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As with my other articles posture plays an enormous role, but especially in the health of your lower back. In fact, the lower back is likely to be the first area that musculoskeletal dysfunction occurs if your posture is poor. To begin to make the link between lower back pain and posture make sense we must first look at what makes healthy and strong back.

A strong core (or strong abdominal muscles) equals a strong lower back! A weak core equals a weak lower back. For many people a lower back problem is actually a lower front problem that leads to a lower back symptom. In other words, poorly functioning core muscles result in the lower back being unsupported.

But how do so many people have a weak core? Our core muscles are our stabilizer muscles and provide strength and support to our spine. When we sit down our core muscles do not need to work as every seat we sit on is stable and it never requires our core muscles to engage. As we sit down for so much of our day these core muscles eventually become weak, and they can even ‘switch off’ neurologically.

It is easy to observe this in people when they stand. Have a look and see how many people have a ‘pot belly’. It is everywhere! It is not always related to bodyweight either. Have a look at a thinner person and see if their abdominal wall seems to project forward at the level of their belt line. Your core muscles are designed to act like a girdle and to hold everything in tightly. If your core is weak then the intestines and other internal organs push forward giving you a protruding stomach. This, in turn, leads to the front of your pelvis dropping down into what is known as an anterior pelvic tilt. This means that the front of your pelvis is not being held ‘up’ by your core muscles and is sitting lower than the back of your pelvis. Have a look at people from the side and look at the top of their pants, skirt; etc. Does it look like it tilts forward at the front? Try it on yourself when standing sideways in front of a mirror. Again it is everywhere!

If your pelvis tips forward then your lumbar spine (lower spine) is placed in a position where it has a greater than normal curve – it looks like your lower spine curves deep into your back. This loads up the joints of your lumbar spine and places a huge amount of stress on the discs between your vertebrae. This is why people who prolapse discs in their lower back nearly always have an anteriorly rolled pelvis and weak core muscles. Even if you do not prolapse a disc you will ultimately suffer premature wear on the joints of your spine at which point it can not be fixed – only managed.

To summarise.

If your core muscles are weak your pelvis rolls forward. If your pelvis rolls forward then your lumbar spine will have a greater than normal curvature (known as a lordosis) which leads to wear and tear of the joints and discs of your spine. So the point to remember here is that core strength is vitally important. This does not just mean doing crunches at the gym, but rather engaging in activities that challenge your balance. You must also be aware of how you hold your pelvis when walking, sitting, washing the dishes, going shopping, etc. The best time to engage your core is all the time! A good exercise to try is to push your fingers in to the sides of your stomach, and then cough. See if you can feel your abdominal muscles contract. These are the muscles you want to engage all the time. Again, it is difficult but does get easier over time.

If you do not correct your posture and pelvic alignment then any treatment you receive will be a temporary fix. It may last days, weeks, or even years, but eventually the lower back problems will return. You have your spine for life so look after it by not loading it up unnecessarily.

Next time, we discuss knee pain…

Stuart Hicks
Myotherapist (Adv. Dip. of Myotherapy)
stuie_1@hotmail.com