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Corrective Exercises: Swayback Posture

by Christine Romani-Ruby, MPT, ATC on Jan 20, 2011

Many fitness professionals confuse faulty lordotic posture with swayback posture. Swayback and lordosis appear similar, owing to the concave curve in the back area. However, upon closer look, it is apparent in the lordotic posture that the lumbar spine is concave, while in the swayback posture the low lumbar area is actually flattened. In the swayback posture the concave curve of the spine is much higher, in the lower thoracic spine. A fuller understanding of swayback posture can help you retrain clients.

Swayback posture is common in runners, ballerinas and sedentary individuals. It is also common in older adults because of the characteristic weakening of the aging gluteals. In addition, those with chronic pain frequently present with swayback posture. Common overuse injuries related to faulty swayback posture include labral tears at the hip, low-back pain, plantar fasciitis, iliopsoas bursitis and tendinopathy, recurrent hamstring strain and shoulder impingement.

Swayback Posture: Exercise Program Goals

Specific exercises for swayback posture should include movements that achieve the following:

  • Increase mobility at the hips, specifically hip flexion.
  • Increase strength of the gluteus maximus.
  • Decrease length of the external obliques and reduce dominance of the rectus abdominis.
  • Strengthen the short hip flexors (psoas).

For best results, incorporate as many of these goals into one functional activity as possible, rather than doing individual activities. The goal is to include exercises that promote co-contraction of the muscles about the spine with increased power for hip flexion and extension, which would happen simultaneously. Avoid traditional curl-ups with swayback clients, as curl-ups continue to build dominance of the rectus abdominis. To incorporate abdominal strengthening, do core exercises that maintain a neutral spine and pelvis and produce stiffening of the core.

Here are several Pilates exercises that are beneficial for swayback posture:

1. Side plank and leg pull effectively shorten and strengthen the external obliques while maintaining length in the internal obliques and rectus abdominis.

Side Plank
Sit on side of hip with legs extended slightly out in front. Cross top leg over bottom leg, resting ball of foot on floor. Bottom leg will take your body weight, while top leg is for balance. Place lower hand on floor aligned comfortably under shoulder. Align spine, and draw shoulder blades down by lifting rib cage to prepare for movement.
Movement. Lift hips from floor in one movement as top arm sweeps upward. Bring entire body to rest on one hand and on side of lower foot. Align body so ribs are directly in line with pelvis and you are completely in frontal plane. Square shoulders and hips to front of body. Hold for a set of breaths and then lower to floor while keeping body aligned. Repeat on other side.
Breathing. Inhale to prepare, exhale as you lift into side plank, inhale at top and exhale to return to setup position. Be sure to keep weight-bearing elbow soft without hyperextending elbow joint.

Leg Pull Variation
Lie on stomach, propped up on elbows, as if reading a book. Align elbows directly beneath shoulders, heels below ischial tuberosities. Curl toes so you will be able to bear weight on balls of feet.
Movement. Draw ribs up and away from floor and then follow by lifting pelvis and placing weight on elbows and on balls of feet. Be sure to keep head and neck in line with spine and to maintain neutral pelvis. Once you are in this elbow plank position, you can add challenge by reaching one foot at a time up and off floor.
Breathing. Inhale as you lift ribs, and exhale as you lift into elbow plank position. Hold position for three breaths, or inhale and exhale as you alternate reaching legs for 8 repetitions.

2. Bridging and single-leg march strengthen the gluteals and psoas while increasing hip mobility.

Lie on back with feet flat on floor and heels directly in line with ischial tuberosities. Position spine and pelvis in neutral. Place arms at sides and lengthen neck.
Movement. Draw navel toward spine and begin peeling one vertebra at a time up from floor, starting at tailbone. Stop to rest on shoulder blades, then return to floor, one vertebra at a time.
Breathing. Inhale to prepare, and exhale on movement. Inhale at top, and exhale as you return to starting position.

Single-Leg March
Lie on back with feet flat on floor and heels directly in line with ischial tuberosities. Position spine and pelvis in neutral. Place arms at sides and lengthen neck.
Movement. With bent knee, lift one leg up to tabletop position. Be sure to maintain neutral pelvis and spine as you lift. Return to setup position and perform movement on other side.
Breathing. Inhale as you lift leg, and exhale as you bring it back to floor.

For additional guidelines, please see “Designing a Program for Swayback Posture” in the online IDEA Library or in the November–December 2010 issue of IDEA Fitness Journal.

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About the Author

Christine Romani-Ruby, MPT, ATC

Christine Romani-Ruby, MPT, ATC IDEA Author/Presenter

Christine Romani-Ruby, MPT, ATC, is a licensed physical therapist and a Pilates Method Alliance gold-certified Pilates instructor. She is an associate professor in the exercise science program at Cali...