Kyphosis and lordosis refer to the types of natural curves that you have in your spine.
Your lumbar spine (lower back) and cervical spine (neck) have a natural “lordosis”, while the middle of your back has a natural “kyphosis”.
Kyphosis is completely normal to have in the middle of your back, but, just like pelvic tilt, EXCESSIVE kyphosis can create problems.
The excessive curve in the upper back, combined with rounded, slumping shoulders, creates not only a significant postural distortion, but also a long list of upper body symptoms,
including, but not limited to:
- Shoulder impingement
- Altered breathing function (which can create a WHOLE of
list of issues itself!)
- Chronic tension in the muscles in the back of your neck
- Thoracic outlet syndrome
This is a just a short list of the major issues that can occur as a result of an excessive kyphotic curve.
Correcting this postural issue can be either a simple task, or one that takes an in-depth analysis of why it is happening, specific corrective exercises and usually neuromuscular therapy techniques for long term
However, there are 2 fundamental exercises that must be introduced to start correcting this postural distortion:
- Standing postural correction:
Since it is a postural issue, which is a “learned behavior”, part of
correcting it must include behavioral intervention. That means that the more
you manually correct your posture, the faster the position will become
ingrained in your nervous system. Here is what you need to do: First,
imagine you have a helium balloon attached to each of your chest muscles, and
they are pulling your chest up toward the sky. This movement will assist with
reversing some of the kyphosis. Next, gently pull your shoulder blades BACK
and DOWN. This encourages lengthening the muscles in the front of your body
that are pulling you down, and strengthening the postural muscles that will
lead toward long term correction.
When doing postural correction, the key is reps. I’ve been known to instruct my patients to get a watch with an alarm on it, and set it to go off every hour on the hour. With an average of 16 corrections per day, this can really accelerate the correction procedure.
The Prone Extension Exercise: This is by far my most favorite postural correction exercise.
Here is how to do it:
- Lay face down on the floor, with your arms at your
sides, palms face down.
- Put your feet together.
- Squeeze your butt muscles together.
- Lift your chest up as high as you can comfortably go.
- Lift up your arms, while simultaneously EXTERNALLY
rotating them (the direction that feels MORE difficult to do is the correct
one!), and squeeze your shoulder blades both together, and downward toward the
middle of your back.
- Look straight in front of you (which means you will be
looking straight to the ground) so that your head is in alignment with the
rest of your body.
The best way to start doing this kyphosis exercise is to hold the position for 10 seconds, then rest for 10 seconds. Repeat up to 10
What IS Lordosis?
Lordosis refers to the inward curve of the spine. Both the lumbar and cervical regions of the spine have “lordotic” curves. It can also be referred to as “extension” of the curve.
How much lordosis is normal?
According to orthopedic physical therapy text books, the normal curve in the lumbar spine should be approx. 30-35 degrees while standing during postural evaluation.
Reduced curves in the lumbar spine can cause increased pressure on discs, which too much lordosis increases pressure on the facet joints in the spine.
Lordosis and Pelvic Tilt: The Link To Back Pain
The degree of tilt in the pelvis has a direct influence on the curvature of the spine. If you imagine your pelvis as a bucket of water, and it was tipped forward so that you were pouring water on your toes, this would be referred to as anterior pelvic tilt. This tilt is correlated with an increase in lumbar spine lordosis. The opposite tilt, called posterior pelvic tilt, reduces the lordosis in the spine.
How To Correct Excessive Spinal Lordosis
The correction protocol for too much lumbar lordosis first starts with understanding which muscles can affect this position. Since excessive anterior pelvic tilt is directly correlated with increased lordosis, the same muscles must be addressed. Lordosis exercises must be selected based on the muscle imbalances present.
The lordotic curve itself is created by the tension in the lumbar spine extensors as well as the quadratus lumborum. The rest of the muscles that need to be addressed are the ones I talk about with excessive anterior pelvic tilt. They include:
- Psoas Major
- Rectus Femoris
- Tensor Fascia Latae
The muscles listed above are all frequent contributors to excessive anterior pelvic tilt, which, as discussed, increases the lumbar curve. Stretching these muscles will allow for a reduction in pelvic tilt, and therefore lumbar lordosis. Here is an example of how to stretch the hip flexor muscles that contribute to excess lordosis:
The weaknesses which are present that allow for increased lumbar lordosis include:
The muscles listed above can either be weak and de-conditioned, or simply inhibited due to excess tension in the tight muscles. For example, when the hip flexors such as the psoas is tight, its opposing muscle which is the glute maximus, will be weakened. This is due to a neurological law called Reciprocal Inhibition. Put simply, if for example you contract your bicep muscle, then your tricep muscle must to some degree lengthen to allow for the bicep contraction.
The TOP Lordosis Exercise
If I were to choose one exercise that I use very consistently for correction of excess lumbar lordosis, it would be the Reverse Hyperextension. The Kneeling Hip Flexor stretch, which is in the video above, is VERY useful, but will not address the glute weakness. Most often both of these movements must be used to get the desired result. Watch the video below:
This movement is highly productive, but must be used sparingly, especially considering how much back pain is present. I use it only after my initial corrective exercise protocol for addressing the basic muscle imbalances associated to back pain.