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

Copyright Posturo Global Ltd

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.

Copyright Posturo Global Ltd

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!

Mattress in a Box | Sleepovation Review Dr Paula Moore

I was skeptical when I first sat on my Sleepovation Mattress because it felt softer than the firm memory foam mattress I have slept on for years. My first night’s sleep, I slept for 10 hours straight and didn’t wake to use the bathroom once! That was miraculous for me.

I was on my way out to buy a new memory foam mattress for my bed – which I’ve had before and loved – when Brian from Sleepovation emailed me asking if I would endorse the Sleepovation mattress. He said it uses the latest sleep technology.

Having never even sat on a Sleepovation mattress, much less had one on my bed, I wasn’t prepared to offer an endorsement, but I was happy to give the mattress a try. A true endorsement will only ever come from me if I love and use a product regularly.

Brian was cool with that, and within the next 48 hours, my Sleepovation mattress arrived in a box.



I love several things about this mattress and a few things I’m not so keen on. Here is my review of the Sleepovation Mattress in a Box. I’m not that keen to endorse something that can be so subjective. Please have a read of my pros and cons, do a little research, and then decide for yourself.

Sleepovation Mattress |The good

  1. Support: Sleepovation claims to be the first ‘pocket system’ mattress – also known as ‘tiny mattress.’ In theory, the individual suspension system (made up of 700 tiny mattresses) supports the spinal column and each bone separately. It cradles the body’s curves while providing enough firmness for the back’s muscular and bony structures. This should give pain relief and pressure relief on the neck as there is motion transfer between the different air channels. This is potentially great for spinal alignment, depending on your sleeping position.

    I was skeptical when I first sat on my Sleepovation Mattress because it felt softer than the firm memory foam mattress I have slept on for years. On my first night’s sleep, I slept for 10 hours straight in comfort and didn’t wake to use the bathroom once! That was miraculous for me.

  2. Cleaner: The Sleepovation has removable, washable covers – two in fact! The one you see with the blue zipper in the image above and an elastic mattress cover fits over the top of the quilted cover. This is a definite benefit, as a quality mattress cover can run upwards of $100 and is advised to give you unmatched cleanliness.

    You can also vacuum between each of the 700 tiny mattresses to remove dust. That’s pretty unique!

  3. Cooler: The individual pocket system allows air to circulate right through the mattress channels. I don’t suffer from being too hot at night, so it will be interesting to hear from some of you on this potential benefit.
  4. Motion Isolation: Because each of the 700 tiny mattresses moves independently, you shouldn’t get much co-sleeping disturbance from your partner. So far, I have found that to be true.
  5. Greenguard Certification: Greenguard products are certified for low chemical emissions, so they are considered acceptable for sensitive individuals. I don’t have any allergies myself, so that will be for you to decide.

Sleepovation | Less good

  1. No Slats: Because there are 700 tiny mattresses, box spring or coil underneath isn’t ideal, and neither are slatting because the individual segments can slip through. So you need to use a platform bed or buy a thin sheet of plywood to place over the top of your slatted base.

  2. Not Organic: The material and foam for the Sleepovation mattress are not organic. Organic mattresses are part of the luxury mattress market, and you can expect to pay upwards of $3,000 for one; and by the way, memory foam mattresses are also not organic.

    Typical (non-luxury) mattresses contain chemicals that are probably not that healthy for anyone but particularly unsafe for babies and children. Most mattresses contain petroleum-based chemicals, toxic foams, synthetic fabrics, and fire retardant barriers or chemicals. These chemicals can off-gas and expose your family to dangerous toxins while they sleep.

    Organic mattresses are often made of cotton or wool and use no chemical treatments, but do your research before you buy!

  3. Price: I consider Sleepovation in the quality mattress market, typically between the $1,000 – $2,000 price point. Considering the average person sleeps for 8 hours each night, I did a little calculating:

    8 hrs x 30 days/mth x 12 mths/year = 2,880 hrs sleep/year

    If you start sleeping on a quality mattress like Sleepovation at the age of 30 and live to be 84, that is:

    54 years on a quality mattress. 54yrs x 2,880 hrs/year = 155,520 hrs sleeping on your quality mattress this lifetime.

    155,520 hrs / 24 hrs (per day) = 6,480 days of your adult life spent sleeping! That is 18 total years of sleep from age 30-84! Slightly depressing, isn’t it.

    A Sleepovation Mattress typically costs about $1,500:

    $1,500/6,480 days = approximately 23cents/sleep on your Sleepovation Mattress.

    I’m ok with that. You?

Where to get your Sleepovation Mattress

>> SleepOvation Mattress discount: Use coupon code POSTURE to save $50.

You can also buy a Sleepovation pillow made up of 77 tiny pillows and is recommended to give you a good night’s sleep.

 

Infinite Moon Everpillow Review

Simplicity is the word that comes to mind. Infinite Moon has kept things simple with the Everpillow. There is a regular shaped pillow (The Original) for back sleepers and a curved pillow (The Curve) for side sleepers.

The Everpillow by Infinite Moon is yet another option of comfortable pillows available online. In my never-ending search for the perfect night’s sleep, one of my posture pupils brought this pillow to my attention.

Sleeping is a competitive market. There are ergonomic pillows, organic pillows, memory foam pillows, thin pillows, fat pillows, extra firm, extra soft, down-filled, goose-filled, and even pillows filled with cooling gel. With so much choice in the sleeping marketplace, it’s getting harder to be different. Infinite Moon doesn’t just make different pillows. They make a difference too.

Everpillow is more than just a comfortable pillow. When you purchase an Everpillow, you become part of a pretty cool story. More on that later…

Overview of the EverPillow


Simplicity is the word that comes to mind. Infinite Moon has kept things simple with the Everpillow. There is a regular shaped pillow (The Original) for back sleepers and a curved pillow (The Curve) for side sleepers. Notice there isn’t one for stomach sleeping, because as any good posture doctor will tell you, you should avoid stomach sleeping!

You have three options for the pillow fill you get. 100% natural latex, Kapok silk from the Java Cotton Tree – which is meant to be particularly good at resisting moisture and mites – or a combination of the two, allowing you to customize what kind of pillow you get. Nice!


Infinite Moon is a Movement


Infinite Moon’s business model is part of a movement called Emergent.

Emergent is a movement of people and businesses dedicated to transforming business and society. Over the last 15 years, our shared mission and 20/20/60 model has transformed local communities through more than 2 million dollars of charitable giveback.

The idea is that 20% goes to charity, 20% is re-invested, and 60% is profit for the company. I already loved this company before my pillow even arrived as one with a high level of ideals.

Infinite Moon Philosophy


If you like to choose the companies you buy from based on their philanthropic endeavors or impact on the world, then this might sway your pillow-buying decision. Infinite Moon has paired with a Denver-based company that helps transition people at risk back into the workforce. This includes people with addictions formerly incarcerated or homeless.


Everpillow is Natural


These days I’m a little cautious when I read 100% natural. Even the label no sugar added sadly, does not mean free from sugar. It just means they haven’t added any more sugar to the original recipe ingredients. Everpillow fill comes in 100% natural latex or Kapok silk. There are synthetic latex varieties, but natural latex comes from rubber trees. Kapuk silk comes from the Java Cotton Tree of Central and South America. I love the idea of sleeping on silk!

Kapok Tree silk

While I really like the EverPillow, there are 2 small things I would change or add. I’d like to see each pillow come with a slipcover. Although the pillow I ordered has a lovely organic cotton cover that feels like heaven, it is still the only barrier from drooling mouth to pillow fill. I usually buy my own slipcovers for all of my pillows, but I think it would be a really nice added feature to include one in the purchase.

The second thing I’d change is the shape of the curved pillow. I ordered The Original without the cut-out for the shoulder. I am a side sleeper, but I wouldn’t say I like the idea of a semi-rigid seam, but I didn’t test this model, to be fair. I’m not too fond of the aesthetics of funny-shaped pillows. I like symmetry – hence my affinity for good postural alignment. I like to make up my beds with nice sheets and pillowcases. A c-shaped pillow looks darn funny. Plus, I find The Original is nicely pliable. It easily forms into my shoulder—no need for a curve.

My Infinite Moon EverPillow Recommendation


I was pleasantly surprised with the EverPillow. I normally get contacted by companies who want me to test their ergonomic products. This was one of the first companies I actually contacted. I wasn’t sure what to expect, and in fact, the pillow stayed boxed for several weeks before I even opened it. Unboxing the pillow and customizing the fill levels to make my sleeping posture and alignment as close to ideal as possible was a very intuitive and enjoyable experience.

Everpillow is a quality product that is accurately priced. I like that they’ve made a real effort to be different and give back financially and directly to their local community. Oh, and I’m in love with Kapok silk; from the very moment, my hand dove deep into my silky pillow fill… heavenly!

Shop Infinite Moon

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



How To Sleep + Best Mattress In A Box | Posture Doctor

Because we spend 1/3 of our lives sleeping – actually 28 years, if we live to 84 – it’s  important to give some real attention to our sleeping posture.

Because we spend 1/3 of our lives sleeping – actually 28 years, if we live to 84 – it’s  important to give some real attention to our sleeping posture.

Here are my Top 6 Sleeping No-Nos:

  1. Do not sleep on your front (prone)
  2. Do not sleep on an old mattress (10 years +)
  3. Do not use more than one pillow (see video below)
  4. Do not sleep in the recovery position
  5. Do not sleep in a tight fetal position
  6. Do not sleep more than eight hours a night (ideally)

Front Sleeping

When sleeping on your front (prone) you have to twist your neck and spinal cord 90º to lay your head on the pillow. That puts massive strain on the neck. In this position, the nerves and blood vessels, that run through the neck to the head, receive most of the tissue stress.

When sleeping on your front the lumbar region can sink into a swayback position, putting hours of additional strain on your lower back joints and discs. Over time, this can begin causing degeneration and wear.

Imagine a garden hose with water running through it. Think of the water as your nerves, and the hose as your bony spine, acting as a channel for the nerves. Now imagine twisting the hose (as your neck twists when you sleep on your stomach). The nerves are put under great tension in this twisted sleeping position – and because the nervous system directs and coordinates the functions of all your body’s parts (organs, muscles, hormones, glands, digestion, even your brain) you can begin to imagine how a twisted spinal cord is a potential health risk over time.

If you find you start off sleeping on your back or side, then wake up on your front, try sleeping with a pillow between your knees. This will help prevent rolling over onto your front. It may take time for this to work fully – you may find that you still roll onto your front occasionally – but eventually you will learn a new sleeping habit.

Best Mattress

Don’t be cheap when buying a mattress. You spend one third of your life sleeping (actually 28 years if you live to be 84), so invest in a good night’s sleep. Personally, I love my brand new SleepOvation mattress so much, I made a video about it!


https://youtu.be/Ts3VNbM9vCM

Pillows

Use only one pillow. The object of sleeping with a pillow is simply to fill the space between your ear and shoulder – I demonstrate this in the video above. Too many pillows or too small a pillow means your neck is likely to tilt down toward your shoulder, or be forced up toward your ear. The material you choose for your pillow is a matter of personal preference. I’m not a fanatic about orthopedic pillows, because they are generally only offered in small, medium and large, and that isn’t exact enough for each individual body size. Note in the video above how the head stays completely horizontal when side lying with the correct sized pillow. That is the goal.

Sleeping On Your Back

Sleeping on your back is also a good position to choose. Adding a pillow under your knees takes the strain from the lower back and hips. If you prefer to sleep on your side, use a pillow between your knees and avoid the recovery position, which will twist the spine.

Notice the position of your knees. Resist the urge to pull the knees right up into your body (fetal position) as this will flatten the lumbar spine, making flatback posture worse. Ideally, keep your knees, thighs and hips in line to maintain a gentle curve inward (lordosis) in your lower back.

How Long To Sleep

Do not sleep more than 8 hours. This is good advice for anyone – because there is living to be done – but if you have flatback posture, you need to pay particular attention to this advise. During sleep you gain height, as the cartilage discs absorb water, a little like a sponge. People with flatback posture often have worn spinal discs, with less cushioning than in those people whose discs are healthy. The longer you sleep, the stiffer you will be on waking.

If you experience morning stiffness, then I am definitely talking to you. When our discs regain height during sleep, tissues lengthen and become taut. That is why it takes an hour or two after waking before you limber up and the tissues become slack and more mobile, because the discs have once again decreased in size.

Back To School – How to Improve Your Child’s Posture

Recently, taking a little look around, I’m shocked by the postures I am seeing in our youth. Do your kids have mobile phones and tablets? How many hours a day do they spend using them?

Recently, taking a little look around, I’m shocked by the postures I am seeing in our youth. Do your kids have mobile phones and tablets? How many hours a day do they spend using them?

Many of these kids and young adults may already have Text Neck. How’s your own posture by the way?

What is text neck?


Just take a look around you. How many people do you see staring down at their phones? Our modern lifestyle means we spend several hours a day (minimum) with our necks bent forward and down staring at our smartphones and computer screens. By doing so, we increase the weight of our heads dramatically, causing extreme pressure on our necks.


Related >> How to hold your phone and avoid Text Neck


Over time, the nerves in the neck are continually put under great stress and tension, leading to significant health risks like chronic headaches, fatigue, spine degeneration and even depression and anxiety! So, in celebration of back-to-school,  teach your slouchy teen how to tuck their chin!



Related >> Text Neck – How to avoid neck pain, fix Text Neck and improve your posture

The Truth About Standing Desks | What Desk Should You Buy?

If sitting is truly the new aging disease, should we all through away our desk, buy a treadmill and carry out walking meetings like business innovator Nilofer Merchant?

With the new surge in sitting research, ergonomics companies, standing desk manufacturers and wearable fitness tracker entrepreneurs are raking it in. If sitting is truly the new aging disease, should we all through away our desk, buy a treadmill and carry out walking meetings like business innovator Nilofer Merchant?


Instinctive Sleeping – Are Pillows Necessary?

It is clear that sedentary ‘civilized’ people likely have much higher incidence of musculo-skeletal lesions (especially low back pain) compared with native peoples, nomads and forest dwellers. Anecdotal evidence suggests that low back pain and joint stiffness is markedly reduced by adopting natural sleeping postures.

Chimpanzees and their common ancestors have been sleeping without pillows for millions of years – do we really need one?

Instinctive Sleeping


Humans are one of many species of primates – ancestors that lived in the trees of tropical forests. With the exception of humans, most primates live in tropical regions of Africa, Asian and the Americas. The earliest primates go back nearly 60 million years – primates have been sleeping without pillows for a long time!

Great apes (that’s us) are unique in that they build sleeping nests, or beds. Other primates, like Chimpanzees sleep on branches. Chimpanzees build their nests from a sturdy tree called Ugandan ironwood – perhaps suggesting firm is best, or more likely, firm branches prevent a weak branch breaking and leaving the chimp vulnerable to predators.

Our ancestors eventually moved out of wooded rainforests; no longer dependent on trees for shelter and safety. Whilst researching sleep habits among primates, I stumbled upon a very interesting article:

Instinctive sleeping and resting postures: an anthropological and zoological approach to treatment of low back and joint pain by Michael Tetley, PT. The article suggests that we are too far removed from our primate origin. I remember my youth spent sleeping under the stars in nothing but a sleeping bag. Now, in my forties, I’d find it hard to relax and sleep on a hard floor, let alone a forest floor, or tree branch!

What Type Of Mattress?


When you lie down on a hard, flat floor you will immediately feel all your tension (try it). Once you sense your tightness, you can do something about it and let go the areas that are holding stress and rigidity and release the stiffness. When you get down on the floor, something has to give, and it’s not going to be the floor; that’s for sure! Think of the floor as your personal biofeedback device. Use your breathing to release tension and encourage relaxation.

So what type of mattress is best? Choose whatever gets you a good nights sleep, but I’m in love with my Sleepovation!


https://youtu.be/YUabVbK628c

Best Sleeping Position


It is clear that sedentary ‘civilized’ people likely have much higher incidence of musculo-skeletal lesions (especially low back pain) compared with native peoples, nomads and forest dwellers. Anecdotal evidence suggests that low back pain and joint stiffness is markedly reduced by adopting natural sleeping postures.

One such position, uses a rotated arm as a pillow when side-lying. This allows you to listen out for danger with both ears. Note, that even the Chimpanzee sleeping position is remarkable similar to this ‘best’ sleeping position.

When lying on one side you do not even need to use your arm as a pillow. When your lower shoulder is fully hunched, the neck is supported. The neck then gently deviates towards the ground and gravity shuts the mouth (preventing insects from crawling in), and a slight traction and elongation is applied to the cervical spine. Further research on instinctive sleeping is needed.

Still want your pillow? Don’t worry, I haven’t got rid of mine. I am seriously testing out instinctive sleeping and trying out no pillow – I’ll let you know how I get on. In the meantime, watch the video below for some tips on best sleeping postures:

1. Back Sleepers – try memory foam to mold to the curve of your neck
2. Side Sleepers – try a pillow between the knees and one for the neck to keep your spine aligned and neutral
3. Stomach Sleepers – avoid – stomach sleeping twists your neck and spinal cord 90 degrees!

Anyone else trying instinctive sleeping without pillows?