Lumbar Lordosis – A Guide on Treatment, Prevention & more

3

 

Introduction to L. Lordosis and LBP

Given the very physically demanding nature of running, the body is exposed to a multiplicity of external stressors which can give way to injury, especially when running outdoors because the ground is not level and any number of obstacles can be in the avid runner’s way. These stressors can become very frustrating to deal with as they might become symptomatic and painful. Then, factor in trying to maintain the often strict training regimens needed to meet the demands of planning for running events, and the result on the body is not a pretty picture.  So it is very important accurate information presented cowritten by Jessica Sommerfield and curated by Diana Rangaves, PharmD, RPh be taken as a whole and discussed with your health care provider. What can best be described as a tough as nails “no-quit” culture involved with runners, having a stubborn attitude can go from what was once just a frustrating annoyance to deal with, to develop into a symptomatic issue halting running goals and progress altogether—seriously, remember to take time to adequately rest, runners.

 

Lumbar-Lordosis-Women-Runner

 

Lower back pain (LBP) can become one of these many symptomatic issues for runners, and like many of the other preventable potential issues from running, it is likely a result of overuse. So racking up the running mileage is not inherently an issue if done properly, but it should be noted that lower back pain like this can be developed from inadequate preparation, form, and rest, after the stressor of running is introduced.

A cause of LBP is called Lumbar Lordosis, and this is one issue that every runner should know how to address, treat, and prevent. So, this article will lay out in an easy, interesting way, what Lumbar Lordosis is, so that injuries can be avoided, and personal running goals can be met. 

 

What is Lumbar Lordosis?

Where some animals called invertebrates do not possess a “spine”, humans are gifted with this fantastic and complex structure which allows for an equally complex range of motions, increased bodily support—more so than invertebrates— and structural integrity during the demanding tasks of life and running.

Standing to either side looking at an individual facing forward, the healthy spine should follow a gentle curvature, where unhealthy deviance in it might even be noticed just with our eyes alone. These curves are not just for looks too, they play a key role in helping absorb stress load during movement and the constant force of gravity that our bodies bear daily; whether that is in running, other recreational activities, or day to day jobs that require heavy lifting, the spine supports it all.

 

Lumbar-Lordosis-normal-spine-curvature
Normal spine curvature

 

As a refresher in anatomy, because it has been a while since highschool, remember that the spine is a major backbone made up of many smaller bones stacked vertically called vertebrae— 33 to be exact. Each of these 33 vertebrae has a cartilaginous disc between itself and its relatively alike neighbor, stacked vertically above and below, which allows them to act cohesively by gliding and cushioning during movement articulations. Then, on a larger picture, the spine is divided into three regions: cervical, thoracic, and lumbar to further describe it.

“Lumbar” is a word derived from the latin root “lumbus” given to the lower back region, it is translated in english to mean “lion”. So, lumbar spine refers to this lower back region where the spine curves inward toward the abdomen. Basically it starts around 5 or 6 inches below the shoulder blades of the back, then connects with the thoracic spine (middle of the spine) at the top, and finally extends downward toward the sacral spine (the bottom of the spine).

So why call the lumbar region “lion”? The lumbar region is called “lion” because the lumbar is primarily built for power and flexibility, via lifting and twisting, some of which is experienced during running. And, because the lower back has such a high task to serve, it is also an area prone to failure should it be over or improperly used, like in the case of  “Lumbar Lordosis”.

 

Lumbar-Lordosis-lumbar-twist-sprint

 

In spine terminology three words are used to describe when the natural curvature is misaligned or exaggerated in areas: kyphotic, scoliotic, and lordotic. Now do not feel overwhelmed by latin terminology, it is just a fancy way to explain very basic concepts. Kyphotic spinal curvature is often referred to as “hunchback” and is what Quasimodo suffered from in the Hunchback of Notre-Dame.

The term “scoliosis” is a commonly used medical term, it is derived from the word scoliotic, where the spine is curved to the left or right of its normal midline. Last, lordotic refers to an excessive inward curve in the spine, which is where the term “Lumbar Lordosis”, or “swayback” as it is also called, comes from. Lumbar lordosis can become damaging over time if prolonged during running, where the angle that the hips and the spine hold during improper form cause a hyperextended lordosis and resultant excessive pressure and strain in areas not meant or trained to receive it.  

 

Symptoms

Being able to recognize symptoms early on is a learned practice that could prevent permanent damage during running. This requires mindfulness, time, and patience to address what might be causing the issues.


Here is a list of common symptoms related to lumbar lordosis to look out for:

  • Developing a c-shaped back which can be seen when viewed from the side profile of an individual. The buttocks will noticeably be sticking out as well.
  • When lying on the ground, look for a large gap between the lumbar lower back portion of the spine and the ground when relaxed.

 

Lumbar-Lordosis-symptoms
https://upload.wikimedia.org/wikipedia/commons/b/b5/Lordoz.jpg

 

As mentioned earlier, LBP and discomfort can result from prolonged lordosis. Sciatica is another name for this condition. Sciatica is described as being caused when a nerve root in the lower spine is compressed, in this case by lordosis, and manifests itself in a variety of ways:

 

Lumbar-Lordosis-lower-back-pain-symptoms

 

More common symptoms of sciatica:

Symptoms as they relate to running:

According to most research done on lumbar lordosis it is mainly going to cause LBP as a symptomatic issue for runners. The good news is that in most cases of lumbar lordosis during running is completely reversible with the right instructions and practice. This is why it is important to make sure proper running form and muscle memory is implemented before attempting more serious running goals and distances, leaving no room for negative feedback loops such as lumbar lordosis, which generally is a form issue, to develop.

 

Lumbar-Lordosis-proper-posture

 

As previously stated LBP issues can be a direct result of lumbar lordosis and it is going to affect overall running performance when compared to those without, especially in the long run— no pun intended. People with LBP have a reduced range of motion in all directions of movement, slower lumbar movement, and poorer proprioception—”proprioception” meaning their nervous system functioning and awareness of surroundings. Reduced postural control is also a result of LBP.

 

Causes

The common causes of lumbar lordosis are:

  • Achondroplasia: This is where a person’s bones do not grow normally throughout maturation, often resulting in a short stature. The term “dwarfism” is associated with achondroplasia.
  • Spondylolisthesis: This is a vertebral disc and bone disorder where a vertebrae slips forward onto the bone below it. Both genetic and physical factors influence this.
  • Osteoporosis: This is a condition in which vertebrae become fragile and break easily.
  • Obesity: This is a condition defined as a person’s body weight being at least 20% higher than it should be given an individual’s body metrics. If a person’s Body Mass Index (BMI) is between 25 and 29.9 they are considered overweight, if over 30 they are considered obese.
  • Kyphosis: This is a condition which causes the upper back to become haunched and abnormally rounded.
  • Discritis: This is where inflammation of the disc space between the bones and spine occurs, it is most often caused by an internal infection.

 

Lumbar-Lordosis-causes-obesity

What are the other causes of Lumbar Lordosis?

When you are seated, the following are bound to happen: the top of the legs become closer to the torso, the hips become flexed, and the gluteus also gets more active. This type of compressed seating position can lead to the restriction and tightening of the soft tissues and the muscles at the hips top. These muscles are referred to as the hip flexors. But again, when you start to rise up, the mentioned structures of the soft tissue becomes so inflexible that the hips get a very hard time in pushing forward to allow you stand up in a straight manner. This tightness experienced at the hips’ front also has some side effects to the body. It also restricts the gluteus from carrying their job effectively and pushes the hips in a forward manner. It is a pattern that can affect the functionality of some of the body parts.

It really does not matter whether too much lumbar lordosis is caused by tight hip flexors or weak gluteus. What matters is addressing the two variables to allow the hips to have an extension. This will in turn make the lumbar lordosis stop excessive arching and keep you safe at the end.

How To Assess For Excessive Lumbar Lordosis

It is very easy to evaluate if a person has an excessive lumbar lordosis. The first thing you will do is to ask the patient to stand against a space that is flat such as a wall or a door. They should be able to stand while their back is against the wall with buttocks, heels, head and shoulders touching the wall. You should then place your hand, (with the palms down) on the surface of the wall and then slide it behind the lower back.

Once you have done that, the next thing you are supposed to do is to evaluate the space between the spine and the wall. To know that a person has an acceptable level of lumbar lordosis, you will just push your fingers behind the lower back as you move up. Move up the point where the fingers will be able to meet the hands. You will notice that the person has an excessive lumbar lordosis if the space between the wall and the back is big enough for you to push in your entire arm or hand through it. The greater the space that exists between the lower back and the wall, the more extreme the imbalance or deviation is.

During this assessment, if a person has a big gluteal complex and the tailbone does not get in contact with the leaning surface, then it will be important to make an allowance for the extra space. You can also apply your best judgment to identify whether the lumbar curvature is in excess.

You can correct the excessive lumbar lordosis using a balance trainer.

The place where the hips, spine and top of the leg come together is a very significant body’s articulation that allows us to walk, stand and play. Whenever there is a dysfunction or weakness in this area, the other muscles ensure that the area is splint and kept in a stable condition. It is for that reason why a number of people especially runners encounter a tight lower back. When this happens, the lumbar erector muscles are forced to work even more hard to make up for the weakness in another section of the body such as the glutes. The lumbar spine muscles can be made to release and subsequently reduce the excess lumbar lordosis. This can be done by strengthening the muscles around the lower back in a simultaneous way. Others can also be stretched.

The Balance Trainer has a dome shape that is ideal for carrying out exercises for the lumbar spine. This type of exercise should be done while the patient is lying in a prone-like position. Apart from flexing the lumbar spine, this device will also tilt the pelvis. This process will ensure that the tension encountered to the lumbar erectors is greatly reduced. The Balance Trainer dome also has a kind of air that can be helpful in providing resistance during the serious stretching activities. This air is capable of contracting and relaxing a group of muscles by simply pushing into the surface of the dome. The relax & contract technique used here greatly mimics the manner at which muscles responds to real life movements and give the body an opportunity to respond to various stretches in an effective manner.

The Balance Trainer tool is therefore the best tool that you can use to alleviate back pains that comes as a result of too much lumbar lordosis.

Risk Factors

Lower back pain which can be onset by lumbar lordosis is a significant healthcare issue in America. According to a recent study, more than 70% of Americans have experienced at least one episode of LBP in their lifetime. In fact many people reading this article likely know a part of that 70% who are suffering from LBP, if not the reader themselves.

Lumbar lordosis if not treated and taken care of properly can lead to:

  • Lumbar disc herniation: where the soft center of a cartilaginous disc forcibly pushes its way through the harder exterior casing, leading to pain.
  • Disc degeneration: the discs between vertebrae do not have a blood supply and very few nerves, so damage to them is not recognized until significant and after being damaged because there is no blood supplied to them they do not heal.
  • Sciatica: this is characterized by pain typically felt down one leg, not past the knee. Felt as a severe burning or tingling instead of dull ache. Felt significantly after sitting for long periods of time and somewhat relieved while walking or moving.

Is Running Harmful To Your Lower Back?

Back pain has grown to become very common with a high percentage of the total number of people. 70% of the world’s population at least experiences this condition about at least once in their entire lifetime. But when it comes to back pain in runners, certain few questions should be answered. Does running cause additional stress on your back? If that is the case, then does it expose you to higher risks of injury? What are the main causes of this menace in athletes? Those are some of the areas that much attention should be turned to.

Lower Back Pain In Runners

Research carried out some few years ago used a very innovative means of measuring stress on the back of an athlete while  running on the racing tracks. This particular study surmised that the impacts that are absorbed by the back when an athlete is running affect the spine’s general length.  The heights of a group of marathon athletes were measured- some of who had encountered lower back pain in their lives. This was done before and after completing a series of a thirty-minute race at 70, 85, and 100% of a pace of the marathon. At the end of the study, a huge correlation between running speed, spinal shrinkage, and the distance covered was found to exist. It revealed that the longer and faster you are able to run, the shorter you will get. This is however temporary.

The amount of shrinkage, on the other hand, was small but had to be noticed. After a thirty-minute race at the pace of a marathon, the heights of the athletes dropped by close a half of an inch. What is even more important is that the study revealed that the level of spinal shrinkage was not connected to whether the athlete in question had experienced lower back pain in the past. This is clear evidence that the spine is fully equipped to manage the loads that are involved with running, even at speeds that are a bit fast.

 

Lower Back Pain In Elite Athletes 

There have also been more other studies to reveal the relationship that exists between lower back pain and running. In certain samples, the researchers went a bit further to examine the MRI scans of this condition of close two dozen of different partakers in the fields of sport. Those who were examined were the weightlifters, runners, soccer players and even shooters. Lower back pain was discovered to be less common among the runners than the entire population.

In the studies, the soccer players and weight lifters were found to have a high rate of disc bulging and degeneration in the area of their lower back. Shooters and runners, on the other hand, were very different than the entire population.

Despite the fact that runners seemed to have healthier backs than the weight-lifting and sedentary controls athletes, the research found no drawback or benefit to training loads that are heavier in the runners in regards to preventing the back pain.

Another study to determine the possible causes of back pain in runners was also carried out some time ago. The hip flexibility of various runners was evaluated and then compared to that of sedentary subjects’ control group. The runners who were evaluated had a very limited ability to be able to flex their knee and hip straight. This was a clear indication that they had a considerably tighter hamstring muscles if put into contrast with the control group.

There was no any major difference between the control groups and the runners in regards to the matter of hip extension. However, the two groups had excessive tightness owing to the idea that most of the subjects sat for almost half or more of the day. Hip flexor tightness, in a way, could affect the back pain by suddenly pulling the pelvis into a position that is more forwardly rotated.

The back seems to be properly adapted when it comes to handling the stresses that are caused by running. This is due to the fact that there is no apparent increased deterioration in the spines of runners who have been in this game for a long time. It even seems to be an advantageous effect when it comes to low back pain and running. A reduced number of runners report cases of lower back pain as compared to others of the general population. However, a thorough scientific work on treatments and causative factors for low back pain in runners seems to be missing.

 

What is Cervical Lordosis?

This is a curve that is located in the cervical spine, a location of the spine that holds the neck vertebrae. This particular curve is fully normal and even very desirable since it assists in providing stability to the spine and head. The problem only comes when it straightens out, faces in the wrong direction or becomes too deep all over sudden. There are a number of treatments that are available for this condition, and all of them should be overseen by a spinal care health professional.

In a normal and healthy and normal spine, the cervical lordosis appears like a very broad C. the C actually points towards the side of the neck. The C can then start to straighten or bows in another direction in a strange condition known as Kyphosis.

 

What Are The Causes?

Several contributing factors have been identified as the triggers of this condition that affects even runners. In most instances, it is an inherited condition. It can also happen as a result of trauma, injury, and strain to the neck or even stress. In other cases, it can also occur as a result of neglecting to keep and maintain a proper posture. The other cause that is also known is obesity. Obesity is a condition that can affect the center and balance of the body by providing an unnatural strain and weight to the body making the body ill-equipped to maintain and support the posture.

 

How Do You Treat The Cervical Lordosis?

 

When the problem is detected earlier enough, there are several treatment options that can be administered immediately. When this is done, you will not have any complications later on. A physician will be able to diagnose alterations to a healthy cervical lordosis upon a completion of a physical exam with MRI’s and the X-rays.

To help with regaining a good posture, those suffering from cervical lordosis may consider undergoing physical therapy or chiropractic care. These two treatments have been proven to be effective as they strengthen the spine properly.

There is also a list of other items that are instrumental when it comes to treating this condition. They include special traction wedges that are used to correct the nerves at home, a support pillow to offer stability to the neck, and orthotics that are used to maintain the right posture when walking or standing.

When it becomes serious, surgery may be recommended for some patients. The lack of cervical curve will make people quickly go out of spine alignment. You will, therefore, experience more pain and discomfort at certain times. When this happens, do not hesitate to see your chiropractor.

Lumbar-Lordosis-leading-to-hernia
Herniation

 

Diagnosis

Lumbar lordosis can be diagnosed using a combination of previously recorded personal symptoms and measuring tools to find joint angles from three different planes of measurement. This method of calculation factors in angles from the spine, body-trunk, hips, and knees. The spine angle is calculated as the relative angle between the trunk of the body and the pelvis segments. This is then used to detect deviance from the spine’s natural placement, which should be directly midline down the back, following a gentle curvature when viewed from the side making a natural “S” shaped curve.

 

Lumbar-Lordosis-Diagnosis-posture

 

In some cases advanced motion-tracking computer technology is used to track specific points placed throughout the body. Researchers have used computer methods to study the effects of lordosis, kyphosis, and scoliosis on people during motion, such as running giving insights into proper form and function and long term results of improper form as detailed in this article.

A normal healthy spine should exhibit a cervical region—remember this is the upper portion of the spine connecting to the head—with a lordotic curvature; a thoracic, or middle portion, with a kyphotic curve; and a lumbar portion with a lordotic curve. This natural lordotic curve is not excessive and hyperextended as in lumbar lordosis. The spine should run perpendicular, up and down the back, right in the middle between the shoulder blades. When abnormalities occur it is due to factors and forces causing a misalignment or exaggeration of areas resulting in lordosis (excessive inward bend), kyphosis (excessive outward bend), and scoliosis (excessive side bend).

The Changes In Environment And Excessive Lumbar Lordosis

The body of a human is designed to be upright, regardless of your belief in creationism or evolution. There are two very significant elements that help the body to maintain that upright posture. The first one is a situation where the hips are pushed forward by large gluteus maximus muscles into extension. The second situation is where the spine is arched upward and backward by a curvature of the lumbar spine so that it can lift the torso on the hips’ top.

The environment in which we reside and the tasks we do to sustain that living has really changed over the past century. Prior to the availability and invention of modern staples like computers, televisions, stationery bicycles and automobiles, people still spend much of their time carrying out different types of activities as well as movement from one corner to the other. The technological advances that have been introduced in the recent past just mean one thing: most of the people now spend a majority of their time sitting down. When one is seated down, the hips and the butts becomes behind them, possibly supported by a seat or a chair.

The whole spine then bends forward into a flexed and rounded position. When you are seated down, the gluteal muscles no longer perform their role of supporting the spine and hips; the work is all done by the chair you are sitting on. Therefore when you are needed to stand up, the gluteus will not be strong enough to be able to make the hips create a quality support base for the spine when they are pushed forward. To add on that, there is another area that would also suffer from the effects of prolonged seated positions, and that is the thoracic spine. The thoracic spine has a natural curve that is slightly forward. It is located in the midst of the upper back. This thoracic curve would become excessive after an extended period of seating and even cause more harm to a part of the spine. Section of the spine would, as a result, lose its ability to arch in a backward way and help in standing erect.

The dysfunctions at the upper back and hip mean that the duty of lifting the torso upright lies with only one single structure in the body, and that is the lumbar spine. In the lumbar spine, there is a natural curvature that is designed to lift the torso upward. However, the lordotic curve becomes so heavy when it is used to maintain and achieve the upright posture excessively. This is what is known as excessive lumbar lordosis. This condition can bring in the degeneration of disc, wear and tear to almost all the structures of the lumbar spine and other soft tissues around that area, and compression of the nerve root.

 

Lumbar-Lordosis-diagnosis

 

Treatment

Keep in mind that this is not an official diagnosis and health professionals should be seen for one, but according to recent research studies done these treatments have shown to be the most successful when treating persons with lumbar lordosis and LBP:

  • Medication or painkillers to relieve pain and swelling in the back or surrounding regions.
  • Exercise and physical therapy to increase muscle strength and flexibility.

During excessive lordosis the back is abnormally curved, some muscles are stretched and tightened abnormally which can cause or exacerbate LBP. To reduce the tightness of muscles, perform exercises that stretch the tightened areas, such as the commonly problem causing lower back muscles and hip flexors that extend from the groin area into the back. Stretching these areas through daily exercise and routine helps relieve symptoms of lordosis. The key here is to develop a consistent routine as the therapy will take time. It is also important to keep in mind when constructing a muscle strengthening routine for lordosis that the buttocks and hamstrings tend to be weakened as a result of lordosis and should be focal points of a strength routine.

When selecting muscle building exercises bear in mind that a number of factors play into postural misalignment through lordosis, such as:

  • Weak Core Muscles
  • Tight Hip Flexors
  • Poor Exercise Form
  • Weak Gluteal Muscles

It is important to select muscle building exercises that address these areas, promoting back alignment. Good muscle building exercises for lordosis often occur with the participant lying on their abdomen, this is because while lying on the stomach a person is most likely going to engage their back muscles to do more of the work.

Some recommended exercises to learn:

  • Abdominal Crunches
  • Leg Curls
  • Seated Leg Press

 

Lumbar-Lordosis-treatment-seated-leg-press

 

As mentioned previously, stretching can be one powerful tool to use in combating the symptoms and progression of lumbar lordosis. While there are many ways to go about stretching: dynamic, static, progressive-loaded, etc. Detailed below are a few great exercises to begin with and supplement a further research journey:

The Lower Back Stretch

  1. Sit in a chair and lean the body forward, placing head and arms between legs.
  2. Reach arms as far through legs as comfortably capable.
  3. Now rest and return to starting position.
  4. Perform this exercise multiple times as comfortable.

Hip Flexor stretches:

Due to the biomechanical process called “reciprocal inhibition”, which describes when muscles on one side of a joint relax to accommodate contraction on the other side, when the hip flexors are chronically tight the glutes, which is their opposing muscle group, become weak. This as a result has an adverse effect on a person’s pelvic alignment.

Here are some ways to stretch the hip flexors:

Kneeling Hip Flexor Stretch

  1. Start in a kneeling position.
  2. Place a foot on the ground directly in front as if performing a modified lunge.
  3. Now lean forward slightly until a stretch is felt in the hips— do not allow the forward leg’s knee to go over the ankle as this can overly strain the leg.
  4. Move in and out of the stretch comfortably, alternating legs.

 

Lumbar-Lordosis-hip-flexor-stretch

 

Foam Roller

Known as a “myofascial release” which is basically a relaxation of  muscle fibers through stimulation, this method provides the benefits of both massage and stretching.

  1. To begin, lie prone, aligning the hip flexors with the center of a foam roller.
  2. Allow the body weight to push into the roller, do not be afraid to dig into it.
  3. Wait approximately 30 seconds in this position and alternate.

 

Standing Hip Flexor Stretch

The hip flexors can also be manually stretched while standing, this stretch also works the buttock and deep abdominals, the muscular core of the body.

  1. Lung forward on one leg.
  2. With one leg extended behind try to straighten it and feel stretch in hips.
  3. Now hold this position for 30 seconds.
  4. Alternate legs.

Standing Hip Flexor Stretch

The hip flexors can also be manually stretched while standing, this stretch also works the buttock and deep abdominals, the muscular core of the body.

  1. Lung forward on one leg.
  2. With one leg extended behind try to straighten it and feel stretch in hips.
  3. Now hold this position for 30 seconds.
  4. Alternate legs.

Gluteal Activation Lift Exercise

The main purpose of this exercise is to wake up the gluteal muscle that is charged with the role of extending the hips. The gluteal activation lift exercise will assist you to get the hips under the torso while you are standing. This will in turn lower the offsetting excessive arching felt at the lumbar spine.

The directions of movement

You should begin by lying facing down while the center of your hips is on top of the balance trainer dome.

  1. To decrease the arch in the lower back, tilt the pelvis
  2. Lift just a single leg from the ground about three to six inches. This should be done without arching the lower back.
  3. Return your leg to the ground
  4. Perform ten repetitions on the two legs

Toe Touches With Pushdown Exercise

The muscles that are greatly responsible for arching of the lower back are known as the lumbar erector spinae muscles. These muscles have a tendency of becoming restricted and tight patients that suffer from too much lumbar lordosis. The rectus abdominus is the opposing muscle group of the erector spinae, and it is the one responsible for flexing in the spine.

The directions of movement

  1. Stand behind the Balance Trainer and reach down so that your two hands are flat on the surface of the dome.
  2. If you have trouble going down that far, then bend your knees
  3. Push down gently into the balance trainer dome. This will be able to engage a muscle known as the rectus abdominus. It will then release the erector spinae muscles’ antagonist.
  4. Hold stretch for about three to five seconds, then return to the starting position and repeat the process.

 

Lumbar-Lordosis-standing-hip-flexor-stretch

 

Exercises to avoid:

Performing exercises with proper form is important in order to prevent further injury. Those with lumbar lordosis should avoid certain exercises because they may be difficult to perform without the proper practice and form.

Until the condition is corrected, try to avoid these movements:

  • Squat
  • Hack Squat
  • Military Press
  • Roman Chair Sit-Up

 

Wearing a Back Brace can help

Motion of the lumbar spine can delay healing in spinal fractures or postoperative fusions. With lumbar lordosis a back brace may aid in restricting movement and has been found to decrease LBP and discomfort for a time. There are currently two popular back braces to choose from, each with their own advantages and disadvantages:

  • Rigid Braces

These are braces that are made from form fitting rigid plastic materials, such as the Boston Overlap braces or the Thoracolumbar Sacral Orthosis (TLSO). If the brace is fitted properly it has been found to restrict at least 50% of all lower back movement. Patients that wear these braces do complain of overheating in them and because of the rigidity, it may become uncomfortable to wear. This kind of brace is only meant to be worn while standing, and should be taken off at night or while lying down.

 

Lumbar-Lordosis-TLSO-brace

See them here: (TLSO)

 

  • Corset Braces

Sometimes these braces are recommended to limit the motion of the lumbar. This kind of brace does not allow a person to bend forward. People with jobs involving routine heavy lifting sometimes wear corset braces to prevent lower back injury, or help a previous injury heal. These act by limiting motion and serve as a reminder to keep proper posture during work, requiring a person to properly engage their leg muscles instead when lifting.

 

Lumbar-Lordosis-Corset-Brace

See them here: (Corset Brace)

 

Weight Loss

People that are overweight or obese may experience LBP, sciatica, and more which can be onset from lordosis. Losing weight can reduce stress on the lower back over time and strengthen the lower back and surrounding core muscles, depending on the exercises used to lose excess weight. Healthy eating can also improve the body’s ability to heal as well as lose weight.

 

Surgery

If lumbar lordosis persists over time it may lead to permanent damage in the lower back such as disc degeneration or slipping. When this happen surgery becomes a viable option to fix LBP. Instruments are installed on the spine such as hooks, rods, wires, attaching to the spine to realign the bones of the spine and keep them secure following injury. Surgery should always be considered as a last resort as it can lead to permanent restriction in movement, and there is a risk of rejection or infection following the implants.

Here are some common lower back surgeries:

Spinal Fusion

This is a major surgery lasting for a few hours in the operation room. It is meant to join or fuse two or more vertebrae in the back. In order to fuse the bones a bone graft can be taken from the pelvis bone or a bone bank, and is grafted onto the vertebrae in order to make a bridge between them. Metal implants are often used in conjunction with the grafts to hold the vertebrae in place until the graft is finished fusing and healing. Some risks of this surgery are: pain at the bone graft site; failure of the fusion, breakage of the metal implants, or both; blood clots which may lead to a pulmonary embolism—which is a very serious instance where an artery in the lung is clogged; nerve injury; graft rejection; or infection.

 

Lumbar-Lordosis-spinal-fusion-treatment-surgery

 

Artificial Disc Replacement

This surgery is often needed when disc degeneration occurs.

Disc degeneration is when the cartilaginous discs between vertebrae become damaged by natural causes or a twisting injury where the inner and outer portions of a disc may tear or break, irritating the nerves on the outer edge of the annulus—which is just a fancy term for vertebral disc.

A micromotion instability can be caused from disc degeneration because the discs can no longer hold the vertebral column together as well as it used to. Keep in mind that the discs themselves already have no blood circulation and very little nerve endings. Without a blood supply they are not able to heal themselves like other portions of the body can.

 

Lumbar-Lordosis-disc-degeration

 

Pain from damaged discs can last for years if not treated, felt as either chronic pain or flaring up occasionally. Disc degeneration and the symptoms resulting are commonly felt from ages 30 to 60 years old, but can be onset by injuries during lumbar lordosis. Lumbar artificial disc replacement “total disc replacement”  is used to treat lumbar lordosis. This surgery is used to treat painful, injured lumbar discs. It does not restore complete spine range of motion, but will maintain some form of motion and reduce pain which is important in keeping the rest of the spine healthy. Keep in mind that disc implants may wear out after 10-20 years following surgery, and infection at the area of operation can occur, but is rare.

 

Prevention

Prevention of lumbar lordosis is possible if the signs and symptoms are recognized before permanent injury can occur. At the first sign of symptoms pay careful attention and rest from suspected activity, which may be causing them, to avoid overuse and permanent injury.

The following are ways to prevent lordosis and resultant LBP from happening during running:

  • Back muscle strengthening exercises
  • exertive exercises
  • Do not sit hunched, slouched, or remain in improper posture for long periods of time, the spine is created to flex and move in a variety of ways. Some jobs require remaining stationary, get creative in implementing ways to move: medicine ball chair, standing desk, even a treadmill desk can help.
  • Lower back braces, especially corset braces, have been found to teach by reminding to keep proper posture. And if injury has already occurred they can reduce chance of further injuries to the lower back area by restricting movement and allowing to heal.

 

Lumbar-Lordosis-back-strengthening-exercise

 

False Positives

False diagnoses of lumbar lordosis is not generally something to be worried about as it is fairly simple to diagnose using calculations of angles as they relate to the pelvis, spine, and knees and the common corresponding symptoms laid out in this article.

When trying to treat their own symptoms an individual may confuse the lordotic excessive inward bending of the lower back with either kyphosis or scoliosis and should be careful to understand the differences between them in order to address a change in running. Progressive injuries to the lumbar region of the back can also be confused with lumbar lordosis, such as disc degeneration or disc slipping caused by another force, perhaps by over twisting, called torsion, during exercise.

 

To Sum It Up

Lumbar Lordosis is the excessive inward bending of the lumbar region of the back, the region which in latin means “lion” because it is built for the power and flexibility required during lifting, twisting, and bending which happens in everyday lives.

Lumbar Lordosis can become an issue during running if not corrected as it puts strain and pressures in areas of the lower back by misaligning the natural “S” curve which is by nature designed to absorb impact forces most effectively. As a runner it is important to be aware of any painful symptoms and not stubbornly push through them, as this can result in permanent damage to either the vertebrae or discs lying between them.

 

Lumbar-Lordosis-runner-stretching



This is a treatable issue if caught soon enough and is most likely caused by poor running form. In this case the runner should research and learn from experts about proper running form and alignment to avoid further irritation to the lower back. If pain already exists it is recommended to rest from running or wear a corset brace until the pain has subsided and then try to address the running form in practice. Other causes of lumbar lordosis include being overweight or obese, and weak core-muscles which may need to be strengthened through training, something that runners may neglect while exercising primarily the cardiovascular system when running.

If the advice suggested in this article to address lumbar lordosis does not bring relief from lordosis pain, see a licensed physician for spinal examination. This is especially important if the back is becoming progressively difficult to stretch or is more inflexible after the exercises detailed. It should also be noted that in some studies the use of abdominal muscle strengthening exercises and stretching exercises of the back and one-joint hip flexor muscle to correct faulty posture is questioned for its efficacy in treating lumbar lordosis.

Co-written by Jessica Sommerfield

Curated by Diana Rangaves, PharmD, RPh

Sources Used While Conducting Research

Research for this article has been done with reputable sources that have been linked below for the convenience, trust, and cross evaluation of readers. The majority of sources were written by medical professionals or consist of published studies in medical journals, and peer reviewed studies.

Sources