Positive Health Online

The title above needs to be qualified: lordosis is the mother of all acquired distortions which de facto eliminates from my assertion all congenital ones. And in ‘acquired’ I do not include distortions which are a direct result of injuries such as fractures.  And maybe the ‘all’ in ‘all distortions’ is a bit too bold so I should have written that lordosis is the primary cause of the vast majority of acquired distortions but that would have been a bit long-winded for a title.

Yet this way of explaining the origin and evolution of distortions is little known. Most professionals and lay persons are still misled by the usual but wrong suspects: Gravity and a lack of strength and muscle tone to counteract it. To demonstrate my point, I propose to analyse a newspaper’s article given to me by a patient of mine for my perusal and which reflects the commonly held view about posture and distortions.

Before I do that though, I think it necessary to give a basic description of the human spine and to define some anatomical terms pertaining to it. The normal spine has three curves: two which go inward, one which goes outward. The inward curvatures of the spine or, if you prefer, the concave regions of the spine are termed lordoses (plural of lordosis); the outward or convex ones, kyphoses (plural of kyphosis).

In anatomy books, the lordoses are said to be cervical (in the neck region) and lumbar (in the lower back region) but in reality the lordoses both extend into the thoracic region. The important thing to understand here is that the kyphosis in the thoracic region of the spine is simply the meeting point of the two lordoses and is made of only a few vertebrae (from one to four).

 I would hate to sound pedantic but, for the sake of exactness, note that lordosis and kyphosis, in spite of what says The New Shorter Oxford English Dictionary, are normal, physiological curves. But beyond a certain degree, these curves are no longer normal and then we talk of hyper-lordosis and hyper-kyphosis which, I admit, are terms which are a bit of a mouthful.

Let’s turn now to the newspaper article.[1] The author describes how shocked she was to see herself on photos and videos of herself taken during a skiing holiday. Although she thought that she “always, always stand tall”, the photos and videos revealed a very different picture: one of a woman who looked a little stooped with “a real dowager’s hump”. This is a common example of faulty sensory appreciation that teachers of the Alexander technique aim to re-educate.

To remedy her condition, the author enlisted the help of a physiotherapist who gave her exercises designed to strengthen her neck and counteract her stoop and which consisted in regularly pushing her shoulder blades together, to direct her sternum to the ceiling and to bring her shoulders back and down. There was also three years of yoga and Pilates classes to strengthen her core abdominal muscles and improve her posture. Yet another film taken after this period revealed that not only her posture has not been improved in spite of her efforts but it had actually got worse!

Our author then went to see an osteopath who labelled her condition with, to her, a completely unfamiliar word: kyphosis. Wanting to know more about kyphosis, she visits a consultant spinal surgeon who told her that it was an increasingly common problem due to our modern lifestyles. And, it was sadly expected, the surgeon too recommends doing regular core strengthening exercises which, according to him, has “proven to be of benefit”.

A good part of the article is then devoted to blame our excessive use of phones and laptops which is suspected to cause ‘text neck’, a condition which can lead to back and neck disorders, including kyphosis, and could result in permanent spinal damage. It is said to be becoming an epidemic.

In spite of three years of conscientiously doing strengthening exercises which have done nothing to stop the evolution of her condition, the author tells us that she is persisting in doing more of this misguided regimen such as “trying to keep a straight back and pulling my navel into my spine to work my spine to work my abdominal muscles and strengthen my ‘core’”. In the 21^st century, even after the discoveries of FM Alexander and F Mézières, postural problems are still treated with the simplistic, symptomatic, reductionist, harmful and military-like admonition of ‘chest up, tummy in’! It is no wonder postures are not getting any better but rather deteriorate more.

You cannot have failed to notice that all the exercises given here are all of a strengthening nature: strengthening the mythical core, strengthening the neck and so on. The hump has to be erased, the spine straightened and it is believed that strengthening is the answer. Unfortunately, it can only make matters worse because there are no muscles covering the spine that can lengthen it.

Let’s go back to our lordoses. They are subtended by muscles which form what F Mézières called ‘muscular chains’ and which always end up too tight. As a result, our lordoses deepen and are drawn away from their natural position: in the most common cases the ‘cervical’ lordosis moves forward and down; the ‘lumbar’, forward and upwards. In other words, they move forward in relation to the kyphosis which then appears more prominent. And because humps are easier to see than hollows, the mind is fooled and  focuses on the(hyper) kyphosis which then becomes the target of our postural efforts when it is only a mere result of the excessive arching of our lordoses.

If your hunchback gives you the hump, stop trying to remedy it by strengthening muscles, ‘core’ or others - it can only aggravate your condition. Treat the problem according to anatomical evidence and not on misleading hunches.  It might sound counter-intuitive but to reduce your protuberant back you must decrease the excessive bow in your lordoses. And you will never achieve that by strengthening muscles.

References

1. Sharon Morrison. How your mobile can make you a hunchback. Daily Mail, Tuesday, January 19, 2016