Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
Lumbar lordosis is often interpreted as an anatomical problem responsible for back pain. It's a myth.
What exactly is lumbar lordosis? When does it get serious? What are the ways to straighten a lumbar lordosis?
The following article explains everything you need to know about lumbar lordosis, with a focus on exercises and tips for dealing with potential problems caused by this posture (when indicated).
Definition of lumbar lordosis
Lumbar lordosis is the curvature observed in the lumbar region of the spine. This curvature is normal in humans, and has several roles:
- Helps the body absorb shock
- Helps stabilize the pelvis
- Allows to counterbalance the anterior position of the sacrum
- Supports center of gravity
- Allows straight posture
- Enables walking in bipeds
Normal lumbar lordosis is characterized by a mean lumbosacral angle varying between 39° and 53°. It should be noted that there is a wide disparity in studies measuring the angle of lumbar lordosis, and the results depend on how the angle is measured.
The degree of lordosis can be modified according to external constraints. Certain factors promote exaggerated lordosis such as osteoporosis, obesity, pregnancy, weakness of the trunk muscles or spondylolisthesis.
If the lumbar curvature is too pronounced, we speak of lumbar hyperlordosis.
The difference between lordosis and kyphosis
When looking at an individual from the front (called the frontal plane), the spine should normally be straight. If we look at this same person from the side (called the sagittal plane), we can see a series of curves in the spine, these curvatures giving it an "S" shape.
The two forward bends refer to cervical lordosis and lumbar lordosis. As for the backward curvature, it is called kyphosis.
Kyphosis is normal in the dorsal region. It can be pathological when associated with pathologies of the spine (Scheuermann's disease, osteoporosis, fracture, etc.)
Is it serious, a lordosis?
Lordosis represents the normal curvature of the spine at the lumbar level. It is even necessary to absorb shocks and facilitate standing posture. A lordosis as such is not pathological.
Hyperlordosis, on the other hand, represents an exaggerated curvature of the lumbar spine. In theory, it increases stress on the facet joints and creates contractures in the lower back muscles. In addition, it moves the center of gravity forward.
On the other hand, several scientific studies have failed to establish a direct correlation between hyperlordosis and back pain. This is due in particular to the fact that the human body has a tremendous capacity for adaptation, and therefore that the spine and its surrounding tissues have succeeded in adapting to hyperlordosis.
In certain cases, on the other hand, excessive lordosis causes lower back pain, and sometimes even radiating pain in the legs. Although it is difficult to establish the exact cause of the symptoms, they can occur after attempting an activity that increases stress on the lumbar vertebrae.
Most often, these are static postures or activities that promote lumbar extension, such as running, swimming, mountain walking, or even an exaggerated standing posture.
Hyperlordosis also comes with consequences on the related joints. Exaggerated lordosis often results in increased flexion of the hip joints. The knees can be hyperextended, which indirectly affects the plantar arch.
Again, these anatomical changes can be problematic in some people, while they won't cause any dysfunction in others.
How to straighten a lordosis?
Many therapists prescribe exercises and stretches to straighten lordosis. In general, one should attempt to correct the lordosis primarily if the patient complains of low back pain, and the excessive lordosis is believed to be related to the symptoms.
If the lordosis is structural, it will be impossible to change the angle of the lumbar curvature as such. On the other hand, it is possible to act on the surrounding muscles to correct imbalances and hyperlordosis.
A widely held theory states that exaggerated lordosis comes from a retraction of the psoas muscles, and a weak activation of the glutes and hamstrings (called “Lower-Crossed Syndrome as demonstrated by Dr. Janda). Although this theory is not unanimous from a scientific point of view, many therapists prescribe exercises focused on correcting these imbalances.
More specifically, they prescribe exercises aimed at softening contracted psoas muscles, and exercises aimed at strengthening the glutes and hamstrings. The following are examples of exercises that may be prescribed:
Exercise 1: Psoas Stretch
- Put yourself in the position of a knight.
- Move your pelvis forward while keeping your back straight until you feel tension on the upper thigh.
- Hold the stretch for about 30 seconds and do 3 sets.
- Then do the stretch on the opposite side.
Exercise 2: Bridge
- Lie on your back
- Tighten the buttocks without moving the legs
- Continue the exercise by lifting the buttocks off the ground while pushing with the heels.
- Slowly lower your buttocks to the ground.
- Repeat fifteen times, taking breaks as needed.
Besides strengthening and stretching, motor control exercises are also prescribed to straighten lordosis and correct pelvic position. Thus, retro-version movements of the pelvis (tilting backwards) allows the lumbar spine to be flattened and the overdose to be reduced.
Exercise: Retroversion of the pelvis (William exercise)
- Lie on your back with your knees bent
- Bring your knees to your chest and apply pressure with your hands
- Hold the pressure for 5 seconds then return to the initial position
- Repeat the exercise 20 times, twice a day
Conclusion
Lumbar lordosis does not always have to be associated with back pain. Indeed, lordosis is a normal anatomical curvature of the spine.
On the other hand, it happens that an exaggerated lumbar lordosis can be responsible for pain. This is called symptomatic lumbar hyperlordosis.
Once we have determined the potential causes of hyperlordosis, we can act through exercises aimed at straightening the lumbar lordosis. This correction can sometimes relieve symptoms, and even cure back pain in some patients.
It is important to consult a health professional to determine if your lumbar lordosis is problematic, and to identify imbalances specific to your spine in order to make specific adjustments.
Good recovery !