you wouldn’t still be reading. If I were to give you a list of exercises to choose from, you could pick the one most relevant to you. Or just choose the one that looks like the most fun.

Take a look through the list – watch as many of the videos as you like, until you’ve chosen your exercise. Once you’ve selected your exercise, I want you to drop what you are doing, set the timer on your phone for 30 seconds and do the exercise for 30 seconds.

Does that sound easy? It is!

  1. Basic chin tuck 
  2. Prevent hump back 
  3. Treat your bunions – home mobilization 
  4. Sciatica leg pain relief 
  5. Neck pain exercise 
  6. Spine shifts – for stiff lower back 
  7. How to treat a stiff neck
  8. Chest opener – for round shoulders
  9. Driving stretch  
  10. Hip flexibility exercise 

Recap

  • choose your exercise from the list above
  • set the timer on your phone for 30 seconds
  • do the exercise
  • set your phone alarm to go off same time each day
  • do the exercise daily for the next 30 days

CONGRATULATIONS, you have a new mini Posturecise habit! What exercise did you choose?

What Causes Forward Head Posture & How Severe Is Yours?

Understand the specific cause of Forward Head Posture; use that knowledge to begin the appropriate mirror-image exercises and know when to seek treatment and/or further medical investigation.

Understand the specific cause of Forward Head Posture; use that knowledge to begin the appropriate mirror-image exercises and know when to seek treatment and/or further medical investigation.

Further Learning: Forward Head Posture: Cause & Cure



Core Workout | Best Abs Exercise You Can Do in Your Car

Traffic jams are frustrating! In this lecture we use the time you are stuck in your car (maybe during a traffic jam) to strengthen your abs.

Traffic jams are frustrating! In this lecture we use the time you are stuck in your car (maybe during a traffic jam) to strengthen your abs.

Further Resources: Travel Exercise – Best Travel Workouts for the Car or Plane


How to Fix Unattractive Round Shoulders | Posture Doctor

The way we hold ourselves is a reflection of the way we feel about ourselves; so good posture improves confidence.

The way we hold ourselves is a reflection of the way we feel about ourselves; so good posture improves confidence. If you sit for long hours and worry about your slouching, you can learn to open and expand your chest with this simple and rather fun exercise.


Further Resources: The Posture Makeover | The Posture Doctor’s ‘Best-of’ Series