T Nation

Rounded Back


#1

As you can see in the pic... There's clearly something wrong with my back .. I've been to see an osteopath a few times and my back is slowly getting better.. It doesn't look as bad when I standup, but when I sit down it looks mangled

I've also have epididymitis / prostatitis (looks like it's been caused by pelvic dysfunction and not infection) probably from neglecting hamstrings and dodgy form on my deadlifts , squats & benching. Now Whenever i lay on my back in bed my left nut aches and I get discomfort in both sides of my pelvis. Also been told I might have a meniscus tear (waiting for an MRI)

Anyone ideas on what's up with my spine / what I can do to fix myself?? I'm still seeing the osteopath

I can't train or work and I'm losing weight by the day

Desperate to get this fixed!

Standing posture:


#2

the body doesn't like to sit. are you able to stoppit? alternatives include squatting, kneeling (japanese style), standing, lying down (on your stomach propping yourself up on your elbows allows typing) moving about fairly frequently...


#3

Not really supposed to lay on my front cos of the pelvic dysfunction , Don't suppose it's good for the back either?


#4

It looks from a quick glance like your pelvis is in an extreme posterior pelvic tilt. How is your hamstring flexibility (straight back hamstring flexibility specifically)?


#5

Thought it could be a pelvic tilt. What would be the best way to check? Straight leg hamstring stretch?


#6

First I'd try just seeing if you are capable of anteriorly pelvic tilting while on all four ("cat/cow" stretch), then while seated. Make note of where you feel the stretch most strongly.

The problem with doing/trying a straight leg hamstring stretch is:
1) most people who have tight hamstrings totally butcher the exercise and instead of hinging from their hips like they should (thus actually testing/building flexibility of the hamstrings), they instead simply round forwards from their spine (which only serves to further increase their degree of PPT, and doesn't address their flexibility issues)

2) there are numerous muscles groups that can limit hip flexion ROM and trying to address all of them or figure out which one is specifically limiting ROM is less than optimal.

Instead I would suggest stretching your:
-Soleus
-Gastrocnemius
-Gluteus Maximus
-Piriformis
-Perform a bent leg hamstring stretch
-Then finally try a single sided straight leg and flat back/anteriorly tilted pelvis or neutral at worst hamstring stretch

That sequence will give you better insight into which links along the chain might be limiting your ROM, and will make your final straight legged/flat back hamstring stretch more productive and easier to get into (I would also strongly suggest using a strap or belt to help you attain the correct stretching position).

Good luck, hope this helps.


#7

If your back is currently in a lot of pain the best thing would be to get in a pool and float in the deep end to de-weight the spine and also do some walking.

The picture is blah, the chair is horrendous probably adding a little to how poor your posture appears. That being said, biomechanically your spine probably has decreased lumbar lordosis which is most likely bony and partially correctable. A posterior pelvic tilt implies your hamstrings are place in a shortened position and the hip flexors are in a lengthened position. You should focus on creating a neutral pelvis as well as strengthening the multifidus for stability.


#8

"Partially" correctable? So my spine can never be "fully" corrected??

Never really have pain when I'm standing/walking.. However , my lower back cramps up badly after sex with the girlfriend.

Do you think seeing a Corrective exercise specialist along with the osteopath can help me fix the spinal problems/pelvic tilt?


#9

perhaps you have yet to master the hip drive (you have lazy glutes)


#10

Partially" correctable? So my spine can never be "fully" corrected??

In part you may never achieve "perfect posture", I can't say for sure because your not in front of me to examine, but do not let that discourage you from making progress and improvements. You have to understand that everyone is built different biomechanically, think less about having perfect posture and lets focus on improving posture.

If your not having back pain then no, I would not recommend seeking help. I'll go with the old saying, if it aint broke dont fix it. If you have a history of back related pain then a consult may be warrented.

The cramping is most likely due to poor endurance and not poor posture. Maintaining spinal extension is most likely causing your erectors to cramp up. Planks etc will be good for that


#11

Planks? How are planks going to help spinal extension endurance?

If he wants to strengthen his erectors, he would be much better off doing Supermans/Arch holds than planks.

But, those will still not help him develop his hip flexion mobility.


#12

What position most closely imitates having sex. A plank is quite functional at imitating this position as well as challenges his ability to sustain a position (specificity of training). Planks will stress muscular ENDURANCE, not sure why you cited arches as promoting strength, as they won't achieve overload. Arches and supermans are good as well at promoting muscular endurance but are clearly not as functional in this instance as planks. Plank will promote extension and flexion endurance.

Surface electromyography (sEMG) of selected trunk flexors and extensors, and an intervention of pre-fatigue core workout were applied for test validation. Intraclass correlation coefficient (ICC), coefficient of variation (CV), and the measurement bias ratio */÷ ratio limits of agreement (LOA) were calculated to assess reliability and measurement error.
RESULTS:
Test validity was shown by the sEMG of selected core muscles, which indicated >50% increase in muscle activation during the test; and the definite discrimination of the �30% reduction in global core muscle endurance subsequent to a pre-fatigue core workout. For test-retest reliability, when the first attempt of three repeated trials was considered as familiarisation, the ICC was 0.99 (95% CI: 0.98-0.99), CV was 2.0 ± 1.56% and the measurement bias ratio */÷ ratio LOA was 0.99 */÷ 1.07.
CONCLUSION:
The findings suggest that the sport-specific endurance plank test is a valid, reliable and practical method for assessing global core muscle endurance in athletes given that at least one familiarisation trial takes place prior to measurement.

If you read my previous post, I already stated my stance on correcting hip mobility. He currently is not having any back issues except mild cramping when having sex. Attempting to correct something that is not causing problems is opening up a can of worms for creating new problems.


#13

I understand your stated position, I disagree as even if his lack of hip mobility is not causing him pain right now, it will at some point and the longer he waits the more difficult/time consuming it will be to fix.

But let's even say that your advice to ignore his hip mobility issues is correct, I still fail to see how an exercise which is designed to strengthen the anterior core and if performed correctly will place the OP in a PPT, with the lumbar spine flexed will help him.

Arches may not be an advanced extensor exercise for some (then again, most people could gain considerable spinal extension, hip extension, and shoulder flexion strength from correctly performing this exercise), but judging by the fact that the OP gets cramps in his extensors after sex, they should be challenging enough at this point to build strength and endurance.


#14

I disagree with the portion of you trying to diagnose his condition and recommend treatment/exercises for something in which OP has no pain or dysfunction and are basing off one seated picture. It reminds me of strength coaches and personal trainers using the Functional Movement Screen to diagnose conditions and attempt to correct them (which they have no qualifications to do) rather then as a screening tool. In my opinion, telling people what "might" happen to them is dangerous waters to tread without proper qualification, examination, and evaluation as the true cause of the dysfunction cannot properly be identified and may in fact not be related to muscular imbalance.

Again, the plank does not simply stress the anterior core, please read the abstract posted. The goal being maintaining a neutral pelvis (not PPT) and promoting muscular endurance. The plank is more functional in this instance then the arch, and therefore will most likely have more benefits to OP's chief complaint.


#15

Planks should not be performed with a neutral spine, they are designed to be an anterior core exercise. I know all of the so called "experts" say that a neutral spine is a "safer/more functional" position, but it's simply not the case in application or practice. I know quite a few Physios who were taught the same thing, only to realize that this is incorrect when they were exposed to the correct method of performing planks (which is with a "hollow" spine/PPT, protracted scapulae, and at least slighty flexed lumbar spine).

Arches are far, far more functional, challenging for the extensors, and specific to the OP's needs than neutral planks. And seriously, who has sex with a their pelvis held in a neutral position the whole time instead of rocking between an APT to PPT (or at least Neutral to PPT)?

The OP asked for opinions on what might be wrong with his back, I didn't just walk up to him out of the blue and start diagnosing him unsolicited (this is an Internet forum). His description was that his back wasn't so bad when he was standing (in hip extension), but got worse when he sat down (hip flexion), which signifies that he likely has one or several hip extensors that is limiting his ability to APT. So, I suggested that he test his flexibility in all of the potential muscles which might be limiting his hip flexion/ability to APT to see if he could figure out which one to focus on stretching (with the added benefit that he would hopefully also learn/realize that stretching all of those muscles would more effectively improve his hip flexion ROM faster than simply trying to stretch the hamstrings directly right from the get go).

I don't see how that is
1) going to be detrimental to his health
2) diagnosing him
3) really in opposition to your suggestion that his hamstrings may be shortened thus leading to his excessive PPT

And as far as my warning to him, in his OP he stated that he was having discomfort in his left testicle and pelvis while laying down. To me that suggests that something is wrong. I have trained quite a few people who have postural issues which never bothered them in their youth, but always wind up causing chronic pain or worse yet injuries once they hit middle age or become seniors. At that point it's a long, much more difficult, and in some cases even impossible road back to correct body mechanics. So, yeah, I stick by my assertion that the OP should attempt to fix his postural issues now rather than wait until he does experience pain or injury later down the road.

As the old saying goes "an ounce of prevention is worth a pound of cure". Why wait till he has pain or injures himself if he could potentially prevent that from happening?


#16

Again your lack of biomechanical understanding limits your interpretation of the plank. I am not entirely sure why you delve into discussing safety of dynamic positioning and postural safety since in this instant it is completely irrelevant. Your arguement for functionally safe pelvic positioning is meh, it is not proven which is safer as yuri verk argues for dynamic pelvic positioning during exercise while many of today's biomechanical experts believe maintaining a neutral spine is safer.

You sound like an exercise physiologist so you must be familiar with the 3 points of contact. Planks are taught with this method aka a neutral spine. It is biomechanically almost impossible to be in a true ppt while in this position and not to mention the abs and hams/glutes are actively insufficient to produce a true post tilt, hence why true ppt involves hook lying or quadraped. I'm not sure why I have to repeat this for a third time but planks are simply not just an anterior stability exercise, way too simplistic it doesn't matter what it was designed for it matters what it does ..and that's produce cocontraction around the pelvis hence the emg study. I agree with many people doing planks wrong, some sag into an atp while other produce way too much lumbar flexion (ppt the pipe would not lie flat and touch the 3poc), the technique u describe is very similiar to the description of a neutral pelvis.

I'm not gonna argue again for which I think is more functional (in this instance) its apples v oranges, both are fruit and in my original post I said planks etc. Not being mutually exclusive. I don't see why op can't do both

You sound very intelligent but turning this into a peeing contest doesn't do this any justice. No one cares how many people you ve supposedly cured etc. All the instances u described curing people involved having the person in front of you, and being able to properly perform an examination and evaluation. My favorite portion is where you state, "chronic pain or worse yet injuries once they hit middle age or become seniors", riveting that middle to elderly people have back pain, can you solely attribute that to poor posture as you stated "always". I feel more inclined to believe that it is more of a combination of posture, lifestyle, increases in obesity, increased lifespan, increases in co-morbidities, smoking, etc. I'm not sure how your not recognizing the fact that your offering suggestion and correction for something you have no idea what the cause is, and therefore have no clue how to correct while potentially altering OP's mechanics (which may not need altered) and could lead to injury (which he currently does not have). A more simplistic and easier approach is for OP to learn how to create a neutral alignment and maintain it from standing to sitting via neuromuscular control, which disregards cause and focuses on endpoint. Not sure what the testicle point is ??? Not sure why you mentioned this as op already stated he has an inflammed epipydidemis. Are you going to correct that with postural intervention or are you implying causation poor posture causing inflammed testey.


#17

My biomechanical understanding of the plank is just fine.

It seems that we are arguing semantics in regards to PPT, which I agree is not really adding to the discussion or helping the OP out any. I think what is important is that the OP at least now has a goal to work towards (learning or developing the ability to APT while seated or squatting/dead lifting.

I also apologize if I came off argumentative before, it's just that I have seen such a huge improve my in my clients' and my own core strength, reduction in back pain, improvement in posture, and improvement in biomechanics since moving away from the whole neutral spine craze that it's become somewhat of a pet peeve of mine when people tell others to do things like Planks with a neutral spine.


#18

I am not trying to be argumentative as well, sorry OP, Im glad we could hash this out. Clinical experience is important, I agree and I am glad you are able to find things that work for yourself and your clients. We can agree to disagree on the plank issue, as I still believe the closed-chain aspect of the plank promotes co-contraction around the joint (emg study) thus being more beneficial to perform in a neutral aspect (the closed-chain aspect also making it impossible to achieve a true PPT if maintaining 3 points of contact and thus the individual makes isometric gains in static holds of a neutral posture[specificity of training]).

Open-chained exercises, like arches, will fail to produce co-contraction and can be performed with either a true APT or PPT. Training in a closed-chain environment makes it nearly impossible to produce isolated results of either APT or PPT. Take the knee, for example, when performing static hold at 30 degrees of knee flexion which promotes co-contraction of the quads and hamstrings, you do not gain benefits in, nor isolate , either knee flexion or extension, but rather gain benefit of both (plank). But performing an open chain isometric quad contraction benefits only knee extension (hooklying pelvic tilt).


#19

Update : urologist doesn't think I have an infection, went to the osteopath and have been diagnosed with gilmores groin/ athletic pubalgia (he checked after i told him about a popping / clicking sensation i get where the pelvis meets the leg) most likely paired with FAI hip impingement (this is likely to be what's causing the left testicle ache)

Hopefully gonna get this fixed soon so I can go back to fixing my posture


#20

Co contraction is very beneficial for exercises which provide axial loading (like barbell squats) as in such cases the joints of the spine must line up correctly in order to maximally utilize the supportive properties of the disks as well as prevent disk slippage or nerve damage. However, it is not necessary, nor even that beneficial IME (nor is there much carryover) to focus on co contraction with regards to exercises which produce a primarily radial loading effect (like planks).

Also, closed chain movements can absolutely involve either APT or PPT. Perhaps they can achieve a greater degree of PPT while on their hands and knees, but once the pelvis tips beyond neutral towards the posterior it is technically still a PPT. The fact that most people find it difficult to do so (usually representing tightness in the hip flexors due to too much sitting, tightness in the lower back, and weakness/inability to properly recruit the Gluteus Maximus and Rectus Abdominus) while those who can generally have no back pain or spinal injuries makes building the ability to do so even more of a compelling reason to perform planks with a PPT.

But, none of this really matters in the OP's case as he does not seem to have an issue with PPT, and so shouldn't spend much time at this point working on exercises that develop it. What he should focus on instead is exercises that build his hip flexion ability (both passive and active) as the only picture of his posture we have to go by suggests that these muscles are weak and his hip extensors are tight.

I do think that he should go see an Orthopedist though to get examined in person as no one is going to be able to get the whole picture from a post on an online forum.