Sway back posture – a leading poor posture type causing back pain

Following the arched back posture and the flat back posture, the third most common incorrect posture leading to low back pain is the sway back posture. In this article, our principal physiotherapist and spinal specialist Sylvia Ho explains more about the sway back posture and how you can relieve low back pain.

What is Sway back posture?

The sway back posture — casually known as the ‘lazy posture’, is identified by shoulders and chest leaning backwards, with hips turned in and pelvis and chin thrust forward.

Why does it happen?

This posture is usually due to a lack of support for the hips and pelvis, hinging at the back, thereby applying immense pressure on the lower back, leading to pain. Weak abdominal muscles also contribute to the problem, as these muscles function to bring the upper body forward.

Who has this posture?

Those with weak buttocks, quads and lower abdominal muscles; people who adopt this posture often find themselves needing additional external support, such as a wall or other grounded objects to lean against. The sway back posture is almost the antithesis to the flat back posture.

Why does this posture cause back pain?

Like the arched back posture, the sway back posture is also an extension, albeit a more severe one as it overstretched the back and pelvis. So similarly, the forward shear force worsens the extension of the lower back. Additionally, this posture will lead to excessive compression and even degeneration in the joints, which causes pain and instability.

Don’ts to prevent sway back posture

Stand hanging off your hips and spine. Stand up tall using your muscles.
Swim breaststroke, or practise yoga poses like Superman, Cobra or Upward Dog.
Use back support accessories with an arched shape.

Dos to prevent sway back posture

Sit deep in your chair, with your back straight and your chin facing ahead.
Train your butt and quad muscles (see image below) with the correct exercises, such as half squats.
Strengthen your lower abdominal muscles with leg lifts and reverse crunches.

Further treatment

It is imperative to first and foremost correct your sway-back posture, and physiotherapists do this by guiding your pelvis to stack onto your hips, and your thorax forward in order to bring you to a neutral posture, relieving pressure and pain on your lower back.

Follow-up treatments will involve continuous pelvic work; retraining your posture; releasing and mobilising the stiffened joints in your lumbar spine (LSP) and thoracic spine (TSP).

Motor control in this scenario would require retraining the thoracic-lumbar vertebrae and overall posture, as this is the most challenging posture to correct; it is important to constantly adopt a neutral posture while undertaking activities that will likely encourage you to relapse into your sway-back posture, such as pushing a trolley at the supermarket.

Experiencing back pain? Click here to find out more about physiotherapy for back pain relief and how Core Concepts can help

References

_{McGregor, A. H., & Hukins, D. W. L. (2009). Lower limb involvement in spinal function and low back pain. Journal of back and musculoskeletal rehabilitation, 22(4), 219-222}
_{Brumagne, S., Janssens, L., Janssens, E., & Goddyn, L. (2008). Altered postural control in anticipation of postural instability in persons with recurrent low back pain. Gait & posture, 28(4), 657-662}
_{Hamaoui, A., Do, M. C., & Bouisset, S. (2004). Postural sway increase in low back pain subjects is not related to reduced spine range of motion. Neuroscience letters, 357(2), 135-138}
_{Tüzün, C., Yorulmaz, I., Cinda?, A., & Vatan, S. (1999). Low back pain and posture. Clinical rheumatology, 18(4), 308-312.}
_{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.}