Flat back Posture

Previously, we introduced the arched-back posture, and how to identify and fix the problems associated with it. In this edition, we’ll talk more on the flat back posture.

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The flat back or C shaped posture is identified by a forward head and a hunched upper and lower back to form a distinct C-shaped curve. Many of us who slouch would most likely have this posture.

Why does it happen?

This is a result of a weak erector spinae, which is a group of muscles that moves vertically to prop you upright. Being in this C shaped posture persistently overstretches the erector spinae, thereby increasing load on the discs — our natural shock absorbers and protective pads for our vertebrae. Other structures in the area, such as the ligaments are also stretched, causing lower and middle back pain, and is worse cases, disc herniation.

Who has this posture?

Habitual slouchers and exceptionally tall people who would usually have a tendency to hunch over their desks, look downwards at standard height objects.

What makes it worse?

Stress points that aggravate the flat back posture can include hunching over a computer or laptop at a desk or generally, long hours of sitting incorrectly.

Don’ts to prevent flat back posture

Perform certain exercises such as cycle, rowing, or squats that round the back.
Bend down using your back. Activate your thighs instead!
Sleep on a soft bed or sit on a soft-cushioned sofa, which provide no support.

Do’s to prevent flat back posture

Swim the breaststroke. It extends the back to counter the rounded posture.
Yoga poses such as the Superman, Cobra or Upward Dog to arch your back.
Use back support accessories, and sit fully against the backrest. Use a footstool to prop your feet at a 90-degree angle, if you have to.

Further treatment

The role of physiotherapy for the flat back posture is mainly to introduce specific exercises like anterior pelvic tilts, which teach you to pivot your pelvis in the opposite direction. Pelvic tilts also helps strengthen the weakened erector spinae. Other treatments include mobilisation of your spine via extension exercises to correct rounded posture.

Experienced physiotherapists will provide ergonomic advice, and train your back for endurance, eventually strengthening the weak erector spinae muscles. Again, motor control is emphasised — it retrains your brain to tell your nerves and muscles how to adopt this new neutral posture.

References

_{Malik, A. N., Rasul, H. N. u. & Siddiqi, F. A. (2013) Cross sectional survey of prevalence of low back pain in forward bend sitting posture. Rawal Medical Journal, 38 (3), 253-255.}
_{Potter, B. K., Lenke, L. G., & Kuklo, T. R. (2004). Prevention and management of iatrogenic flatback deformity. J Bone Joint Surg Am, 86(8), 1793-1808.}
_{Pynt, J., Mackey, M. G., & Higgs, J. (2008). Kyphosed seated postures: extending concepts of postural health beyond the office. Journal of Occupational Rehabilitation, 18(1), 35-45.}
_{Kitazaki, S., & Griffin, M. J. (1997). Resonance behaviour of the seated human body and effects of posture. Journal of Biomechanics, 31(2), 143-149.}
_{Tüzün, C., Yorulmaz, I., Cindaş, A., & Vatan, S. (1999). Low back pain and posture. Clinical rheumatology, 18(4), 308-312.}