Could You be Suffering from Lumbar Lordosis?
By: Brian Howell
This article is not meant to be taken as medical advice
and consulting a physician is of the utmost importance for proper diagnosis!
What is Lumbar Lordosis (LL)?
Lumbar Lordosis (LL) is an excessive
curve of the lumber spine. The lumbar spine does have a natural lordotic curve that
is necessary for proper balance and functional movement in
conjunction with the other natural curves of the spine. However, Lumbar Lordosis is characterized by an exaggerated
frontal curvature accompanied by an anterior (frontal) tilting of the pelvis. This appears as an anterior protrusion of the abdominals creating an excessive prominence of
the hindquarters.
How does Lumbar Lordosis occur?
It isn’t easy to identify a specific
cause of Lumbar lordosis due to the variety of potential causes, some preventable and some inherent through genetics. First, the genetic conditions that contribute to LL are conditions such as Achondroplasia
Discitis or dwarfism, Osteoporosis, and birth defects which all inhibit the patient from assuming correct
posture. The next category for LL causation would be negative daily habits and a
sedentary lifestyle. A large contribution comes from poor posture held for
extended periods of time (work related or unhealthy static postures) and
obesity/sedentary lifestyle that causes muscles to work improperly.
Negative effects of Lumbar Lordosis.
The effects of LL range from some being mild in early onset
and others severe stemming from untreated LL. First the mild effects consist of pain or discomfort
in the hip joint, groin region, lower back, and hindquarters. If LL is left
untreated mild discomforts will evolve into severe conditions such as lumbar
disk degeneration (LDC), hip bursitis, and Sacroiliac joint dysfunction. The severe effects also create dysfunctional muscles around the pelvis, abdominal
region, and hamstrings. Also, a prominent characteristic of the LL population
is "Dominant, overly tight hip flexors and low back muscles"
(DAWSON-COOK, 2011).
What to do to prevent Lumbar Lordosis?
Not to be confused these remedies should only be used after
physician clearance and asymptomatic of the chronic conditions that LL can lead
to. To prevent the mild effects, stretching of tight muscles and strengthening
of the weak(under active) muscles is ideal.
Stretching: Focus on hip flexors and lower back
muscles (hold each stretch 30-40 seconds repeat two times).
1) Hip Flexor: Start in a kneeling position, step forward
with one leg creating roughly a 100-120-degree angle. Next slowly press hips
forward toward the lead foot until mild discomfort/stretch is felt and repeat on the opposite side.
2) Low back/Erector Spinae: Start lying in a supine (on
back) position and slowly bring knees to the chest. Like assuming an upright
fetal position.
Strength Training: Focus should be on strengthening
core muscles, pelvic muscles, and hamstrings.
1) Core: Begin with planks, assume a standard push up
position with hands under shoulders, feet no wider than shoulder width apart,
and maintain a neutral/flat back positioning. If the full plank cannot be
maintained modify by starting with elbows under the shoulders and place knees
on floor in a kneeling position and complete timed intervals as tolerated.
Follow with side planks using the same guidelines with modifications. Start on
right/left side with elbow under the shoulder of targeted side with feet
stacked or if needed feet slightly split. When in position reach free arm up
towards the ceiling and hold the position for timed intervals as tolerated. If
locked out legs cannot be maintained knees can be placed on the floor to lessen
intensity.
2) Pelvic stability: The first movement is the pelvic
bridge, begin by assuming a comfortable position lying on your back with feet
flat on the floor shoulder width apart. Once position is assumed slowly raise
your hips/bottom off the floor straight towards the ceiling focusing on not
over extending hips to keep focus on glute muscles and to eliminate overarching
the back. Complete 6-10 slow and controlled repetitions, add sets as tolerated
with rest. To add intensity, start with upper back/shoulders and head resting
on stability ball to increase stabilization throughout the core.
Next, would be called clam shells which target the glute medius.
Begin with lying on your side in a comfortable position. A pillow can be added
to support the head. Keep your feet on top of one another throughout the
movement with a slightly larger than 90-degree angle in the knees. Also, keep your
hips perpendicular to the floor throughout the movement to keep the focus on
the glutes. If needed, begin by completing repetitions with back and buttocks
against a wall. Complete 6-10 repetitions and add sets as tolerated.
3) Hamstring strength/pelvic stability: Firstly,
Heel-on-ball rolls. This movement tackles both hamstring strength and pelvic
stabilization. To start assuming a position lying on your back, place heels up
on stability ball with hands down at your side. Once a comfortable position is
assumed begin by lifting hips off the floor, pushing heels into ball and
pulling the ball towards your buttocks. Finishing with heels under the
knees and in a slow and controlled manner extend legs back into the starting
position with hips off the floor/mat. Complete 6-10 repetitions adding
sets as tolerated. If no stability ball is present use sliding foot
mats on slick surface.
To conclude:
The spine has natural curves for balance and functional
movement however, when the lumbar curve is extended past its natural
positioning Lumbar Lordosis becomes present. This extended curve can be caused
by inherent genetic properties along with poor posture habits throughout
everyday life and sedentary onset of obesity. This condition can cause mild
pain/discomfort in the early stages which can
be prevented by lifestyle changes and various movement-based interventions. However, left untouched it can develop into severe effects that require surgical intervention. After its all said
and done this article is meant to merely inform readers of this
condition and not to be taken as medical advice and physician
diagnoses/clearance is of the utmost importance!
References:
- Cook, S. D. (2011). How's Your Posture? American
Fitness, 29(3), p.24–30.
- Walker, M. L., Rothstein, J. M.,
Finucane, S. D., & Lamb, R. L. (1987). Relationships Between Lumbar
Lordosis, Pelvic Tilt, and Abdominal Muscle Performance. Physical
Therapy, 67(4), 512–516. doi: 10.1093/ptj/67.4.512
- Been, E., & Kalichman, L. (2014).
Perspective Lumbar lordosis. The Spine Journal, 14(1),
87–97. doi: https://doi.org/10.1016/j.spinee.2013.07.464
