EXERCISES TO FIX LORDOSIS

A guide to the causes of lordosis, and the exercises you can use to fix it

Over the last twenty years I’ve often been asked about exercises to fix lordosis. If this is something which interests you, then please read what I have to say about the subject and hopefully you will find it both useful and interesting.

Additionally, I have written an article about exercises to fix kyphosis, which you are welcome to read, but the content is fairly similar. If you have lordosis AND kyphosis, then I would recommend that you only read one of my articles.

Image showing progressively more pronounced lordosis, from left to right

What causes lordosis?

Lordosis, sometimes referred to as ‘hollow-back’ or ‘saddle-back’, is a spinal condition where the lumbar part of the spine curves excessively. The lower part of the spine is supposed to curve inwards but when the curvature goes beyond a certain degree it is referred to as lordotic.

There are many reasons for lordosis:

• It can be present from birth for various reasons, including Achondroplasia and Spina bifida
• It can come about because of postural imbalances
• It can be triggered by weight gain or pregnancy
• It can be caused by diseases like osteoporosis, or by trauma

Exercises to fix lordosis

You will find all sorts of physical exercises for fixing lordosis - they may well be advised by a physiotherapist or chiropractor. Massage and stretching are also recommended and, depending on the individual situation, these solutions may be very effective.

Exercise, massage and stretching are all good for you, providing they are not violent or counter-intuitive. The problem is, I often meet people who have done something apparently
recommended by a professional and have ended up injuring themselves.

A combination of these approaches may well result in you looking straight, or straighter, which may solve part of the problem. However, they will do nothing to correct the underlying, resilient muscular tensions that have caused, or contributed towards, your back being pulled in. You may look straight but still feel uncomfortable.

It is very easy for people, including professional care givers and medically trained experts, to overlook the fact that most people have very strong, resilient muscular habits. It is the BRAIN that controls these muscular habits; for muscles to contract, messages need to originate in the brain, travel along the nerve fibres and activate the muscle spindles. When we have habits of
tension and misuse it is our brain that needs to be retrained.

The messages from the brain to the muscles travel along well-worn routes which we feel familiar with. Unless the messages are re-routed, they will always follow the habitual path. It is perfectly possible to learn new routes, which begin as little footpaths, then become lanes and end up as super-fast highways.

The Alexander Technique focuses on this form of ‘neuro-muscular reeducation’. Lessons in the Alexander Technique are a gentle but thorough way of getting the muscles to function in their optimum state and can be used instead of, or in conjunction with, other approaches.

Using the Alexander Technique to fix the different causes of lordosis

Lordosis from birth

Lordosis can be present from birth for a number of reasons. Usually people have a range of often essential treatment, including massage, surgery, braces etc, some of which can be very successful.

In my opinion lessons in the Alexander Technique are always worth trying in conjunction with the medical treatment. They won’t cure the lordosis but they could help in the same way as they help anyone, by addressing underlying, habitual patterns of muscular tension. Most people can be helped to make the best of what they’ve got in terms of comfort, well-being
and maximising their potential.

It is possible to teach very young children the Alexander Technique; F.M. Alexander himself ran a little school. Usually, the younger a person is, the quicker they will respond because there are fewer bad postural habits and they are less firmly entrenched. However, the younger a person is, the shorter their attention span - so, little and often works well but is often
impractical.

If a little child has regular access to a teacher at school, in hospital or at home, then I think it’s well worth having some lessons.

Postural lordosis

All sorts of people can develop lordosis through postural habits, especially if they already have an exaggerated lumbar curve. Having a slightly hollow back is quite common. Some activities, such as modelling or gymnastics, almost seem to require it.

In this image, the model has probably been chosen for her curvaceous back to better display the cut of the jeans. The deliberate stance and the height of the heels will further accentuate the curve, which will only be referred to as a lordosis if she begins to experience discomfort or pain.

Many people with really curvy backs will experience no problems at all. However, I have taught models, dancers, yoga teachers and athletes with disc injuries, muscle spasms, sciatica etc. - resulting from overarching their backs too often.

The lumbar spine is incredibly strong - so is an iron bar. If you bend an iron bar backwards and forwards enough times it will snap!

I would strongly recommend Alexander Technique lessons for teenagers with postural lordosis.

Often, when the whole problem is postural, the child can easily be trained to just stop. When the lordosis is more serious, or is progressing, I think it’s vital to try some lessons before considering a spinal brace or surgery. If these solutions can be avoided, all the better.

If these interventions are already in place it’s still worth having some lessons as the child can learn to make the best of the situation as opposed to developing additional problems such as extra tension in some muscle groups, weakening in others and altered proprioceptive feedback.

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Lordosis in pregnancy and other weight gain

The lumbar part of the spine usually curves inwards, creating a sturdy, shock-absorbing shape to support the weight of the body in upright balance and movement. When a person experiences excessive weight gain in front, as in pregnancy or obesity, this can result in lordosis.

In order to counterbalance the weight, a person will sometimes lean their shoulders back and their hips forwards; or they might simply give in to the weight and allow it to pull forwards.

In any case, lessons in the Alexander Technique can usually help massively.

Lordosis as a result of injury or illness

Some of the symptoms of lordosis caused by ageing diseases such as arthritis, osteoporosis, disc degeneration etc. or by other trauma can be alleviated with lessons in the Alexander Technique. This is not a scientifically proven fact but a practical approach based on common sense which many sufferers will endorse.

One or two lessons should give someone a sense of whether the technique will help them.

A case study - lordosis with disc injury

I once taught a 13 year old girl who had pain from an operation on one of her intervertebral lumbar discs. The original problem had come about as a result of a riding injury. The girl had a slight postural lordosis. I taught her regularly for about three years and she found relief from the start.

Lessons in the Alexander Technique meant that I was able to train her to avoid putting extra pressure on the lumbar region. She learned to effectively redistribute her muscular effort. The shape of her lower back was still quite curved but she was able to ‘free up’ within that shape rather than submit to it and allow it to get worse. With practice she was able to avoid allowing her own postural use to exacerbate the original problem.

The pain from her operation gradually diminished. Scientifically speaking there is no way of proving that the lessons helped; however, my pupil and I both felt sure that the improvement in her muscular use was at least partly responsible for her recovery.

For clinical evidence of the Alexander Technique curing lower back pain, please go here.

Lordosis or habitual slouching?

The vast number of lordotic postures I encounter in my work as an Alexander Technique teacher are not serious; in other words they are caused by postural habits as opposed to congenital defects, accident or disease.

When people perform repetitive actions and hold postures over long periods of time, poor habits of muscular use are inevitable.

I often come across ergonomic office solutions that are supposed to enable correct posture. The reality is that humans still find a way of letting their bad habits get the better of them.

In this image a woman is sitting on a very expensive chair designed to enable good
posture. Clearly, the way she is slouching means that her lumbar spine is unsupported.

Very often, chairs are designed with no lumbar support at all. Unfortunately this is the case in a lot of schools. Add to that potential boredom, fatigue, suppressed energy or any number of emotional states and it’s no surprise to me that kids get into the habit of slouching

Habitual slouching and collapsing the lower back causes repercussions throughout the entire musculoskeletal system and can contribute to lordosis.

• the internal organs are squashed under the weight of the upper body
• movement, circulation, digestion and breathing are put under strain
• any existing discomfort, ailment or injury will be aggravated

Lessons in the Alexander Technique can permanently and thoroughly correct this type of lordosis, depending on the age of the pupil. The older we get, the more our bones and connective tissue grow and adapt to fit the posture we habitually hold.

The risks of treating lordosis through medical intervention

When lordosis reaches a certain degree, surgery sometimes becomes essential. If the angle of the spine is severe, the increase in pressure on the spinal cord can cause neurological issues, disc damage etc. Sometimes doctors will prescribe a spinal brace for fixing lordosis. This forces the spine into a better position and gives support to the back.

Hopefully the doctors will advise their patients of the risks. These include muscle weakness; proprioceptive distortion and a false sense of strength which can encourage people to lift more than is safe, or to exercise more than is appropriate.

Unfortunately, my colleagues and I, including osteopaths as well as other Alexander Technique teachers, regularly come across people who could have avoided surgery and have ended up in a regrettable state.

Sometimes a person may be so desperate for a solution, or their consultants may be so confident, that surgery goes ahead.

There are 3 problems with this:

1. Surgery might have been avoided with neuromuscular training
2. There may be side-effects that are worse than the lordosis
3. There’s no going back

Not all doctors and surgeons know about the Alexander Technique, but this hasn’t always been the case:

‘We are convinced that Alexander is justified in contending that "an unsatisfactory manner of use, by interfering with general functioning, constitutes a predisposing cause of disorder and disease," and that diagnosis of a patient's troubles must remain incomplete unless the medical man when making the diagnosis takes into consideration the influence of use
upon functioning.’

-Extract from a letter signed by nineteen medical men and published in the British Medical
Journal on May 29, 1937

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How to fix lordosis using the Alexander Technique

1. Identify your muscular habits

Muscular habits will either be causing (mild) lordosis or contributing to (severe) lordosis.

I’m trained to feel the human muscular system with my hands much in the same way as a skilled rider is trained to manage a horse via contact through the seat and the reins. Good training and a lot of practice means that when I place my hand on a person’s shoulder, or the back of the neck, I am able to detect how they are using their postural muscles throughout their entire system, let alone in the area I'm touching. I’m able to determine which muscles are over-contracting and which ones are slack – a bit like an osteopath or a physiotherapist. The difference is that I’m able to gauge how the brain is involved – what sort of messages are being communicated to the muscles via the nerves.

2. Learn how to prevent or alter them

The involvement of the conscious brain is crucial to changing muscular habits. The activity that takes place in the skeletal, or postural, muscles is actually under conscious control. It may seem unconscious – we move all the time without thinking about it – but it’s really just pushed to the back of the mind to make space for concentrating on thousands of other everyday
things.

With guidance it’s possible to be made aware of how much contraction is taking place in these muscles. Re-engaging the brain like this is a simple process of re-training. With practice the brain forms new pathways and new habits are created.

3. Learn to ‘project’ length and width in your back

'Muscle memory' is the term sometimes used to describe acquiring a physical skill. When a rugby player spends a few moments mentally projecting before kicking a goal it involves remembering exactly how it felt when he did it last time.

With lordosis, the lumbar curve of the spine is exaggerated, creating compression and narrowing in the back that needs to be replaced with ‘freeing up’. When you picture this in conjunction with being physically shown it and being told when you get it right, the brain registers the positive feeling and remembers it for next time. With practice the desired result can be achieved in a matter of seconds and without assistance.

Freeing up

With the human musculoskeletal system, the backbone is designed to almost effortlessly lengthen upwards in upright balance, through a series of gentle curves. The effect of gravity pulling on the weight of the head activates the erector spinae muscles and the spine extends, leaving room for the ribs to move so that breathing can be expansive and easy. Habits of muscular tension can work against this process.

When I teach ‘freeing up’ I sometimes use the image of The Jet d’Eau fountain in Geneva. A healthy, naturally curved spine, might feel something like the water flowing upwards. The feeling is powerful, steady and supportive, and yet, somehow light.

Having a crooked spine is in no way ideal. With severe lordosis it may not be possible to straighten up, but it should be possible to ‘free up’ within that shape, and so increase comfort, mobility and ease of breathing.

A case study - lordosis with sciatica

I gave a course of lessons to a lady in her sixties. Her lordosis was not particularly pronounced but she had a lot of muscular tension in that part of her back. She was suffering from sciatica and had no idea what had caused it, but it seemed possible that her muscular habits of tension might be contributing. She had a scan but nothing really showed up and her doctors
could only suggest pain killers.

She had a course of Alexander Technique lessons with me. Taking things one lesson at a time, the sciatica did eventually settle down and the client felt certain she could now identify what had triggered it. By avoiding certain positions and movements, and by generally using herself more efficiently, she kept the condition at bay.

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Endorsements

The technique is primarily educational in nature, but learning and applying it has therapeutic benefits and preventative consequences for the health of the individual in the following cases:

Backache, neck ache, where posture is a factor
Pregnancy
Vocal disorders and vocal cord nodules
Stress
High blood pressure
Asthma
Hyperventilation
Anxiety states, including performance anxiety
Functional disorders
Osteoarthritis
Temporo-mandibular joint syndrome
Scoliosis
Kyphosis
Lordosis
Spondylosis
Migraine
Tension headaches
Cerebral palsy
Multiple sclerosis
Parkinson’s disease
Rehabilitation after stroke, injury, operation or other treatment
Prevention of backache in pregnancy
Dystonias
Non-specific regional pain syndrome

Alexander Technique lessons are relaxing, fun, enlightening and very non-intrusive. The teacher will use verbal and manual guidance, while you remain fully dressed, to show you where you’re holding tension.

It will always be a revelation. The whole problem is that your muscular habits have evolved over a lifetime and you’re simply used to them being there. You feel normal. So when the tension stops it is a great relief and seems so obvious you wonder how you didn’t realize what you were doing to yourself before.

A lot of what I teach is practical common sense: mechanical - simple ergonomics.

My job is to show you how to feel better and function more efficiently.

‘The Alexander technique is a well established method of teaching people to (among other things) return to their general level of muscle tone (invariably selectively increased in [certain] disorders) towards a more normal level. It is not an alternative technique (based on a non-conventional view of human physiology such as those of acupuncture or homeopathy) but is entirely consistent with orthodox medical and physiological theory and practice. It has been taught in this country for over 100 years and claims for Alexander lessons have been paid by major medical insurance companies, such as B.U.P.A. for over 50 years.’

-Dr Miriam Wohl, medical practitioner specialising in making functional assessments of
people who have applied for DLA.

The National Back Pain Association
The British Association for Performing Arts Medicine

Medical applications of the Alexander Technique

In this image the teacher is gently using his hands to encourage the pupil to free her neck.

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I’ve been doing the Alexander Technique for over 30 years so I know a great deal about correcting lordosis.

I am an expert in everything to do with body ergonomics.

I have had extensive, first class teacher training.

I have taught thousands of people over the last 20 years.

I love my work!

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Many famous people have had lessons

Jack Stern, spinal neurosurgeon:

'97% of people with back pain could benefit by learning the Alexander Technique - it is only a very small minority of back pain sufferers that require medical intervention such as surgery.'

Professor Nicholas Tinbergen, Nobel Prize winner for medicine and physiology :

'We already notice, with growing amazement, very striking improvements in such diverse things as high blood pressure, breathing, depth of sleep, overall cheerfulness and mental alertness, resilience against outside pressures, and in such a refined skill as playing a musical instrument.'

Sir Charles Sherrington, neurophysiologist:

'Mr Alexander has done a service to the subject [of the study of reflex and voluntary movement] by insistently treating each act as involving the whole integrated individual, the whole psychophysical man. To take a step is an affair, not of this or that limb solely, but of the total neuromuscular activity of the moment, not least of the head and neck.'

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