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What is Lordosis?

Definition of Lordosis:

Lordosis refers to the natural inward curvature of the spine, typically present in the cervical (neck) and lumbar (lower back) regions. However, excessive or abnormal curvature, resulting in an exaggerated arch, is often termed hyperlordosis. This pronounced curve can give a swayback appearance, as observed from the side views.

lumbar lordosis posture

Anatomy Overview

spine curves anatomy posture

A healthy spine, or vertebral column, is a masterpiece of natural engineering. Our spinal curvature is designed to offer structural support and balance to the body while protecting the spinal cord, a vital central nervous system component. The gentle spinal curves work synergistically with the rest of the body to provide optimal weight distribution, flexibility, and shock absorption.

There are specific regions of the spine, each with its distinct curvature:

Cervical Spine

The cervical spine (neck region) has a naturally inward curve. This concavity is known as a lordotic curve.

Thoracic Spine

The thoracic spine (mid-back region) has a gentle outward curve, termed a kyphotic curve.

Lumbar Spine

The lumbar spine (lower back) returns to an inward or lordotic curve, mirroring the curvature of the cervical spine.

These natural curvatures enable the spine to distribute mechanical stress during movement and weight-bearing activities effectively.

Between each vertebra are intervertebral discs. These discs serve a crucial role as the spine's shock absorbers. They’re made of a soft, gel-like center (nucleus pulposus) encapsulated by a tougher, fibrous ring (annulus fibrosus). These discs provide cushioning between the vertebrae, absorb and distribute loads, and contribute to the spine's overall flexibility.

Surrounding the vertebrae and discs is a complex web of muscles and connective tissues that comprise the myofascial system. This system plays a pivotal role in maintaining the spine's posture, providing movement, and ensuring stability. Muscle imbalances - where certain muscle groups become overly tight while others become weak - are a common cause of vertebrae being pulled out of alignment, leading to or exacerbating deviations such as hyperlordosis.

In addition, the joints of the spine, known as facet joints, allow for motion between the individual vertebrae. These joints, along with the intervertebral discs, facilitate movements such as flexion, extension, rotation, and lateral bending of the spine. They work in harmony with the muscular and myofascial systems to provide a wide range of motion while maintaining stability.

Exaggerated or diminished curves in the spine, whether in the cervical or lumbar regions, can lead to various structural and functional challenges. These changes in natural alignment can affect the spine's biomechanics, potentially causing pain, reduced mobility, and other musculoskeletal issues.

herniated disc anatomy lordotic curve

Synonymous Posture Terms

  • Hyperlordosis
  • Hyperextension
  • Swayback
  • Arched back
  • Lumbar hyperlordosis
  • Cervical hyperlordosis
  • Lower crossed syndrome
  • Upper crossed syndrome

The Biomechanics of Lordosis

Biomechanics refers to the dynamic interplay between form and function. It embodies the union of mechanical laws with biological structures, particularly pertinent when discussing the spine. This intricate relationship dictates how forces are distributed across the spine, ensuring it operates optimally. When both form (the spine's structure) and function (how it moves) are harmonious, the spine thrives, remaining resilient and supple. However, any discord in this partnership can lead to undue stress on specific segments, paving the way for pathological changes.

The spine is made for movement and stability

Skeletal and Muscular Structures

The skeletal, muscular, fascial, and joint structures lay the foundation of spinal biomechanics. The skeletal structure offers form, shaping the spine's natural curves. The encompassing fascial and muscular systems further support or challenge these curves, highlighting the symbiotic relationship between form and function. When they operate in unison, they fortify the spine, promoting healthy mechanics. Any imbalance, however, can lead to compromised spinal integrity, emphasizing the importance of understanding and preserving this delicate balance.

lumbar lordosis with anterior pelvic tilt posture

Anterior pelvic tilt and lumbar lordosis are synergistic movements commonly seen together. However, we're also seeing more flat back postures with anterior pelvic tilt due to modern lifestyles.

Lumbar Lordosis:

Shortened Muscles: Muscle shortening or hypertonicity can pull the spine into a hyperlordotic posture. Key players in lumbar lordosis include the lumbar erectors, multifidi, and quadratus lumborum. When there's an anterior pelvic tilt – which means the front of the pelvis drops and the back of the pelvis rises – muscles like the psoas major, iliacus, rectus femoris, and tensor fascia latae become shortened and influence the curve of the spine.

Lengthened Muscles: On the opposite side, certain muscles become lengthened or inhibited. This includes the abdominal muscles (rectus abdominus, transverse abdominus, and the internal and external obliques). If there's an associated anterior pelvic tilt, the hip extensors – notably the gluteus maximus and hamstrings – are lengthened and may weaken over time.

cervical lordosis with kyphosis posture

Cervical lordosis is commonly seen with thoracic kyphosis. As the upper back rounds, it creates the need for the neck to hyperextend to keep the eyes on the horizon.

Cervical Lordosis:

Shortened Muscles: In the cervical region, hyperlordosis often involves the tightening of cervical extensors like the upper trapezius, levator scapula, semispinalis capitis, longissimus, multifidi, and rotatores.

Lengthened Muscles: Conversely, the neck flexors, such as the sternocleidomastoid, anterior scalenes, longus capitis, and longus coli, become lengthened. This can result in an extended head posture, a common sign of cervical lordosis.

Joint Movements

Any deviation from the spine's natural alignment has repercussions that ripple through the musculoskeletal system. For instance, increased lordosis significantly disrupts the lumbo-pelvic rhythm – the coordinated motion between the lumbar spine and the pelvis. This can lead to compensatory movement patterns, not just at the site of deviation but in adjacent joints. An anterior pelvic tilt can become prominent in the lumbar region, affecting the hips, knees, ankles, and feet. Similarly, the chin might jut forward in the cervical region, a posture often termed "forward head posture."

Over time, these postural deviations can lead to movement pattern dysfunctions. The body is adept at creating compensations, which are rarely efficient or beneficial in the long run. Such deviations and compensations can cause spinal misalignments, which, if left unchecked, can lead to more severe cases with pronounced movement disorders. These, in turn, accelerate joint wear and tear, increase vulnerability to injuries, and can manifest as chronic pain or specific medical conditions. Addressing the root causes and intervening early is crucial to prevent a cascade of negative biomechanical and physiological effects.

Postural Deviations Found with Lordosis

Individuals with pronounced lordosis often present with these other postural deviations:

  • Anterior pelvic tilt
  • Forward head posture
  • Protruding abdomen
  • Thoracic kyphosis (upper back rounding)
  • Knee hyperextension

What are the Symptoms of Lordosis Posture?

When diagnosing lordosis, healthcare professionals typically utilize advanced imaging techniques such as X-rays, MRIs, or CT scans to visualize the intricacies of musculoskeletal structures or identify abnormalities. However, a comprehensive physical examination and a detailed medical history are critical beyond imaging. This holistic approach assists in identifying associated or contributing factors. It's imperative to remember that low back pain is a symptom, and it doesn't always pinpoint the exact issue. Hence, identifying the root cause of low back pain or neck pain—whether related to lordosis or not—is essential to devising an effective treatment plan.

Common Pains and Limitations

Lumbar Lordosis:

  • Low back pain
  • Muscle spasms
  • Lumbar disc herniation
  • Hip pain
  • Knee pain
  • Distended abdomen
  • Digestive issues

Cervical Lordosis:

  • Neck pain
  • TMJ disorder
  • Headaches
  • Neck tension
  • Tinnitus
  • Tension in the upper trapezius

Long-Term Risks and Issues

Persistent and untreated lordosis isn't merely an aesthetic or postural concern. It can pave the way for a series of more severe cases, orthopedic spinal conditions, and health implications:

  • Chronic pain
  • Diminished range of motion
  • Nerve impingements or compressions
  • Greater susceptibility to spinal injuries
  • Compromised quality of life
  • Osteoporosis, increasing the risk of fractures
  • Spondylolisthesis: Forward displacement of a vertebra, often due to degeneration
  • Retrospondylolisthesis: Backward displacement of a vertebra

Acting on the early symptoms and seeking appropriate intervention can help mitigate these risks and ensure a healthier spine and overall wellness.

What Causes Lordosis?

what is lordosis posture

The Interplay of Muscle Imbalances, Lifestyle, and Underlying Conditions

Lordosis is often caused by genetic predispositions, muscle imbalances, lifestyle choices, and habitual poor posture. Sedentary lifestyles, frequently involving prolonged sitting, can exacerbate these imbalances, disconnecting the typical lumbo-pelvic rhythm. Such disruptions can lead to the lumbar spine remaining in an extended position, even when the pelvic position is neutral or tilted anteriorly. Understanding the underlying causes can provide clarity on management and prevention.

Genetic Predispositions: Some people might be genetically predisposed to developing lordosis. This genetic factor can affect the structural alignment and biomechanics of the spine, making individuals more susceptible.

Muscle Imbalances: One of the primary culprits behind lordosis is muscle imbalances. Over time, certain muscles become overactive or shortened while others become underactive or lengthened, disrupting the spine's natural alignment.

Lifestyle Activities: Our modern lifestyle, characterized by prolonged periods of sitting—be it at desks, in front of the television, or during commutes—can intensify muscle imbalances. Sitting for extended durations can lead to tightened hip flexors and weakened glutes, abdominal muscles, and hamstrings. This exacerbates the anterior pelvic tilt, thereby enhancing the lordotic curve.

Habitual Poor Posture: Years of maintaining poor posture, whether standing or sitting, can engrain certain patterns into our musculature, leading to the reinforcement of the exaggerated spinal curve seen in lordosis.

Underlying Health Conditions: Several health disorders or conditions can either cause or exacerbate lordosis. These include obesity (where excess abdominal weight pushes the spine forward), spondylolisthesis (a condition where one vertebra slips forward over the one below it), osteoporosis (weakening of the bones), and conditions like achondroplasia (a type of dwarfism) or discitis (inflammation of the intervertebral disc space).

Understanding the multifaceted causes of lordosis underscores the importance of holistic assessment and intervention, encompassing lifestyle modifications and targeted therapeutic interventions.

Posture Terms Related to Lordosis

  • Swayback
  • Hyperlordosis
  • Lumbar hyperextension
  • Kyphosis
  • Forward head posture (anterior head carriage)
  • Knock knees
  • Bow legs
  • External knees
  • Internal knees

Conclusion

Excessive lordosis is more than just an aesthetic concern related to spinal curvature. It's about recognizing its profound impact on an individual's health, from physical discomfort to long-term mobility constraints. With insights into the diverse causes, from genetic predispositions to lifestyle factors, we can make informed decisions about intervention. Embracing proactive measures such as posture therapy can help rectify spinal misalignments and pave the way for a more active, pain-free life. It's a journey towards a healthier spine and a better quality of life.

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