How To Fix Back Pain
Pain With Standing, Walking, Running, & Golf, and Feels Better to Sit, Bend Over, Or Lie Down With Knees Bent
What Abs Really Do May Surprise You
PLUS neutral spine and healthier training of core and abdominal muscles, Swayback, Hyperlordosis, Hyperextension, Facet Joint, S.I. joint, Lumbo-Sacral Pain, Spondylolisthesis, Zygapophysial Joint Syndrome, some forms of Stenosis, Sitting with too much inward lumbar curve.
Welcome to fixing lower back pain felt during and after standing activities (and some exercises like pushups). You are on my large no-charge web site DrBookspan.com. I am a research scientist and clinician in physiology and medicine of medicine in extremes of heat, cold, injury states, altitude, underwater, nutritional states, and more. My work is to develop evidence-based sports medicine that you can use yourself, right away, to fix back pain, neck pain, knee pain, other injuries, and learn healthier training methods. I also put fun stories on this web site of my lab research in environmental medicine and physiology of the human body in extremes of heat, cold, injury states, altitude, underwater, and different nutritional states.
This page covers an important technique that I spent years investigating, to fix a specific kind of lower back pain felt with standing, walking, running, and certain exercises. This pain is often from standing with a simple bad spine position of too much lumbar inward curve (hyperlordosis, also called swayback). You can start fixing this pain yourself, right now, today, using this summary.
For more, get my BOOKS. Hope to meet you in my CLASSES, an Online Individual Consult, or maybe in a rare Private Appointment. More about me in Adventures.
SITE MAP. At the bottom of this page (and every page) are main navigation links to other articles, plus buttons to SHARE, TWEET, and LIKE.
Now let's fix your back pain.
Answers In A Nutshell
- If you get lower back pain mostly with standing activities, and the pain stops when you sit or lean over or lie down with knees bent, this article explains the most common reason, and what to do to fix it yourself.
- If you have pain when lying down flat, face up or face down, this article explains why and how to fix that too.
- If you were told you have facet damage, S.I. syndrome or spondylolisthesis (vertebral shifting, also called anterolisthesis and retrolisthesis depending which direction), Zygapophysial joint problem, or pars defect, this will show how to stop the cause of the pain, and prevent a major cause of the damage to the area. This technique also increases vertebral space to stop pain from some forms of stenosis.
- Many people who are told they have "flat back" may not in reality have a flattened lumbar curve. They may lean their upper body backwards, making the lower spine look flat, but it is actually compressed in a swayback position. They may be examined or scanned (X-ray, MRI, etc..) while lying down with knees bent which reduces the curve, or in other ways that change their real curve that they actually use when standing and moving in real life.
- You do not need surgery, extended medical treatments or bed rest to relieve this kind of lower back pain. You do not need to give up impact activities like running or martial arts, give up weights or heavy occupational work, or other activities you love to do. You do not need special lifting belts, expensive beds, ergonomic chairs, or other devices to do what you can do with your own body yourself.
- Exercises and treatments do not stop this cause of pain. You do not need to strengthen your "core" - that is a myth. Strength does not make you change this injurious slouch. Pain felt with long standing, walking, running, is usually from too much inward curve to the lumbar spine. That is a slouching habit, not a medical condition. This method teaches you how to stop this kind of slouch, called hyperlordosis.
- This method also shows you how to stop this kind of slouch during exercising, and gives a variety of levels and kinds of exercise - for the health and benefits exercise brings. Don't confuse a direct way to fix this one source of pain through stopping your slouched lumbar posture, with "doing exercises" in hopes to fix some misunderstood pain.
- If you have been told to push or tilt your backside or hips far out in back to stand or squat, this article explains that fad, and what is healthier to do instead.
- If you have been told you must "bend your knees to protect your back" this article shows why that is not so, and how you can control your own spinal angles even with your legs straight - needed for standing and other real life. This is different from doing sets and reps of exercises, then going back to injurious spine positioning habits.
- The most important time you use your abdominal muscles is standing up. Not by any tightening. You cannot move well with tight muscles. Abdominal muscles prevent swayback by bending the spine forward enough to keep you straight upright, not leaning back or letting the pelvis tilt. This does not ever come from stronger muscles, or from conventional ab exercises, but by you using the muscles you have deliberately and voluntarily until it becomes habit. This article explains how. This article also explains how to use abdominal and core muscles the way you need them for real life and movement.
- Many common medicines and prescription drugs can cause back and body pain. Without knowing the pain is from the medicines, un-needed treatments and surgeries are done. Easy changes in lifestyle can stop or reduce the need for medicines with muscle and joint pain as-side effect.
- Study of posture rules, exercises, and devices has shown they have made as much or more pain and damage as slouching, and do not create healthy movement. They are also no fun. Instead, healthy spine positioning during movement needs to be learned. Then all daily movement builds-in healthy, comfortable, positioning habits.
- This is not alternative medicine. This is evidence-based sports medicine techniques of neutral spine, applied to real life - where you actually need it. My web site also has more articles so you can understand how to fix your disc pain and sciatica, another covering other causes of back pain, one covering healthy pain-free sitting, and others. After learning how to stop pain with standing, walking, and running (etc) using this article, check those next. A list of my articles is on the Clinical Page. The end of this article (where it says "More fun...") gives many helpful links to pages on this site for more help. The bottom of every page on my web site gives main navigation links.
- Even if you do not have back pain, you can use this technique for a large variety of healthier exercises.
- My book The Ab Revolution FOURTH edition covers this one topic in depth. The cover makes deliberate tongue-in-cheek fun of most abdominal training book covers which feature overarched torsos indicating no use of brains or abs Print, Kindle, and eBook - see my BOOKS page.
What Does Swayback Look Like?
All the following are swayback (also called hyperlordosis). Too much inward curve of the lower spine (lumbar spine). Look at the following photos and see if you can see the swayback. It can come from leaning the upper body backward, letting the pelvis tilt forward with belt line downward in front, or doing both at once.
What Causes Pain From Swayback and How To Stop That Cause
- Too much inward curve of the lower back pinches and compresses the area, like bending a soda straw too much. Joints of the spine called facet joints (also called z-joints, for zygapophysial) are compressed, along with surrounding soft tissue and discs. Shear force on the discs is increased (structural strain by lateral shifting). Standing this way is slouching. Although slouching like this is sometimes regarded as natural, so is wetting your pants. A little control, and life is healthier.
- People create too much inward curve in two main ways. One is tilting their hip and pelvis. The other is leaning the upper body backward and the pelvis may not be involved at all. Some people do both at once, pictured in the left-hand photo, below.
- Restoring neutral spine is a simple posture change that you can do immediately - red photo example, below right.
- Swayback may be taught by trainers and used in gyms to do exercises "for health." However, neutral spine is healthier for the spine, and uses abdominal muscles more. There is no tightening or "sucking in" - It is movement of the pelvis and spine, not any tightening or clenching.
Photo #1 Left - Swayback (lower spine overly arched). Belt line tipped down in front and up in back. Upper body is leaning (slouching) backward.
Photo #2 Right - Neutral spine. Note level belt line. Upper body is more vertical.
A short gif should appear below of one of my students, David of Belgium. He starts with overarched lower spine, mostly from the tilted pelvis, then shows reducing the overarch (hyperlordosis) to neutral spine by moving the pelvis to vertical.
Note: Watch the lower spine reduce in inward curve. The pelvis changes from tilted to vertical. Do not push the pelvis forward of the midline. The knees (off camera) do not bend. Practice so you can move your spine without needing to bend the knees.
the gif does not work on your device, let me know at helpfulreader@DrBookspan.com.
This and other videos are on my Flickr / SmugMug account, TheFitnessFixer - http://www.flickr.com/photos/39972966@N03/4899716752/
Eugene C. Kelley, Esquire writes:
"I wanted to thank you for all of your kindness. Your books and workouts literally provided the only pain relief I had for a long time. You are by far the kindest medical person I have encountered over a four year saga (except my wife who is a nurse and would get mad if I did not qualify my praise)."
A Quick Way to Learn Neutral Spine
"Neutral Spine" does not mean whatever shape your spine takes naturally. Neutral spine means a specific position where the upper body does not tilt backwards, and the pelvis does not tilt, and is vertical. The exact amount of pelvic angle is debated. From my years of lab work I found that in almost every case, vertical pelvis, or close to it, works best. Here is how to change a swayback to less swayed:
- Stand with your back against a wall. Touch your heels, backside, upper back, and the back of your head against the wall. Do you have to increase inward curve of your lower back or raise your ribs for your head to reach the wall? Does your belt line tip down in front? Does it hurt or strain to straighten this much? This tells you you are standing in a painful way.
- Gently, without forcing or tightening anything, press your lower back closer toward the wall. Feel your pelvis and hip change in tilt, and reduce the lower spine inward curve. Don't flatten completely against the wall, simply learn to reduce an overly large inward curve.
- Feel that your hip is no longer tipped downward in front. The large space between lower back and the wall becomes a smaller space. Don't round your body forward of the wall or make anything hurt. You know you are doing this right when the pain stops, not when it hurts.
Below, a gif should appear, showing how to reduce swayback, by moving your spine so that you flatten toward a wall. There is no tightening or "sucking in" of the abdomen. All movement is from the spine. The arms are held out of the way, overhead so that you can see the spine.
My student Annie is demonstrating against a mirror. Her arms are overhead so you can see the torso. You can start with arms by your sides, then do the same movement to prevent swayback when you raise arms overhead.
A Second Way to Feel The Same Idea of Changing Swayback to Neutral
- Stand up and put one hand at the top of your abdominal muscles (front center where ribs come together is a reference point for this) and the other hand at the bottom of your abs on the front center of the pelvic bones (the actual origin of the abs).
- Notice the distance between your hands. Notice if your lower back has a large inward curve, if your belt line tilts downward, and if your upper body is leaning backward.
- Move your torso so that your hands come closer together until your body is upright and the too-large inward lumbar curve is reduced to neutral.
Left photo: Academy student Mireille demonstrates swayback (hyperlordosis). Ab muscles too long. Right photo: Neutral spine. Ab length shortened to pull ribs downward to level, without tightening.
- Mireille Harmouch, pictured above, personal trainer, student of the Academy Of Functional Exercise Medicine. writes:
"I had been suffering for years from lower back and side hip pain, and underwent X-rays, and went to many physiotherapists and doctors to hear only that I should reduce my activity. One doctor even prescribed Xanax medicine to me and said I need to stop training, stop doing squats and lunges. But since limiting exercising means to me to die & live insipid life, I continued to train, but with pain until I read in this page by Dr. Bookspan about how to fix sacroiliac pain and hyperlordosis so now I am pain-free. I also benefited from many other pages on the web site."
A Third Way to Feel The Same Idea of Changing Swayback to Neutral
- Stand with both hands on your hips. Fingers face forward, toward the front. Thumbs face backward.
- Roll your hip under so that your thumbs come downward in back. Fingers rise in front. Feel that your pelvis is no longer tipped forward, but level. The large space between lower back and the wall becomes a smaller space. It may help to do this with your back against a wall, as above.
- This movement is the same as taught above to reduce a too-large lower back arch and returns your spine to neutral spine. When you walk away from the wall, keep the new neutral spine position.
Kate was told that only surgery would help her, and that her injury was so severe that she should never be pregnant again. A year after working with me and taking the photo above, I checked in and Kate said she was still pain-free. At her two-year follow up, she was nine months pregnant with her second child, pain-free, doing well. When I checked in with her the next year, she wrote me, "We are doing well. My son is almost 1 already and we are all happy and healthy. My lower back is much better than it was. Thanks so much! "
How Much To "Tuck" The Pelvis?
If your pain is from leaning your upper body backward only, then you may not need to tuck your hip at all. If your pelvis is not tilted to start with, then tucking will not do anything that is needed. In this case, it is the upper body that you straighten.
If your pain is from an anterior tilt to the pelvis - a slouch so that your pelvis tips forward at the top - then you tuck the bottom under until the whole pelvis is vertical. No more than that is needed.
If you tuck too much, or tighten and clench abdominal or gluteal muscles, or move the wrong part, that will not fix the cause of of the pain.
Make sure you understand what is needed before trying random motions and wondering why that does not work.
Do Not Push Your Pelvis Forward
Often, people push the lower body forward, which increases hyperlordosis, not fixes it. Then they think the "hip tuck" does not work, when they never tucked or straightened the pelvis, they made things worse.
Many people who have hyperlordosis by leaning the upper body backward, also hold the pelvis forward of midline. They need to bring the pelvis back to the midline, check that it is vertical, and use their "tucking" maneuver for the upper body to bring it upright and vertical.
The idea is not to push the pelvis forward of the midline, but to make it vertical instead of tilted. If the entire hip and pelvis is held behind the midline, then bring it forward as a whole to the midline, and fix any tilt to vertical, if needed.
This is pushing the hip / pelvis forward, not tucking. It results in more swayback. This is not flat-back, but a kind of swayback.
When You Correctly Fix Swayback To Neutral Spine, Pain Reduction Should Be Immediate
My work is not exercises or therapy to do for weeks. My work is designed to give you instant feedback if you are doing it right or not.
Swayback does not take "treatments" or exercises or strengthening to fix. If your only injury is swayback and you do not immediately feel the compressive ache stop when you correct to neutral spine, then you have not done it right. Check everything above, and compare what you are doing to what is described above.
If swayback is part of your problem, then fixing swayback will fix part of the pain. Then we check other causes and fix those. Other common causes are listed in my articles on Fixing Back Pain and Fixing Discs and Sciatica.
Dr. Andrew Weiss wrote on March 10, 2010:
"After attending Dr. Bookspan's classes in Snowmass in July I followed her advice on spine positioning and was able to realize a lifelong goal of running my first marathon at 40. I have also since done scuba and belaying without the back pain to which I was accustomed, and have increased the intensity and enjoyment of my regular exercises, weightlifting and running. I refer regularly to her books and use this advice for the benefit of my patients as well as the Scouts in my sons' Pack and Troop, as they train for high adventure activities. Thanks."
Andrew Weiss MD FAWM
Six month follow-up from Dr. Weiss on September 10, 2010:
"I enjoyed meeting you at last year’s WMS session in Snowmass, and have benefited immensely from following your advice, and my patients, friends and family have also benefited from what I’ve been able to share with them regarding what works and what doesn’t with recurrent pain. I’m belaying, running (including my first marathon last year), diving, and hoisting canoes, kayaks, and my boys, all without the back pain to which I’d been accustomed, and can’t remember the last time I used an analgesic. Keep up the good work."
Why Do People With This Kind of Back Pain Often Feel They Need To Bend Forward To Feel Better?
The answer is the reason they hurt in the first place - excessive inward lumbar curve that shortens and compresses their lower back. When they bend forward, they feel the needed lengthening and uncompressing. However bending over all the way forward to do a stretch is not what is needed. It is not even healthy on a regular basis.
Only the small amount of flexion that reduces the large inward curve is needed. You remain standing upright and can walk and do all your activities. The difference is that you no longer are crushing your lower back while you do them. You are no longerstanding and walking in a slouch called swayback. The mistaken idea of "fixing" back pain with forward bending has resulted in numerous unhealthful exercise and pain rehab programs relying on excessive flexion (forward bending) exercises, which cause other problems for discs, and much hip pain and dysfunction.
If you get an achy back during standing and other upright activity, check for swayback and fix it. Not just each time it hurts. Prevent swayback all the time. You will stop ongoing damage and let areas heal. If you don't compresses, pinch, and pressure your lower back with excessive inward curve, then you will not need to stop and relieve the pain by doing the opposite movement. You will not get the pain in the first place.
Why Do People With This Kind of Back Pain Often Feel They Need A Pillow Under The Knees?
A pillow under the knees for lying on your back, and bent knees for exercise on the back, reduces the lower back arch (while knees are bent). It is mistaken for a fix, but perpetuates two problems:
1. Not knowing to prevent swayback with better habits. 2. Not being able to easily prevent swayback because of shortened hip flexor muscles which pull the pelvis forward. This is different from slouching from habit. The answer is not to take away the pillow, just the need for it. For what to do for tightness, scroll down to "Some People Are Too Tight in the Anterior Hip (front of pelvis) To Straighten To Neutral." A lot more on this is in my book The Ab Revolution, with info on my BOOKS page.
What Do Abdominal Muscles Have to Do With Stopping Back Pain?
- Strengthening the core or abdominal muscles does not fix the pain because it does not stop the cause, which is too much inward curve. Stopping the painful bad posture stops the pain.
- Abdominal muscles only help your back when you use them to move out of bad position into neutral spine. Strengthening your abdominal muscles does not make you stop slouching, and strong abs do not automatically support anything. It is a voluntary movement. No amount of abdominal or back strengthening will stop you from standing badly.
- The most important time you use your abdominal muscles is when standing. Not by any tightening. You cannot move well with tight muscles. Abdominal muscles prevent swayback by bending the spine forward enough to keep you straight upright, not leaning back or letting the pelvis tilt. This does not come from stronger muscles, or from conventional ab exercises, but by you using the muscles you have, deliberately and voluntarily, to make a small change in spine position, until the new neutral spine becomes habit.
Kinds of Hyperlordosis
In my research work, I have identified several kinds of hyperlordosis, all the same concept. It's good to stay simple, so here is a summary drawing. #1 Neutral Spine, #2 Anterior Hip Tilt, #3 Upper Body (thoracic) Lean:
Technically the word "lordosis" originally meant the normal inward curve of the lower back. It has commonly come to mean too much inward curve, allowing the lower back to sway. The technical word is hyperlordosis, meaning too much lordosis. Hyperlordosis creates much back pain including facet pain, which is pain and damage to the facet joints that hold your vertebrae together. The facets are the joints that your body weight presses on when you let your back sway or arch.
Can You See Swayback (Hyperlordosis / Overarching) In Real Life? Compare the photo below to the drawing above:
Now can you see hyperlordosis in real life? The photo shows #2 Anterior Hip Tilt, #3 Upper Body (thoracic) Lean.
Can You Tell If You Are Standing in Swayback? (Hyperlordosis / Too Much Inward Lumbar Curve)
Check - When you stand. When you look up. When you reach up. When you carry a load in front like a laundry basket, chair, or child. When you carry a backpack in back.
Check to see if you can pull you shoulders back or drink a glass of water or take a photo without leaning backwards or increasing the inward curve of the lower back.
This bad posture is, surprisingly, taught in many gyms, or done deliberately mistaking it for a cute posture. It is unhealthful and injurious bad posture that interferes with healthful movement and creates much lower back pain. If you get an achy back during these activities, check for swayback and fix it.
Hyperlordosis (Swayback) Is the Cause Of Much "Mystery" Pain
Hyperlordosis pain does not often show up in X-rays or scans, and keeps coming back no matter how many exercises, massages, or "adjustments" you get. Many people get repeated injections, but the pain keeps coming back. The reason is that they return to swayback posture.
You'll see the swayed hyperlordotic spine posture in an astonishing number of fitness videos, magazines, books, and classes. They may say, "keep neutral spine" but they arch their back and stick out their behind in dozens of exercises from leg lifts, to lifting weights, to bouncing around in aerobics.
It is not neutral spine to have a large inward lumbar curve. It is not "just the way you are made." It is bad posture that you can change.
Do you know why there is often a foot rest in pubs? People who arch their lower back during long standing often get back pain from it. They feel better when they put one foot up on the foot rest. The reason putting one foot up on the low foot rest reduces the pain is that you unwittingly reduce the large lower back arch. You don't need a foot rest to reduce the arch. Change your spine positioning yourself and stand with neutral spine. Then you won't have the arching that causes the pain.
On Apr 6, 2017, Jack Ryder wrote:"This quotation seems meant for you!!! - 'Talent hits a target no one else can hit; Genius hits a target no one else can see'. - Arthur Schopenhauer"
Don't Tilt The Pelvis, or Push Your Backside Far Toward the BackPeople hear they need a small inward lumbar curve, so they make a big one. They tilt their pelvis forward in front with the backside tilting out in back. You can see this unhealthy practice in many fitness publications, videos, and gyms. There is supposed to be a small inward curve to the lower back for shock absorption and protection of the discs. But only a small one. Increasing the inward curve does not help more. It causes pain of its own.You will have a healthy lumbar curve without tilting your pelvis. The pelvis should be vertical - from the crest of the hipbone down to the top of the leg bone - like the seam down the side of pants or shorts. The seam should not tilt forward at the side of the hip.The belt-line should be horizontal. Some people visualize the proper pelvic angle by thinking of a bucket full to the top with water. Hold the bucket upright and vertical so the water doesn't spill out, not tilting forward.
Notice and Correct If You Lean Your Upper Body Backwards
Even if your pelvis is vertical and your belt-line level, leaning the upper body backwards increases lumbar curve, causing swayback. I named it "Thoracic Lean" for lack of a better name. (I am still working on a better name.)
Leaning the upper body backward is common. There are several reasons people do it. Mostly it is simple slouching. Often people do it deliberately, mistakenly thinking they are "standing up straight" -or "bringing shoulders back" but they are actually leaning the entire upper body backwards. Both photos below are examples of an upper body (thoracic) lean. In the yoga photo, the model is not only leaning the upper body backwards, but tilting the pelvis forward, described previously.
Here is one way to tell if you lean your upper body backwards - Look at yourself sideways in a mirror. Look to see the position of your upper body relative to an upright. Make sure you notice what leaning backwards feels like. Taking side-view photos also helps to see where your body is in space in relation to where you think it is. To fix leaning backwards, bring your upper body forward enough to become upright.
Feel This Technique Work
When standing, your pelvis should be vertical, not tilted, from the top of your upper leg bone to the middle-point of the crest of your hip. Your upper body should be upright and vertical. Once you understand this, and can do it, use the following test and technique to feel it working against resistance.
This is not an exercise that fixes any injury or pain. This is a way to check how well you have already reduced your swayback and can use neutral spine during activity.
When you are already using neutral spine and press against a wall or object to be pushed, notice that there is no compression or pain in the lower back, and you gain a stronger pushing action in the arm:
- Stand facing a wall, or any sturdy surface as in the photo above, with one arm outstretched. Press the knuckles of your curled fist against the wall. Notice if you stand badly, shown in left-hand photo. See if you can tell if you tilt your hip out in back, or let your lower back arch inward. Let your upper back lean backward. You will probably feel pressure in your lower back (don't do this if you have pain or injury).
- Now, change to neutral spine by tucking your hip under to vertical, shown at right. The movement is like a pelvic tilt or a standing crunch. The arch in your lower back reduces. The first thing you will notice - if you do this correctly - is your lower back stops hurting because you have stopped swayback. You should also notice a stronger push against the wall and new strength in your arm and upper body. You will feel the muscles in your trunk and abdomen working. Remember, this is not an exercise to fix pain. This is a drill to test how well you know how to stop swayback, and to feel that it is a better spine position for activity.
A gif should appear below of my student Dennis, Olympic wrestler, demonstrating changing to neutral spine when pushing against resistance:
See this video and others directly from my Flickr / SmugMug page: https://www.flickr.com/x/t/0094009/photos/thefitnessfixer/22991412054/
Prevent Overarching (Swayback/Hyperlordosis) When Reaching and Lifting Overhead
Check to see if you arch your lower back and lean the upper body backward when reaching overhead.
You may be doing this dozens of times daily doing things as simple as putting things on shelves, pulling off shirts, stretching arms overhead, even combing and washing hair. Damage accumulates.
#1 Left - Leaning the upper body backward, and tilting the pelvis.
#2 Right - Straightening the pelvis and upper body to vertical
Prevent Swayback / Hyperlordosis When Carrying Loads - Backpacks, Packages, Pregnancy
- Loads Carried on the Back - Check to see if you increase the lower spine arch when carrying a load on your back, like a knapsack, or someone piggyback. Heavy bags and backpacks don't make you arch your back or have bad posture. Not using your ab muscles to counter the pull, and allowing your back to arch is the problem. Hold neutral spine against a posterior load. Your bags will be a built-in abdominal muscle exercise.
- Loads Carried In Front of You - Check to see if you lean your upper body backward when carrying an anterior load (something held in front of you), like a chair, a package, a child, pet, a pregnancy, or anything. Stand upright.
- Pregnancy - If you have swayback during pregnancy, it is not true that being pregnant makes your posture poor. You are leaning the upper body backward, and/or tilting the hip and pelvis forward. People do this to try to offset weight in front, the same as carrying a chair, grocery bag or dog as pictured in the examples below. You do not have to lean back or tilt your pelvis to carry more weight in front. Use neutral spine so that your front (ab) muscles offset the weight. Even if it is true that you are more flexible due to pregnancy, you can (and need to) stand in neutral spine without leaning backward. Of all good times to prevent this arching, this is it. Use the same pelvic tilt described above to change to neutral spine. You do not have to have a backache when carrying a pregnancy.
LEFT - Leaning upper body back, pelvis tilted (ouch!) RIGHT - Upright and neutral
Prevent Overarching (Swayback / Hyperlordosis) When Wearing Heels and Standing on "Tip-Toe"
Standing on the ball of the foot, as when wearing high-heels, does not "make" you stand badly or "arch your back" (stand in swayback or hyperlordosis). You control your spine and can hold neutral spine the same as during all other standing, walking, and activity. People may lean backward and/or increase lumbar arch when they haven't trained balance and neutral spine. It does not take much training, just knowledge and doing it.
In the two photos below, my student Leslie demonstrates standing "tip-toe" (raised heels).
In the first photo, Leslie stands swayback (yellow arrow points to area of increased lumbar compression. Red line shows tilted pelvis).
The second photo shows standing with raised heels in neutral spine. Green line shows vertical pelvis. One foot is more forward for two reasons - first so you can see both feet and also that is part of how you walk, while wearing heels or not. (Note, in the second, corrected photo, Leslie is still leaning the upper body back very slightly. When you do this, keep upper body vertical for standing)
Movement to change swayback to neutral comes from the spine. There is no tightening of abs. There is no "sucking in," and no "navel to spine." That is not how you move. Leslie is 75 years old in this photo. See her video of doing 30 neutral spine pushups on the Fitness as a Lifestyle page. Scroll down toward the end to see it. Also using the article until getting to the video is a nice idea.
Next my student Paula:
In the above two photos, my student Paula shows standing in raised heel position, first with swayback (first photo with red X), then correcting spine to neutral (second photo with green check mark). Note that no knee bending is needed. I asked her to do this for photos in the middle of an exercise class. She had no warning or prep time. A great student.
Some People Are Too Tight in the Anterior Hip (front of pelvis) To Straighten To Neutral
Sometimes, the front hip muscles and connecting tissue get so tight, that you can't straighten the hip to stand upright. Then standing and moving is uncomfortable, but you are also too tight to change to healthier neutral spine, and trying to use neutral will also feel tight or uncomfortable.
The drawing below shows the forward bend (flexion) where leg meets body in the front of the hip. It is increasingly common for people to keep that front hip area bent for all they do - to walk and move and do exercise. I have seen people jumping rope and doing standing weight lifting like this, do entire exercise classes with the front hip bent, walk out of the class, and never straighten their front hip.
It is a common assertion that sitting makes front hip tightness (hip flexor tightness). I am finding, so far, from preliminary data from studies I am doing that there is a stronger correlation between tight anterior hip and thigh muscles (hip flexors) and people who do mostly flexion based exercises than from sitting alone - people who do most conventional exercises of leg lifts, pilates, yoga and other forward bending systems, and use that same bent posture for all their exercise. More on this work on my Lower Body Revolution page.
What to do if you are tight in the front hip? Stretch the front hip. The stretches I use are the ones that are the most effective in both stretching the front hip and thigh and also teach how to use that length with neutral spine. (You can have a stretchy front hip and thigh and still stand terribly). Two examples are below:
Use as much neutral spine as you can. The motion of moving to neutral stretches the front hip because you stop bending that area and lengthen as far as a straight position.
When doing lunges, tuck the hip under until vertical (not pushing it forward), as described above. When you use neutral during lunges, you will feel a stretch in the front hip, even standing in a lunge without lowering. That is how you know you are tucking properly. Then lower until you get the stretch you like and need. (Not until it hurts).
I have a large number of fun, good-feeling stretches for the front hip. They are not conventional stretches, but specifically designed to let you feel front hip position and muscle length, and how to lengthen it. Some of the stretches are done standing to get balance and functional practice for daily movement you actually do, and others are lying down to practice relaxing and not tightening. See my book Stretching Smarter, take one of my classes, make an appointment, or contact me through Individual Care to learn many healthy techniques to get needed resting length of the front hip (and anywhere else needed).
Below is a tweet from one of my Fitness Fixer readers on Twitter. Thank you for smart use of my work, Rob.
Prevent Swayback (Overarching / Hyperlordosis) When Sitting
- Most people who overarch the lower back when standing feel better to sit down. Why? When they sit, they round their back reducing the painful overarch. The pain from it goes away. However some people sit with a too-large lower back curve. Sitting with too much arch also makes back pain.
- Don't keep a large inward curve of the lower back when sitting. It is not healthy sitting, any more than rounding forward too much. Use neutral spine for sitting.
Don't overdo. Don't sit with increased inward lumbar curve, shown above. That hurts too.
The Healthy Sitting article on this web site tells more.
If You Dont Believe That "Tightening" Is Not How to Use Abdominal Muscles, Try The Following:
1. Tighten your abdominal muscles, as commonly taught. Press your navel to your spine. Tighten the entire area. Now try to breathe in. Note that tightening inhibits breathing in. Belly breathing is prevented. You could take half-breaths high in the chest with tightened abs, but that is not a healthy or relaxed way to breathe and go about your life.
2. Next stand with overarched lower spine posture. Tighten your abs and surrounding musculature. Note that the lower spine angle does not change.
3. Stop tightening the area so that movement is now unrestricted. Use easy relaxed movement of your spine and hip to remove the hyperlordotic arch, straightening your posture. Understand that "using your abs" means using them, like any other muscles, to move your body.
Instead of lying on the floor and hunching forward to exercise your abs, train your abs to work the way you really need them - standing up. By using your abdominal muscles to hold healthy spine positioning during all your activities, you will get free exercise, and abdominal and core muscle training that benefits your life and back. Strengthening abs will not help your back. Using them to keep healthy torso posture is how it works.
Arching (Back Extension) By Itself Is Not Bad
Arching your back to create needed range of movement, for example, a big tennis serve, is not injurious by itself. The problem is compressing an overly-extended segment of the spine under load. Don't allow your lower back to fold backward under your upper body weight. Instead, use your abdominal muscles to keep the load lifted, with more space in the posterior spine. By holding your upper body weight upward with your abdominal muscles, you can lean and extend back without weight shifting and pressing downward onto your lower back. Supported extension, compared to sagging in hyperlordosis are often confused, leading to rules that you must never extend the spine, rather than understanding the concepts and creating healthful movement. Healthful back extension is an important and good-feeling exercise for back health and is covered in the back pain article on this web site (and my books).
What's Wrong With Crunches?
It's practically universal to see a gym full of people doing crunches, then stand up and walk away with arched backs and no use of abs, or knowledge that you are supposed to use abs standing up.
1. Crunches don't work your abs the way they are needed to work for real life.
2. Crunches don't train or teach you how to use your abs the rest of the day.
3. Crunches promote rounding posture, even when done properly. Crunches take a person, who likely spends much of their day already hunched over a work area, practice that hunched posture which may be mechanically promoting the back and neck pain they think they are working their abs to prevent.
A fitness industry survey looked at common abdominal muscle exercises and ranked them from most to least effective in using abdominal muscles. But the surveyors missed three basic concepts. An exercise can work a specific muscle but still promote bad posture and not be good for you. Even if an exercise activates your abdominal muscles, it still may not be useful for things you need for daily life. Simply strengthening a muscle will not transfer posture skills you need for proper use in sports and recreation, or for back pain control. Exercises that I specifically developed to learning and using abdominal and core muscles the way needed for better exercise and also healthier spine, at the same time, follow below in Part II - Real Core Training.
This family - mother, father, and son - all fixed their pain together with me.
Part II - Real Core Training
You do not need to do exercises to fix back pain. Fixing back pain is mostly about stopping bad bending for all you do all day, stopping bad exercises, and using good bending and healthy exercise instead. All described above.
Core and ab exercise cannot stop swayback or change posture. Stronger muscles do not create any movement. Healthy positioning comes from you doing the needed movement away from painful slouching, and do not need stronger muscles to do that.
This section explains how to use this method to exercise for general health, and for better abdominal and core exercise that is also healthier for the spine.
A Little About The Ab Revolution To Understand and Use Neutral Spine:
The way your core works, is to deliberately move to neutral spine position instead of swayback (hyperlordosis).
You do not need stronger abdominal muscles to move your spine to healthy position. You need the knowledge and practice of what movement to use your abdominal muscles to do. Strengthening does not make movement or teach you healthy ways to move.
Healthy core training means using the healthy spine position to exercise. Keeping neutral spine uses the abdominal muscles with no tightening and no rounding or bending forward. The key is that neutral spine strengthens your abs. It is backward to strengthen your abs hoping that will automatically give you neutral spine.
I developed an innovation in core training. Instead of curling forward or doing a bunch of planks, I developed a system to exercise your abs and back at the same time, plus show you how you are supposed to use abdominal muscles to change spine position when you stand up again. This collective work including many dozens of retraining drills is called The Ab Revolution. Some Ab Revolution exercise examples follow. Many more are in the The Ab Revolution, book, and in my classes.
My Ab Revolution teaches you how to use your abdominal muscles the way you need for real life when standing, moving and living. I developed more than a hundred Ab Revolution retraining drills. Most of them are done standing, which is much of how you live your life. Below are three that are not done standing. They change conventional exercises into effective retraining drills.
THESE ARE NOT CRUNCHES. This is not an arm exercise. It is not a back pain fix - by itself. Use this drill to learn how to stop swayback - if you do it as taught - while you exercise. Then, use the same knowledge when you stand, and go about your life.
"Isometric Abs" retraining drill. By itself, it is a great ab exercise (IF you prevent your lower back from lifting upwards, increasing inward curve). The benefit to stop back pain comes when you TRANSFER the knowledge of using this to prevent swayback all the time, when walking, running, and lifting loads overhead:
- Lie face up, arms overhead on floor, arms by your ears holding hand weights only an inch or two above the floor, one in each hand. Keep legs lying flat and relaxed on the floor.
- Notice the common result - most people allow their ribs to lift upward and the lower spine arches upward off the floor (increasing inward sway).
- To correct the increased lumbar sway, press your lower back toward the floor. Feel the change in tilt of the pelvis. You will feel your abdominal muscles working to do this right. See if you can flatten your back against the floor without your legs pulling upwards, which indicate tight anterior hip muscles that needs stretching.
- Quickly start raising and lowering the weights an inch or two above the floor, repeatedly. Don't let your lower spine increase in arch. Control spine position using your abdominal muscles. Done right you will feel your abdominal muscles working. That is instant feedback - you can feel your spine move to less sway and you feel your abdominal muscles do it.
- Notice that each time you lower the weights, it is tempting to allow the lower back to lift of the floor. Maintain the lower back against the floor, and feel the lower abdominal muscles work, along with a nice stretch across the front of the hip as you maintain neutral spine.
- Your upper body and legs never lift from the floor. Head and neck stay relaxed.
The gif below shows Isometric Abs as done in my exercise classes to music. See the short description above to understand why and how to keep this an abdominal and core exercise and neutral spine retraining drill, not an upper body exercise alone. Note that the lower back never lifts or arches. We use a bench to practice this with more stretch to the anterior hip and arms, while still maintaining neutral spine. In the mirror, you can also see another student working on chest presses with neutral spine.
See this video and others directly from my Flickr / SmugMug page: https://www.flickr.com/photos/thefitnessfixer/17050894548/in/photostream/
In this short movie below, David Demets of Belgium and his first new baby Aiko demonstrate my "Isometric Abs" drill to retrain neutral spine against load. Turn your speakers on for what my readers call, "The Most Charming Fitness Video Ever Made." Notice he sits at beginning and stands at the end without using arms to balance or push off the floor:
If this video does not display on your device,
Trainers and instructors - See the Ab Revolution Syllabus for instructions how to explain, demonstrate and get a class to successfully do this Isometric Abs retraining drill in 30 seconds. Send me your gif or video of teaching this (best is teaching real people, not the camera) - small file size, and no more than 15-30 seconds total of concept and practice. Correct videos will get helpful feedback from me and will go up on this web site with your name, and you as role model - mail to: Success at DrBookspan.com (please do not clog my e-mail with large or unsolicited files).
Why Keeping Knees Bent During Core Exercise is Not Needed
There are trainers who say you must bend your knees to "protect your back" from arching. But it is your own abdominal muscles that are supposed to hold your back in position. How could you stand up and go about your life, if the only way to "protect your back" is to keep your knees bent? Use this exercise to strengthen your abs at the same time as retraining standing posture.
RETRAIN Your Push-ups and Plank
Planks and pushups do not work your abs without using neutral spine.
To learn this, start a push-up (or plank) position (hands and toes, not on knees).
Notice your lower back. See if it is making any downward curve, like a hammock. To fix that, tuck your hips under, as if starting a crunch so that your lower back doesn't sway or arch.
Done properly, you will immediately feel your abs working when you do this. You will also immediately notice the lower spine no longer feel uncomfortable.
Use a mirror, if available, to see yourself and learn what healthy position feels like. Learn how to correct to neutral spine doing a plank, then transfer this knowledge and practice standing, so that you use this new healthy position all the time, when you stand, walk, run, and reach overhead.
When you allow your lower back to increase inward curve,
you are not using core muscles, you are sagging your weight onto your lower spine.
Tuck your hip to reduce inward curve and straighten your lower spine.
You will immediately feel your abs working. Lumbar compression from the swayback will disappear.
The weight of your body shifts to your abdominal muscles and off your lower spine.
The short gif below shows fixing swayback to neutral spine for planks and push-ups. This is my first try at making gifs. Let me know if it does not run automatically. It may take a moment to load:
To see the same in movie format, click directly from my Flickr / SmugMug account: https://www.flickr.com/photos/thefitnessfixer/16884539117/
Why do neutral spine planks? The purpose of this re-training drill is to exercise your abs at the same time you practice preventing swayback for all you do, especially when it is needed in real life - when you are standing up.Trainers and Everyone - Send me your gif or video of changing swayback pushup or plank to tucked straight spine - small file size, and no more than 15 - 20 seconds total. Ideally - no speaking at all, so everyone, including non-English speakers benefit. Correct videos will get helpful feedback from me and will go up on this web site with your name, and you as role model. Full instructions on the Projects page for videos and photos. Mail to: Success at DrBookspan.com (please do not clog my e-mail with large or unsolicited files).
Rethink "Bird Dogs"
A common but ineffective exercise is to kneel on hands and knees and lift one leg in back, and/ or one arm in front, or both at once. It is sometimes called a "bird-dog" position. It does not work the back, hip, or leg muscles very much. Some people do it saying they are stretching or working the back muscles, especially the multifidus muscles. It cannot stretch the multifidus or other back muscles, since it is an extension exercise which is in the other direction. Without knowing that you must control spine position, it does reinforce faulty movement patterns - to increase lumbar curve to move your leg. Many people unfortunately also do this when standing and walking. It is no wonder they hurt.
Notice increased sway/ increased inward curve in the lower back to lift the leg (left). Instead, tuck your pelvis under (right). As soon as you tuck correctly, you will feel a big difference; You will have to use your abs to tuck, and use the hip and leg muscles to lift your leg instead of arching your back. Also - Use upper back muscles to raise your neck and head to level instead of bending back your neck at a sharp angle at one vertebra - lift chest not chin.
The hands and knees position gives extremely little exercise or stretch and does not train you how to hold your body weight up against gravity. It is not useful except if you use it to retrain how to not sag into weak, droopy, sagging lower spine. Here is what to do instead:
Instead of spending time on ineffective exercises, get off your knees. Hold a real push-up or plank position as in the drawing below. It will strengthen your arms and is more ab exercise - when done right. Make sure to use abdominal muscles to tuck under your hips or you will get no ab exercise. Hold a good pushup position. Lift one leg without letting your spine sag. To advance, hold this same position and lift one arm straight out in front of you. Don't drop your head or hunch your shoulder. Use your muscles to hold you as straight as if you were standing.
Use this neutral spine drill to train yourself to prevent your spine from sagging, then transfer that re-positioning skill to standing. You will change it from a mindless exercise to good abdominal exercise that also retrains functional movement habits when you stand, walk, and run.
Fixing Swayback is Better Exercise and More Exercise Than Allowing Swayback
Even if you do not have pain from allowing inward sway in the lower spine, you are still missing a lot of good exercise, and you are practicing bad posture during exercises "for health."
The following two examples of exercises, a pull up and an easy wall handstand, are not exercises that magically fix back pain, they are to learn how to use neutral spine during all your more active activities to prevent spinal compression and use your abdominal muscles in a functional way to get smarter healthier exercise.
Pull ups. With swayback, pictured in the pull-up below, abdominal muscles are not being used to hold the lower spine in neutral, which is supposed to be their job:
The red arrow shows the large swayback.
Even if you are doing "exercise" you are missing all the abdominal exercise that should be part of it, if you allow swayback and don't use muscles to hold straight neutral spine position.
Try the same pull-up with neutral spine:
- Straighten your torso into one one line, not two separate halves of upper and lower body bent at an angle at the lower spine.
- The action is like a crunch until you are hanging straight, not bending in any direction.
- The moment you pull to neutral spine, you will feel for yourself how much abdominal muscles can add to exercises you already do.
- Send in your photo or video to appear here as a success role model.
To change your wall handstands to neutral spine
1. First, my student Dennis (an Olympic wrestler) steps each foot back and up on a wall for an easy wall handstand,
2. Notice the swayback lower spine. It causes spine joint compression and doesn't use abs. Red arrow and frown face,3. Then Dennis tucks his hip to neutral spine. Healthier for spine, more core exercise. Green arrow and happy face.
See this and other movies on TheFItnessFixer Flickr / SmugMug Account: https://www.flickr.com/photos/thefitnessfixer/17003384442/
Thank you Steve Kramer PhotoEnvisions (http://seatraveler.com) for adding the arrows and faces for teaching points
Why Do I Say "Use Your Brain?
Most of my students have heard me say, or have seen my written articles which state, "use your brain to change spine position."
I was surprised it was misunderstood. Students changed it into standard "fitness" dogma that neurologic changes happen automatically and doing exercises somehow fix posture without you having to think about it. What it means is, "USE YOUR THINKER TO RECOGNIZE SLOUCH AND YOUR MEMORY TO REMEMBER TO FIX IT." The brain has many functions. Ab Revolution drills train the deliberate conscious mental portion.
Turn to the side on one arm, hold your body straight, using oblique abs to prevent sagging. When you can do this, lift the top leg so that you are standing on one arm and the side of your bottom foot. Use the knowledge from this drill to retrain standing position with packages and bags on one hip without sagging. Your bags change from back pain from bad body mechanics into built-in exercise and ab training.
For more Ab Revolution, hold one leg out to the side, holding a straight pushup position. Lift the opposite arm and hold. Then try pushups like this:
Hold a flat "plank" (pushup) position. Hold one leg out to the side. Lift the opposite arm.
You will feel your abs working hard to hold your body straight against your body weight.
Hundreds Of Fun ExercisesThe short drills shown above are a few Ab Revolution retraining drills. There are hundreds more. Try the workshops, and get the new FOURTH edition book The Ab Revolution No More Crunches! No More Back Pain! The book has two parts. The first shows how to reposition to neutral spine. No exercises needed to fix pain. The second part is all the fun you can have getting in shape using this concept.
Got the Core? Get the "T"
What About Hamstring Stretching To Fix Lower Back Pain?
I did studies that found no relation between hamstring flexibility and lower back pain with standing. Then why does bending over forward seem to stop this kind of pain?
Flexing the back (bending or rounding forward) temporarily stops the pain because it stops the hyperlordosis - although only temporarily for the duration of the stretch. People don't know this and often go right back to standing swayback. Soon, pain returns from the compression of swayback. Another stretch, and the pain would seem to go away. It was the back stretch not the hamstring stretch. That back stretch became further confused with hamstring flexibility. The stretch itself is not as healthy as it could be and does not fix the problem. Neutral spine stops the whole cycle of mistaken identity. Enjoy my Hamstring Page to see more about this work.
What The Ab Revolution Book Has That This Article Does NotMy goal is that if you have pain from hyperlordosis, explained above, that you correct it to neutral spine right then with my information. I spent years in hyperlordosis research to identify and quantify this previously ignored source of so much lumbar and sacral pain. I want the world to be a better place with healthier happier people intelligently applying this breakthrough method. If this article alone fixes your pain, I am thrilled!
The full book has many more examples, expanded explanations, photos of the same principle applied to many different needed real life examples, and much that can be immediately put into use by those who want to teach, coach, lead health programs, help patients right in the office, or just make their own lives better
PART I shows how to stop lumbo-sacral pain during various upright activity in daily life, both non-active and active, such as long standing, walking, running, overhead lifting. It has many examples, (neutral spine, repeated for each) for all the different times that this principle is needed, but usually forgotten. There are photos showing overarched and corrected position for standing, walking, reaching, bending, running. This Part ! should show you how to stop the pain. No exercises fix the cause of the pain - that is a fad and a myth - unless you also stop the injurious and painful hyperlordosis too. Part I makes sure you have the examples needed. For all the different ways people learn, it also gives several (I think seven) different ways to understand, learn, incorporate, and internalize what is neutral spine and how to achieve it. It reinforces functional exercise as a lifestyle. Does the book need to repeat the concept for each different activity with photos and descriptions? Readers asked me to, and have shown me that they need it to!
PART II shows how to get exercise for general health and for high core training without flexion exercises. Innovative exercises are shown with swayback and corrected spine position photos and descriptions. The purpose is so that you can exercise in healthier ways using neutral spine for all the various exercise you need for health benefits, to improve sports skills, and for impressive abs if that's what you want. Don't confuse exercising with the simple PART I retraining that shows you how to stop a painful overarching habit, but that does not require any exercise to do it. The many (many) exercises are a variety of kinds and levels of difficulty so that everyone can try, and those who want, can advance. They teach many innovations in functional exercise and fitness. My book Health & Fitness - How to be Healthy Happy and Fit for the Rest of your Life has a chapter summarizing the topic, plus chapters on most everything needed for what the title says. See book descriptions on the BOOKS page so you can get all the books or eBooks that suit your needs.
NOTE - if you get The Ab Revolution book, check which edition is being sold. Make sure you get the FOURTH Edition, not earlier editions. My web site books page has example cover photos of the correct edition.
How Long Does It Take To Stop Lower Back Pain Using Neutral Spine Instead of Swayback (The Ab Revolution)?
If your pain comes from swayback (hyperlordosis as explained in this article) you should feel that the pain and pressure stops the moment that you stop swayback by moving your spine and pelvis to neutral. If you're not feeling better right away, check all the following.
- If you don' t have swayback, then, of course, fixing swayback is not what you need.
- If it hurts you ARE doing it wrong. Stop and assess. Check what you are doing compared to what is presented above. None of this is "exercises" to "do" but retraining drills to learn to stop doing the thing that hurts.
- Are you still arching from anywhere in the lumbar spine? Leaning your upper body backward? Did you push your hips forward instead of tucking (tilting) under to straighten? DId you round your upper body forward instead of becoming straighter?
- Are you doing bad exercises from other sources? It is common to do a few movement from my work, but continue or add injurious moves from other sources that slow recovery and re-injure.
- Are you tightening or clenching any muscles? Tight muscles can hurt and impede healthy movement. Although it was an almost universal fad to "tighten" ab muscles, tightening does not change faulty movement, inhibits normal breathing, and can make pain of its own.
- Are you overcompensating? Are you making new bad movement habits, thinking that will "undo" or fix?
- Are you changing this work from exactly the way it is presented into something else, or that you have heard elsewhere? This work is different.
- Is something else causing the pain, such as infection, shingles, growths, Lyme Disease, SIckle Cell, food sensitivities, allergies, medicines that have pain or cramping as side effects, or other non-movement based situations?
If you did not have hyperlordosis before, (no swayback and no upper body lean back), then reducing the arch will not change your source of the pain. Make sure there is not something else contributing to your pain. It is is almost always quick and easy to start getting your life back and start feeling better right now. Don't wait.
On Mar 11, 2010, Paul Jenkins wrote:
"My approach was to read Dr. Bookspan's free Abs Article from her web site.
Then do what it says. Then ordered her books and did what they said.
14 years of lower back almost 100% gone and I was doing cartwheels for fun last night.
Healthier Core and Abdominal Training and Use Summary - No More TighteningThis is new and different from what we learned in school and at the gym. New research has shown a better way. This is good news. Discard outdated "tightening" your abdominal muscles, or any muscles, to use them, or the old "press navel to spine." You cannot breathe properly or function that way, and walking around with "tight" muscles is a factor in headaches and stress/ strain related muscle pain. Tightening muscles does not change your posture. The "support" does not come from tight muscles, but using them to a healthy spinal angle:
- One kind of lower back pain comes from too much inward curve in the lower back. Too much inward curve can come from tilting the pelvis, or leaning the upper body backward, or pushing the pelvis forward, or any combinations of those three. Changing the painful posture means moving your spine like moving any other body part. Move out of painful spinal angle to vertical pelvis and neutral spine. Use healthy neutral position, easily, no matter what you are doing or carrying.
- The postural change is right then and there. No lengthy treatments needed.
- Learn the repositioning to prevent too-large inward curve to the lower back. Use that for how you stand and move in real life, not merely as an exercise.
- When you stand, walk, run, or lift overhead, notice if you are allowing a large inward lumbar curve - hyperlordosis. See if you are tilting your pelvis forward at the top and outward in the back. Tuck (pelvic tilt) back to upright vertical pelvis and neutral spine. Don't tuck so much that it huts - but so that it does NOT hurt. If it hurts, you are not doing it right.
- Make sure you know the difference between tuck (change angle from tilted to less tilted) and "push forward." Don't push your hip or pelvis forward, as that increases hyperlordosis, not decreases it. Don't "do" postures as a rule, understand what you are doing to hurt and change to healthier ways. Use your brain.
- When you carry loads in front of your body, don't lean back to "balance it" or stick your backside out, increasing the lower back inward curve (don't increase normal lordosis to hyperlordosis / swayback).
- With packs on your back, don't lean back or hunch forward.
- With a bag on one shoulder, don't let it pull you to the side; simply use your own side (oblique) muscles to hold upright posture against the sideways pull. It's free exercise and it's good for you.
- Does my work mean you never do any flexion? Of course not - that is misunderstanding the concepts. The idea is notice if you spend most of your day that way and then use flexion exercises on top of that. Then it is no mystery why you hurt. Understand, don't memorize blanket and arbitrary rules. Please don't combine other people's injurious stretches and exercises then come back to me and say my work isn't fixing that.
- Dont memorize rules and postures or think that an exercise or kind of exercise will fix back pain, - which is more likely from a number of all your bad movement habits.
- Often people tuck too hard, or tighten, or push their hip / pelvis forward instead of changing the tilt, then claim neutral spine is wrong or does not work. Use a side view mirror and learn to feel and tell how you are moving your body. Also if your pain is not from a too large too large tilt and you use neutral spine, don't complain it isn't fixing your pain just as you wouldn't, with any consideration, blame penicillin for not fixing your back pain unless your pain was from something needing that particular cure. Most of the people coming to me saying that neutral spine is making them hurt or isn't fixing their pain turn out to not be using neutral spine or actually able to produce it. If it hurts, you're doing it wrong. Make an appointment with me instead of debating the same wrong points on Internet forums.
Don't Change These Concepts and Methods To Fit Conventional Fitness Dogma - They Won't Work That WayIt's been said, "Any man who afflicts the human race with ideas must be prepared to see them misunderstood" Even so, please don't change my work back into what you know, or what others say, or what you learned somewhere else. his is different and works differently than the pop fads that have become ingrained in fitness and health. To paraphrase Bertrand Russell, "An untrained man's report of what a knowledgeable man says is never accurate because he unconsciously translates what he hears into something he can understand." My work is primary source, and often - not what we learned in school and the gym. Remember, that is good.
With This New Knowledge of How The Core Works
- You can stop this kind of lower back pain immediately.
- You'll know why your lower back hurt and how to prevent this kind of pain from returning.
- You'll strengthen your abdomen and core without going to a gym.
- You'll save your back without having to do exercises
- You'll exercise your brain - It's a whole different way of thinking about abs; It's a revolution.
A Short Story of My Work Developing This Method
This information is not copied from someone else who said it, or something I heard in a gym or in medical school. I am the scientist who researches what really happens. I started formalizing this method in the 1970s, of lower back pain with standing and running, too much inward sway to the lumbar spine, and what abs really have to do with it. I collected data on students and patients who used it. I did more studies testing the results and printed the first training manual (typed actually, from hand printed notes) in 1982. Later work in injury research for University and Military was preventing back pain from running and carrying loads. Disease Non-Battle Injuries (DNBI) from exercising in the gym and doing PT is a huge military issue - grounding far more personnel than combat casualty. I ran several more studies on overarching (hyperlordosis), confirming it is a major overlooked cause of lower back pain.
My work shows how to understand and reverse the cause of pain for yourself, with simple repositioning to neutral spine instead of swayback. It was unexpected news to some, who had been taught lumbar overarch in the gym and deliberately tilt the hip and backside too far back for exercise, or who lean the upper body backward thinking that is standing up straighter. For the rest, it was welcome relief, including for my guys who liked to joke that they were my STRACguys - combat slang for "Stupid Troops Running Around in Circles."
The training manual upgraded through several printings to improve layout and photos. My life's work in stopping pain from injurious spine positioning during life and from conventional exercises became summarized in the book Ab Revolution™ No More Crunches No More Back Pain, so that you don't have to suffer any more. The book has two main parts. PART I shows how to stop lumbo-sacral pain during various upright activity in daily life, both non-active and active, such as long standing, walking, running, overhead lifting. It is not exercises which stop the pain, but stopping the overarching with simple repositioning. PART II gives ways to exercise in healthier ways using neutral spine - for all the various exercise you need for health benefits, to improve sports skills, to learn functional exercise, and for impressive abs if that's what you want. Don't confuse exercising with the simple PART I retraining that shows you how to stop a painful overarching habit, but that does not require any exercise to do it. There is a fun Part III with ab myths, facts, and answers.
"Hi My Favorite Person,
My back is healed! Very rarely does it gently tell me I am not standing right. When it does, I straighten the way you say and the pain is gone. I appreciate you so much. You did this for me for free. I want to send you a Thank You. Please send me your PayPal."
What To Do Next
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If you want to tell me this is all wrong, and someone else told you to tilt your pelvis because swayback is natural, and people do it in undeveloped countries, use the donate box to educate me. Keep in mind that I get frequent reports from doctors working in "natural undeveloped countries" where they see back pain from hyperlordosis in their clinics daily. They find that teaching this technique stops the pain.
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TYPOS - Are You A Helpful Reader? If you found typos, broken links, or things needing correction on my site, tell me so I can fix them to help everyone, with my thanks: typos@DrBookspan.com.
Mailing list. I don't send out any newsletters or keep any lists. For updates, info, articles, fun helpful stuff whenever you want, look at my TWITTER page. No sign-up or log-in needed. If you join ("follow") then you can ask questions too: www.Twitter.com/TheFitnessFixer.
Mental & Emotional Training. A page of Dr. Bookspan's short articles for stronger emotional health.
The Fitness Fixer Dr. Bookspan IS The Fitness Fixer. My column ran on Healthline from 2006 to 2010. After that, they took them all away in favor of their own articles that sell medicines and treatments, The BlogSpot archives still have some of them. Check for articles on Achilles pain, foot, shoes, orthotics, knees, back, nutrition, and more by alphabetical listing. Click here for fun Index. Updates through Twitter, above.
Bookspan Basics. Quick training drills for yourself and your groups. Set up healthy movement training programs for schools and groups, eventually as part of my nationwide program.
Open our RESORT for healthy life training - maybe at your campus, studio or cruise ship? Also join fun and instructive Dr. Bookspan projects - design our Academy logo, be in my next book, write rap and songs about back pain fixes. Click Projects.
Cool T-Shirts, Mugs, Mouse pads, More. T-shirts for teachers and slouchers, mugs that remind healthy neck for drinking, Learn and promote functional health with UNcommon sense gifts from the Academy.
All my books together cost less than your pain killers, and show you how to stop needing them. Fun, easy to read, illustrated, immediately helpful.
Healthy Martial Arts
Top level book for all athletes to train thinking, spirit, and top performance. Sun Tzu's "The Art of War" is the classic strategy manual in business and power. "Healthy Martial Arts" is the strategy manual for your life.
Order from Amazon - Healthy Martial Arts.
Fix Your Own Pain Without Drugs or Surgery
Neck pain, back pain, shoulder and hip pain, knee pain, ankle and foot injuries, wrist pain, and "when everything hurts," featuring real patient stories in every chapter.
Print edition from Amazon.
Print and eBook Instant download from the publishers, Healthy Learning and Coaches Choice: https://healthylearning.com/m-1422-jolie-bookspan.aspx
Stretching Smarter Stretching Healthier
Fun, innovative, immediately useful. Almost 200 simple fun line drawings show each concept.
Print and Kindle from Amazon and instant eBook download from Kobo Books.
The Ab Revolution Fourth Edition - No More Crunches No More Back Pain Print 4th Edition.
Core training the way your body actually needs. Part 1 - Learn neutral spine to stop a major form of lower back pain. In Part 2, apply Part 1 for functional strengthening from simple moves to the toughest you can get. Details on anatomy and physiology are in Part 3.
Click for print edition from Amazon.com.
Also available in Kindle.
Health & Fitness THIRD Edition
Fix pain plus healthy living - How to be happy healthy and fit for the rest of your life.
Order directly from Amazon.
Print and eBook Instant download from the publisher: https://healthylearning.com/m-1422-jolie-bookspan.aspx
Diving Physiology In Plain English
New BLUE cover edition. The diving cult classic.
Signed collector copy direct from the author. See this and more diving and hyperbarics books on the BOOKS page.
Click book links and get whatever else you want. Amazon will send this site some pennies for orders through my links, without ever sending me your name. Have fun!More on the BOOKS page.
worry about people stealing your ideas.
This article is © copyright and here as a benefit to the world. Information, drawings, and photos are © protected copyright. To cite this article or any parts, put author Dr. Bookspan, and link to this site DrBookspan.com at the top and bottom of your reprinting. A suggestion to get my books is also nice. No Derivative Works License means no changes to content, wording or links
Drawings of Backman!™ copyright Dr. Jolie Bookspan from the book The Ab Revolution™ No More Crunches No More Back Pain
If this article fixes your pain, send it to a friend (the article, not the pain) with full reference and citation.
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