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Gaining Posture Awareness Through Low Back Curve Exercises

Gaining Posture Awareness Through Low Back Curve Exercises

by | Lower Back Pain, Posture

For individuals trying to achieve healthy posture, could using posture awareness training be effective in treatment and prevention?

Gaining Posture Awareness Through Low Back Curve Exercises

Posture Awareness

Spinal curves help support the body’s weight, movement, and balance. Five areas include the neck, upper back, lower back, sacrum, and coccyx. The bottom of the spine or sacrum rests between the two hip bones that comprise the pelvis. Because of this location, the movements made with the pelvis significantly affect the spine. (Ibrahim Alkatout, et al., 2021) When the pelvis moves, the spine moves.

  • Posture-related back pain and associated symptoms are often caused by a weakened strength and flexibility ratio between the opposing muscle groups that hold the body upright.
  • Achieving healthy posture requires technique and consistent practice for maintaining a healthy pelvis and low back curve. (DeokJu Kim, et al., 2015)
  • Finding the low back curve and exploring how it responds when moving the pelvis is important to effective posture awareness training.

Lower Back Curve Awareness Exercise

One important thing to do to increase postural awareness is to become aware of the low back curve. (Arkadiusz Łukaz Żurawski, et al., 2020)

Sit On a Firm Chair or Stool

  • So that the weight is planted into the seat in a balanced way.

Hold Onto the Arms of the Chair

  • If the chair doesn’t have arms, hold onto the edge of a desk/workstation or the sides of the chair seat.
  • This will support the back when moving the pelvis.
  • Maintaining core abdominal strength is key to preventing back injury. (Erika Zemková, Ludmila Zapletalová. 2021)

Movement

  • Tilt the pelvis forward.
  • In this position, notice the slightly exaggerated arch in the lower back and the increase in lower back muscle tension.
  • A moderate amount of this increase and exaggeration is normal.

Relax Back to the Start Position

Sitting upright with the hip bones/top of the pelvis directly above the bottom.

  • Next, tilt the pelvis back.
  • The abs may have to work hard to support this position
  • Use your hands against the chair for support.
  • Check the lumbar curve area, noticing if it has flattened out.
  • Notice the tension in the back muscles.
  • Is it a little looser? This is normal.

Relax Back to the Start Position

  • Sitting upright.
  • Repeat the sequence again.
  • This time, when in the forward position, pause briefly and slide a hand between the lower back and the back of the chair or the wall.
  • When in the backward position, there will be little to no space between the lower back and the seatback or wall.

Problems

  • If there are problems moving the pelvis back and forth, imagine a basket or bowl of fruit.
  • The pelvis has a round shape and is open at the top, like a bowl or basket.
  • Imagine the fruit is placed toward the front of the bowl, and the weight brings the bowl/pelvis forward.
  • To go back, imagine the fruits are placed toward the back.
  • The weight causes the bowl to roll backward.
  • This may help to get the rhythm of the movement.

This posture awareness exercise can be used as a posture muscle builder by doing it with the back against the wall.

  • A more challenging position for this exercise is standing against a wall.
  • Keep the heels against the baseboard to really work the abs.
  • Start with sitting and gradually to standing.

Foot Motion and Posture

References

Kim, D., Cho, M., Park, Y., & Yang, Y. (2015). Effect of an exercise program for posture correction on musculoskeletal pain. Journal of physical therapy science, 27(6), 1791–1794. https://doi.org/10.1589/jpts.27.1791

Alkatout, I., Wedel, T., Pape, J., Possover, M., & Dhanawat, J. (2021). Review: Pelvic nerves - from anatomy and physiology to clinical applications. Translational neuroscience, 12(1), 362–378. https://doi.org/10.1515/tnsci-2020-0184

Żurawski, A. Ł., Kiebzak, W. P., Kowalski, I. M., Śliwiński, G., & Śliwiński, Z. (2020). Evaluation of the association between postural control and sagittal curvature of the spine. PloS one, 15(10), e0241228. https://doi.org/10.1371/journal.pone.0241228

Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International journal of environmental research and public health, 18(10), 5400. https://doi.org/10.3390/ijerph18105400

Fixed Sagittal Imbalance

Fixed Sagittal Imbalance

by | Posture, Spine Care

Individuals with fixed sagittal imbalance, a condition where the normal curve of the lower spine is greatly reduced or absent altogether that can cause pain and difficulty balancing. Can chiropractic treatment, physical therapy, and exercise help improve the condition?

Fixed Sagittal Imbalance

Fixed Sagittal Imbalance

The condition is commonly known as flat back syndrome and can be present at birth or can happen as a result of surgery or a medical condition.

  • It can also happen for other reasons, including degenerative disc disease, traumatic injury, or as a result of spinal surgery. (Columbia University Irving Medical Center. 2023)
  • Individuals with flat back syndrome position their head and neck too far forward.
  • A major symptom is difficulty standing for long periods of time.

Symptoms

The spine has two curves. The lumbar spine in the lower back and cervical spine in the neck curve inward. The thoracic spine in the upper back curves outward. The curves are part of the spine’s natural alignment. They help the body balance and maintain the center of gravity.

  • If these curves begin to disappear the body can have trouble and difficulty standing up straight.
  • The loss of curvature causes the head and neck to pitch forward, making it hard to walk and do regular normal activities.
  • Individuals have to flex their hips and knees and adjust their pelvis in order to stand up straight. (Columbia University Irving Medical Center. 2023)
  • There is a tendency to stoop forward which gradually increases and can even feel like the body is falling forward.
  • By the end of the day, the body is exhausted from the strain of trying to maintain balance.

Causes

Some causes of fixed sagittal imbalance include: (Columbia University Irving Medical Center. 2023)

  • Congenital – present at birth.
  • Degenerative disc disease.
  • Ankylosing spondylitis – a type of inflammatory arthritis of the spine.
  • Compression fractures of the vertebrae – for example, caused by osteoporosis.
  • The condition used to be common after spine surgery to correct scoliosis/abnormal curvature of the spine.
  • The devices implanted could cause flat back syndrome, especially for older individuals.
  • However, new and updated surgical techniques have decreased the complications.

Diagnosis

A doctor will ask about medical history, injuries, or back surgery. This will followed by a physical exam, that can include:

  • A musculoskeletal exam.
  • A neurologic exam.
  • A gait examination will assess standing and walking ability.
  • The gait exam is done because the gait can change to compensate for the loss of the curvature.
  • X-ray imaging will show spinal alignment.
  • Other possible sources of symptoms will be considered before a diagnosis can be confirmed.

Treatment

Treatment often involves physical therapy and exercise, bracing to provide increased support, and sometimes surgery.

  • Physical therapy typically begins with stretching and targeted strengthening exercises to improve posture.
  • The goal is to reverse the pattern of muscle imbalance that keeps the lower back flat.
  • Exercises to strengthen the neck, rear shoulder muscles, back, core, and buttocks can include: (National Health Service. n.d.)
  • Abdominal stretches
  • Hamstring stretches.
  1. Hamstring stretches improve the alignment of the lumbar spine.
  2. Hold the stretch for about 30 seconds at a time.
  3. Repeat three to five times once or twice a day.
  • Back extensions
  • Chest stretches
  • Planking
  • Side-lying leg raises
  • Seated rows in a gym or pull-ups

In severe cases, patients may need corrective surgery. A few options include: (Columbia University Irving Medical Center. 2023)

A chiropractor and/or physical therapist can recommend exercises and other forms of treatment. (Won-Moon Kim, et al., 2021)

Life-Changing Chiropractic Relief

References

Columbia University Irving Medical Center. Flatback syndrome.

National Health Service. Common posture mistakes and fixes.

Lee, B. H., Hyun, S. J., Kim, K. J., Jahng, T. A., Kim, Y. J., & Kim, H. J. (2018). Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities. Journal of Korean Neurosurgical Society, 61(2), 251–257. https://doi.org/10.3340/jkns.2017.0181

Kim, W. M., Seo, Y. G., Park, Y. J., Cho, H. S., & Lee, C. H. (2021). Effect of Different Exercise Types on the Cross-Sectional Area and Lumbar Lordosis Angle in Patients with Flat Back Syndrome. International journal of environmental research and public health, 18(20), 10923. https://doi.org/10.3390/ijerph182010923

The Importance Of Sleeping On The Right Pillow

The Importance Of Sleeping On The Right Pillow

by | Sleep Hygiene

Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.

The Importance Of Sleeping On The Right Pillow

Importance of Pillows

Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.

Shape

The shape of the pillow has a definitive role in the cervical/neck’s curvature.

Posture

Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.

Sleep quality

Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.

Height

Cervical alignment can become significantly impacted by the shape and height of the pillow.

Pillow Comfort Importance

Trying to find the right pillow will require trial and error. The basics to consider include:

  • One sign that it’s time for a new pillow is waking up with pain.
  • Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
  • If problems are getting comfortable and being able to fall asleep.
  • Constantly readjusting or fluffing the pillow/s.
  • The pillow has become lumpy or lost its shape.
  • It is flat with no cervical support or, too high placing the head in a forward tilt.
  • A new pillow to consider are those that control temperature.
  • Cooling pillows are made to prevent heat retention if a warm/hot pillow keeps you up at night.

Temperature affects sleep quality.

  • Tossing and turning all night means loss of sleep.
  • The frustrating, angry, shifting movements can aggravate back and neck pain/issues.
  • Consider bed linens and pillowcases that cool the body.

Pillow Types

Today’s pillows are made from a variety of materials. Learning about the different kinds of materials can help make an educated choice.

  • Choose a retailer or brand that offers a guarantee or fair return/exchange program.
  • If the pillow isn’t right, you can return it and try another type.

Memory Foam

  • This material is polyurethane that has been combined with certain chemicals to make it viscoelastic.
  • These pillows return to their shape, can stretch and conform to the curves of the body.
  • Different kinds of memory foam include Open cell, Egg crate, and Gel.
  • They will mold to the contour of the spine, helping with misalignments.

Down Pillows and Down Alternative/polyfill

  • These pillows are generally softer.
  • They are made from actual down feathers or a non-allergic synthetic alternative that feels like real down.
  • There is not a great deal of firmness, but they are a good option because they are soft and workable.

Latex

  • These can be natural or synthetic latex, also known as rubber pillows.
  • They offer soft cushioning and proper support.
  • The latex is generally shredded, meaning it can be customized with more or less filling depending on the individual’s needs.

Combo style

  • There are combination pillows that could have a foam core, with down around them for comfort and support.
  • Gel cores are common, specifically in cooling pillows.

How to Choose

Tips and things to keep in mind include:

  • Does it conform to the shape of your neck and spine?
  • How soft is it?
  • Is the pillow stiff?
  • Is it too high?

Remember the importance of sleeping positions. Back, side, or stomach. Pillows that match an individual’s sleeping position criteria:

  • Back sleepers are recommended to use a medium-thick pillow. This keeps the head, neck, and spine properly aligned.
  • Side sleepers are recommended to use a slightly thicker, firmer pillow for proper alignment.
  • Stomach sleepers are a challenge because of the strain placed on the pelvis and lower back. An almost flat pillow is recommended.

Shopping

  • If possible, try out the pillow before buying it.
  • Most stores will allow this, and some companies take it further.
  • For example, The Sleep Number company offers a service called PillowFit.
  • This is an online quiz along with a personalized process in their stores.
  • The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
  • Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
  • Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
  • A third of an individual’s life is spent in bed. Make it as comfortable as possible.

Body Health

Sleep Body Composition Importance

Not getting enough sleep makes it difficult to gain muscle.

  • Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
  • Testosterone is negatively affected by lack of sleep.
  • Not enough sleep increases cortisol levels, impairing muscle development.

Not getting enough sleep makes it difficult to lose fat.

  • Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
  • Not getting enough sleep has been linked to eating more.
  • Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
  • Tiredness reduces spontaneous movements.
References

“Effect of sleep posture on neck muscle activity.” Journal of Physical Therapy. June 2017. https://pubmed.ncbi.nlm.nih.gov/28626314/

“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. https://pubmed.ncbi.nlm.nih.gov/27635354/

“How Often Should You Replace Your Pillows?” Sleep Foundation, Seattle, WA. https://www.sleepfoundation.org/bedding-information/how-often-should-you-replace-your-pillows

“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. https://pubmed.ncbi.nlm.nih.gov/25008402/

“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. https://pubmed.ncbi.nlm.nih.gov/33895703/

Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14

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