How to fix Flat back posture

What is a Flat back posture?

Flat back posture is a type of posture that is characterised by the lack of natural curves in the spine.

As a result – the alignment of the spine (as viewed from the side) is flatter than normal.

Characteristics of Flat back posture:

flat back posture

  • Forward head posture: The head is poked forward.
  • Rounded shoulders: The shoulders are slouched forwards.
  • * Flat thoracic spine: Lack of upper back natural curve (Thoracic Hypokyphosis)
  • * Flat lower back: Lack of lower back natural curve (Lumbar Hypolordosis)
  • Posterior pelvic tilt: The pelvis is rotated backwards.

(* This blog post will cover these main areas to address your Flat back posture.)

a) Flat thoracic spine

This is where there is a loss of natural curve (kyphosis) in the upper back.

The thoracic spine is locked into extension.

Cause: This occurs when the thoracic spine attempts to position the shoulders and head (which are generally slouched forwards in most people) into a more up right position.


Muscles responsible:

  • Spinalis thoracis
  • Iliocostalis thoracis
  • Longissimus thoracis
  • Posterior intercostals

b) Flat lumbar spine:

This is due to a Posterior pelvic tilt.

This is when the pelvis is rotated backwards.

Cause: Sitting with a slouched posture.

This leads to an imbalance of the forces around the pelvis causing a net force to tilt backwards.


Muscles responsible:

Tight/overactive:

  • Hamstrings
  • Abdominals
  • Gluteal muscles

Weak/inhibited:

  • Lumbar paraspinals
  • Hip flexors

Note: If you would like to know more about the ideal pelvis position, check out this post: The correct pelvis position in sitting.

Why is having a Flat back posture a bad thing?

… because curves are sexy! (… in moderation, of course)

Having natural curves in your spine is actually a good thing! (… plus it’s normal)

It helps with load distribution.

In Flat back posture, the spine has a poor ability to absorb and distribute mechanical stress evenly throughout the body.

As a result, the muscles may have to work harder to help stabilise and move the spine.

How to test for it?

a) Flat thoracic spine:

Take a side profile photo:

Observe for the presence of a flat segment in the upper back region.

Note: Make sure that you do not confuse the shape of your shoulder blades as a curve in your upper back.

b) Posterior pelvic tilt:

posterior pelvic tilt flat back posture

In standing, place one finger on your pointy hip bone at the front, and the other on your pointy bone at the back.

If you have a Posterior pelvic tilt, the finger at the front of your hip bone will be noticeably higher in comparison to the finger on the pointy bone at the back.

Exercises for Flat back posture

Image courtesy of Idea go at FreeDigitalPhotos.net


Note: All exercises are to be performed gently and pain-free


Flat back posture:

1. Flat thoracic spine

a) Releases:

Thoracic paraspinals

releases for flat back posture

Instructions:

  • Place your body weight on a massage ball in the areas to the sides of the spine and between your shoulder blades.
    • Find all of those tender areas!
  • Roll over the ball in a circular motion.
  • Spend at least 5 minutes to do the whole area.
  • Do NOT place the ball directly on the spine. (… It’ll hurt!)

b) Stretches:

Stretch into flexion

Instructions:

  • Whilst sitting, interlock your fingers behind your neck.
  • Proceed to gently pull your neck downwards.
  • Focus on bending at the upper back as much as possible.
  • Aim to feel a stretch in your thoracic spine area.
  • Hold for 30 seconds.
  • Take deep breaths in whilst in this position
    • Imagine the air expanding the area between your shoulder blades.

Stretch with foam roller

Instructions:

  • Whilst sitting, place a foam roller on your lap.
  • Bend and round your back whilst your chest is in contact with the foam roller.
  • Focus on bending at the upper back as much as possible.
  • Aim to feel a stretch in your thoracic spine area.
  • Hold for 30 seconds.
  • Take deep breaths in whilst in this position
    • Imagine the air expanding the area between your shoulder blades

c) Joint mobilisation:

Rotations

Instructions:

  • Get into the 4 point kneel position. (see above)
  • Place one hand behind your head.
  • Proceed to twist your body to the side where the hand is on your head.
  • To isolate the thoracic region:
    • Do not allow your lumbar spine to move:
      • Brace your abdominals.
      • Keep your ribs cage low.
  • Repeat 20 times.
  • Repeat on the other side.

Translations

Instructions:

  • Whilst keeping your pelvis stationary, slide your upper torso to the side.
  • Try to also lift the shoulder on the side you are sliding to.
  • Aim to feel a stretch on that side of your torso.
  • Alternate both sides.
  • Repeat 15 times.
  • (This is a difficult one. Don’t worry if you can’t get it the first time!)

d) Improve Control

Standing Segmental cat/cow

Instructions:

  • Whilst standing, wrap your arms around an exercise ball as much as you can. (see above)
    • Try to get your fingers tips to touch.
  • Starting from the neck: Proceed to round your spine down one vertebra at a time until you reach mid-back.
  • Emphasise the rounding over the areas where your spine is the flattest.
  • From here, reverse your movements back to the beginning.
  • Repeat 20 times.

Intersegmental cat/cow

flat back posture exercises

Instructions:

  • Get into the 4 point kneel position.
    • Hands in line with shoulder joint. Knees in line with hip joint.
  • Starting from the neck: Proceed to round your spine down one vertebra at a time until you reach mid-back.
  • Emphasise the rounding over the areas where your spine is the flattest.
  • From here, reverse your movements back to the beginning.
  • Repeat 20 times.

e) Regain your natural curve

It may take some practise… but you want to keep a slight natural curve in your upper back at all times.

If you don’t do this, your thoracic spine will likely just go back to being flat again.


2. Flat lumbar spine

a) Releases

Hamstrings

Instructions:

  • Place your hamstrings on top of a massage ball.
  • Use your body weight to apply pressure onto your hamstrings.
  • Make sure to cover the whole hamstring muscle on both sides.

Abdominals

Instructions:

  • Lie on your stomach.
  • Place a massage ball under your abdominal region
  • Gently circulate your body weight on top of the ball.
  • Do not to apply too much pressure. 
    • (Do NOT squash your organs! STOP if it hurts.)
  • Use deep breaths to help relax your muscles.
  • Spend at least 1-2 minutes.

b) Stretches

a) Upper hamstring

Instructions:

  • Whilst standing, place a slightly bent knee in front of you. (see above)
  • Lean forward by hinging at the hips.
  • Remember to keep your back straight!
  • Aim to feel a stretch in the upper portion of your hamstrings.
  • Hold for 60 seconds.
  • Alternate legs.

b) Lower hamstring

Instructions:

  • Whilst standing, place a straight knee in front of you.
  • Lean forward by hinging at the hips.
  • Remember to keep your back straight!
  • Aim to feel a stretch in the mid/lower portion of your hamstrings.
  • Hold for 60 seconds.
  • Alternate legs.

c) Abdominal

Instructions:

  • Lie on your stomach.
  • Place hands on floor directly under shoulders.
  • Straighten your elbows.
  • Arch backwards.
    •  (Note: Be careful if you have lower back issues)
  • Aim to feel a stretch across your abdominal region.
  • Breathe and expand your stomach as you stretch.
  • Hold for 60 seconds.

c) Strengthening

Sitting knee lifts

This is to activate the hip flexor muscles.

Instructions:

  • Sit up right.
  • Whilst keep your back still, bring one knee up towards the roof.
  • Hold for 5 seconds.
  • Alternate on other side.
  • Repeat 30 times.

Superman

This is to activate the lower back muscles.

Instructions:

  • Lie on your stomach.
  • Stretch out your arms in front of you.
  • Lift your upper body and legs off the floor.
  • Hold for 5-10 seconds.
  • Repeat 30 times.

Pelvic tilt (4 point kneel)

Instructions:

  • Assume 4 point kneel position. (see above)
  • Tilt your pelvis forward.
    • Your back should start to arch
  • Hold for 10 seconds.
  • Repeat 30 times.

Pelvic tilt (In sitting)

exercises for flat back posture

Instructions:

  • Whilst sitting up right, proceed to tilt the pelvis forward.
  • Hold for 10 seconds.
  • Repeat 30 times.

 Glute strengthening

You will also want to strengthen your gluteal muscles whilst in the correct pelvic position. I’ve written a whole post on this here.

d) Maintain neutral pelvis

If you do not maintain a neutral position of the pelvis throughout the day, then your posterior pelvic tilt will continue to be an issue.

Make sure that you tilt your pelvis forward to a neutral position whilst you are walking, standing, sitting etc.

As your body has had this posture for a long time now, it will try to go back to it as a default settingYou need to resist this!

3. Other areas to consider

*** READ THIS ***

If you have a Flat back posture, then you will most likely have:

I have already covered these areas in detailed posts that include EVERYTHING that you will ever need to know.

(Click the links above!)

(I’ve only included 2 exercises for each area in this post just to get you started. Don’t miss out on the rest!)

a) Forward head posture:

Sub-occipital release

Instructions:

  • Place the ball underneath the base of the skull.
  • Gently rotate your head on top of the ball.
  • Continue for 3-5 minutes.
  • Do both sides.

Chin tucks + nods

Instructions:

  • Gently tuck your chin in.
    • “Make a double chin”
  • Aim to feel a gentle lengthening sensation at the back of your neck.
  • Make sure to keep your eyes and jaw level. Move the head horizontally backwards.
    • Think of the movement like a book sliding back into the shelf.
  • Whilst maintaining this position, nod your chin downwards.
  • Hold for 5 seconds and repeat 30 times.

b) Rounded shoulders:

Chest stretch

Instructions:

  • Place both hands on the door frame.
  • Lunge forward.
  • Do not flare out your ribs.
  • You should feel a stretch in the front part of your shoulder/chest region.
  • Hold for 30 seconds.

Elbow flares

Instructions:

  • Start position: Place both hands (elbows forward) on the sides of your head.
  • End position: Pull your elbows all the way back.
  • Aim to feel your shoulder blade muscles contract.
  • Hold for 5 seconds.
  • Repeat 20 times.

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!

95 thoughts on “How to fix Flat back posture”

  1. Hello Mark,
    I am 22 years old.
    I have a flat lumbar spine, forward head posture, rounded shoulders, scapular dyskinesis on the right side. I cannot sit for more than 15 mins without pain in the lower back that goes up into my thoracic spine region. I also have weak deep abdominal muscles (i have the external abs visible tho). Should i work on strengthening my core alongside the exercises here in this post? Or should i focus on fixing the flat back first?

    Reply
  2. Dear mark, one year ago i started doing a ridiculous exercise to treat my forward head posture. It involved manipulation of the spine, giving me posterior pelvic tilt and loss of natural curvature in the thoracic area.After that I had intense breathing problem. I counteracted by doing posterior pelvic tilt correction exercises it gave me relief to a certain extent but it is not completely healed. My chests does not appears to be expanding properly and it feels tight, the problem might be with the shape of ribcage or something. And every second of my existence, I am facing this shortness of breath. Local doctors could not diagnose it and declared that I am either fine or I have psychological problem. But I am sure it is physical.https://youtu.be/CqTtScFQ5-c (the exercise) from 4:00 and i did them excessively with over intensity and certain modifications

    Reply
    • Hello Ash,

      The exercises mentioned in the video look fine.

      If you a flat back now, you may have jammed up your joints in the thoracic spine.

      This can affect the ability to completely expand your lungs due the rib position.

      I would focus on flexion based thoracic spine and breathing exercises.

      Mark

    • hey ash, i was also doing the same thing. i noticed when i was doing alot of chin tucks. i feel hopeless, i’ve been through so many doctors and they said nothing is wrong but i know 100% it doesnt feel right. my shoulders are rounded, really bad forward head posture. and my thoracic spine is flat. when i was doing the chin tucks i was stretching my neck and i think when doing the chin tucks i moved some muscles out of alignment. have you figured out what was going on with yourself?

    • Hi Tom,

      The short answer: As much as you can.

      The more practical answer: Try to do it 2-3/week to start with. See how your body feels and responds do this frequency. Increase/Decrease frequency as appropriate.

      All the best!

      Mark

  3. I was just wondering if you have ever seen someone restore their thoracic curve with consistency of these exercises. And if so, how long would you say it could take of everything is only postural related?

    Thanks

    Reply
  4. Will these exercises work for those you have flat back due to Scoliosis surgery. I am 51 now and had surgery at 12. Having two babies and a couple of falls on my back have made my posture worse also I guess the aging process. I have a double curve that was fused using a Harrington rod. The crazy thing is my right shoulder and neck have issues. My left leg, hamstring and back are tight. I tend to favor my left side when sitting. I am trying to do all I can to stay healthy and active. I tend to get stiffer easier and have a harder time walking long distances.

    Reply
  5. Hi Mark!!

    This site has great content and Knowledge. I thank you for helping people out

    I am 35 and please see below link for my Lower back and neck Xray

    Lower Back – https://ibb.co/dtpyjDw
    Neck – https://ibb.co/KWYF394
    Normal Posture – https://ibb.co/3rRnBrN

    I want to know abot my lower back curve is it normal or i have to work out to make it more curve? I get lower back pain but not regularly.

    For neck as you can see i might have forward head posture but i want to know if i correct my lower back curve then will the neck position improve?

    Also, I tried to do the hamstring test you mentioned by sitting straight against the wall and I really can not put my legs straight to touch the floor nor I am able to bend and touch my toes.

    Please guide me on the exercises I have to start step wise or can I take all 3 simultaneously? i.e lower back, forward head and hamstring?

    Also

    Reply
    • Hey Vipul,

      Looks like the pelvis is in a bit of a posterior pelvic tilt from neutral.

      This can make your lumbar spine flatter.

      If you have identified that your hamstrings are very tight, that might be a good place to help address your flat back.

      Your head is quite forward, but so doing the forward head posture exercises will help. Ultimately – you will also need to address your upper back curve!

      Start with the hamstring and pelvis! See how it goes from there.

      Mark

    • Thaks i have started few exercises will share you the results soon

      I want to know(looking at my xray and photo) is my Lower back curve too flat or is it close to normal?

  6. Hi MArk

    Really great content and knowledge you have given on this site

    can i have your email id i want to share my lower back spine xray to know your views

    Thanks

    Reply
    • Hey Andrea,

      I use the standard sized lacrosse massage balls.

      Keep in mind – they all come in different levels of hardness. You might need to start with the softer balls and progress to the harder ones when you can.

      Mark

  7. Hello, I am thrilled to find you. I have lumbar hypolordosis due to several years of a worsening stenosis between L4/L5. I have had a partial laminectomy of those to vertebrae and had immediate relief from the worst of the spasms and numbness and expect the nerves to continue to heal. This was two months ago. I have started with a physio and I am doing the exercises. He indicated that my flat back might be permanent. I have just found out what the name of the condition is and then found your site. I intend to try very hard for a long time as required if there is a possibility of getting my pelvis back in proper orientation so my hip doesn’t hurt so much. What do you think? Obviously I have to check this out with him too at my next appt.

    Reply
    • Hey Nancy,

      I haven’t assessed you personally so it might be hard to give you specific recommendations, however, I would give the exercises a good try and see how far they can get you.

      You would be surprised at how the body will respond to consistent exercises!.

      Mark

  8. Hi Mark.

    Thank you a lot for this post, i think it will help me a lot!

    I’m 28 soon 29, but since year 16 i’ve had problem with my breathing which made me stop pursuing my dream of professional football. I had everything checked, heart, lunges, brain, but as of a few days ago i started to wonder if my back was the problem.

    I have a flat thoraric spine and my muscles around it are nearly ALWAYS tight and sore. Whenever i play football or are psycical active with high intensity, i have troubles breathing the next couple of days. But i don’t experience problems when i ride a bike or use the cross-trainer with low/middle intensivity, probably because i don’t use my back.

    When i sprint i get very tight in my back and i instantly loose my breath and become fatigue very quickly.

    I did some of your stretches yesterday, and already at my football game later the evening i could feel a difference. Quite big actually. Already before the game i felt more loose and light in my back and today (the morning after) i even feel that my legs are light, which they haven’t been for ages. For the first time in 13 years i feel like i’ve found the reason why i have breathing problems when i’m active or sometimes when i just lay on my back or side (Probably because i start to getting tight in the back again)

    Well. My question is. How do i get my back muscles completely released? Do i need to get my flat thoraric spine to curve, before i can entirely get rid of the problem, or can i stretch my way out of it?

    Should i do the above excercies everyday, and that would make the tightness go away, or do you have a suggestion? Maybe especially a suggestion on how NOT to make the tightness come back. Because even when i take a break from football for a month or more, i still feel my back being very tight.

    Again thank you for this post, since i feel this can change my life!

    Reply
    • Hello Henrik,

      Great to hear you have responded to some of the exercises.

      In order for the diaphragm (your main breathing muscle), you need your back to have its natural curve.

      The exercises in the blog post will help with that! You can do them everyday if you like. More the merrier.

      I would also encourage you to work on Rounded shoulders and a Forward head posture (if you have them) as they can contribute to the flat thoracic spine.

      Mark

  9. thank you so much for a terrific site! Im an OTA and have some knowledge (always a danger lol) but also had a mastectomy on R 24 yrs ago w lat flap reconstruction which has added to issue (slight lower scoliosis and tendency to forward head-i.e. read, computer, knit, sew, etc) (some hospitals have discontinued this recon procedure, imagine lat mixed with pec location!!) Very grateful for your knowledge and willingness to share.. I’ll be back after I practice the stretches for a while..Namaste..Deborah

    Reply

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