How to work with a client w. Lumbar Lordosis
I have a possble client with a severe lumbar lordosis. Is there specific movements to try on her to correct/help/improve? Any certain ones to really avoid? I have a few ideas but I would love your input.
BBU Student
by Lesley Powell
When a client comes in with certain misalignments, I first observe throughout the lesson how the client organizes movements, what is tight and what is weak. Each client arrives in a certain posture for different reasons: some are structural, habitual, an injury, history of fitness and cultural.
I always go to the basics first, core support, observing what is mobilizing and stabilizing. Their patterns of posture will reflect in all the exercises even simple ones like cat & camel, bridging, basic abdominal training and back extensors training. Part of making change in a client is making them aware of their habits.
How do they lie on their backs? Is the tension of their backs hyperextending their ribs? If I have them stretch the back muscles, does that help? Sometimes just saying “let your back go” can make a change. We all have patterns how we all hold tension. Learning to relax is key. Breath is a great way to help relieve tension.
I always look how they use their legs. When the legs are weak, the back has to carry the load. When they are doing bridging, footwork, etc., what is initiating first; the legs or the back? For instance, observe how they do a neutral bridge. Are they arching their backs to get the pelvis up? Get them to initiate through the legs. Make the movement small until they understand to push from the legs.
Sometimes they are so used to lifting their legs from their backs, they feel pain. Work in small ranges of motion until they can move painfree. Lying prone and lifting their legs, they always feel pain. Take the exercise to a different position and see if they can initiate from the correct place. For example, bridging, Pilates footwork and leg straps or modified side leg kicks. How is their form? Can they differentiate the leg from a stabilized pelvis?
Remember to have patience. A posture is created from years of habits. Keep observing, problem solving and making sure the movement principles are within each exercise. If a client is always in pain, make sure that they see a medical professional to rule out serious problems like disk herniations.
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Accentuated lordosis? The key is the psoas. Because of its attachment the psoas will create extension in the lumbar spine. Over time, the lumbar paravertebral muscles shorten. Most therapists waste their time attempting to stretch the paraspinals when they should be focusing most of their effort on the psoas, iliacus, and rectus femoris. I have a video on how to effectively stretch the psoas at http://www.eraseyourbackpain.com.
This is a very nice website. Stretching the psoas is important as well as creating a better foundation. I as a dancer have very tight psoas, find relief also when I do bridging exercises as well as improving my standing foundation.
The ONLY proven way to change a lumbar lordosis is via CBP technique. http://www.idealspine.com
Any other way is only temporary symptomatic relief, but not structural correction.
It is important to seek medical help when in chronic pain. My practice includes many awareness to keep better alignment of the joints to stay painfree. From my dancing career, I have knee discomfort. If I keep up my practice of maintaining balance and alignment of my legs, my knees feel fine. I can never fix the problem. There has been definite meniscus tears and spraining of ligaments around the knee. Even my dancer friends with knee surgeries, they have similar problems.
I am not sure what you mean by permanent fix. I rarely see that even when clients are seeing medical professsional help. Life is change, body is change.
I agree, working with the psoas is crucial!