Sway back, scoliosis, excessive lordosis and kyphosis are common postures associated with back pain. On the other hand, there are many people with these postures who don’t have back pain. So what is the mechanism of pain? All these postures would reduce the size of the gap between the lower ribs and the iliac crest thereby increasing the risk of Hip Rib Impingement. On the other hand, Hip Rib Impingement damages the para-spinal and lateral abdominal muscles thereby creating these postures.

When I see patients with these postures, I would measure the size of their Hip Rib Gap (HRG), then I would measure the HRG again when the patient has taken a deep breath to see if this would increase their HRG significantly. By using some of the exercises in the book, we can improve the patient’s posture and reduce the long term risk of Hip Rib Impingement. Posture breathing and the Abdominal Rotation Exercise would benefit all these postures; the Siesta stretch would be good for scoliosis and especially kyphosis. The single leg raisers would be good for the sway back especially but would probably be contra-indicated in the excessive lordosis.

Convincing patients to remember to do these exercises is another matter. If they see their own posture in a mirror especially when they walk around in shopping centres, that may trigger a reminder to straighten up; or if they walk pass someone with a bad slouch, that may cue them to straighten up. Ciao from www.drchrischinbackpain.com