Kyphosis is a common condition of the upper thoracic spine that gives the spine an excessive forward curve. Minor postural kyphosis of 20 to 40 degrees is common; however, hyperkyphosis -- more than 50 degrees -- is usually due to vertebral disorders like osteoporosis or Scheuermann's disease. The bone has weakened and become more wedge-shaped than rectangular. In the case of osteoporosis, simply bending forward as you would during a sit-up could be enough to cause small stress fractures. Upper back and core stability and mobility are extremely important for anyone with this condition, to maintain posture and prevent further damage.
The Sit-up
When you hear core training, you may immediately think of the traditional sit-up. A major concern with the sit-up is too much flexion in the thoracic spine and not enough mobility and lengthening in the lumbar spine. The movement should be linear, lengthening the spine one vertebra at a time, like rolling over links on a watch band. Form is compromised when the lower back and hamstrings are tight and rectus abs are just not strong enough to bear the weight. When the upper spine is already in flexion, the lower spine doesn't have the leverage it needs to lengthen without some type of ballistic movement. This can be dangerous even for a healthy spine. You can increase leverage and allow the spine to flex in a more natural curve by increasing the angle at the knees, lifting the feet slightly off the floor, placing a rolled-up towel under the small of the back, and pointing arms straight alongside the thighs.
Kyphosis and Core Training
According to the National Osteoporosis Foundation, activities like sit-ups that place stress on the spine can increase the likelihood of breaking a bone and should not be performed. For a healthy spine to flex properly, all vertebrae must work together to provide leverage to safely bring the sternum toward the pelvis. Proper form and changes in leverage may work for a healthy spine, but for anyone dealing with kyphosis, it can be very difficult and dangerous to perform traditional core exercises that are weight-bearing and require bending forward. When the upper spine is already in a semipermanent state of flexion, it increases the risk of hyperflexion.
Change the Exercise
Weigh the risk and the reward of any exercise, especially if you have any type of spine disorder. Alternative exercises like pulse-ups and reverse crunches hit the lower abdominals and offer lumbar flexion, but it is still flexion. Depending on the condition of your vertebrae, lumbar flexion might not be desirable. Talk to your doctor about the condition of your vertebrae and what movements are safe for you specifically. Consider exercises that focus on full core strength using neutral spinal alignment, like the plank, side plank, and leg raise.
Considerations
Core training will help improve posture and assist with power for other compound movements. Movement of the spine, rocking of the vertebrae, is also the only way to provide the disks with the blood flow and nutrition they need to stay healthy.
References
- Mayo Clinic on Osteoporosis; Stephen Hodgson, M.D.
- National Osteoporosis Foundation: Protecting the Spine From Kyphosis
- Northwestern Health Sciences University: Avascular Necrosis and Related Disorders
- Journal of Neurology, Neurosurgery & Psychiatry: Effects of Flexion-Extension Movements of the Head and Spine Upon the Spinal Cord and Nerve Roots
- The Journal of Bone & Joint Surgery: The Pathogenesis of Idiopathic Scoliosis. Biplanar Spinal Asymmetry
- Spine: Correlations of Spinal Mobility with Degree of Chronic Low Back Pain After Correction for Age and Anthropometric Factors
