Flat-back Posture

flat back posture

What is Flat Back Posture?

Flat back posture definition:

Flat back posture is a type of postural imbalance that involves reduced curvature of the spine, particularly in the lower back region. In individuals with flat back posture, the spine's natural curve is diminished, resulting in a flattened appearance.

Observed in the side views, flat back is when the spine does not curve forward as it should in the lumbar spine. Flat back in the thoracic spine is when there is no upper back rounding, and the vertebrae are observed to go straight up and down. The cervical spine can also be considered a flat back (also called military neck).

The boney landmarks commonly palpated to discover flat back are the spinous processes of the spine.

The opposite of flat back in the lumbar and cervical spine regions is hyperlordosis (too much curve). In the thoracic spine, excessive rounding or flexion is the opposite, referred to as kyphosis or hunchback posture.


In the lumbar and cervical spines, the vertebral column is in flexion. 

Shortened muscles typically include the lumbar flexors, such as the rectus abdominis, external obliques, internal obliques, and psoas major. And while posterior pelvic tilt is commonly associated with lumbar flexion, this may or may not be the case as observed in the clinic.

Lengthened lumbar spine muscles include the spinal extensors such as longissimus, iliocostalis, multifidi, rotatores, quadratus lumborum, and latissimus dorsi.

Many of the muscles mentioned with the lumbar spine also cross over into the thoracic area. Also, some of the long muscles of the cervical spine cross into the thoracic area. (This is why we look at the spine as a unit versus in individual regions).

Shortened muscles include multifidi, rotatores, spinalis, interspinalis, and others, depending on the thoracic vertebrae involved.

Lengthened muscles include the internal intercostalis, serratus posterior inferior, rectus abdominis, external obliques, internal obliques, and others, depending on where the flat portion of the thoracic spine spans.

Shortened muscles include the sternocleidomastoid, anterior scalenes, longus capitis, and longus coli.

Lengthened muscles often include the trapezius (upper fibers), levator scapulae, splenius capitis, splenius cervicis, multifidi, rotatorers, interspinalis, and more.

Common Issues:

Flat back posture can lead to several problems, including reduced mobility, lower back pain, neck pain, mid-back or upper-back pain, arthritis, disc degeneration, disc herniation, stenosis, S-I joint issues, muscle tension, and difficulty standing for prolonged periods. Individuals with flat back posture may also experience fatigue and discomfort when performing activities that require prolonged standing or sitting.

Lumbar flat back can limit pelvic and sacral movement and throw off the natural curve in the rest of the spine. 

Several factors, including genetics, poor posture habits, and muscle imbalances, can cause flat-back posture. Treatment for flat back posture typically involves a combination of exercises, stretches, and posture therapy techniques to improve posture and restore proper curvature of the spine.

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