Corrective Exercises: Swayback Posture
by Christine Romani-Ruby, MPT, ATC
Client Share Save to Library
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
Setup. 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
Setup. 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.
Bridging
Setup. 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
Setup. 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.
Christine Romani-Ruby, MPT, ATC
IDEA Author/Presenter
Subscribe
Christine Romani-Ruby, MPT, ATC, is a licensed physical therapist and a Pilates Method Alliance g... more
IDEA Fit Tips, Volume 9, Number 2
February 2011
© 2011 by IDEA Health & Fitness Inc. All rights reserved. Reproduction without permission is strictly prohibited.
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Jonathan Urla
On Feb 03, 2011
Great article Christine,
I work with alot of clients with swayback posture and I would add a couple of ideas to your program regarding exercises for this condition. Many people with this postural condition are unaware that their pelvis is commonly anteriorly tilted. I always start with Pelvis isolations on the floor so clients first learn to be able to articulate the pelvis and then to sense what a neutral pelvis feels like since that will be new to them. Learning this before any stabilization exercises is important so they can self-correct when given a cue. Another area to isolate is the rigcage as you note that as opposed to lordosis, it is the thoracic area that is concave for those with swayback. Often the ribs are distended in the front and clients have a hard time closing the ribs in a more neutral position. I place the client on their back and have them breathe fully with the ribcage to help them find the natural mobility of the ribs and get them to contract them in more. While I can see your point about upper trunk curls being difficult to do properly using the transverse and obliques over the rectus, if they can learn to close the ribs effectively, they will reduce the rectus abdominus from being so dominant. Doing controlled roll-downs using the breathing bar on the cadillac and having them focus on softening the chest and ribs in I think helps. Lastly, having a client on their back and pushing against a wall or bars that are over their head can help them depress the ribs, which is what we do when doing the leg springs on the cadillac, but could also help when doing roll-down from bridge.
| Report as Inappropriate
Karen Goeller
On Feb 03, 2011
Well written and informative...
| Report as Inappropriate
Mara Iancovici
On Feb 07, 2011
Dear Christine,
I enjoyed very much reading your article. I work also with Sway-Back Posture cases and I'd like to add few observations from my experience.
The major characteristic of this faulty posture type is hahing the pelvis in posterior tilt, long kyphosis with posterior displacement of upper trunk, the hip joints with anterior displacement of pelvis that might create the ilusion of anterior tilt. The knee joints are hyperextended. The body is getting in a "locked up" position, leaning on the ligaments.This posture is a result of our modern sedentary life, too much sitting. I stongly agree with Jonathan comments. I'm also starting my corrective exercise program with Functional Mobility of Pelvis and Ribcage breathing rebuiding the lower back lordosis and thoracic extention.
Mara M.Ed.
| Report as Inappropriate
Christine Romani-Ruby
On Sep 09, 2011
I would like to respond to Jonathan's comments. One of the main points of this article is that in the sway back posture, the pelvis is not anteriorly tilted. The pelvis is shifted forward in the sagittal plane and is in a posterior tilt. An anteriorly tilted pelvis is only possible in a hyperlordotic posture. These are two different postures. The roll up/down and curl up would not be appropriate for the sway back posture but would be indicated for the hyperlordotic posture (anteriorly tilted pelvis). So if you read Jonathan's post, please realize that he is discussing the hyperlordotic posture and the exercises that he is proposing would not be for the sway back posture.
| Report as Inappropriate
m b
On Oct 08, 2011
You know, as a Pilates client trying to correct swayback posture, I really have to say first that it can really be harder for us when instructors don't *demonstrate* what they mean when they say "anterior tilt to pelvis" or "posterior tilt to pelvis", because, as we can see with Christine and Jonathan's comments, it is very easy for us to end up confused.
I'm also always confused about "what neutral spine feels like" when, since I do have swayback, an instructor -- and I've had more than one of them do this -- says "stick out your butt" for neutral spine when I'm laying on the Reformer. I really hope instructors understand that for those of us with long legs and a perhaps disproportionate load of the body weight below the navel, that "stick out the butt" direction can really make the lower back hurt, which is not what I think is supposed to be happening.
After all, isn't the first directive in the work that Pilates is not supposed to be painful ...?
| Report as Inappropriate
Joyce Coolidge
On Nov 13, 2011
mb-I totally agree. It is confusing. I have a very big sway in my back, and when my instructors showed how the pelvis should be more parallel to the ceiling,I felt that I was arching my lower back. I've since been told in a private lesson, that neutral should be comfortable for each individual.
I have not read the "owners manual" on the human body, so I do not know where every little muscle is, or what different postures are called. I can be instructed, but instructors must assume that a class full will not all know what they are speaking about.
btw-my posture is not one I've acquired over the years, I've been like this my entire life.
| Report as Inappropriate
Jason Slowiak
On Jan 08, 2012
I have an Idea which may seem sorta old fashioned to most people but to me it's an easy trick..(If you have glasses on)Sit completely straight on the couch, preferably with a lumbar support for adjustment to keep your shoulders back to the couch straight..Look straight ahead completely so your neck is sitting correctly no matter how uncomfortable..Slide the glasses down till just when your nose curves down, You will notice that you can't see as much above(Example when you look at the ceiling; it takes much more effort to stretch your actual muscles rather then let your head hang down "Bing straight! It HURTS, at first..It is uncomfortable and you also may look like your 80 or just a blast from the past but this ones free!
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On Nov 10, 2011
I thought the rectus abdominis was responsible for trunk flexion (as in a curl) and the obliques were responsible for lateral trunk flexion. Please clarify.
On Jan 08, 2012
by Christine Romani-Ruby, MPT, ATC
Client Share Save to Library
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
Setup. 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
Setup. 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.
Bridging
Setup. 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
Setup. 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.
Christine Romani-Ruby, MPT, ATC
IDEA Author/Presenter
Subscribe
Christine Romani-Ruby, MPT, ATC, is a licensed physical therapist and a Pilates Method Alliance g... more
IDEA Fit Tips, Volume 9, Number 2
February 2011
© 2011 by IDEA Health & Fitness Inc. All rights reserved. Reproduction without permission is strictly prohibited.
Share this on
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Article Comments
Post a comment
Jonathan Urla
On Feb 03, 2011
Great article Christine,
I work with alot of clients with swayback posture and I would add a couple of ideas to your program regarding exercises for this condition. Many people with this postural condition are unaware that their pelvis is commonly anteriorly tilted. I always start with Pelvis isolations on the floor so clients first learn to be able to articulate the pelvis and then to sense what a neutral pelvis feels like since that will be new to them. Learning this before any stabilization exercises is important so they can self-correct when given a cue. Another area to isolate is the rigcage as you note that as opposed to lordosis, it is the thoracic area that is concave for those with swayback. Often the ribs are distended in the front and clients have a hard time closing the ribs in a more neutral position. I place the client on their back and have them breathe fully with the ribcage to help them find the natural mobility of the ribs and get them to contract them in more. While I can see your point about upper trunk curls being difficult to do properly using the transverse and obliques over the rectus, if they can learn to close the ribs effectively, they will reduce the rectus abdominus from being so dominant. Doing controlled roll-downs using the breathing bar on the cadillac and having them focus on softening the chest and ribs in I think helps. Lastly, having a client on their back and pushing against a wall or bars that are over their head can help them depress the ribs, which is what we do when doing the leg springs on the cadillac, but could also help when doing roll-down from bridge.
| Report as Inappropriate
Karen Goeller
On Feb 03, 2011
Well written and informative...
| Report as Inappropriate
Mara Iancovici
On Feb 07, 2011
Dear Christine,
I enjoyed very much reading your article. I work also with Sway-Back Posture cases and I'd like to add few observations from my experience.
The major characteristic of this faulty posture type is hahing the pelvis in posterior tilt, long kyphosis with posterior displacement of upper trunk, the hip joints with anterior displacement of pelvis that might create the ilusion of anterior tilt. The knee joints are hyperextended. The body is getting in a "locked up" position, leaning on the ligaments.This posture is a result of our modern sedentary life, too much sitting. I stongly agree with Jonathan comments. I'm also starting my corrective exercise program with Functional Mobility of Pelvis and Ribcage breathing rebuiding the lower back lordosis and thoracic extention.
Mara M.Ed.
| Report as Inappropriate
Christine Romani-Ruby
On Sep 09, 2011
I would like to respond to Jonathan's comments. One of the main points of this article is that in the sway back posture, the pelvis is not anteriorly tilted. The pelvis is shifted forward in the sagittal plane and is in a posterior tilt. An anteriorly tilted pelvis is only possible in a hyperlordotic posture. These are two different postures. The roll up/down and curl up would not be appropriate for the sway back posture but would be indicated for the hyperlordotic posture (anteriorly tilted pelvis). So if you read Jonathan's post, please realize that he is discussing the hyperlordotic posture and the exercises that he is proposing would not be for the sway back posture.
| Report as Inappropriate
m b
On Oct 08, 2011
You know, as a Pilates client trying to correct swayback posture, I really have to say first that it can really be harder for us when instructors don't *demonstrate* what they mean when they say "anterior tilt to pelvis" or "posterior tilt to pelvis", because, as we can see with Christine and Jonathan's comments, it is very easy for us to end up confused.
I'm also always confused about "what neutral spine feels like" when, since I do have swayback, an instructor -- and I've had more than one of them do this -- says "stick out your butt" for neutral spine when I'm laying on the Reformer. I really hope instructors understand that for those of us with long legs and a perhaps disproportionate load of the body weight below the navel, that "stick out the butt" direction can really make the lower back hurt, which is not what I think is supposed to be happening.
After all, isn't the first directive in the work that Pilates is not supposed to be painful ...?
| Report as Inappropriate
Joyce Coolidge
On Nov 13, 2011
mb-I totally agree. It is confusing. I have a very big sway in my back, and when my instructors showed how the pelvis should be more parallel to the ceiling,I felt that I was arching my lower back. I've since been told in a private lesson, that neutral should be comfortable for each individual.
I have not read the "owners manual" on the human body, so I do not know where every little muscle is, or what different postures are called. I can be instructed, but instructors must assume that a class full will not all know what they are speaking about.
btw-my posture is not one I've acquired over the years, I've been like this my entire life.
| Report as Inappropriate
Jason Slowiak
On Jan 08, 2012
I have an Idea which may seem sorta old fashioned to most people but to me it's an easy trick..(If you have glasses on)Sit completely straight on the couch, preferably with a lumbar support for adjustment to keep your shoulders back to the couch straight..Look straight ahead completely so your neck is sitting correctly no matter how uncomfortable..Slide the glasses down till just when your nose curves down, You will notice that you can't see as much above(Example when you look at the ceiling; it takes much more effort to stretch your actual muscles rather then let your head hang down "Bing straight! It HURTS, at first..It is uncomfortable and you also may look like your 80 or just a blast from the past but this ones free!
| Report as In
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