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Is “Sway Back” Really Still A Thing?

April 11, 2014 //  by Dr. Liou

Balancing RocksApparently it is …*head shaking in disbelief*

If you do an online search of “sway back” you’ll see a bunch of links referring to “hyperlordosis” or even just “lordosis” with a variety of images of the spine from a side view showing the curves of the spine.  Prevailing, mainstream information resources on this “condition” will have you believe that it’s a disorder….something that needs fixing.

Not so fast.

The natural shape of the spine should look like this:

Google Images

Notice, the term “lordosis” simply refers to the natural shape of the neck and the low back.  There is nothing pathological about this and in fact it’s necessary for spinal health that these two areas curve the way they do.  If you do not have enough of a lordosis in either area you will experience spinal dysfunction and eventually pain.

This pervasive age-old idea that “sway back” is something bad, is extremely misleading.  If there is something that looks like “hyperlordosis” or an accentuation / exaggeration of the natural curve or sway of the lower back, it may or may not be a bad thing.  The worst thing you can do is to tell a developing body to flatten that part of the spine.

I spend ninety percent of my patient education time explaining that tucking the pelvis and sucking in the belly while upright – sitting or standing – is actually damaging and stressing the spine.

What makes any shape of the spine dysfunctional is muscular and chemical imbalance in the body.  You cannot assess whether or not there is a problem with the spine by simply looking at the degree of lordosis.  If the curve in the low back is sharper than average, look at the neck – is that curve also sharper than average?  Look at the upper back – is that curve sharper than average in the opposite direction? Then it’s possible that this sharp lower back curve is actually completely appropriate for that person.

The shape of the spine is like a mathematical equation that should equal zero when effectively balancing the weight we carry front to back (and side to side). We need to have two S-shapes in order to provide appropriate shock absorption against gravity.  We also need to keep the spine strong in order to keep these curves from lazily collapsing on top of each other – which is when we run into trouble.

Weakness of our spinal stabilizers – the teenie-tiny muscles (multifidi mainly) that connect our spinal bones to each other deep inside – is what leads to back pain and dysfunction.  Lordosis is not a problem until weakness in the muscles allows the bones to collapse on top of each other with the forces of gravity.  This is true for kyphosis as well.  No matter what your shape, it’s not until weakness and de-conditioning sets in that there’s any problem with whatever shape that is.

So, please stop trying to flatten your spine.  It’s not helping you.

Do keep working on core stability with things like plank and hover and balance work.  Be careful of crunches since that motion curls your lordosis in the wrong direction.  Honor your curves in every sense of the word.  You’re shaped the way you are for a reason.  Don’t let that reason be that someone told you long ago to “suck it in” or “tuck it in” going against natural design.

Stay active and avoid sitting when possible and your lordosis will thank you!


For more on what’s really behind pain and dysfunction go to stopeverydaypain.com

 

 

photo credit: Fotolia

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Category: Biomechanics of Pain, Pain, Thoughts from the Treatment TableTag: back pain, exercise, kyphosis, lordosis, muscle imbalance, spine, strength, sway back

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