What to expect in this post:
- What is Sway back posture?
- How to determine if you have Sway back posture
- What’s happening with the muscles?
- Common injuries
- The best exercises to fix your Sway back posture
What is Sway back posture?
The sway back posture is where the pelvis is pushed in front of the center of gravity.
This causes a chain reaction in the posture as the body attempts to compensate for the shift in alignment. (see below)
What are the characteristics of Sway back posture?
- Pelvis pushed forwards in front of centre of gravity (see above)
- Posteriorly rotated/neutral pelvis
- Early flexion in the upper lumbar levels
- Long thoracic curve
- Increased tension in the thoracolumbar junction
- Upper back shifted backwards
- Hyper extension of hip
- Hyper extension of knees
- Slight dorsiflexion of ankles
- Head poked forward (*compensatory adaptation)
- Upper back curved forward/sunken chest (*compensatory adaptation)
- Shoulders protracted (*compensatory adaptation)
- Tight upper abdominal (Tight internal oblique)
*compensatory adaptation: These changes in posture are usually a direct result of the body attempting to compensate for the forward position of the pelvis.
What are the causes of Sway back posture?
a) Over-active/tight hamstrings:
Tight and/or over-active hamstrings drive the pelvis forwards in sway back posture.
This hamstring dominance can be as a result of genetic factors, lack of stretching, poor gluteal muscle group function, sitting posture… the list goes on.
The good news is that we can do exercises to reverse this!
b) Ligament laxity:
Whether you are born with it, or you are someone who has excessively stretched themselves, ligament laxity can cause sway back posture.
Since the stability of the joints has been compromised, sway back posture occurs as it allows the weight of your body to rest on the excessive curves of the spine.
Unfortunately – there is nothing we can do to reverse the “looseness” of the ligaments.
The only option is to improve the strength and control of the muscles which support the spine. (… which we will definitely be going through!)
c) Incorrect strategy for good posture:
For some reason, your brain has learnt to hold you in a Sway back posture.
This could be attributed to bad habits such as sleeping on your stomach and poor posture in sitting.
How to determine if you have Sway back posture
1. Take a side profile shot of your standing posture
Make sure that:
- your clothing attire allows clear vision of your body
- the photo is taken at hip level
- the head to the feet are completely visible
2. Locate your land marks
Greater trochanter (Hip):
Place your palm on the side of your hip. Feel for a bony prominence that sticks out.
Lateral malleolus (Ankle):
You know that bony bit that sticks out at the outside of your ankle? That’s the one we want.
In the ideal posture, you should be able to draw a straight line between the greater trochanter and lateral malleolus.
With your picture, draw vertical lines through the midpoints of the land marks.
If you have Sway back posture: the line of the greater trochanter will be in front of the lateral malleolus
Is your pelvis in the correct position?
Don’t confuse Sway back posture with an Anterior pelvic tilt
It is common for people to get confused between having a Sway back posture versus having an Anterior pelvic tilt.
Both postures will have a sway back component where the lower back has a pronounced arch.
The 2 main differences being that in a sway back posture:
- The center of the hips are in front of the line of gravity.
- Whereas with anterior pelvic tilt, the hips are generally stacked over the ankles.
- (However – it is still possible to have an anterior pelvic tilt with your hips in front of the line of gravity)
- The pelvis is in a posterior pelvic tilt to neutral position.
It is important to know the difference between these postures as their respective treatments and exercises are different!
Doing the right exercise for the wrong diagnosis will not help you.
What’s happening with your muscles in sway back posture?
Overactive/tight hamstring drives the hips forward causing:
- elongated and weak hip flexors
- end of range hip extension in standing
- weak gluteal muscles
- anterior translation of femoral head
- elongated/weak external oblique
- short internal oblique –> pulls lower ribs forward/down
- over-active muscles in the thoraco-lumbar junction
- upper cross syndrome
Common injuries associated with the Sway back posture
- Hip: Arthritis, impingement, labral tears, bursitis, hip flexor tendinopathy, hamstring strains
- Lower back: Muscular tension, facet joint degeneration, disc bulges
- Shoulder: Impingement, bursitis, tears
- Neck: Headaches, muscular tension, degneration
If you suffer from any of the above issues and have tried everything to try to get it better, your Sway back posture may be the leading cause!
The sway back posture will place your body in sub-optimal positions which will cause excessive stress through the structures.
Avoid the following:
a) DO NOT stretch the hip flexors
In the sway back posture, the hip flexor muscle group (psoas, iliacus) is already in a lengthened position.
Stretching will elongate your already stretched out hip flexors and potentially make the issue worse.
b) DO NOT sleep on the stomach
Sleeping on your stomach will encourage the Sway back posture.
Have a look at the picture above.
You will see that the curve of the spine is exactly the same as Sway back posture.
That means the same muscles that hold the sway back posture will continue to drive this posture.
c) DO NOT sit with bad posture
Slouching on that chair is probably the main reason why you have your bad posture in the first place!
d) DO NOT stand like this
This position is something I see it a lot of bystanders standing around.
The arms crossed, hips thrusted forward and the classic pronounced middle back arch.
e) DO NOT over do abdominal crunches
Abdominal crunches may give you nice 6 pac abs, but it will also increase the dominance of rectus abdominus.
This may increase the forward curving of the upper back which is seen in the sway back posture.
The best exercises to fix your Sway back posture
Goals of these exercises:
1. Release hamstrings
2. Strengthen hip flexors
3. Strengthen gluteal group
4. Strengthen external obliques/decrease rectus abdominis dominance
5. Address upper cross syndrome (compensatory postural changes)
6. Re-train proper posture in functional positions (Neuro-muscular control)
Aim: To decrease the over-activity/tightness of the hamstring muscle.
a) Ball release
- Get a ball. You can use a massage ball, tennis ball, lacrosse ball etc. Take your pick.
- Starting from the top of your hamstrings in the buttock region, position your body over the ball of your choice.
- Use your body weight to apply the appropriate amount of pressure to the hamstring muscle.
- Gradually work your way down to the back of your knee.
Time: 2 minutes per leg.
- Whilst upright, place one leg straight in front of you.
- Hinging forwards at the hip joint (and keeping the back straight), bend towards the leg at front.
- Ensure that you can feel the stretch of the lower hamstrings.
- Repeat on both sides.
- To stretch upper hamstring, repeat the previous steps with a slightly bent knee in front instead of a straight leg.
Time: Hold for 60 seconds each. Repeat 2-3 times per leg.
I have covered even more specific stretches for you hamstrings in another post. Check it out!
Tibialis anterior release
An overactive/tight Tibialis anterior will pull your body forwards.
- Place the outside of your lower leg on a massage ball. (Tibialis anterior)
- Apply pressure over the ball.
- Make sure to cover the whole front/side of the lower leg.
- Draw circles with your ankle to increase release.
- Duration: 1-3 minute
2. Hip flexor group (iliopsoas)
Aim: To increase the strength of the hip flexor muscle group.
DO NOT stretch your hip flexors!… we want to strengthen this muscle group. Stretching the hip flexors will make the sway back posture worse as they are already excessively elongated!
a) Sitting hip flexion (on the chair)
- Sit up right on the edge of a chair.
- Lift knee as high as possible.
- Hold for 5 seconds.
- Alternate lifting knees.
- Repeat 10 times.
Time: 2 minutes in total.
b) Sitting hip flexion (on the floor)
- Long sit on the floor with the support of your hands behind you.
- Keeping your leg straight, lift your leg
- Hold for 5-10 seconds. Repeat 10 times on each leg.
Time: 2 minutes
Note: Make sure your back and pelvis stay in the neutral position whilst performing this exercise. The pelvis should not rotate.
c) Jack knife with exercise ball
- Assume a push up position with your feet on an exercise ball
- Brace your abdominal muscles.
- Bring your knees towards the chest.
- Hold for 5 seconds. Repeat 15 times.
Time: 2 minutes
Note: Make sure your back arch does not collapse whilst in the push up position. This can make sway back posture worse. Keep your core braced at all times.
3. Gluteal group (aka the “butt muscles”)
Aim: To increase the strength and recruitment of the gluteal muscle group.
a) Hip extension
- Whilst standing upright, extend your leg backwards until you feel your gluteals contract firmly.
- Do not rotate your body.
- Hold for 5 seconds.
- Alternate legs for 20 repetitions each.
Note: Maintain your upright posture. You should not lean forward when doing this exercise. Hold onto a support (eg. back of a chair) if you have issues with maintaining your balance.
- Lie down on your back with your knees bent.
- Flatten your lower back to the ground.
- By pushing off with your heels, lift your buttocks off the floor.
- Hold for 5 seconds.
- Repeat 15 times.
Check out this post to see the complete list of gluteal strengthening exercises (+ progressions).
4. External obliques
- Increase strength/Decreased length of external obliques.
- Increase length of internal obliques.
- Decrease dominance of rectus abdominis
a) Side plank
- Assume the side plank position as above.
- (either on knees or feet depending on level of ability)
- Push out your lower ribs.
- Create some extension in the upper lumbar spine region.
- Contract the muscles on the side of your abdomen to prevent that side for sinking down
- Keep your shoulders, hips and knee/ankle in line with each other
- Hold for 30 seconds.
- Repeat on other side.
b) Lower rib upward tilt
- Sit down on the edge of a chair.
- Lock in neutral pelvis.
- Tilt up your lower ribs.
- Create some extension in the upper lumbar region.
- Hold for 5 seconds.
- Repeat 30 times.
5. Thoracolumbar junction
Aim: To release the muscles of the thoracolumbar junction.
a) Ball release
- Place the muscles of the lower to mid back on top of a massage ball.
- Use your body weight to apply pressure to the area.
- You may need to adjust your positioning over the ball to target the right area.
b) Cobra pose
- Lie on your stomach.
- Prop your torso up onto your forearms.
- Lift up your torso as high as you can whilst keeping the belly button in contact with the floor.
- Aim to feel tension in the upper lumbar region ONLY.
- Repeat 20 times.
6. Addressing upper cross syndrome
As I have covered this a multitude times in several posts on the Posturedirect.com blog, I will link to the appropriate posts to bring you up to speed.
- Anterior chest/shoulder, intercostals
- Sub-occipital/Upper cervical posterior
- Upper abdominals
- Thoracic joints
- Fascia of the upper limb
- Latissimus dorsi
- Cx DNF/Retractors
- Scapula stability (rhomboid/lower trap/SA)
7. Functional training
This section is the most important part of the post.
If you do all the above exercises, but fail to do this, your sway back posture will likely not get better.
Functional training is all about using the right muscles at the right time, to sustain the correct posture, in your daily activities.
It’s connecting the brain, the nervous system and your muscles together to produced a desired result.
a) Learn how to stand properly
Now that your tight muscles have been released and your weak muscles strengthened, this is where the magic happens.
1. Stack pelvis on top of the ankles by bending forwards at the hip.
In sway back posture, the hips are driven too far forward.
The greater trochanter and lateral malleolus should be in the same line. (Click here if you forget what these are)
2. Return hips and lower back to neutral
Using your gluteal muscles, bring the upper body in line with the rest of the body.
3. Re-position your rib cage
Slightly tilt up your lower chest. (… but not too far that you flare your ribs!)
4. Re-position shoulders
Gently roll your shoulders back and down.
“Tuck your shoulder blades into your back pockets”
5. Elongate/retract neck
This will prevent your neck from poking forward.
How do you feel in this new position?
Yes, it will feel weird.
But just remember – you have most likely been standing with your sway back posture for many years and any change to the norm is going to feel different.
Practice this throughout the day.
When you’re waiting in line at the supermarket, brushing your teeth, cooking at home etc.
Try to incorporate this posture throughout your day to day activities.
b) Learn how to Sit-to-Stand properly
Bend forwards at the hip before standing up from a chair. A simple cut to remember is “nose over toes”.
As you sit down, bend forwards at the hips before descending. Remember the cue – “stick your bum out”
People with sway back posture tend to avoid bending forwards.
Wow! This post was 2464 words long!
I hope that it will help you.
If you know of someone who has this posture, please share this post with them.
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What to do next…
1. Any questions?… Leave me a comment down below.
2. Come join me on the Facebook page. Let’s keep in touch!
3. Start doing the exercises!