When your back is against the wall…

By Shane Jansa, MSPT, CSCS, Horizon Physical Therapy

The old saying, “sit up straight,” doesn’t seem to work as well today because most people arch their back. Many of us sit, sleep and stand with too much arch in our lumbar spine already. The technical term is “excessive lumbar lordosis.”

Everyone has three curves in their spine. From the side these curves form an “S”. If one of the curves becomes excessive, it can affect the others.

Keeping your spine and pelvis properly aligned decreases stress on the muscles and joints, not only in the bones that form the foundation of your trunk, but in your arms and legs as well.

If your pelvis tips down too far in the front, you can get too much curve in the lumbar spine (excessive lumbar lordosis). This tipped position decreases the spine’s ability to bend and twist. Arthritic changes can occur from ecreased motion of a joint. The above scenario is further complicated when one side of your pelvis tips further forward than the other. This is called an
anterior rotation of your ilium.

We all have two ilium bones that come together in the back and attach to
the sacrum (tailbone). These are called our sacroiliac joints. This bony ring is attached at the front at the pubic symphysis. If this bone becomes misaligned, sacroiliac dysfunction can result. In this case, every activity hurts your low back because motion in the spine and legs depends on equal
movement in the sacroiliac joints.

The sacroiliac joints support weight from the upper trunk and allow movement in the lower body. Although the joints are meant for stability,
they do move slightly. If both joints don’t move equally, stress and pain may result on the side that moves too much. The question most people ask is “why me?”

Many muscles attach in and around the sacroiliac joints. Patients with sacroiliac dysfunction typically have lengthened abdominal muscles. This
protruding abdomen phenomenon may be at the heart of the problem. If one side of the abdominal muscles becomes weaker than the other, it can cause one ilium to rotate downward, leading to sacroiliac dysfunction.

Medical professionals can perform many tests to assess pelvic misalignment.
You may want to perform the following simple beginning screen to see if you have too much lumbar lordosis. Stand with your heels a couple inches from a wall. Rest your shoulders against the wall. There should not be more than
two inches between your back and the wall. In this scenario, you may notice
that your belt buckle is much lower than the back of your belt (see photos).
The space between both sides of your back and the wall should be the same.
If not, you may have one ilium rotated downward.

There are many causes for low back pain. One answer to the problem may be strengthening your abdominal muscles without putting stress on your back.
Consulting a professional that takes into consideration the position of your pelvis, spine and entire trunk is vital. Also, assessing the amount and quality
of movement in the trunk and extremities is crucial. Of most importance is maintaining proper position and movement in years to come.

For more information, contact Horizon Physical Therapy at 420-2500.