The Selfie That Broke the Camel's Back
Despite what Instagram would have you believe, arching your back and sticking your rear end out is NOT an ideal posture. A pose that seems to generate tons of ‘likes’ is what we in the biz refer to as “an anterior pelvic tilt with excessive lumbar lordosis.” While it may be tempting to place the desire to be a social media phenom over back health, I’m here to provide you with a few words from atop my soapbox as to why this may not be the best idea.
Anterior pelvic tilt, APT for short, refers to a pelvic alignment in which the front (anterior) portion of the pelvis is lower than the back (posterior) portion of the pelvis. While this is generally a position we passively adopt secondary to muscle imbalances, one can actively achieve this position by relaxing their abs, arching their back, and smiling for the camera. It should be noted that the ability to perform an anterior pelvic tilt is not in and of itself a bad thing. Additionally, the mild curvature of the low back, referred to as a lumbar lordosis, is normal and important for spinal health and proper acceptance of weight. It is when we adopt this anteriorly tilted pelvic positioning with excessively arched lumbar spine as our resting posture that we get into trouble.
Most people aren’t born with an APT, but rather, develop one over time from muscle imbalances caused by certain activities or lack thereof. Here’s a quick biomechanics/anatomy lesson for ya; for our purposes we’re going to use the right hip. Think of the pelvis, when viewed from side, as a dial that can be rotated either clockwise or counterclockwise. This dial has at its center, the head of the femur. What maintains this dial in a neutral position is a balancing act of muscle strength and appropriate muscle tension. Muscle tightness at the hip flexors (iliopsoas/psoas and rectus femoris) and the back extensors (erector spinae) cause the dial to rotate to the right, creating an APT. The muscles that prevent or reverse an APT via include the abdominals (rectus abdominis primarily) along with the glutes and hamstrings.
Aside from selfie nation, the main culprit in the development of an APT is usually prolonged sitting, aka our generation’s version of smoking when it comes to developing chronic illness. The psoas muscle is the primary hip flexor, originating at the lumbar vertebra and inserting on the femur. When we sit, our hip flexors are placed in a shortened position, which over time causes them to get tight. Additionally, if we’re always sitting, we’re likely not exercising all that much, which means weaker glutes and abs.
When we do manage to finally get out of that chair and stand up, our tight hip flexors pull on the front of our lumbar spine, and our weak glutes and abdominal musculature are unable to counter this force. This causes our back to arch and our pelvis to tilt forward. As the pelvis tilts forward, the back extensor muscles are also placed in a shorted position, causing them to tighten and maintain this APT. In this arched low-back position, the distance between the ribs and the front of the pelvis is increased. This is also the area spanned by our rectus abdominis, or 6-pack. When stretched out because of an APT, your 6-pack is unable to contract optimally, contributing to weakness, and perpetuation of the APT. What we see here are examples of the cyclical nature of causation and contribution to the APT.
The effects of this APT extend both up and down the human body. The spine arches, causing compression and pain at the low back. Further up the chain we see the altered spinal positioning creating a forward head posture with excessive strain on the neck. The hips, due to their relationship with the pelvis, rotate out of neutral alignment, with effects being felt at the knee and foot. Conversely, poor alignment at the foot, knee, or hip will have an impact on pelvic alignment and can cause an APT. In two previous articles I wrote, I discussed the implications of the Elvis knee and the arch collapse, so I won’t bore you again. But if you have forgotten, or dare I even say, didn’t read the other articles, check them out here. Lastly, this APT prevents us from achieving neutral spinal alignment, which is required for proper recruitment of the core muscles, for proper breathing patterns, and for proper movement patterns in general.
Check yo’self: Get off of the sofa or up from that chair that you’re currently sitting on to read this. Take a deep breath in and out and relax into your most comfortable and natural resting position. This next part may be easier to do in front of a long mirror. Turn sideways, and while still in this relaxed position, look at your posture. You should NOT look like you’re at the club about to have a dance-off with Miley Cyrus. Now look at the waistband of your pants and the arch of your back (now would be a good time to put pants on if you were enjoying living alone). In a neutral position, your waistband should be nearly parallel with the floor, though a mild (as in a FEW degrees) forward angulation is ok. In this position you should have a slight curvature of the low back.
To assess the curvature of your lower back, stand against a wall with your arms down at your sides and your heels, buttocks, shoulders, and the back of your head touching the wall. Assume that same relaxed position you were in before. From here, attempt to slide your hand into the space between your back and the wall. If you can fit more than your hand in this space, you’ve likely got an APT with excessive lumbar lordosis. For those of you blessed with a little more booty, the space between your back the wall may be slightly increased. If you’re unsure if it’s excessive, find a PT and get it checked out.
Correct yo’self: If you flunked the wall test it’s time to get on the floor and get to work. While on the floor, lay on your back and bend your knees so that your feet are flat on the ground. From here, rock your pelvis forward and backwards, exaggerating that lumbar curve then reversing it and pressing your low back into the floor (as if trying to tuck your tail between your legs). Try to minimize the role that your glutes play in performing these motions, and achieve these positions by gentle abdominal contractions.
Once you’ve mastered this, stand up with your back against the wall and perform this same pelvic rocking. If this is too difficult then walk your feet away from the wall and try again. The ultimate goal of the corrective exercise is to be able to perform this pelvic rocking while standing without a wall behind you for cueing. Remember, we’re going for the Goldilocks of spinal alignment, not overly arched nor overly flat, but NEUTRAL, and just right. If you feel like you need some hip flexor stretching to help you achieve this position, try this stretch.
For the next week, I challenge you to adopt this neutral pelvic and spinal alignment each time you’re standing. Gently contract the abs and glutes to get that pelvis to rotate slightly backwards so that your waistband is (roughly) parallel with the ground. It’s going to feel weird, but embrace it. Oh and while you’re at it, lay off the selfies. Your body will thank you.