Do you have flat back posture?

Isn’t everyone’s back flat?  Actually no, not everyone has a flat back.  Let’s actually consider what flat back posture is. 

Identifying Flat Back Posture

When you look at a person with ideal or normal posture from a side view you will see that their spine creates an elongated “S” shape.  This “S” shape provides a shock-absorbing or spring-like function which reduces stress on the vertebral column when weight is loaded.  Remove, decrease or increase any of the curves in the “S” shape and the ideal posture is no longer there compromising the shock-absorbing, spring-like function of the spine.  In a flat back posture, the lower curve is decreased or flattened out.  In other words, the lumbar spine is more flexed than normal.   The pelvis is tilted posteriorly, so it looks like there is a tucking under of the gluteals.  The hip joints are more extended or open as are the knee joints.  Sometimes the knee joints will be flexed to try and bring the body more forward to compensate for the increased flexion in the lumbar spine.  The thoracic or upper part of the spine is more curved or the flexion is increased so it appears the person is leaning forward.  In some cases, the treatment requires surgery but starting with a non-operative treatment like physical therapy or Pilates is usually preferable.  What corrections are required muscularly to help a flat back posture?

Muscle imbalances with flat back posture

In a flat back posture, muscles that are short and strong are the hamstrings and abdominals.  Muscles that are elongated and weaker are the hip flexors, the iliopsoas muscle.  The lower back muscles while elongated may not necessarily be weak.  What we want to do is strengthen the hip flexor muscles to help tilt the pelvis anteriorly or forward.  We want to try and lengthen the abdominal muscles. The upper thoracic spine is increased in flexion. So we want to try and strengthen the upper back muscles.

Since our flat back posture has increased flexion in the lumbar spine and a posteriorly tilted pelvis it’s as though our flat back person is always in imprint position.  To counteract this, we’ll try to work in a neutral pelvic position as much as possible.  To lengthen the abdominals, we can try some exercises on the mat or reformer that will work on extending the spine and as a result provide a stretch for the abdominals.  i.e. Swan dive on the mat would be such an exercise.