David R. Beatty and Camilia Makyhoun

David R. Beatty, DO, Professor of Osteopathic Principles and Practice, WVSOM

Camilia Makyhoun, Assistant Editor, WVSOM Class of 2016

Tuesday, June 11, 2013


A common cause of chronic back pain is increased lumbar lordosis, otherwise known as sway back. What's cute in teen years often causes pain in the back muscles and ligaments when abdominal muscles become weak after prolonged inactivity, pregnancy, abdominal surgery, or aging. The resulting hyperlordosis upon standing will stretch the iliolumbar ligaments, strain the paraspinal muscles, and compress the spinal joints. In other words, OUCH!

Abdominal strengthening is the key to reducing hyperlordosis pain because the front muscles help to support a straighter spine. These exercises can be painful for an already sore back so it's better to begin with a little relief. First use the LUMBAR POSITION OF EASE to reduce back pain and the PELVIC TILT to gently stretch the back muscles before proceeding to this abdominal strengthening routine.

DOCTOR'S NOTE: Seek evaluation by a health professional if you have leg weakness or incontinence because sway back (hyperlordosis) can cause pressure on the spinal cord, resulting in these symptoms.


Midline abdominal curl (WVSOM)

  1. Lie on your back with knees bent, feet on the floor, and arms crossed;
  2. Slowly lift your head and shoulders until the head is 3-6 inches from the floor;
  3. Hold your head and shoulders in this position for 20 seconds, return to the floor, and rest for 5-10 seconds;
  4. Repeat this head and shoulder lift by reaching your right elbow toward the left hip for 20 seconds, return to floor, and rest for 5-10 seconds;
  5. Repeat by reaching your left elbow toward the right hip for 20 seconds, return to the floor, and rest for 10-20 seconds;
  6. Repeat the midline, left, and right abdominal curls 3 times. If the third time is easy, increase the holding time 10-20 seconds in the next session;
  7. Do this abdominal curl every other day;
  8. Add the SUPINE LIMB LIFT when low back pain is no longer present.


Supine limb lift (WVSOM)
  1. Lie on your back with legs straight, toes pointing downward, and arms straightened above your head;
  2. Tighten your buttocks and slowly lift the legs, arms, and head until your hands and feet are 3-6 inches from the floor;
  3. Hold your legs, arms, and head in this position for 30 seconds, return to the floor, and rest 5-10 seconds;
  4. Repeat 3 times. If the third time is easy, increase the holding time 10 seconds in the next session;
  5. Do this supine limb lift every other day.

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