yogabook / pathologie / Lumbar spine hyperlordosis (hollow back)

Lumbar spine hyperlordosis (hollow back)

Definition

Chronic hyperlordosis of the lumbar spine

Cause

1. mostly acquired
2. Shortened tendons and ligaments due to chronic poor posture
3. Wedge vertebrae, e.g. in the context of senile osteoporosis

Predisposing

– Behavior

1. sedentary work
2. Lack of exercise
3. Frequent unhealthy sitting
4. high footwear

– Disposing diseases of the musculoskeletal system

1. Spondylolisthesis
2. Muscular imbalance with shortened hip flexors, often weak buttocks, abdominal and back muscles

Symptoms

1. Often compensatory hyperkyphosis of the thoracic spine
2. Hypertonus and possibly hypertrophy of the paravertebral back muscles
3. possibly lumbar back pain

Complications

1. Disc hernia
2. Baastrup’s disease
3. Spondylolisthesis
4. Spinal canal stenosis

Therapy

1. Compensation of muscular imbalance
2. Training of postural awareness

Asana practice and movement therapy

In the case of hyperlordosis of the lumbar spine, possible causes must first be sought: is there a hypertonus of the hip flexors without a corresponding counterweight of the hip extensors, or is Scheuermann’s disease present? In Sheuermann’s disease, the disease does not progress after the age of around 18. However, the acquired changes to the vertebral bodies and therefore the shape of the spine remain, and a tendency to back pain usually occurs with a certain time delay, which is referred to as post-Scheuermann’s syndrome. The hyperkyphosis of the thoracic spine and the hyperlordosis of the lumbar spine place significantly greater demands on the respective regional musculature than in the physiological case, as the horizontal component of the lever arms is more pronounced. This usually leads to premature fatigue of the autochthonous back muscles during the course of the day, which manifests itself as a pulling sensation in the thoracic spine and a hypertonic sensation in the lumbar spine, which, if there is no scoliosis, is usually bilateral. Those affected are then usually unable to sit at their desk all day without pain, as their unaffected colleagues may be able to do. Small movement units in between with stretching of the hip flexors, strengthening of the hip extensors and exercises with extensory moments in the thoracic spine can then significantly improve the subjective condition for a limited period of time. However, it must always be checked whether muscular dysbalances exacerbate the abnormal shape of the spine, in the lumbar spine, for example, contracted hip flexors iliopsoas and secondarily
rectus femoris, underperforming hip extensors and in the thoracic spine both hypertonic abdominal muscles and a tendency to protract the shoulder blades, which shifts the centre of gravity of the shoulder blade arm system to ventral and increases the moments reflecting the thoracic spine, which those affected generally have too little to counteract for hours at a time. The extensor muscles of the thoracic spine and the retractors of the shoulder blade must therefore be strengthened, while all muscles with a protractive effect must be checked for hypertonicity and countered if necessary. Activities in which the head is tilted forwards and downwards for long periods of time, i.e. the cervical spine is flexed with parts of the upper thoracic spine, can place an unacceptable demand on those affected in the long term, which often leads to disc damage, for example at the transition between the cervical spine and thoracic spine.