When a client presents with thoracic hyperkyphosis (rounded back), there are many approaches for how Pilates can treat thoracic hyperkyphosis. And for each of these approaches, many Pilates exercises can be utilized. Before addressing these approaches, let’s briefly review thoracic hyperkyphosis…
Tight hip flexor musculature causes excessive anterior tilt of the pelvis… hyperlordosis of the lumbar spine… hyperkyphosis of the thoracic spine… hypolordosis of the lower neck with hyperextension of the head at the atlanto-occipital joint… forward head carriage… tight posterior neck muscles… headache.
The following is a brief overview that links the low back condition with its corresponding assessment procedure and its corresponding treatment.
Good posture is defined as a balanced posture that is symmetrical and does not place excessive stress on the tissues of the body.
Facet syndrome is a condition in which the facet joints of the spine (usually lumbar spine) are overloaded and become irritated, inflamed, and painful.
The lumbosacral spine should have a healthy anterior pelvic tilt and lumbar lordosis. If they are excessive, the client has lower crossed syndrome.
Stretching all hip flexors, including the rectus femoris of the quadriceps group, is extremely important for clients with lower crossed syndrome.
There is an old saying that no posture is bad unless you get stuck in it. The problem is that the thoracic spine often does get stuck in bad posture.
Two opposing muscle groups, the “facilitated” muscles that are locked short and the “inhibited” muscles that are locked long.
Case Study: Kori is a 30-year-old store clerk. Her low back has been tight for as long as she can remember, but she never had any pain until recently.
For the client with lower crossed syndrome, it is also important to recommend moist heat followed by stretching of the low back and hip flexor musculature.
If consistent manual therapy care is given, including heat, massage, and stretching, lower crossed syndrome responds very well to treatment.
Assessment of lower crossed syndrome is made by the characteristic postural dysfunction of increased anterior pelvic tilt with hyperlordotic lumbar spine.
Vladimir Janda’s lower crossed syndrome is characterized by increased anterior tilt of the pelvis and a hyperlordotic lumbar spine.