How to fix Sway back posture

What to expect in this post:


 

sway back posture
Image from FixTheNeck


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// What is Sway back posture?

It is a type of posture. Unfortunately, it’s one of the bad postures that some people have…

To completely understand why the sway back posture is considered a bad posture, one must first know what a good posture looks like. Check out the post: Ideal sitting posture to know exactly what good posture is.

Do you suffer from a Sway back postureI hope not… But if you do, please let me help you!

The sway back posture is where the pelvis is pushed in front of the centre of gravity. This causes a chain reaction in the posture as the body attempts to compensate for the shift in alignment.

 

// 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 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

sway back posture

 

Greater trochanter: Place your palm on the side of your hip. Feel for a bony prominence that sticks out.

Lateral malleolus: You know that bony bit that sticks out at the outside of your ankle? That’s the one we want.

Humeral head: This is the top of your shoulder bone.

3. Compare the alignment of these 3 landmarks

In the ideal posture, you should be able to draw a  straight line between the 3 points of greater trochanter, humeral head and lateral malleolus.

With your picture, draw vertical lines through the midpoints of the land marks. If they all line up, great! You don’t have sway back posture.

If you have Sway back posture: the line of the greater trochanter will be in front of the other 2 points.

Is your pelvis in the correct position?

 

// Don’t confuse Sway back posture with an Anterior pelvic tilt

 

aptvsswayback

 

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:

  1. The centre of the hips are in front of the line of gravity. 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)
  2. 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.

Want to know more about anterior pelvic tilt? Check the post: How to fix an anterior pelvic tilt to find out more.

 

 

 

// 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. Fix your posture, fix your pain!

 

// Do not:

Aim to reduce the following until you have corrected your sway back posture.

a) DO NOT stretch the hip flexors

xhipflexor stretch

In the sway back posture, the hip flexor muscle group (psoas, iliacus) is already in a lengthened position. Stretching will further elongate your already stretched out hip flexors and thus drive the issue further.

b) DO NOT sleep on the stomach

xsleep

Sleeping on your stomach will encourage the Sway back posture. How? 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

xarmcross

This position is something I see it a lot of bystanders standing around. The arms crossed, hips thrusted forward and he classic pronounced middle back arch.

e) DO NOT do abdominal crunches

xabcrunch

Abdominal crunches may give you nice 6 pac abs, but it will also increase the dominance of rectus abdominus which will increase the hunch of the upper back which is seen in the sway back posture.


The solution: 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)


 

1. Hamstring

Aim: To decrease the over-activity/tightness of the hamstring muscle.

a) Ball release

hamstring release

Instructions:

  • 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.

 

b) Stretch

hamstring stretches

Instructions:

  • 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.

 

Tibialis anterior release

An overactive/tight Tibialis anterior will pull your body forwards.

Instructions:

  • 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)

sitting hip flexion

 

Instructions:

  • 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 hip flexion

Instructions:

  • 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

jacknife ball

Instructions:

  • 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

hip ext

Instruction:

  • 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.

b) Bridge

Bridge start positionbridge end position

Instructions:

  • 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.

// Want to know the best exercises for your gluteal muscles? Check out this post: Is sitting destroying your butt muscles? to see the complete list of gluteal strengthening exercises (+ progressions).


4. External obliques

Aim:

  • Increase strength/Decreased length of external obliques.
  • Increase length of internal obliques.
  • Decrease dominance of rectus abdominis

a) Side plank

side planks

Instructions:

  • 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

Instructions:

  • 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

Ball QL

Instructions:

  • 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.

Time: 2 minutes

 

b) Cobra pose

Instructions:

  • 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.

Stretches/Releases

  • Anterior chest/shoulder, intercostals
  • Sub-occipital/Upper cervical posterior
  • Sternocleidomastoid/Scalene
  • Upper abdominals
  • Thoracic joints
  • Fascia of the upper limb
  • Latissimus dorsi

Strengthening

  • 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 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.

bow

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

shoulde reposition

Gently roll your shoulders back and down.

“Tuck your shoulder blades into  your back pockets”

5. Elongate/retract neck

chintuck

 

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 forward them this post.

 


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What to do next…

1. Any questions?… Leave me a comment down below.

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3. Start doing the exercises!


About

I am a physiotherapist who has personally experienced the pain as a result of bad posture. I would like to offer you some of the solutions that I and my patients have greatly benefited from.

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197 thoughts on “How to fix Sway back posture

  1. I just found out that I actually have this problem, could it be the cause that my knees cant fully straigthen? the area around my hip to knee is too far forward and the area below the knee is too far backward. Can it still be corrected? I am 21 years old now

    1. Hey Adam,

      It could be a factor.

      But even so, you should still be able to straighten it whilst you are sitting down? If not, you may need to get a scan to check out what is happening structurally.

      Mark

  2. Hey Mark,I’m 17 and recently discovered that I have swayback. I imagine that the cause is slouching, as I have spent almost every day of the past 2 years slouching in a chair and always have done anyway. Because of this I’m attempting to always sit uprights d provide back support of nesccesasy. I have been trying your exercises over the past few days and whenever I’m standing or walking, tried to ensure I pushed my shoulders and pelvis backwards in line with my ankle. However I’m experiencing a lot of lower back pain from doing this. Just wanted to know if I’m doing anything wrong or affecting my back negatively.
    Thanks, Max

    1. Hey Max,

      Try not to force the posture. This will cause increased tension into your muscles.

      The exercises are designed so that you fall into better posture. (But this takes time)

      Gently guide your body into a more neutral resting position.

      Mark

      1. Thanks for be advice! Would probably be good to ask how many times a day I should be doing them? (i.e all the steps).

  3. Hey Mark,
    I recently became aware that I have a swayback posture. When standing, I tend to rely on my hamstrings. I have tight hamstrings and hip abductors while my quadriceps and hip adductors are weak and over-lengthened. I am currently doing the proper exercises and stretches to fix my hip and leg issues, but I’m a bit confused when it comes to the obliques. Although I am 5’10” and 155 lbs, I have a large gut. Also, I have noticed that there is excessive pressure under my sternum/upper abdominal area. This pressure is much more noticeable when my stress increases. If I sit for too long, my lower back begins to hurt and my abdominals feel like they are being overexerted. My abdominals begin to flare and I sweat more than normal. I have read online that the internal obliques are responsible for increasing abdominal pressure. Do I need to stretch my internal obliques while strengthening my external obliques? And how would I go about this? Thanks!
    p.s: I’m currently doing my under grad in Kin Exercise Science and hope to be a future PT. Love the website.

    1. Hey Leo,

      It is common to have tight internal obliques with a sway back posture.

      I would stretch them out in the cobra pose and then practice lower ribs tilts whilst sitting.

      Mark

  4. Hi,
    My natural posture is Swaybcak however when I stand up tall and hold good upper body posture I have hyperlordosis. This has cased me to have flared ribs.
    To fix flared ribs it’s suggested that you get stronger abs, however it’s not wise to to abs with swaybcak. Help

    1. Hi Ben,

      You still want strong abs even with sway back posture. If you are training your static standing posture, You just want to train them in a more neutral position.

      Mark

  5. Hi Mark.

    I have pain in my lower mid back and neck. I have checked my posture and I have hips swayed forward and noticeable anterior pelvic tilt. Upper back – thoracic kyphosis and forward head (curved neck). Since the exercises for these postural issues (sway back and anterior pelvic tilt exclude each other (are opposite), I would really appreciate your advice what exercises to do to fix swayed hips with anterior pelvic tilt.

    Thank you in advance!

      1. Is there a fool proof way to figure out posture deficiencies? Or an article to figure it out?

        I’m having trouble figuring out if I have sway back, ATP or a combo of both. Just saw you are posting an article on that soon and curious if it has been posted.

        Thanks

  6. Hi Mark
    Thanks for sharing this great information. I have pretty severe sciatica-related pain (I think) and it’s probably piriformis related (at least that’s what I’ve concluded) – maybe inflammation of the muscle. I’ve had shooting pain for the last 8 years. It begun after I had some lower back stiffness following some exercise one day and it has got progressively worse over the years. Now it’s so bad I can’t sleep at night and the pain is chronic. Not a great story. Anyway, I’ve read about sway back now, and ive read your blogs. Could you take a look at a picture of me and let me know if you think I have sway back? (If you provide your email I could send you a photo) To me it doesn’t look like sway back too much, or maybe it is? I would greatly appreciate your advice. I’m willing to pay for any consultation you provide. Please let me know. Thanks

  7. Hey Mark, can you explain to me how the upper abdominals are tight because of the internal obliques, or do the internal obliques run into the upper abdominals somehow?

    1. Hey Rabelle,

      In sway back posture, the lower back over arches which places the whole upper torso leaning back.

      As the body will always try to keep the eye sight parallel to the horizon, the mid torso will then flex forwards to maintain balance.

      Due to their attachments to the front lower ribs, the muscles responsible for this are mainly the upper abdominal and internal obliques.

      Mark

  8. Hi Mark thank you for this information it’s amazing however I’m. Not sure if I have sway back orr APT would you please look at this photo and tell me
    m.imgur.com/a/nQL7D

  9. Hi Mark!
    I am confused about the “groin” muscles like the ones stretched in a butterfly stretch. Are those hip flexors as well? I can’t find info on whether I should stretch these or not.

    1. Hi Elli,

      The groin muscles which are situated more towards the front of the body can act as hip flexors as well.

      With sway back posture, it is fine to stretch out the groin muscles.

      Mark

    1. Hey hey,

      Looks like you have a degree of knee hyper-extension which may be causing your pelvis to shift forward a bit.

      Do you have tight calves?

      Mark

      1. Here is a picture of my maximum calf flexibility (around 10cm from the wall): https://i.imgur.com/L1TYVMS.jpg

        1) Do you think these calves are flexible enough?

        2) I struggle to understand the link between the calf lack of flexibility & the knees hyper-extension. Could you please explain it? 🙂

        1. Hey Sodraguy,

          1) 10cm from wall is good! Click here for more info on ankle mobility if you would like.

          2) If you are hyper extended at the knee, this will mean the ankle is in more of plantarflexion. If the ankle rests more in plantarflexion, this can lead to or be caused by tight calves at the distal end (and more elongated nearer to the knee).

          Other than that, looks like a slight case of sway back posture.

          Mark

          1. Hi Mark,

            Thanks for the explanation!

            So I need to focus mainly on my hamstrings flexibility, I have only a mobility of approx. 60/70% as you can see here:
            Left leg: https://i.imgur.com/ek438Qw.jpg
            Right leg: https://i.imgur.com/93MhFcX.jpg

            I have another problem linked to this sway back posture. The pelvis being shifted forward, that’s put a lot of pressure on my bladder and my rectum during the day. That’s more problematic during the night because I need to wake up to pee or poo.

            Do you have any good posture to recommend when I sleep to avoid the pelvis to put too much pressure on the bladder and rectum ?

  10. I just read this post and I seem to have a lot of these problems. I sit in a slouched position all day where my pelvis seems to be posteriorly tilted. I have a long history of injuring my hamstrings when sprinting or doing explosive work. I notice during squatting or any leg pressing exercise my quads are doing all of the work and sometimes I develop pain right above the knee. I find when I do bridges that my hamstrings do all of work no matter how hard I try to extend the hips with the gluteal muscles. I believe that my hip flexors are weak because when flexing the leg above 90 degrees muscles like my TFL tend to cramp up. My quads are overdeveloped which I believe is because they are compensating for my weak psoas major. Some other things that I have noticed is that the inner part of my calf muscle is really overdeveloped and the outer seems to be nonexistent. Also whenever I try to strengthen my external oblique muscles by doing anti-rotational work or side planks I get no activation in this muscle group at all. My question is would strengthening the psoas major feed slack to overdeveloped muscles like my quads? Also what are some ways that I can better activate my external obliques and stretch my internal obliques?

  11. Hello Mark,
    Thanks for all of your sound advice. I am quite sure I have APT. It could probably be corrected with these exercises, but to be honest, I’ve never been able to stick with anything even remotely athletic or physical activity related. So question number one is: what is the most important thing to takeaway from all of this? Is there one exercise that is more important than the rest?
    Also, I have upper back pain on one side from carrying my toddler around all day (She is very big; I am rather small). I tried carrying her on the other side to even out the strain, but it just doesn’t work. Is there anything you can recommend as far as stretches or ways I should be carrying her/ picking her up?

    1. Hi Bri,

      The most important to understand is that every one is different. Each person will respond differently to different exercises and will usually will require a mixture of them. This is why I encourage people to do all of them (…to begin with) until you can see/feel/understand the effects that each exercise has on your body.

      Carrying toddlers is hard! But here are some of the most important things you need to consider:
      – always brace your core muscles before any lift and during any carry. Here are some examples.
      – keep your shoulders neutral. You will need to engage your shoulder blades muscles to prevent them rounding forwards. (see post: rounded shoulders)
      – Get strong arms. Resting your toddler on a hitched pelvis will eventually take its toll on your body. (… and it doesn’t help when the babies only get bigger with time!). Biceps and back training is the way to go here.
      – only lift when you really have to. Don’t give in to the cries! (This one may be the hardest of them all)

      Mark

  12. Help!!! When I slouch I form a swaybck posture, however when I stand up tall I have an excessive curve in my lower back. For fixing swayback you suggest strengthening the hip felxors, however to fix lordosis you suggest stretching them instead. What would be more beneficial for me to do, so I can improve my posture?

    1. Hey Ted,

      If sway back posture is your natural posture, then I would focus on that.

      You would stretch hip flexors if you have hyperlordosis with an anterior pelvic tilt.

      Mark

      1. Ok, many thanks. Will focus on fixing my swaybcak. Also, many thanks for the help fixing swaybcak I would be lost without this.

  13. when I slouch I form a swaybck posture, however when I stand up tall I have an excessive curve in my lower back. For fixing swayback you suggest strengthening the hip felxors, however to fix lordosis you suggest stretching them instead. What would be more beneficial for me to do, so I can improve my posture?

  14. Good afternoon,

    To start, sorry for my English … This is not good at all.

    I’m dealing with a big problem that goes with this article … And please explain:

    I am a 33-year-old man and have had a scoliosis from childhood. Since my 20 years I have been struggling with my back and I have a lot of pain … There is a difference in leg length and my pelvis are crooked … My legs are measured and they are the same length, so the problem is in the pelvis or back.

    My pain is situated at the bottom right of the back. There have been many diagnoses, but now I’m probably close to it. I went to a scolios clinic, and there they told me that my Iliopsoas on the right side is shortened and therefore my Si joint is blocked so that I am constantly blocked. For example, I can not lay my right leg completely flat on the floor. It is shortened but it may also be tense? Since I have constant pain?

    They taught me to slide my pelvis to the right and keep the tailbone low (ie tilting the pelvis backwards). This is because I have a hollow back at the bottom, and push it to the right as my pelvis is higher on the left. I have to pay attention to my breathing during the exercises (4 counts in, 8 counts out). The problem is that in this posture I contract my abs, but apparently that is not possible …
    The exercises consist of opening the weakside and point through breathing.

    But since I have no pain on my back myself, they pose stretching.

    Important: my back is hard on the right side, can not be released … My lower back is hollow and my upper back is leaning backwards.

    I feel the pain when I walk or straight away (immediately). When I sit or lie I do not feel it …. When I sit down after a long walk or stand for 10 minutes I feel like it when I sit down, and I can mobilize the pain (by moving with hip).

    My questions:
    – would you recommend me to do these stretch exercises?
    – What else can you recommend to me?
    – I read somewhere that it is better to let the iliopoas muscle relax first and then stretch them (after a while)? Direct stretching of a shortened muscle would work badly? and relax by doing the following exercises: http://sequencewiz.org/2014/02/15/short-yoga-sequence-hip-flexors/
    – as I tilt my pelvis to the right and to the back (through the hollow back) my stomach muscles … But apparently this is not allowed. How can I avoid this?
    – how can I do breathing correctly in daily life?
    – Does massaging the Iliopsoas muscle have any use?
    – what is your vision about my situation?

    My big shock is that it will never disappear, I will remain an unhappy for the rest of my days …

  15. Hi Mark,

    Very informative read, thank you! I definitely have APT (The front of my belt is lower than the back of my belt, when I look at my boxer waistline the front is lower than the back, and my butt sticks out. I also believe I have a little kyphosis, I have always had a slight hump in my mid/upper back when I bend over to stretch. This had led to years of acute lower back pain, poor posture, and neck pain. As a result, I recently have been working on my APT by stretching my hip flexors, quads, strengthening my core with planks and bridges (I squeeze my butt in both instances), and also activating my glutes by flexing them when I walk, etc. I have been working on my kyphosis by doing shoulder dislocations, stretching my chest, prone-ys. I have also been getting back into strength training my back, chest, arms, glutes (squats) and other prominent muscle groups. With that being said, I have a few questions:

    -Does this appear to be an appropriate approach? I know I can’t do everything out there, there is so much good info!
    -Could focusing on fixing APT result in swayback overtime? Or in other words, can my front pelvic tilt reverse? That is my worry by focusing on my APT at the moment.

    Thanks so much,
    Ben

    1. Hi Ben,

      In regards to your exercises, you are definitely on the right track to addressing your APT! All that you have mentioned sounds good to me.

      If you over activate your glutes and cause your pelvis to shift forwards so that the hip sit in front of your ankle joint, then yes, you can in fact over shoot the correction. You will need to make sure that you keep an eye out for this so that you don’t develop the wrong posture.

      Mark

  16. Hi, so I think I developed this from overstretching my hip flexors since I thought I had APT, um I’m just wondering if it is a good idea to sleep on the floor on your back, but I feel like my hips are stretching even more when I’m lying down on the floor, I dont know if it’s a good idea. I have been confused from trying to stretch out stiff muscles such as my quads and around the hip area but I think I made things worse. Like I feel some tension in the hamstring and glute. I dont know if there is a proper mattress to sleep on or whatever, I usually sleep terribly due to past problems with posture and strained my right foot from basketball which caused a lot of things since

    1. Hey Kevin,

      Doing the exercises for fixing an anterior pelvic tilt may make people with a sway back posture even WORSE!

      Sleeping on your back is fine… You can consider placing a thick pillow underneath your knees as you sleep if it is more comfortable.

      Mark

  17. With the hip hinge I can barely reach below my knee caps.
    On my back I can hardly get 45 degrees of hamstring range of motion before my lower back rounds.
    I get Pain when jumping and deadlifting fro the floor and squatting. However as long as I keep a neutral spine and only go to my knees with RDLs and do Box Squats to a high box and keep a neutral pelvis, I won’t get pain.

    Is this Pain from tight hamstrings?

    Would doing good form loaded RDLs help stretch me out? I know my hamstrings and glutes are pretty weak. I ask because I’ve heard some people say go for static stretching and some go for loaded.

    Same with my back in relation to my chest.
    Do you have a ratio of Bench Press to Barbell Row strength I can shoot for?
    I think I can Bench around 300 and Row around 190. Probably not a good ratio.

    Do you use a lacrosse ball for the hamstrings or a bigger ball?
    I can’t seem to get them to release.

    My right shoulder is also more rounded than the left. Is there a way to tell if it’s from the chest or shoulders or back?

    1. Hey Max,

      Tight hamstrings can cause premature lower back rounding when you are hinging forward.

      Dead lifts are great to improve hamstring mobility. Focus on lowering the weight in a slow and controller manner. Only lower as far as you can go as long you are maintaining neutral spine/pelvis.

      You can use either a ball to release the hamstrings. If you can’t feel the release, perhaps try the bigger ball and get as much of your body weight on top of it. (Alternatively – you can go for a massage)

      I am not sure of a solid push:pull ratio.

      If your pelvis/torso is not rotated, then it is likely the right shoulder itself that is causing the rounding.

      Mark

  18. How does abs can make sway back? When u sway back – your abs are stretched and relaxed and it takes efforts of abs as well to bring body in normal posture.

    All articles except yours actually recommend abs exercises. Very weird. But for all other tips – big thanks!

    1. Hey Eugene,

      Thanks for the question.

      With a sway back posture (in general), the upper abdominal muscles tend to shorten as to bring the upper torso more forwardly tilted.

      You still want to train the abdominal musculature, but in a neutral and/or functional way.

      Mark

  19. Hi, Mark. First off I just wanted to say thank you for making this wonderful website. You are a really wonderful person for making such a great resource available for free and you have helped so many people, including me.

    I’ve scoured over your website and I’m fairly certain I have both posterior pelvic tilt AND sway back posture. I have reeeeeally tight hamstrings and my hip mobility is terrible. However, I’m not sure what to do for one thing. For sway back you advise to strengthen the glutes, and in the PPT article you advise stretching them. Should I both strengthen and stretch them?

    I hurt my knee 6+ months ago playing basketball (i was sooo stupid and thought I had APT, so I was stretching my quads and hip flexors and that’s what caused the injury I’m sure) and haven’t been able to squat since then. However, when I was squatting my butt would always get really sore afterwards and I got a bit of a bubble butt while I was squatting regularly because I guess they were doing a lot of the work. I’m not sure if that info is relevant or not, but I’m just writing it because I believe it means I have no problem activating my glutes (which would contradict the sway back posture symptom).

    1. Hey Matt,

      You ultimately want to strengthen your glute (tight and weak) muscles with a neutral pelvis.

      You can still stretch them if they are tight.

      You can still have a sway back posture if your glutes are strong. In fact – if you over activate them , they can push your pelvis forward. (Think of how some power lifters finish their dead lifts)

      Mark

  20. Hi Mark,

    I found your post after suffering from pelvic floor dysfunction and pain for one year. All the female health specialists I saw were sure my hip flexors were tight and had me constantly stretching. This caused me to become horribly weak and also caused my psoas to knot up near my spine.

    After three days of following your routine the knot near my spine left and after six weeks – my hip flexors are “shrinking” and strengthening and my low back is getting a curve. My sleeping butt has also finally woken up! So, thank you for all of this!

    A few of my issues that I didn’t see a way to address are a complete lack internal hip rotation, both legs externally rotate, and I have one “duck foot”. I’m assuming my external rotators are tight as a compensatory measure and I think that’s the source of my pelvic pain.

    Do you have any exercises or suggestions on how to target strengthening weak internal rotators?

    Thank you so much!

    1. Hey Steph,

      I am happy to hear you are finally getting some promising results with these exercises!

      For your lack of hip internal rotation,

      – Stretch your hip external rotators

      – Mobilise into hip internal rotation:


      – Strengthen your internal rotators:

      9090 Hip shift (video)

      Please note: As you improve your pelvis position, you may also find that your rotation improves as well!

      Mark

      1. Good afternoon,

        To start, sorry for my English … This is not good at all.

        I’m dealing with a big problem that goes with this article … And explain you:

        I am a 33-year-old man and have had a scoliosis from childhood. Since my 20 years I have been struggling with my back and I have a lot of pain … There is a difference in leg length and my pelvis are crooked … My legs are measured and they are the same length, so the problem is in the pelvis or back.

        My pain is situated at the bottom right of the back. There have been many diagnoses, but now I’m probably close to it. I went to a scolios clinic, and there they told me that my Iliopsoas on the right side is shortened and therefore my Si joint is blocked so that I am constantly blocked. For example, I can not lay my right leg completely flat on the floor. It is shortened but it may also be tense? Since I have constant pain?

        They taught me to slide my pelvis to the right and keep the tailbone low (ie tilting the pelvis backwards). This is because I have a hollow back at the bottom, and push it to the right as my pelvis is higher on the left. I have to pay attention to my breathing during the exercises (4 counts in, 8 counts out). The problem is that in this posture I contract my abs, but apparently that is not possible …
        The exercises consist of opening the weakside and point through breathing.

        But since I have no pain on my back myself, they pose stretching.

        Important: my back is hard on the right side, can not be released … My lower back is hollow and my upper back is leaning backwards.

        I feel the pain when I walk or straight away (immediately). When I sit or lie I do not feel it …. When I sit down after a long walk or stand for 10 minutes I feel like it when I sit down, and I can mobilize the pain (by moving with hip).

        My questions:
        – would you recommend me to do these stretch exercises?
        – What else can you recommend to me?
        – I read somewhere that it is better to let the iliopoas muscle relax first and then stretch them (after a while)? Direct stretching of a shortened muscle would work badly? and relax by doing the following exercises: http://sequencewiz.org/2014/02/15/short-yoga-sequence-hip-flexors/
        – as I tilt my pelvis to the right and to the back (through the hollow back) my stomach muscles … But apparently this is not allowed. How can I avoid this?
        – how can I do breathing correctly in daily life?
        – Does massaging the Iliopoose muscle have any use?
        – what is your vision about my situation?

        My big shock is that it will never disappear, I will remain an unhappy for the rest of my days …

  21. Heya, im confused to what i have even tho ur website is freaky awesome. Can you have posterier pelvic tilt but also have a lower back arch when lying down? It hurts to lye on the floor too long i gotta put my knees up to make my back flat. I lay on my tummy when i sleep if my back hurts but i have all the symptoms of posterier, couch potato sitting, rounded shoulders, slight forward neck, lower back pain, hip pain if i dont exercise for a longtime. I also use my shoulders to hold me up and clench my butt to bend over stead of stickin my arse out n using my legs when im a zombie lol. Can you have slight knee inward bend from posterier? My back bone which i sit on when in full potato mode sticks out when im standing but my butt is flat (im a thin build) thats fully posterier a? Cheers 4 ur time
    And thanks SO much for makin this info free. Badass.

    1. Hey 10,

      With sway back posture, you can have a posterior pelvic tilt with a lower back arch when lying down on your back.

      You can also have knees that collapse inwards with a posterior tilt.

      If you are a skinnier build, it is quite normal to have the bones in your spine stick out.

      Hope this answers your questions.

      Mark

  22. Amazing Post!

    Would an upright low lunge be ok if you were pulling the back knee forward, and the front foot back isometrically?

    1. Hey Krista,

      I like how you are thinking.

      Combining strengthening with stretching is the way to go!

      Although I would still avoid passive hip flexor stretching if one indeed still has elongated hip flexors to begin with.

      Mark

  23. Hi Mark,

    I’m a dancer who has been trying to navigate fixing my sway back and one of my biggest concerns is that I kind of need to stretch my hip flexors for splits, etc. consistently. Would stretching them prevent any progress from your exercises or is there a way around this? Thanks.

    1. Hey Joe,

      If it is required for your sport, keep stretching those hip flexors.

      However, I would encourage you to make sure you have strong hip flexors (especially in the outer ranges).

      Here’s one I like to do:

      Mark

  24. This is very helpful. I have been having a lot of tightness in my hip flexors and kept stretching it for months without any improvements. A chiro did a postural assessment and my sway back seems to be very obvious. However, the chiro only focused on “Adjustments” which i often find to be a temporary fix since they dont really correct the muscular imbalances.
    I started doing these exercises for the past 3 days I already feel some relief. How often do i need to do them? More specifically, can I do the “hip flexor” drills throughout the day. I feel that my posas is very weak which might be the root cause of my pain.

    1. Hi Alec,

      Adjustments are great, but like you said, are only temporary!

      Start the exercises 1/day. And increase/decrease as appropriate to your individual situation.

      You can do the hip flexor strengthening exercises throughout the day if your body can handle it.

      Mark

  25. Ive corrected my posture as you’ve said but it seems that I also have atp. So basically when I pull my hips back my back goes into an anterior pelvic tilt. Should I still try to hold this posture even while walking or would this be pushing it. Is there some kind of lower back support I should get?

    1. Hi Samuel,

      You would want to focus on releasing your quad muscles and lower back.

      After this, focus on core strengthening to lock in correct neutral pelvis position.

      With your day to day activities, try not to overly force the pelvis into position. You want it to become natural.

      Mark

  26. Hi Mark, Thank you for this amazing website, so informative, clear and so easy to go through. I’m so glad for all effort and time you put here, keep doing this great job! I already shared in my Facebook page that other people could get access to your knowledge. I’m 25 years old and I have a really bad posture but I’m a lit confuse to set up what kinda of bad posture do I have (flat back, sway back, posterior pelvic tilt….) Could I send you a picture? I know you went through How to determine if you have this or that bad posture, but I’m not confident if I got the right one, so I’m afraid of working this out in the wrong way. Thank you for your time

  27. Hey, thanks for this, it’s great.

    I am a bit confused by #6, however. Are we supposed to incorporate all the exercises from those other articles in too? That seems a bit unmanageable.

    1. Hi Lorne,

      You don’t have to do them if you don’t have those postural issues.

      However – if you do have them, you should aim to do them as well.

      You do not have to do ALL of them. I try to put everything that you may need to do in these posts to help fix your posture.

      Hope this helps!

      Mark

  28. Hi Mark,
    I am a physcial therapist and just saw a 9 yr old boy with a sway back posture. Can you think of any fun exercises or games to improve his posture?
    Thank you.

    1. Hi Annie,

      I’ll be the first to admit that I find it quite difficult to make the exercises fun when prescribing them to children.

      Some things that you can do are
      – Only focus on 2 or 3 exercises.
      – Incorporate some sort of reward/positive re-enforcement
      – Try to make it a game to see how many repetitions they can do . (And emphasise how good it will be if they can beat their last score)
      – Link the postural exercises to one of his interests (eg. you can say fixing the posture will help him play soccer better etc)

      Hope this helps!

      Mark

  29. Hi Mark
    I don’t really get why I should strengthen the gluteal group while wikipedia says they’re hip extensors… or is wikipedia wrong here ?

    1. Hi Arne,

      You want to strengthen your gluteal group (but with your pelvis in a neutral position) to reduce the over activity of your hamstrings driving your hips forward.

      Hope this makes sense 🙂

      Mark

  30. Hi Mark, I’m pretty sure I have sway back, rounded shoulders, hunch back, and definintly forward head shoulder, you have separate exercises for each. Should I do them all or just start with a certain area to start? Thanks !

    1. Hey Laine,

      You can do them all. Or you can do them one area at a time.

      The question is – how much time do you have to spare?

      If you are short of time, I would start with the sway back posture exercises.

      Get your pelvis in the right position, then everything else can be based on a good foundation.

      Mark

  31. Hi Mark!

    I am so grateful that you have provided the world with such an incredible set of resources. I am sure that I will be using them long after my issues are a thing of the past.

    I just have a quick question for you, you mentioned on this post that in order to sort out my Sway Back posture I shouldnt be doing any sit ups. Are other types of abdominal exercises alright, or should I stop working on my abs altogether until I’m all fixed up?

    Thanks so much!

    1. Hi Gibrael,

      The best exercises are core related exercises. I am a big fan of the Dead Bug exercise.

      If done correctly, you will get a great work out for your abdominals as well.

      Mark

  32. Just a note of great appreciation .. that Hip Extension for gluts really does help me as I could barely stand up straight at times and now feel confident to try out your other exercises. When in pain we go to physiotherapists, massage, acupuncture etc but I have never been shown what movements to strengthen or help to reverse my pain. Many thanks indeed.

      1. Hi Mark,

        Years ago I visited a physiotherapist because of my bad posture. The exercises we did were superman for lower back and cat and camel. The stretches I should do were harmstring stretch and the piriformis stretch. When I stay relaxed my pelvis pushes forward, it looks like in the picture. When I stay for a long period of time my lower back starts to hurt. But Im confused, if I have sway back, why did my physiotherapist showed me exercises for my lower back and stretching my pirifomis? Seems more like exercises for a posterior pelvic tilt, but I dont have it, I can even squat quite deep without a butt wink. Can you have tight abs, piriformis (gutes?) and harmstrings and weak elongated hip flexors and lower back with a sway back posture? Hope you can help.

        1. Hey Daniel,

          It sounds like you may have your hips pushing forward, but your pelvis may be tilting anterior. This would result in tight upper abs, tight piriformis, weak long hamstrings.

          You can have sway back posture or anterior pelvic tilt with your hips pushed forward. They are slightly different in looks but treated differently.

          Check out the anterior pelvic tilt post to see if that fits you (+ the hips being pushed forward).

          Mark

  33. Hi Mark. I have Osteonecrosis in both of my hips and both of shoulders. I have had both of my hips and one shoulder replaced. I have a really bad “trunk sway” as a result of surgeries. What do you suggest I do to stop or minimize that?

    1. Hi Gena,

      Is your trunk sway coupled with a sway back posture (hips in front of ankles)?

      If so – then you would follow the above mentioned exercises.

      If you have a trunk sway, (or a posterior rib tilt), then you would want to work on strengthening your abdominals to hold your lower rib cage down.

      You can try doing this exercise –

      The Dead bug:

      Your focus is to keep your lower back fairly flat to the floor as you bring your arms and legs down towards the ground.

      On top of that, you will need to re- position your shoulders. You can check out this post here to see some great exercises.

      Mark

  34. ohmygod omg omg

    I have been struggling and in pain for so long, my hips hurt, my legs hurt, my ankles, even my back. i thought it was posterior pelvic tilt although that’s only a part of it

    your hip flexor exercise works so well. i’m gonna do the shit out of that now. i feel better already after two sets. that’s what my problem is! weak hip flexors. your exercise worked very well thanks for the info

  35. Great article!! Thank you for sharing such informative knowledge. Besides doing these exercises, would a lumbar support seat cushion help? I sit at a computer all day. Does the triangle cushion help with bringing the pelvis back or make it worse?

    1. Hi Steven,

      Lumbar support is great for prevent rounded of the lower back, but you need to make sure that you place it in lumbar curve (… and not to high in mid back region as this will encourage the sway back).

      Also – it is very important that if you use a lumbar support cushion, make sure you sit all the way back into the corner of the seat. Otherwise your pelvis will slide forwards.

      Triangle cushion tends to tilt your pelvis forward which can be beneficial in sitting. If you use it, just make sure your torso is correctly aligned on top of your pelvis.

      Let me know how it goes!

      Mark

  36. Thank you sooooo much for these helpful hints! I’ve been in pain on and off for months dealing with sway back. I felt almost immediate relief doing some of these techniques. Do you have an suggestions on stretches for people who are multi ligimented?

    1. Hi Crystal,

      Awesome!

      Great to see you are getting immediate relief from the exercises.

      I am not too sure what you are referring to when you say Multi-Ligamented. Please let me know so that I can help out 🙂

      Mark

  37. Mark,

    Thank you for taking the time to share this information. I’m however confused. I think you have shown the posture of “kyphosis” as opposed to “Lordosis”. Would your recommendations be the same for both forms of swayback?

    Thanks kindly,

    Trip

    1. Hey there,

      There can be (and often is) kyphosis associated with a sway back posture. And that’s the same with anterior pelvic tilt (or hyper lordosis).

      Both are treated differently.

      Check the post on Anterior Pelvic tilt to see the exercises for that.

      Mark

  38. does holding the stomach in for the whole day help this situation? because it helps the pelvic to go backward a little.
    Generally, is it good to hold the stomach in for the whole day, and does it do any good for body posture?

    1. Hey there,

      Initially, you might need to consciously hold your core to get an idea of what good posture feels like.

      But the end goal is for your core muscles to engage automatically and appropriately without you having to think about it.

      Mark

  39. I’ve started to notice that my lower back pain when I’m standing for long periods of time, and now that I’ve read this article I’m guessing that’s because my center of gravity is not centered. These exercises look like they would help me strengthen my back muscles! I’m trying to be better about standing up straight, and I bet seeing a physiotherapist would also be really helpful with that.

    1. Hi Cam,

      If you have both a sway back and anterior pelvic tilt, the priority would be to correct the sway back posture first.

      It is important to get the hip joints directly over the ankle joints.

      If then, you still have an anterior pelvic tilt, you can start to do the ATP exercises.

      Hope this answers your question.

      Mark

      1. Hi Mark,

        I’ve been performing these exercises for a little while now, and they have been working, but something I’ve come to notice is that my knees have began to hurt which is probably the result of my body adjusting to the new position of my hips stacked over my knees themselves. Is there anything I can do to alleviate this?

        1. Hi Cam,

          Very normal response. Your knees are trying to get used to new posture.

          There are heaps of things you can do for knee pain. But that really depends on what exactly is hurting.

          Are you doing any form of exercise/sport that may be aggravating it?

          Mark

  40. Hello Mark! This post makes so much sense. I always though I had APT but I have literally every single thing you described here.

    I’m going to PT now for a shoulder injury but I was wondering if you had any idea for how often to do all of this? Is this a daily routine, or every other day, or what?

    Also, do you have a sub for side planks? I cannot put weight on my shoulders at that angle right now.

    1. Hi Mikaela

      Try to do it everyday (if your body allows it). More the merrier.

      If your shoulder hurts, don’t worry about doing them for the time being. Focus on the dead bug exercises.

      Mark

      1. Hey Mark,

        Obviously there is a lot to work on with improving posture. What incorrect posture should I focus on first. Because obviously I’m sure a lot of people have Sway Back or Anterior Pelvic Tilt, Upper Cross Syndrome or a combination along with improper sitting and sleeping habits. It’s not feasible to spend 3 hours everyday doing these exercises and keeping everything in mind, so what you suggest first. I’m addressing my Sway Back and my Forward Head Posture first, while paying attention to my posture whilst sitting and walking. After that should I focus on Rounded Shoulders? Or where do you recommend I start?

        1. Hi Pree!

          I definitely know where you’re coming from.

          You can go about it in many different ways. (And there is no right or wrong way really)

          I would suggest you start with your pelvis.

          This is your foundation. Everything will be based on where the pelvis is.

          However – if you also suffer with pain, it might be an idea to start with the area where it hurts the most to give you a bit of relief.

          Whatever you choose, stick to it, do it well, be consistent and you’ll see good results 🙂

          Mark

  41. Hey Mark,

    I have been sleeping on my stomach for my whole life, if I can’t sleep on my stomach, what position do you recommend? I also read on your rounded shoulders section, which I may have, that it’s not advisable to sleep on my side either. So I guess by default that leaves me to sleep on my back.

    Also is the floor still recommended over bed? Over time will I be able to sleep comfortably in that position for 6 – 8 hours? Because I’ve tried falling asleep for that long but I’m currently unable to.

    Thank you for sharing this vast amount of information!

    1. Hey there Pree,

      The general rule is to sleep on as firm mattress as you comfortably can.

      However, sleeping on the floor may be too big of a jump from your mattress.

      Try to do small changes over a longer period of time to allow your body to adapt and get used to the new positions.

      Mark

  42. Hi Mark thank you for your comprehensive post. What is your take on using posture braces to fix sway back posture? I am including a link on posture correction tips for reference

  43. Hello Mark,

    My 7 year old son seems to have both swayback and lots of pronation and flat feet.

    Can I send you the photos to get your opinion on what to begin with first? Where could I send them?

    Thanks for your advice.

    Kristina

  44. Hello , after going through your site i think i have sway back with round shoulders but in one image which you said dont stand like hand folding in front of you at mid chest region my pelvis shift towards left side ( x ray of my lumbar spine showed little curve ) am i having lateral pevic shift also.
    Right side of shoulder back and upper traps are very tight after i stand in a upright position

    1. Hi Adam,

      Looks like it is more of a sway back posture with a very slight anterior pelvic tilt.

      The thing that stands out to me the most is your Posterior Rib tilt (where the lower ribs are pushed forward).

      Try to do this exercise:
      s

      The main aim is to keep your whole back FLAT against the wall. If this is too difficult, place your hands down and repeat. Do not let your ribs flare up.

      Mark

      1. Hi Mark,

        first i’d like to thank you for your interest.

        i’m 23 years old… so will exercises help me ?
        i’m ready to do exercises for one or two years but at last i’d like to have a normal posture

  45. Hi Mark,

    My son, who is very active, has been demonstrating poor posture. I’ve noticed that when he takes off running he sometimes stumbles as if he is going to fall forward.

    Even after reading your whole article, I’m having trouble diagnosing him. At first, I was thinking sway-back posture but now I’m thinking he has APT with a rounded back (head forward) posture. Is this possible? He is asking for some exercises/stretches to do and I don’t want to steer him wrong.

    Thanks,

    Josh

  46. Hey mark, I dont have swayback or anterior pelvic tilt but still I do have a bigger lower back curve than normal maybe due to tight lower back muscles. Can you please suggest some lower back stretches?

  47. Hi Mark,

    Thanks for this great post. As I proceed, I want to make sure I’m doing the right things with my hip flexors. I’m not sure if I’m:

    a.) Both kyphotic and lordotic. In addition to the curvature in my upper back and my pelvis shifting forward, I also have: internal rotation of femurs, a bit of a “false curvature” shape to my legs, and a pouch like shape of a protruding stomach. In my limited research, these traits are often associated with anterior pelvic tilt. I also have tightness/discomfort in my levator ani region when sitting for what it’s worth.

    or

    b.) Standard sway back, as described in your post. Maybe the other symptoms I described are common in sway back without lordosis, or a result of the higher-up concavity in the mid-back region that people with sway back have. I’m not sure.

    Some sites suggest stretching/lengthening/relaxing the hip flexors (esp. the psoas) for kyphotic-lordotic people, and I just wanted to get your take. Thanks again!

    1. Hi Frank,

      Thanks for the question!

      By the way you are describing your situation, I feel that you may have both Sway back posture AND an anterior pelvic tilt.

      Fixing, the sway back posture, however, should take priority over the anterior pelvic tilt.

      Stretch/Release the rectus femoris and tensor fascia lata muscles. (both hip flexors), but strengthen your Psoas (also a hip flexor, but more of a stabilising muscles more than anything).

      Hope this answers your question, Frank!

      Mark

      1. Thanks for the response! How often should we be doing the above routine? Curious to know if the iliopsoas, glute, and oblique exercises warrant recovery time. I’ve been doing 2 days on, 1 day off…but can probably do everyday if time permits.

        1. Hi Frank,

          Try to do the exercises as often as you can, provided that your body has recovered from the previous session.

          As your body becomes familiar with the exercises, your muscles should recover quicker as well!

          Mark

  48. No not all, but it feels very soft and it is on the inside of spine, it does not feel like a piece of extra meat or tumour or anything, there is no visible presentation of it on my back. It feels like a muscle that you were never aware of before but after you read about it you can feel it. That’s how it is. And I feel it sometimes for a few hours like in a week or two I think mostly after squatting.

    1. Hi Joe,

      I’m not too sure what else it could be without seeing you. It’s likely some sort of extension of your soft tissue in the area.

      You might need to get it checked out by your local health practitioner just to make sure it isn’t anything serious.

  49. Hey Mark,
    Thanks for writing this article and the one for forward head as well. Very informative and easy to understand but I am a little bit confused as I work at a desk 8-12 hours daily on a computer and somehow ended up with pelvis dragging forward, I also came to know that I have a very weak core. I’ve started doing the excercises mentioned above but I am also doing core strengthening excercises which mostly include strengthening the abdominals and as you’ve warned in your article not to strengthen abdominals it is making me wonder what to do?

    1. Hi Joe,

      Good question!

      Try not to get confused “core exercises” with “abdominal exercises.

      Your core muscles are the deep muscles that wrap around your mid section.

      Your abdominal muscles are the superficial muscles (essentially your 6 pac muscles.)

      So it is possible to do core strengthening without exercising your abdominal (6 pack) muscles.

      Hope this clarifies things!

      Mark

      1. Thanks for answering, Mark.
        I also have a very soft and spongy feeling in my mid back probably 2-3 inches above lower back right in the middle of the spine. Any idea what this could be?
        Thank you very much.

  50. Hi Mark.
    I am male, 26, and I have over pronation of the feet and inward knee rotation. Please suggest me some stretches or excercises to correct it.
    Thanks.

  51. Hi Mark,

    Thank you so much for writing this great guide. I have searched online for fixing swat back for a long time but most of the articles I find focus on lordosis. Your article is very helpful.

    I am 26, have sway back, however, my trunk tend to tilt to the right side. My right lower back is way stronger than the left one. So I am wondering for the side plank and single arm weight, is it appropriate that I strengthen the left side for a while and stretch the right side, and then I will start to do these exercise for both sides? Thank you very much!

    1. Hi Liya,

      What a great question.

      Here are some tips for you specifically to address your tilt.
      1. Stretch the right side (Google: stretches for Quadratus lumborum and Psoas)
      2. Strengthen the left side (Side planks with variations)
      3. When sitting, make sure you are not leaning on one side more.
      4. Sleep on your right side.
      5. When standing, do not favour one leg. Stand evenly.

      You are exactly right with regards to doing one side first. When you are even, then you can do both sides.

      Hope this helps.

      Mark.

  52. Hi mark, I am 19 male and I have swayback too, I did too many forward lunges which caused my swayback posture. I’ve been doing these excercises and wanna ask you that my ribs and my pelvis are not aligned My lower ribs are falling forward. Please suggest excercises for bringing ribs backward.

      1. Thanks for replying Mark, as the article says ligament laxity irreversible, I am worried as I have done forward lunches in the past sometimes holding one stretch for 1 min also. I wanna ask If I may have overstretched my ligaments? And I wanna ask if I can do these excercises and squat as well without weights to engage glutes more will that be okay?

  53. Thank you for this generous information sharing. I’m hoping that this might be able to help me.
    Thanks again!
    Sandy

  54. I am 49 and have lots of knee, back, neck issues probably caused by sway back posture.

    A few months ago I tried to be persistent with sitting and standing correctly throughout the day, and I was also laying on my back on the floor & doing leg lifts every day, too. I did this every day for a month, but my back/neck pain became worse and worse. I finally gave up & went back to slouching, and my back pain improved.

    Am I a lost cause? Am I just too old & messed up to fix this? I’m so tired of my ugly posture and I’m worried that it is causing longer term issues, but now I don’t know if I should even try to fix it.

    Please help!

    1. Hi Emily,

      It’s never too late to make improvements in your posture!

      Here are some possible reasons why your symptoms may be aggravated whilst doing the exercises.

      1. You may not have sway back posture. Doing sway back posture correction exercises for someone who does not have it can make symptoms worse.
      2. Incorrect exercise technique. Doing the right exercise the wrong way can also make things worse!
      3. The amount/intensity of exercises that you are doing may not be appropriate for your current level of tolerance. You might need to modify some exercises so that you can do it more effectively/comfortably to suit your current capacity.
      4. It takes time. It can get worse before it gets much better.
      5. Combination of everything.

      Please let me know how it goes. I’m here to help! 🙂

  55. Hi Mark,

    I emailed you as well! My hubby needs some help with a full workout plan that takes into consideration his swayback/forward head and duck foot postural problems! Can you help?

    Nicole

  56. Hi Mark,

    your post is fantastic. I fully match all the features of a sway back position…I started to follow your program and had great relief from my patellar hypertension syndrome which caused me a lot of pain after running or cycling sometimes. I believe that my PHS is due to my bad posture: you think that the sway back position can also affect the knee?

    Many thanks,
    Andrew

    1. Hi Andrew,

      You bet Sway back posture can definitely affect your knee issue.

      Your body works its best when everything is in optimal alignment. It very hard for knee to be moving properly if your pelvis isn’t.

      Mark

  57. I have swayback /lardosis had it for as long as I can remember, im now 45. Even as a 16 year old my stomach was sticking out and it look like I had a big stomach. I found a book when I was about 25 in the library on the Alexander technique, but I never followed up on it. I think its too late for me. too much work and behavior to keep track of and continuously do exercises.

    I read somewhere that putting babies /young kids to sleep on their stomach causes it.
    I was a stomach sleeper, up until about 9 years ago.

    Also it threw up my body out of whack and my clothes don’t look proper when I wear them. jeans are always tighter at the thighs, and one of my shoulder is higher than the other.

  58. Hey Mark, Great Post!
    I have this bad posture and have started doing this exercises but my question is what time of the day should we do this? Morning adter waking up, before bed or afterworkout.

    Also before doing this exerciss do we warm up or anything you recommend?

  59. This is the best post I have seen on the internet on sway back posture! And trust me, I have searched everywhere,
    Thanks mark!

  60. Hi Mark, is it possible to have an anterior pelvic tilt combined with a sway back posture? I mean that the backside of the hip is (significantly) higher than the frontside of the hip, as wéll as the hip is in front of the ankles and shoulderbone. My feet are also pointing outwards.

    If so, what would be the best course of action? I’m anxious to start training because swayback and anterior pelvic tilt diagnoses and excercises seem quite contradictory.

    Great website by the way, keep up the good work!

    1. Hi Justin,

      It is definitely possible to have both sway back posture with an anterior pelvic tilt. However, note also that you may just have pointy bits at the back of your pelvis which may naturally appear to sit higher than the front due to the shape of it.

      If you have both, correcting sway back posture takes priority over an anterior pelvic tilt. Focus on getting your hips aligned over your ankles by strengthening/engaging hip flexors (iliopsoas muscle).

      Let me know how it goes, mate!

  61. What a great post! I’ve had sway back for as long as I can remember (I’m 26 now) and I never gave it much thought until it started causing me problems a couple years ago. You pretty much covered all of the issues I’ve been having, but I have one major deviation from your description: my pelvis tilts forward, not back (like I’m sticking my butt out) and it doesn’t shift forward, it just rotates forward in place. Have you seen this variation of sway back and do you have any alternate recommendations? Thanks!

  62. Hello Mark, this is a great guide!

    I am 22, but when I was 10-12 I started to develop pectus excavatum. Eventually the condition got so severe that it is now clearly visible from the side, even when wearing a t-shirt, and I believe that it significantly affects my sports performances (e.g. I can’t do a 200m sprint without feeling very nauseated afterwards. The same applies to playing basketball or football (soccer) for 15 minutes. And those are stories from when I had actually been sporting competitively (playing badminton) for years, so it’s not like I was a couch potato, but I could just never improve my physical endurance, no matter how much I sported).

    Now I am not sure, but I believe that this condition may have caused my hunchback posture (and forward head posture and forward shoulders, etc.). I don’t appear to have anterior pelvic tilt (or maybe very slightly), but now I was wondering if it is also possible to completely fix the swayback posture even if you have a pectus excavatum.

    I don’t know if it’s useful information for you, but I also do have those hamsting issues and the other stuff that comes along with a swayback posture. E.g.: my hand palms can barely get past my knees when correctly bending forward with stretched legs.

    Also, other than issues with maybe endurance, does a pectus excavatum affect your centre of gravity in a way which negatively affects any strength-training/weight-lifting routine?

    Hope to hear from you soon and thank you for writing this!

    1. Hi there Jamie,

      Any deviation in your rib cage alignment can definitely affect your centre of gravity. This in turn can make your body inefficient in movement which may lead to problems like premature fatigue as you stated. Depending on the severity of your pectus excavatum, it can even affect how efficiently your lungs can function.

      Since pectus excavatum is a structural issue, there is nothing you can do to change that, however, in regards to fixing your sway back posture, it can definitely be improved with the exercises.

      It can also affect your lifting routine such as imbalances, asymetrical loads on posture, uneven growth of musculature, tightness of chest muscles. etc All of which can be addressed with a specific training program.

      Hope this helps you Jamie!

      1. Hey Mark,

        Thank you for getting back to me. Good to know that my pectus excavatum doesn’t make it impossible to fix my posture. I still have one question about the exercise programme, though.

        Is there perhaps an alternative for the exercise “Jack knife with exercise ball” or is that exercise ball really necessary?

        Hope to hear from you soon!

        1. Hi Jamie!

          No – the Jack Knife exercise does not have to be conducted. I like it because it incorporates both your deep core muscles and hip flexor muscles together.

          Is there a reason why you don’t want to do it?

          Mark

          Mark

          1. Sorry for the very late reply, I’ve been quite busy with university. The simple reason for not doing that exercise is because I don’t have a ball, that’s all. So nothing to worry about.

            I do have another question, though: What exactly are the ball release exercises for? For example, for the hamstring, is that purely for massaging, loosening the muscles?

            Kind regards,
            Jamie

          2. Hi there Jamie,

            Ball releases help loosen up the tight muscle.

            I suggest doing the ball releases before you do the stretches.

            Mark

  63. Hello Mark, thanks for this website, its extremely helpful!

    I had some injuries on my legs, and it caused me to be sit most of the time for 8 months. I didn’t know I was sitting in a very bad posture. Now I have sway back because of that.

    I’m already fixing it thanks to you! But I wonder, could 8 months of very bad posture cause some irreverisble changes on the bone structure?

    1. Hi Hugo,

      The longer you have had bad posture, then the longer it is going to take to fix it. As long there is no structural damage (like arthritis, disc bulges, fusion etc), I find that there is always something that you can improve on.

      Keep up the good work and let me know if you have any other questions.

    1. Hi Rafal,

      It is fine to do the McKenzie Press up (especially if you have lower back disc bulges), but I wouldn’t do it excessively or have it as your main exercise if you have a sway back posture.

    1. Hi Rafal,

      You can do the piriformis stretch with any posture, especially if you have tight/overactive glute muscles. If you tend to walk with your feet facing outwards (duck walking), then you might have tight glutes.

  64. Thanks for this post!!!! I’ve had swayback forever because of hypermobile joints, nice to be correcting it now. With this posture, is it common for one side to be stronger? My barbell squats are asymmetrical, as I rise from the bottom of the movement, my right glute rises first and sways to the right. My left glute always lags behind. How can I correct this? I can’t ‘feel’ this happening, so it’s really hard to correct this as I do the squat. I also have lower back pain on my right side, but that has gotten better due to weightlifting and this post.

    1. Hi Emily,

      Cheers for the comment!

      There are multiple reasons why you might shift to the right side in a squat. (Tight right groin, Right leg dominance, Weak Left glute muscle, Tight Left glute, Poor mobility in your left ankle… just to name a few).

      I would have to observe how you squat to determine what might be causing it.

      I am happy to have a look at a video you squatting if you would like an assessment.

      Mark

  65. This guide looks fantastic! I’m self concious about my posture and its long term effects so I’m going to start incorporating these exercises into my daily routine, as they look really nice and simple to do.

  66. Hello Mark,
    When i stretch my lower hamstring and upper hamstring i do not feel hamstring but only feel calf and this place marked on green (http://i.imgur.com/ItZYA0e.png)
    second problem is when i strenghten my hips i feel no hips but quadriceps femoris and Tensor fasciae latae. Its a normal? Sorry for my english 🙂
    Krystian.

    1. Hello Krystian,

      With the hamstring stretches, make sure you tilt your pelvis forward (“stick your butt out”). This should emphasis the hamstring stretch.

      If you feel the stretch behind the knee only, it may mean that you are stretching your hamstring TENDON, which is good! You may just be tighter in your tendon rather than your muscle in your hamstring.

      With hip exercises, try these exercises: http://www.posturedirect.com/is-sitting-destroying-your-butt-muscles/

  67. Hey Mark,
    Thanks for the article. This is the clearest outline of all the symptoms I have, and I’ve been to two different therapists.

    My main issue besides back and spine discomfort is headaches. I get them whenever I exercise or after a long day of work. Icing my upper trapezius muscle helps but I wish I could get to the root of the problem. Do you know of anything I could do specifically to reduce headaches?

    Thanks again,
    Scott

  68. Hey mark,
    Thanks for the post. First time I’ve seen most of my symptoms combined into one overarching issue. And that’s after going to 2 physical therapists.

    I have neck and thoracic pain but my worst symptom is headaches. They are the worst when I workout or play basketball.

    Do you recommend anything specific for headache relief? Icing my upper trapezius helps afterwards but I’d like to treat the cause.

    Thanks,
    Scott

    1. Hey Scott,

      If you have sway back posture, then you probably have a degree of Forward Head Posture. This has been the cause of headaches in many of my patients.

      Check out this post: http://www.posturedirect.com/forward-head-posture-correction/

      When your head is poked forward, it makes all the muscles around your neck and shoulder region work very hard (esp. when playing a sport like basketball or working out). When muscles work too hard over a long period of time, they can start to cause pain, or present as headaches.

      Hope this helps

  69. Hey man! Awesome post, extremely informative… Can swayback be caused soley because of tight, inflexible hamstrings? I’ve got swayback and my symptoms seem to drastically improve with stretching of upper hamstrings and don’t really think Muscle weakness is the root cause. Years of playing volleyball at a high level with very minimal stretching might have been the recipe here, again very good post!

    1. Hey Kyle,
      Tight hamstrings can definitely be the root cause of your sway back posture. (Esp. if you have played a sport for many years like volleyball)
      Thanks for the comment, mate!

  70. I have always had bad posture and sway back for the past few years. As a result I have been living with frequent lower back pain for years and hip pain over the past several weeks. After trying these stretches and exercises for the first time, my back pain has eased substantially and my hip pain is gone. I am amazed!

    1. Hi Christina. It’s true that it gets harder to change the longer you have had it, but it’s never too late to take action!

      Try out these exercises on the post. It takes time. But persist!
      Please let me know if I can be of any assistance.

      Mark

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