"Stop Slouching!": Lordosis

Note: Videos and pictures of exercises to come. Just really wanted to get this up today; I've been working on this one for weeks.


We talked a while back about kyphosis, or the "dowager hump" (which sounds like a new-fangled dance move) and some of the steps you can take to reduce that (stop slouching! I know you're slouching as you read this). Today I want to address a problem that I see occurring more frequently than kyphosis in the athletic population: lordosis.

Lordosis isn't exactly the opposite of kyphosis; it's the same thing in a different part of the spine. Where kyphosis describes an exaggeration in the primary curve of the spine, lordosis is an exaggeration of one of the secondary curves--the lumbar curve. Lordosis, like kyphosis, can be highly pronounced (don't click that unless you're ready to be grossed out), but you'll see much milder manifestations on a day-to-day basis. I get to see it everyday when I look in the mirror. You'll know that you have it if your butt sticks out (ghetto booty, natch), you thrust your stomach and hips forward when you stand, you've been told you're swaybacked, or if you've ever been mistaken for a pregnant person (if you're actually pregnant, chances are good that you're lordotic also, in which case you'll probably need to come back here in a few months and work on regaining correct posture after delivery).



What causes lordosis? There's a matrix of factors that can come together to produce this postural misalignment, but I'll focus on how it can happen for endurance athletes. At the most technical level, lordosis occurs when someone has tight hip flexors, weak abdominals, glutes, and/or hamstrings, and overactive spinal extensors (could be a combination of any of these factors). If you're reading this blog, it's totally safe to guess that your hip flexors are tight from cycling and running so much, your back extensors are overactive from swimming when you're tired, your hamstrings and glutes are weak because your run and bike form reinforce already existent biomechanical imbalances, and your abs are weak because you're too busy/tired/lazy to work in core strengthening and spinal stability with a full schedule of swimming, cycling, and running. Either that, or you're doing the wrong ab exercises.


For the majority of the population, the cure will involve strengthening the abs and glutes. And endurance athletes (particularly triathletes) will also need to do significant stretching and possibly myofascial release of the hip flexors.


But how do I do that, Jamie? Ah, fear not, gentle readers. I shall tell you how to work towards proper posture in ways that (primarily) will not require access to a gym. Here's a start:


Hip Flexor Stretch
I showed you this one a couple months back, when we discussed lumbo-pelvic stretches. Here's a refresher!

Stretch one leg back behind you, drop the knee, and tilt the top of the hips back (this is called a posterior pelvic tilt). Keep the chest lifted. Stand next to a wall if you need to hold on to something for balance. Variations: you can drop the back knee, continuing to maintain upright posture and a posterior pelvic tilt. In either position, you can lift your ipsilater (i.e. on the same side as the stretching hip) overhead and back behind you. That's a more advanced stretch, so be sure you can hold your balance before you try it. Hold that stretch 20-30 seconds 2-4 times on each side.


Pelvic Tilts
This is one of the safest and most basic abdominal exercises you can do. And I don't care if it looks too easy; it's going to be helpful for you, so do it even if you think it's too basic!


Begin by laying on your back, knees bent and feet 3-6 inches from your derriere. You'll need to keep your knees aligned with hips and feet, so if that's going to be hard for you, grab a yoga block (a thick paperback or two will also do the trick) and stick it between your legs. Squeeze together for a little bit of inner thigh work as well! Take a deep breath in, and direct the air into your stomach; make your stomach swell up with the air. As you exhale, force the air out of your stomach and keep tightening down (the rhythmic breathing is to make sure that you engage your deep abdominals). While holding your abs down (still exhaling), pull your hips towards you (posterior pelvic tilt, again) without lifting your bum from the ground. You should feel your low back press against the floor, but don't let your hips come up. On your next breath in, relax, then repeat. Do this 15-20 times, or for 30-60 seconds. Make sure you're engaging your abdominals with each repetition.


Bridge
This is the next step up from the pelvic tilts, and should activate your glutes and hamstrings along with the abs. Bonus? Do it right and you get a mild stretch through the hip flexors as well!


Start like you did with the pelvic tilts. You still need to keep your knees aligned, so keep using the block/books, if you need to. Also? Turn your toes in, a bit, so that you're pigeon-toed. Breathe in, fill the stomach with air. Breathe out, tilt the pelvis towards your chest, push through both heels at once, and lift your hips up into the air. Concentrate on squeezing your butt cheeks and pushing your knees forward (still holding them in alignment). Take a deep breath in at the top of the movement, and as you exhale press each vertebra deliberately into the ground. Repeat 6-12 times.


12 times feel too easy? Try these variations. At the top of your movement, take several deep breaths, focusing on filling your stomach with air on the inhale and tightening your abdominals down while pulling the pelvic floor up (tighten your sphincter muscles--the urethra and anus) on the exhale. You can put your feet on a bosu ("and the butt-ocks") or stability ball (and is it just me, or is that stability ball far too squishy?). You can lift one leg up (think of it as a continuation of the line of your body, i.e. don't lift it too high) and do a one-legged bridge (note that in the video the guy is lifting his leg too high) . . . Lots of options here, guys, if a plain old bridge seems too easy!


Back Extensor Stretch
First off, stop doing spinal extensions. Seriously. Stop it.


There are many stretches that will work to loosen up those erector spinae; most of them involve rounding the back like a cat. Here's my favorite one. Start in a standing position. Stretch both arms up overhead and cross one arm over the other. Flexing at the hips, knees, and back simultaneously, reach over and grab hold of your legs just above the knees (arms are still crossed). Anchor yourself there with your hands, then slowly extend the hips and knees. Allow the back to round. Do this stretch right, and you should feel it all the way up your spine, into your neck, even around the crown of your head and forehead. You might also feel the muscles across your thoracic spine and shoulder blades stretching. Hold for 20-30 seconds, then do the same thing with the arms switched. Repeat 2-3 times on each side.


Self Myofascial Release
Of the thoracolumbar fascia (hell yes, I just worked that into a blog post!). Too long to put it all in a heading. This is an above-and-beyond kind of exercise. If you have access to a foam roller, it'll probably help with the posture, and if nothing else it'll feel good.


But first, do you have lower back pain? If so, don't do this one. Too risky. Go back to stretching. If not, you may proceed.


Lay with the foam roller under your low back. Gently contract your abs to support your back. Roll slightly to one side, so that the foam roller isn't contacting your spine. Slowly roll yourself on the foam roller from the top of your hips to the base of your ribs. If you find a tight spot, pause there for 30-60 seconds. Look for those little spots, and hold yourself right on it; avoid rolling back and forth over those trigger points. Switch sides. Give yourself at least 5 minutes on each side; if it's too intense, switch back and forth, side to side. Try to relax into it a little more each time, but remember to keep the core lightly engaged to support your back.


But Why?
But Jamie, you say, this just occurred to me: you are a random person on the internet. It is entirely possible that you are full of shit. Why should I listen to what you say, let alone bother fixing my supposed excessive lumbar lordosis?


A fair point, my friend. And if you're concerned about following the advice of some random person on the internet, you can feel free to come in and see me at my gym. I will be happy to train you.

As to why you should bother with correcting your posture, the first is a structural concern. The excessive curvature of your spine indicates that the space between your lumbar vertebrae is decreased on the posterior side. Couple problems with this. First off, you're at increased risk of lower back injury, particularly when performing standing or lying hip flexion exercises, spinal flexion or stabilization movements, and weighted overhead activities. Additionally, if you have some pretty serious lordosis (the kind you see when female gymnasts finish their routines), the backs of your vertebrae--the facet joints--might actually be acting to support your spine. And they weren't designed for that; they were designed to sort of steer your spine. In short, you don't want those facet joints knocking together. And apparently (I didn't know this until I researched this article) if the facet joints get too close together, they can cause pain that is very similar to the pain or herniated discs, as well as sciatica; in fact, sciatic pain is more commonly caused by facet joints rubbing together than by bulging discs. So avoiding back pain is a pretty good reason to correct your posture.


For athletes, there's an additional incentive to improve posture, and therefore stability. Ever heard of the concept of energy leaks? The idea is that there are certain points where athletes lose energy. If you've got specific shoes for cycling, you've experienced what I'm talking about: the stiff soles of your cycling shoes allow you better power transfer to the pedals than the flexible soles of regular sneakers. Same idea with your body, whether you're running, swimming, throwing shot, or swinging a golf club. If you cannot use your muscles to maintain the structural integrity of your joints, you're going to lose some of the power that you could be delivering into propulsion at your extremities. I mean, you're going to lose some of the power anyway. But the more effectively--and, for endurance athletes, the longer--you can maintain appropriate biomechanics (in this case, posture), the better you'll perform as an athlete.


And I'd never really thought about it until I started researching this article, but this is a central concept for us triathletes. Possibly one of the most central concepts. Think about it: because we do three different sports, the one commonality between everything we do is posture.  Everything comes back to that basic ability to keep your body functioning properly, and it happens from the core out.


It's for that reason that I intend to make my next installment in the "Stop Slouching!" series about spinal stability. It's a big project. It'll take a while. It'll take a lot of research. It may take multiple posts. But if we, as athletes, can nail the spinal and core strength and stability, we will all get much, much faster and be safer while we're doing it.



Other "Stop Slouching!" Articles
Lumbo-pelvic Stretches 
Pronation 
Kyphosis 
Winged Scapula (and the MOVIE!)


Resources
http://www.pediatric-orthopedics.com/Treatments/Kyphosis_Lordosis/Lordosis/lordosis.html
http://www.ptonthenet.com/articleprint.aspx?ArticleID=2499&m=91418
http://www.exrx.net/Kinesiology/Posture.html
http://www.ptonthenet.com/displayarticle.aspx?ArticleID=3075