Posture and Spinal Compression

Posture and Spinal Compression

 

Posture is one of the very first things I assess when working with a client, especially one who presents with lower back pain.  A majority of the clients who I treat for lower back pain require postural reeducation due to maintaining a slumped or flexed posture. 

 

Keeping this posture throughout the day results in tight anterior muscles, such as the pectoralis, and stretched out, weakened scapula retractor muscles (middle traps).  When we analyse this posture, we can see that the head is anterior, the shoulders are anterior and protracted and the lumbar spine is flexed.  This places an anterior weight distribution to our upper body.  What stops us from continuing to flex forward and eventually falling on our face?

 

The answer is our spinal extensors which run longitudinally up and down our spine.

These long extensors contract in order to limit any more flexion, thereby stopping us from completely flexing forward.  However, the constant engagement of these muscles actually compresses the vertebrae, creating more lower back pain!  You can feel these hardened muscles by palpating the lower back of your clients.  If the muscles on either side of the vertebral spinous process feels "hard as a rock," then you can assume these muscles are "on" all day, and this is part of the reason for their lower back pain.  Keep your hand on these muscles and ask your client to contract their glutes ("clench"), retract their shoulders and tuck their chin.  Now see if these muscles "soften" to your touch.  By relaxing these muscles, you are reducing the amount of spinal compression and eventually the pain will diminish. 

Now certain activities require you to flex forward, such as shaving.  Many of my clients complain of increased lower back pain when shaving or doing the dishes.

  With this, I spend time educating them in performing a hip hinge and a lunge position rather then flexing forward from the spine.  This usually helps immediately.  Others will ask me if they should purchase a posture brace.  I am not a big supporter of these braces, as they do the work for you.  You rely on an external support device to maintain your posture rather than your own muscles.  Therefore, the muscles that need to be strengthened and those that need to be stretched are not really getting what they need, and the person wearing the brace never develops the body awareness to maintain proper posture.  Although not much substantial evidence exists regarding kinesiotape, I find that it does provide the proprioceptive input that "tells" you to maintain the neutral spinal posture rather than the slumped position.  In my experience, upon applying kinesiotape, these lumbar muscles relax and the pain diminishes.

 So first, assess your client's posture.  Second, palpate the longitudinal spinal extensor muscles on either side of the vertebrae.  Third, have your client squeeze their glutes, retract their shoulders and perform a chin tuck.  Assess what the muscles feel like now.  Teaching your client to maintain this posture will be one of your client's main goals during everyday life as well as during resistance training.  For more information on posture and body mechanics, check out the DVD at: www.lowbackpainvideos.com