I have a client who is hyperlordotic and a dancer. I remember hearing something about hyperlordosis being beneficial to dancers as it can aid their flexibility and ability to obtain and hold certain positions. What are your thoughts on this? Is this also relevant to gymnasts? And lastly, are there any other groups where “incorrect posture” is considered an advantage? Many thanks.
Posture: The position from which movement begins and ends. If you begin with poor posture, you end with poor posture. The end result is faulty motor engram patterns, injury, inflammation and pain. So when it comes to posture, we have two types: static and dynamic. Both of these should be assessed, as well as integrated together into a client’s program.
There are a lot of ways you can assess the body and spine, but let’s keep it simple. All three curves have a normal range of 30 to 35 degrees. You can use inclinometers to gather your spinal measurements, as well as using a plumb line. But keep in mind, if you are not measuring a client’s spine with inclinometers, and you are just judging her lordosis on observation, you are just guessing. Here’s why: Let’s say you are working with a large person who has nice overly developed glutes. With static posture, this would show up as a red flag in the lumbar spine, meaning you would think you see an increased lumbar lordosis. This is when you use your other assessments of the lumbar spine to actually find out which way the spine is going. But if you just look at the person, she would give the appearance of having a lumbar lordosis, when all along all she has is large glutes. So the bottom line is, if you are not assessing, you are guessing! I would find a skilled Physical Therapist, MAT practitioner, CHEK practitioner or Physiotherapist that you can work along with.
Having an increased lumbar lordosis would allow most people to have increased lumbar extension and decreased lumbar flexion, but this is not always the case. Someone might have an increased lumbar lordosis with instability, maybe at L4-L5. The segment above and below will become hypomobile to compensate. As well, it can go the other way around. If L4-L5 is hypomobile, the segment above and below would become hypermobile. You can assess this by measuring all spinal segment flexion and extension movements with an inclinometer. Once again, I would refer out.
As well, I would find out what is going on at the other spinal segment levels as the entire body is connected. Maybe her lumbar lordosis is coming from instability of the SIJ, tightness of the psoas, inflammation in the gut or other organs, limited thoracic extension (required in gymnastics and ballet), so she compensates at her lumbar segments, increased cervical extension and so forth. I have found that typically most people view the one site of pain or dysfunction as the dysfunctional site. But in the end, that is the branch, and the root of the dysfunction is coming from somewhere else.
The first thing I would do is assess. This will allow you to know HER body exactly, so you can design an effective stretching and exercise program. As well, I would realign her body, as you don’t want to create poor posture to work from. As I stated above, if you begin with poor posture, you end with poor posture! Secondly, the goal with this client is not to create an increased lumbar lordosis but to create optimal lumbar and thoracic mechanics. This means optimal range of motion in the sagittal plane (flexion and extension). This will allow this client to get into the positions that are required for her life and sport. How do you do this? Let’s say she has an increased lumbar lordosis (i.e., lower cross syndrome).
- Lower Cross Syndrome: (ant tilt >5-7 or 7-10, >35 lumbar curve, hips flexed, hyperext knees, valgus at knees)
- Short: psoas, RF, adductors, TFL, sartorious, multifidus, ES, lats, QLO
- Long: glutes, hams, lower ab, EO, IO, TVA
- Injuries: LBP, SIJ, knees and ankles, hamstring, degeneration
Let’s say you want to stretch the short and strengthen the elongated muscles. Once there, you want to use movements, joint mobilizations, soft tissue work and nutrition to ensure optimal joint mechanics in the sagittal plane. But keep in mind that all dysfunctions and short muscles are not always tight. They can also be taut (too lengthened) or shortened secondary to a weakness. Example: Let’s just say this athlete has GI inflammation, which will shut off her inner unit and create visceroptosis (organs hanging). This in turn will create hyperlordosis, increased anterior pelvic tilt and so forth. But is her dysfunction muscular in origin or is it nutritional? Is her dysfunction from weakness? Just some food for thought!
Off the top of my head, the only dysfunctions that actually create poor posture would be a spinal stenosis. With spinal stenosis, going into extension closes down the foramen and puts stress on the cord, which equals pain! The goal with these clients is to actually work them with all exercises on the flexion side of neutral, strengthening their legs and extensor chain to compensate for their weakness. The weakness is that you cannot bring them into neutral, as this will cause pain. By no means do you want to create posture where they are fully flexed, but you might want their lumbar curve around 27 to 30 degrees, where normal is 30 to 35. This will ensure function without pain. Also, working on strengthening their legs and back will ensure stability in this position.
Hopefully I have answered your question and got you thinking!