Most people who’ve been diagnosed with “flat back syndrome”—a condition where the back has lost some of its normal curvature—can benefit from certain exercises. Why? Because many cases of flat back syndrome are muscle-related, meaning they are brought on by muscle tightness and spasms that affect posture. These kinds of muscle deficiencies can be overcome with the right form of exercise.
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For some patients, however, flat back syndrome is brought on by structural changes to the spine. Trauma, degenerative discs, and previous low back surgeries can also cause a loss of curvature in the spine.
Why do exercises for flat back syndrome?
The curve of your spine plays an important role in spine health, positioning your head over your feet, minimizing the effort of postural muscles, and allowing space between vertebrae for nerves. When you lose that curvature, those spaces can become smaller. Your body has to work harder throughout the day. And all of this can cause pain, tingling, or numbness.
Addressing the muscular deficiencies through exercise brings you closer to your natural lordosis (spine curvature), and helps prevent the pain associated with pressure on the nerves. Even though you may not have pain now, it’s wise to be proactive, as flat back syndrome can become a painful condition if left unchecked.
It’s important to note that people suffering from structural changes to the spine are less likely to be helped by flat back syndrome exercises, simply because exercise can’t change the anatomic condition causing the pain. Sometimes surgery is the only thing that will help—but if you’ve been diagnosed with issues that don’t require a surgical fix, it’s possible you may also see some improvement with flat back syndrome treatment exercises.
Flat Back Syndrome Exercises
The muscular deficiencies that patients with flat back syndrome suffer from include:
- Tight hamstrings, which pull the pelvis and rotate it abnormally. That condition, in turn, causes….
- Weakening of the iliopsoas muscle (made up of the iliacus and psoas hip muscles), which aren’t being used normally when the back is flattened out.
- Weakening of the abdominal muscles.
To correct these muscle imbalances, flat back syndrome physical therapy aims to accomplish three things:
- Stretch and flex the hamstrings.
- Strengthen the iliopsoas.
- Strengthen the core.
The following exercises, done in combination, are a good approach to addressing flat back syndrome:
1. Stretch and flex the hamstrings.
There are lots of ways to do this, including:
- Bend over from a standing position and touch the floor.
- Use foam rollers to help loosen up the tightness in your hamstrings.
- Try massage therapy, which helps to relax the hamstrings.
2. Strengthen the iliopsoas.
Sit in a chair and march in place, raising your knees toward your head by lifting your feet up off the floor. The primary muscle you’re using in this exercise is the iliopsoas.
3. Strengthen the core.
Try one or both of these exercises to strengthen your upper abdominal muscles:
- The locust—Lay on your stomach on a mat, with your hands at your sides or on your lower back. Raise your head and shoulders off the mat. (This exercise helps you to stretch backwards, counteracting the tightness of the upper abdominal muscle.)
- The bird dog—Get down on your hands and knees, hips over knees, hands under shoulders, so you form a nice square. Raise your left leg and your right arm, balancing on the opposite hand and knee. Hold that position for a count of five. Then switch to the opposite side.
Common Questions About Flat Back Syndrome
The Q&A below gives short answers to the most commonly asked questions about flat back syndrome. For more information about appropriate exercises for this condition, scroll up to the preceding article.
1. What is flat back syndrome?
Having the correct curvature, or lordosis, in the lower part of your spine is extremely important for maintaining the ideal posture, where your head is centered over your pelvis. “Flat back” is a condition where that natural curvature in your low back is lost, causing you to bend forward so your trunk is no longer over your feet. People with a small degree of curvature loss are usually still able to function normally, compensating for the unnatural change by bending their hips and knees.
2. What causes a flat back/flat back posture?
The most common cause is simply aging of the spinal column. The wedge-shaped discs in your lower back help create this natural curve; they are also the ones that typically experience the most wear and tear over time. Eventually they may start to lose their wedge shape and become more flat and rectangular, which leads to a decrease in lordosis. The second most common cause is lumbar fusion, where one or more of the lumbar discs is removed and replaced with a cage, often flattening out the natural curve.
3. Is loss of lumbar lordosis serious?
From a pain perspective, loss of lumbar lordosis, or the natural curve of your spine, can be quite severe. It also usually results in faster degeneration of the low-back discs. The new, flatter shape of the affected disc means they accept a greater and abnormal share of the mechanical load; however, they don’t tolerate it well, and can break down more quickly as a result.
4. Is your back supposed to be straight?
No. Your spine naturally has alternating curves that help maintain spinal balance. The curve of your spine plays an important role in spine health, positioning your head over your feet, minimizing the effort of postural muscles, and allowing space between vertebrae for nerves. When you lose that curvature, those spaces can become smaller and your body has to work harder throughout the day. All of this can cause pain, tingling, or numbness.
5. What muscles are tight in flat back?
Many cases of flat back syndrome are muscle-related, meaning they are brought on by muscle tightness and spasms that affect posture. The muscles that are affected in particular are your hamstrings, the iliopsoas muscle (made up of the iliacus and psoas hip muscles), and the abdominal muscles. These kinds of muscle deficiencies can be overcome with the right form of exercise.
For flat back syndrome, yoga is a very good exercise option. Before starting any type of exercise for back pain, however, check with your doctor to be sure that the type of exercise you choose is appropriate for your individual condition.