Lordosis refers to the natural inward curve present in the neck (cervical spine) and the lower back (lumbar spine). These curves are designed to absorb shock and help balance the weight of the head over the pelvis, contributing to efficient walking. When this normal curve becomes exaggerated, it is known as hyper-lordosis or excessive lordotic curve, often creating a pronounced “swayback” appearance that requires targeted strategies for correction.
Defining Excessive Lordosis and Common Causes
Excessive lordosis, particularly in the lumbar region, creates a noticeable posture where the abdomen appears to protrude and the buttocks are pushed backward, sometimes called hollow back or saddle back. This exaggeration of the spinal curve is frequently a result of non-structural, acquired factors that lead to muscle imbalances, a condition known as postural lordosis. The primary mechanical driver of this condition is an anterior pelvic tilt, where the pelvis rotates forward, pulling the lumbar spine into a deeper arch.
This forward rotation of the pelvis is often the consequence of a strength disparity between muscle groups that control pelvic position. Weakness in the abdominal muscles and the gluteal muscles (glutes) allows the pelvis to tilt forward without resistance. This weakness is paired with tightness in opposing muscles, particularly the hip flexors and the lower back muscles, which become short and tense from prolonged sitting or poor posture. Weight carried excessively in the abdominal area can also contribute to this imbalance, as the extra mass physically pulls the back forward, exacerbating the curve.
Corrective Movement and Strengthening Exercises
Correcting an excessive lordotic curve relies on a consistent routine of strengthening and stretching to restore balance to the musculature surrounding the pelvis and spine. The goal is to strengthen the weak muscles that fail to hold the pelvis in a neutral position while lengthening the tight muscles that actively pull it into the anterior tilt. This two-pronged approach ensures that muscular retraining can effectively change the skeletal structure’s alignment.
Strengthening exercises must focus heavily on the abdominal muscles and the glutes, as these muscle groups function to rotate the pelvis backward, counteracting the anterior tilt. The pelvic tilt exercise is foundational, involving lying on the back and flattening the lower spine into the floor by tightening the abdominal and gluteal muscles. Glute bridges are effective for engaging the gluteal muscles and hamstrings to lift the hips while maintaining a stable, non-arched lower back. Planks and side planks are also valuable additions, as they promote core stabilization and help the body maintain spinal alignment against gravity.
Stretching for Flexibility
Stretching the tight muscles is equally important for long-term correction, with the hip flexors being a primary target due to their strong connection to the front of the pelvis. A kneeling hip flexor stretch can be performed by kneeling on one knee and gently shifting the weight forward while tucking the pelvis slightly backward. Hamstring stretches also play a role, as weak or tight hamstrings can contribute to the overall muscular imbalance. A simple knee-to-chest stretch performed while lying down helps to gently flex the lumbar spine and relieve tension in the lower back muscles.
Integrating Better Posture into Daily Life
While formal exercise is important, correction must also be integrated into daily habits, focusing on continuous awareness and environmental adjustments. When sitting at a desk, the goal is to maintain the ears, shoulders, and hips in a roughly vertical line, using a lumbar support or a rolled towel to maintain the natural, slight inward curve of the lower back. Regularly getting up and moving is also important, as extended sitting shortens the hip flexors and weakens the core musculature.
When standing, it is helpful to avoid the habit of “locking” the knees and instead keep them softly bent, which encourages the gluteal and core muscles to engage slightly for support. Distributing weight evenly across both feet and consciously avoiding allowing the pelvis to tilt forward are simple adjustments. The standing posture should feel tall, with the chest gently lifted rather than the ribs flaring out, which is a common compensation for an excessive lordotic curve.
Sleeping posture also influences spinal health during the many hours spent resting. For those who sleep on their back, placing a pillow beneath the knees can help flatten the lower back and promote a more neutral pelvic alignment. People who sleep on their stomach, a position that naturally encourages an exaggerated lumbar curve, may find relief by placing a thin pillow directly under their hips or lower abdomen.
Medical Management and Treatment Options
For many individuals, correcting hyper-lordosis can be achieved through consistent exercise and lifestyle modification, but professional medical guidance is necessary in some cases. If the excessive curve is rigid, meaning it does not lessen when bending forward, or if it causes persistent pain, a consultation with a healthcare provider is recommended. They can rule out less common structural causes, such as spondylolisthesis or congenital conditions, which may require different interventions.
Physical therapy (PT) is a common initial treatment, offering personalized guidance on strengthening and stretching routines tailored to the individual’s specific muscle imbalances. A physical therapist can also utilize specialized techniques to improve spinal mobility and function. Medications, such as over-the-counter pain relievers or anti-inflammatory drugs, may be recommended temporarily to manage discomfort and muscle spasms associated with the condition.
In children or adolescents whose spines are still developing, a brace may be prescribed to help guide the spine toward a straighter alignment. Surgery is reserved for the most severe cases of lordosis, typically when the curve is extreme, causes neurological symptoms like numbness or tingling, or has failed to respond to non-surgical treatment. Surgical intervention, such as spinal fusion, aims to correct the deformity and reduce associated pain.