The human spine has a natural "S" curve that makes it incredibly resilient. The four curves in the spine work together to support your head and body. If even one curve becomes flat it will change the way that the rest of the spine moves and make it more vulnerable to injury. Perform stretching and strengthening flat back syndrome exercises to prevent or fix a flat spine.
Curvature of the Spine
The four curves to the spine are the cervical at the neck, the thoracic where your ribcage is located, the lumbar at the lower back and the sacral at the bottom of your spine. The lumbar spine and cervical spine both curve in the same direction — forwards. The thoracic spine and sacrum at the bottom of your spine curve backward.
The curves of your spine allow it to bend to absorb forces from activities like landing, lifting something heavy and even running. By bending, the spine decreases the shock it receives in the same way that your knees bend when you land from a jump.
Flat Back Posture
If part of your spine starts to flatten out due to a change in posture, it affects the other parts of your spine by increasing the amount of force that the other parts of the spine experience. Flat back syndrome is characterized by a loss of normal curvature in your lumbar spine.
Flat back posture can be flexible or fixed. Flexible flat back has traditionally been treated with surgery. However, a study published in August 2018 by Journal of Physical Therapy Science discusses two patients whose flexible flat backs were successfully treated with traction and manipulation, performed by a medical professional.
Flat back syndrome and surgery are also related. If you've had part of your spine fused or fixed with a metal rod it can lead to postural problems like a flat back because part of the spine was manually flattened. Surgery causes a "fixed" flat back, meaning it can't be changed.
Flat Back Syndrome Exercises
1. Straight-Leg Deadlift
Use this exercise to practice strengthening your lower back muscles, such as the erector spinae and multifidus, which can help pull the lower back into lordosis.
How To: Stand tall with your feet shoulder-width apart, holding one dumbbell in each hand. Pull your shoulders back and stick your chest out. The dumbbells should be in front of you, resting against the front of your thighs. Lean forwards, keeping your shoulders pulled back, and stick your butt back, running the dumbbells down the front of your legs. Keep your knees as straight as possible. Continue to lean forward and stick your butt back until you can't go down any farther.
2. Seated Hip Flexion
The hip flexor muscles can pull your pelvis forward to help correct flat back syndrome. To make the exercise harder, use ankle weights.
How To: Sit in a chair or on a bench. Plant your feet on the ground with your knees bent at 90 degrees. Sitting tall, lift one leg up as high as you can, keeping your knee bent. Hold it for one second and then lower the leg back down and switch sides.
- Columbia Spine: "Flatback Syndrome"
- Journal of Physical Therapy Science: "Non-Operative Correction of Flat Back Syndrome Using Lumbar Extension Traction: A CBP® Case Series of Two"
- Journal of Physical Therapy Science: "Effect of Individual Strengthening Exercises for Anterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROMs of a LBP Patient with Flat Back"