How to fix Sway Back Posture (UPDATED 2020)

What is Sway back posture?

sway back posture

The Sway Back Posture is where the pelvis is pushed in front of the line of the ankles.

As a result, the torso sways backwards in the attempt to compensate for the forward shift in alignment.

characteristics of Sway back posture


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What causes 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 and/or sitting posture.

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 limited (if any) things we can do to reverse the “looseness” of the ligaments.

The only option is to improve the strength and control of the muscles which support the spine. (… which we will definitely be going through!)

c) Slouched thoracic spine

If the upper back is locked in a hunched position, your pelvis may compensate by driving the hips forwards.

(This is to help keep the head more up right.)

d) Bad habits

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
  • Poor posture when sitting

How do you know 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

test sway back posture

a) Greater trochanter (Hip):

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

b) Lateral malleolus (Ankle):

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

3. Compare the alignment of these 2 landmarks

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

With your picture, draw vertical lines through the midpoints of the land marks.

If you have Sway Back Posture: The line of the greater trochanter will be in front of the line of the lateral malleolus.


Sway back posture vs Anterior pelvic tilt

anterior pelvic tilt vs sway back posture

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 (Hyperlordosis).

The 2 main differences being that in a Sway Back Posture:

1. The center of the hips are in front of the line of gravity.

2. The pelvis is in a posterior pelvic tilt relative to the upper leg bone.

It is important to know the difference between these postures as their respective exercises are different!

Doing the right exercise for the wrong diagnosis will not help you.

muscles involved with sway back posture

  • Overactive/tight hamstring drives the hips forward
  • Elongated and weak hip flexors
  • Weak and tight gluteal muscles
  • Elongated/weak external oblique
  • Tight internal oblique which pulls lower ribs forward/down
  • Over-active erectors spinae muscles in the thoraco-lumbar junction

Exercises to fix Sway back posture

Goals of these exercises:

1. Stretch/Release muscles that push pelvis forwards.

2. Activate hip flexors.

3. Strengthen gluteal group

4. Eccenctric strengthening of Hamstring

5. Address thoracolumbar junction.

6. Address tight upper abdominals

7. Address other posture issues.

8. Maintain neutral pelvis throughout the day.


1. Address the muscles that push the pelvis forwards

Hamstring:

a) Release

hamstring release for sway back posture

Instructions:

  • Place your hamstrings onto a massage ball.
  • Use your body weight to apply the appropriate amount of pressure.
  • Make sure to cover the entire length of muscle.
  • Duration: 2-3 minutes per leg

b) Stretch

hamstring stretches for sway back posture

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.

Need more stretches? Check out this blog post: Stretches for your hamstrings.


Glutes:

c) Release

glute release

Instructions:

  • Place your gluteals on top of a massage ball. (see above)
  • Use your body weight to apply pressure onto your gluteal muscles.
  • Make sure to cover the entire muscle.
  • Do this for 60 seconds.
  • Alternate sides.

d) Stretch

glute stretch

Instructions:

  • Lie on your back with your knees bent and feet on the floor.
  • Place your left ankle on the right knee.
  • Grab your right knee and pull towards your chest.
  • Aim to feel a stretch on your left glute.
  • Ensure that you arch your lower back to increase the stretch.
  • Hold for 60 seconds.
  • Alternate sides.

Tibialis Anterior:

An overactive/tight Tibialis anterior will pull your legs/pelvis forwards.

e) Release

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

f) Stretch

Instructions:

  • Whilst sitting, place your ankle on top of your other knee.
  • Place one hand on top of the ankle and the other on the forefoot.
  • Whilst anchoring the ankle joint down, pull the fore foot towards you.
    • (Include the toes!)
  • Aim to feel a stretch on the out side of the ankle.
  • Hold for 30 seconds.
  • Repeat 3 times.

2. Activate 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 may make Sway Back Posture worse as they are already elongated!


a) Sitting hip flexion (on the chair)

sitting hip flexion

Instructions:

  • Sit up right on the edge of a chair.
  • Without moving your pelvis, lift knee as high as possible.
  • Aim to feel a contraction in the front of your hip.
  • Hold for 5 seconds.
  • Repeat 10 times.
  • Repeat on other side.

b) Sitting hip flexion (on the floor)

long sit hip flexion for sway back posture

Instructions:

  • Long sit on the floor with the support of your hands behind you.
  • Keeping your leg straight throughout exercise.
  • Without moving your pelvis, lift up your leg as high as possible.
  • Hold for 5-10 seconds.
  • Repeat 10 times on each leg.

c)  Plank

Instructions:

  • Get into the plank position. (see above)
  • Position your pelvis in a neutral position.
    • Engage the core and glutes to stabilize the pelvis.
  • Make sure your lower back does NOT sink in.
  • Hold for 30 seconds.
  • Repeat 3 times.
  • Progression: Place a weight on top of your bottom.

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.

d) Hip push backs (Standing)

Instructions:

  • Whilst standing, tie a resistance band from around your waist to a pole in front of you.
  • Make sure there is a firm enough tension on the band to pull your hips forwards.
  • Practice pushing your hips backwards to a neutral.
  • Repeat 30 times.

3. Gluteal group (aka the “butt muscles”)

Weakness in the gluteal muscles can lead to over-activity/tightness of the hamstrings.


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.
  • Hold onto a support (eg. back of a chair) if you have issues with maintaining your balance.

Note: Maintain your upright posture. You should not lean forward when doing this exercise.

c) Bridges

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.
  • Be careful not to thrust too high.

c) Squats

Instructions:

  • Start from a standing position.
  • Perform a squat.
  • Make sure to drive your hips backwards as you descend.
  • Return to starting position.
  • Repeat 15 times.
  • Progression: Hold onto a weight.

d) Lunges

Instructions:

  • Perform a lunge.
  • Make sure to drop as low as possible.
  • Return to starting position.
  • Repeat 15 times.
  • Progression: Hold onto a weight.

Need more glute exercises? Check out this post: Exercises for the glutes.


4. Eccentric Strengthening of Hamstrings

Eccentric strengthening involves the contraction of a muscle whilst it is ELONGATING.

In other words: It is a combination of strengthening + stretching at the same time.


a) Dead lift exercise

Instructions:

  • Whilst standing, hold onto an appropriate amount of weight.
    • (… it should be a moderately heavy weight that you can control)
      • And yes, I do realize I am holding a yoga mat (haha)
  • Upper hamstring: Place a slightly bent knee in front of you.
  • Lower hamstring: Place a straight knee in front of you.
  • Shift most of your weight to the front leg.
  • Slowly lower the weight by hinging at the hips.
    • Keep your lower back completely straight.
    • Aim to feel a pulling sensation in the hamstring region before returning to the starting position.
    • Keep the weight close to your body.
    • This lowering phase should take 3-5 seconds.
  • Return to starting position.
    • Do not thrust your hips forwards.
  • Perform 10 repetitions.

5. Thoracolumbar junction

Aim: To release the muscles and joints of the thoracolumbar junction.

If this area remains tight, it will be difficult to correct your posture.


a) Release

Ball QL

Instructions:

  • Place the muscles that run parallel to lower/middle spine 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.
  • Duration: 2 minutes each side

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 middle of your spine. (see above)
    • The goal is to extend at flexed parts of the spine.
    • Do not arch back too far as you will feel the tension at the base of the lower back.
  • Repeat 20 times.

6. Upper abdominal tightness

a) Upper abdominal release

ball upper abs

Instructions:

  • Whilst positioning the massage ball in the upper abdominal region, place your body weight on top of the ball. (see above)
  • Make sure that you keep your abdominal muscles relaxed.
    • Tip: Taking deep breaths in/out will help keep your abdominal region relaxed.
  • Hold each position for at least 30-60 seconds.
  • Proceed to move the massage ball over to the other areas as indicated above.

Note: DO NOT place excessive amount of pressure into your abdominal region! There are many sensitive organs in the area which can be subject to damage when too much pressure is applied.

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 a stretch in the upper abdominal region.
  • Hold for 30 seconds.

c)  Lower rib upward tilt

Instructions:

  • Sit down on the edge of a chair.
  • Lock your pelvis in a neutral pelvis.
  • Without moving your pelvis, tilt your lower ribs upwards.
    • Create some extension in the upper lumbar region.
  • Hold for 5 seconds.
  • Repeat 30 times.
  • Progression: Hold onto weights with hands by the side.

7. Addressing other postures

If you still have Sway Back Posture after trying out all of the mentioned exercises, you may need to address other parts of your posture.

The following are the main ones associated with Sway Back Posture:


a) Hunchback Posture

A Hunchback posture (also known as having a thoracic kyphosis, rounded back or humpback) is where the upper back is excessively rounded forward.

For more information, check out this blog post:

b) Rounded Shoulders

Having Rounded Shoulders is when the resting shoulder position is in front of the mid line of the torso.

For more information, check out this blog post:

c) Forward Head posture

forward head posture

A Forward Head Posture is where the position of the head is in front of the mid line of the torso.

For more information, check out this blog post:

8. How to stand

Step 1: Stack pelvis on top of the ankles by pushing hips backwards

Keep the greater trochanter and lateral malleolus in line with each other.

Step 2: Return pelvis to neutral

If your pelvis is still in a bit of posterior pelvic tilt, you will need to tilt your pelvis forwards until it is in a neutral position.

The neutral position of the pelvis is when the Anterior Superor Iliac Spine (pointy bone at the front of hip) is slightly lower than the Posterior Superor Iliac Spine (pointy bone at the back of hip).

Step 3: Re-position your rib cage

Without moving your pelvis, tilt your lower chest upwards. (… but not too far that you flare your ribs!)

Step 4: Re-position shoulders

Gently roll your shoulders back and down.

Step 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.

Try to incorporate this new posture throughout your day to day activities.

9. Do not:

a) DO NOT stretch the hip flexors

sway back posture hip flexor stretch

In the Sway Back Posture, the hip flexor muscle group (psoas, iliacus) is already in a lengthened position.

Stretching will elongate your already stretched out hip flexors and potentially make the issue worse.

If you are feeling tight in this area, you are most likely feeling stretch tension. (Think of an over stretched rubber band. Is it truly tight or is does it have stretch tension?)

b) DO NOT sleep on the stomach

Sway back posture sleeping position

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 the classic pronounced middle back arch.

e) DO NOT over do abdominal crunches

xabcrunch

Abdominal crunches may give you nice 6 pac abs, but it will also increase the dominance of rectus abdominus.

This may increase the forward curving of the upper back which is seen in the Sway Back Posture.


what to do next:

Any questions?… Leave me a comment down below.

– Follow me on Facebook. (Let’s keep in touch!)

– Do the exercises!

276 thoughts on “How to fix Sway Back Posture (UPDATED 2020)”

    • Hey Andy,

      Avoid flexion for now.

      Once things settle, try to slowly introduce flexion by doing this:

      Lie on your back, slowly bring your 1 knee at a time to your chest, If possible, hug both knees to chest and oscillate in this end range.

      Mark

  1. why does my low back hurts in deadhang?is it because of tight hamstring or tight hip flexors? when i completly relax when im hanging my pelvic goes in slight posterior tilt this is when its starts to hurt.what can be the cause? thx so much
    and sry for bad english

    Reply
    • Hey Andy,

      If your lower back hurts when your pelvis is in a posterior tilt, then it is likely your back may be sensitive to lower back flexion.

      In terms of which muscle would be relatively tighter? The hamstring would be in this case.

      Mark

  2. hi i have sway back and low back pain do you think streching the lowback is helpful? or is the low back already streched in this posture? thx

    Reply
    • thx for reply and another question why does my low back hurts in deadhang?is it because of tight hamstring or tight hip flexors? when i completly relax when im hanging my pelvic goes in slight posterior tilt this is when its starts to hurt.what can be the cause? thx so much
      and sry for bad english

  3. Mister Mark I have two questions, in sway back posture we have pronated foot or supinated? And rib flared out or not? Thank you

    Reply
    • Hello,

      You can have either pronated or supinated feet with sway back posture.

      The lower ribs tend to be more depressed than flared, but this can go either way as well.

      Mark

  4. Hi Mark,

    I have been reading and learning from your posts but cannot figure out which type of posture I am. Can you please help. I can upload some photos for assessment.

    Please let me know. Thank you.

    Reply
  5. Im 100% certain my swayback was due to weak hamstrings and not tight hamstrings. I followed this routine for a couple weeks now mixed with some weight training and my problems were getting worse. I did more research and a good way to learn to contract the hamstring was to do bridges with your feet further away and ankles dorsiflexed and i got an insane cramp almost like a charley horse. Followed it with the hip flexor and glute exercises and i finally felt a neutral pelvis and having a tight lowerback. I honestly wish i could talk to you personally and tell you my story and symptoms because i tried looking for help and my life was just spiraling into a mess. And im also worried about the integrity of my spine now because i was in this posture every single time i squatted, deadlift, pull up, push up, press, you name it. I really am woried as to how much i mightve damaged my body and i dont want to go back to see another PT or chiro at this point

    Reply
    • Just to name some of the symptoms i had that were literally ruining my life. Chronic fatigue, Not necessarily fatigue but the feeling of laziness and not wanting to move much. EXTREME shoulder weakness. Weak grip, i did a set of chin-ups with a 25 pound dumbbell between my knees and after i finished to drink water, the bottle literally dropped from my hand, my hand still look like it was grasping it and i thought i was gripping it but it literally fell from my hand. The absolute weirdest feeling i has ever felt, especially in the middle of a gym. I also usually drop things thats thrown to me (sadly). And my breathing would never get better no matter what i did, whenever i did cardio or played basketball I literally felt like i couldnt breathe enough air into my body no matter how hard i tried, also sometimes id even be too lazy to speak or say things. There were so many times i wanted to go to a doctor but from all of my past experiences and the thousands of dollars i wasted seeking help there was no way i was going to so i took into my hands. Doing that ive gone pretty much obsessed with the idea of “fixing myself” so i can finally be strong and functional. But doing that ive lost track of my goal of becoming a physician assistant and fixated on this im failing all of my courses this semester, im losing all of my friends because i dont ever want to leave my house, im completely self conscious because i look strong from the front but from the side and back i look like a malnourished boy and im physically not able to speak with my chest. My life is destroyed because of this. I know this is a public post and i dont even know if youll read this but i need to say this to someone, i cant talk about this with anyone because no one would understand, somehow i look like im normal because im pain free but the way i move is so weird, im scared people notice. I dont even know what im expecting if you do respond but i just have to get this off my chest

    • Hi Luis,

      Tight hamstrings can come from weak hamstrings.

      People who don’t usually work on their hamstrings will tend to get hamstring cramps. (esp. if weak)

      In regards to a sway back posture, it is possible to have tight AND weak hamstrings.

      Perhaps you will need to strengthen the hamstrings in their lengthened state? A good way to do this is the straight leg dead lift.

      Mark

  6. Thank you Mark. This is fantastic information! I will use and share with a client and friend. We’ve been working on posture but now with your expertise we will take it to the next level. Cheers!

    Reply
  7. Hello,

    I tried to make contact with you via FB but unfortunately you don’t respond to messages.

    I’ve had a physio tell me I’ve ATP and said I was standing in sway extension (is it the same as swayback?), I was wondering if you could tell me if it really is swayback?

    I can upload images via imgur and provide link here.

    Thanks

    Reply
  8. Hi Mark,

    What exactly do you mean by this :Stack pelvis on top of the ankles by bending forwards at the hip.? So you want us to lean forward? or bring the hips back so that is inline with with ribs and ankles?

    Reply
    • Hey KKcho,

      It can be either.

      It really depends on how your hips sit in the hip socket.

      Generally speaking,

      If your feet/knees points:
      – outwards, then it is more likely going to be externally rotated.
      – inwards , then it is more likely to be internally rotated.

      Keep in mind, if you have a posterior pelvic tilt (as characteristic in the sway back posture), the hip joints are already oriented outwards.. so a small degree of out turned foot would actually be quite neutral in terms of hip rotation.

      Mark

  9. Hey Mark- I have this issue only on one side where I sway in that specific side (right side).

    All this happen due to a foot injury that messed up my gait.

    Should I do the exercises just for that side which includes glute strenthening as my glute on the same side is weak.

    Thanks again :)

    Reply
  10. Hi,
    How does the order for strengthening the weak muscles work. Should I get some basic strenght in my hip flexors, like training them for a couple of weeks and then move on to the glutes?
    Or do them all in one training session?

    Reply
  11. When doing any kind of hip extension exercises my hamstring take over drastically. What you recommend to do? Should I stretch/foam roll hamstring prior to doing any glute exercises to reduce recruitment.
    Thanks

    Reply
    • Hey Cam,

      You can roll the hamstrings out. That might help.

      I would also recommend you learning how to do a posterior pelvic tilt prior to doing a hip extension exercise. This will help engage the glutes more.

      Mark

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