Bulging discs, tight hamstrings and lower back pain – the problems of flat back posture
As an avid follower of Core Walking’s blog posts, I used to chuckle at all these people he saw with pelvic tuck ! It was the opposite of many of the clients visiting at the time – their pelvises tended to be tilted forward with bottom’s sticking out. That was, until recently…
A spate of clients with flat backs and backward tilted pelvises prompted more reading and, now, writing…
The spine is actually a curved structure, and that smooth curvature is there for a reason. There are curves in the cervical, thoracic, lumbar and sacral sections of the spine. These curves help the body maintain balance, and allow the body to have a range of motion that’s not possible if it were straight. These curves also help distribute mechanical stress, like a type of shock absorber for the back.
When the lumbar section of the spine is too curved, it’s referred to as “lordosis”. With the pelvis tipped forward, the result for many is lower back pain.
But when the lumbar section of the spine is not curved enough (hypolordosis) and the pelvis is tucked under, the resulting posture is known as “flat back”.
How does someone end up with flat back posture ?
Very few of us are born with postural problems. They’re something that has developed with time – through either accidents or disease or through inadvertently teaching the body to be that way.
For people with flat backs, problems like degenerative disc diseases, vertebral compression fractures or ankylosing spondylitis are causes of flat backs. But, increasingly, I’m finding people have simply taught their body to adopt that posture.
As I was completing last moves for the day for one client, he asked me how he might have gotten this posture, and thus the lower back pain he was feeling from probable bulging discs. I half-joked “did your parents tell you to stand up straight ?”. He laughed, and exclaimed “yes ! All the time !”. And as we talked about this “standing up straight posture”, it basically involved sucking in the stomach, tightening the buttocks, and tucking the pelvis forward. So, after doing what he was told so often, his body learned to adopt this posture. “So, can I blame my parents ?” he winked.
Another client had done much the same. Believing that she needed to strengthen her “core” for good posture, she tightened her abdominals instead of her total core. She pulled her abdominals tight and tucked her pelvis, resulting in a flat-back posture (and ongoing lower back niggles).
More had said that they were worried that they sat too much, or felt their buttocks were sticking out. Tucking the pelvis was their over-compensation for what they believed was poor posture.
What are the muscles doing ?
When people adopt this flat back posture, the muscles in the pelvic region become out of balance.
The pelvis becomes tucked, or has posterior tilt, the top of the pelvis is tipped backwards.
To pull the pelvis in this position and make the lumbar spine flat, a number of muscles are tight and shortened. The back of the legs (hamstrings) and the buttocks (the glutes), together with the abdominal muscles are all tight and short.
Unable to balance these muscles, the front thigh muscles and hip flexors (quadriceps and iliopsoas) and lower back (erector spinae) are long, weak and inhibited.
Looking at someone with this posture, they won’t have much arch in their lower back – their back looks quite flat. The buttocks will be quite firm. And, if they’re thin, you might see that the hip bones at their front are much higher than the noticeable bones of the pelvis at their back.
People with this type of posture often also have their whole body slightly tilted forward. Many also have a “forward head” posture, where the head juts forward of their shoulders.
Some will also find that their knees are hyperextended, or locked.
And, often one giveaway – between tight hamstrings and lack of lumbar flexibility, they can’t touch their toes !
But standing straight with my pelvis tucked is good for my posture, right ?
Reducing that natural lumbar curve reduces the spine’s natural shock-absorbing ability.
This additional stress on the spine creates compression forces on the discs and vertebrae. Compression fractures of the vertebrae may occur, as may reactive bone changes such as bone spurs or osteophytes.
The risk for injury to ligaments of the back is increased. The risk for degenerated or bulging discs is increased. One of my clients with flat-back and suspected bulging discs, also experienced sciatic-like pain.
People with this kind of posture often experience ongoing lower back pain. They’ll typically have trouble standing up for long periods, and this can worsen through the day, the longer they stand up. Also, sitting long periods can also contribute to pain and discomfort.
In addition to lower back pain, it’s not uncommon to experience problems in other parts of the body. Tight abdominal muscles and accessory muscles in the rib area can influence the diaphragm, resulting in shallow, shorter breathing.
Pain can also be felt in the legs, specifically the thighs or groin area – the result of muscle imbalances. Some may also feel increased strain on the forefoot, from the slight forward lean that’s common with this posture. And many find that they can’t plantar-flex their ankles (ie flex their toes toward their knee), finding their feet tend toward being pointed with their back-line being tight.
What to do about it ?
I’d love to say the solution is stretch stretch stretch ! While stretching will help ease the aches for a while, it won’t address the cause of the problems.
Those over-tight, strong hamstrings need to be coaxed to let go, so that stretching can have some lasting impact. Also, those weak, taut thigh, hip and lower muscles need a little nudge so that they know it’s safe to start working again. Strength work can then help them be strong enough to work in unison with their antagonists.
Bowen Therapy is one of the most gentle and effective treatments for helping those tight muscles “let go” and those weak/taut muscles “spring into life”, bringing balance back to the body.
and help bring back the spring in your step… and in your spine !