Hyperlordosis excercises

[MadDogMike]

Hi all,

Sorry if I'm intruding, I'm not a PT or student, but I have a question PT's might be able to help with. I have lower-back pain due to hyperlordosis. I've always been told, by my mom (a nurse practitioner), that I just needed to consciously pull my shoulders back and tighten my abs and I'll be fine. In other words, I have hyperlordosis/bad posture basically because I'm lazy. Most of what I've read previously is that the exercises that will help are things that strengthen my abs and stretch my lower back,etc.

However, recently I've come across information about exercises that I've never thought would be related to my back pain. Specifically, that my hyperlordosis is caused by anterior pelvic tilt, and the exercises suggested are those that stretch the hip flexors and / or those that strengthen the hip extensors. I never thought of leg excercises to help my back pain! After reading about it, it totally makes sense on the surface, but I'm not an expert in the field. The Wikipedia article mentions this, but is lacking in citations: http://en.wikipedia.org/wiki/Lordosis#Treatment

Just wondering what those with actual education / expertise on the subject think.

Thanks!
Mike

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[PTMattI]

Yes, it is true that an anterior pelvic tilt usually goes along with `short / tight` hip flexors and lower back musculature, as well as weak or inhibited abs, glutes and hamstrings.

Usually for anterior pelvic tilt some prescribed exercises can include stretching of the major hip flexors such as rectus femoris and psoas/illiacus, and doing exercises such as planks, and glute bridges

 

[goyo1010]

Lumbar lordosis could be caused by a number of things. One of them COULD be iliopsoas tightness (hip flexors), pulling your lumbar spine into a more lordotic posture, and a consequent anterior pelvic tilit. This could also be accompanied by poor recruitment/weakness of the posterior chain muscles, especially the gluteal group. You could also have weak abdominal muscles (transverse abdominis, rectus, and obliques) that are also contributing to lordosis, probably spinal instability, and ant pelic tilt. So, possibly poor motor control, muscle recruitment (facilitation/inhibition of antagonist muscles), postural syndromes, etc.

Check if you have tight hip flexors. You can look up tests for that. Exercises for the core like planks (and even correctly performed crunches) are good, bridges (bilateral -> unilateral ->weighted, for example) for the glutes are good, body weight squats with engaged core, wall squats (standing against the wall with the low back flat and the knees and hips flexed, abdominal muscles are contracted and the hips and knees are extended), or on your hands and knees while flexing the lumbar spine and rocking back and forth (between child's pose and cobra), and more (e.g. correcting posture).

But I would advise seeing a PT for an actual evaluation. For all we know, I could have totally given you wrong information because you don't have that issue.

 

[MadDogMike]

It's amazing to me that nobody ever told me about this. I first learned about my lumbar lordosis in middle school, when a coach noticed it during a scoliosis screening. Now I'm 44 years old and, though I've seen various Doctors, PT's and nurses over the years about my back pain, nobody ever mentioned the exercises you both did. They just told me to do things like bringing my knees to my chest to stretch out my back, and strengthen my abs, even though crunches often lead to back pain. (Thank goodness I learned about planks - again, no medical professional ever mentioned them!)

I definitely have tight hip flexors, so I'm confident those exercises will help.

Thanks!
Mike

 

[MadDogMike]

Sorry, duplicate post.