How to fix Sway Back Posture

What is Sway back posture?

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

As a result – the torso will “sway back” in the attempt to compensate for the forward shift of the pelvis.

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characteristics of Sway back posture

• Pelvis pushed forwards relative to line of ankle
• Posterior pelvic tilt
• Hyper extension of hip
• Hyper extension of knees
• Slight dorsiflexion of ankles
• Long thoracic curve
• Sunken chest with upper abdominal tightness
• Early flexion in the upper lumbar levels
• Loss of lumbar lordosis
• Upper back shifted backwards
• Rounded shoulders
• Forward head posture

(Note: This is the general presentation of someone with the typical Sway Back Posture. It is not uncommon to see slight variations.)

What causes Sway back posture?

a) Tight hamstrings

Tight hamstrings can tilt the pelvis backwards (posterior pelvic tilt) and drive the pelvis forwards.

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b) “Butt Gripping”

“Butt Gripping” refers to the over use and reliance of the glute muscles to stabilize the pelvis.

This can result in the pelvis being pushed into a forward position.

c) Hypermobility

Sway Back Posture can result from the hypermobility/excessive laxity of joints.

This is due to the body resting on the end ranges of the joint as opposed to muscles holding it in the correct position.

The best way to address Hypermobility is to focus on strengthening the muscles that support the joints.

d) Slouched thoracic spine

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

This is the body’s attempt to keep the head in a more up right position to maintain a horizontal line of sight.

e) Bad habits

How you position your body throughout the day can significantly effect your posture.

Main habits that lead to Sway Back Posture:

• Sleeping on your stomach
• Poor posture when sitting
• Standing with your hips pushed forwards.

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

• Greater trochanter (Hip): This is the bony prominence that sticks out on the side of your hip.
• Lateral malleolus (Ankle): This is the bony bit that sticks out at the outside of your ankle.

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.

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Sway back posture vs Anterior pelvic tilt

It is very common for people to get confused between having a Sway Back Posture versus having an Anterior Pelvic Tilt.

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

(Performing the right exercise for the wrong diagnosis will not help you!)

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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.

• Whereas with Anterior pelvic tilt, the hips are generally stacked over the ankles.
• (However – it is still possible to have an anterior pelvic tilt with your hips in front of the line of gravity.)

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

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muscles involved with sway back posture

The following muscles will need to be addressed:

a) Tight muscles:

• Hamstring
• Gluteal group
• Internal Obliques
• Upper Abdominals
• Anterior shin muscles

b) Elongated muscles:

• Hip flexors
• External oblique
• Erectors spinae muscles in the thoraco-lumbar junction

Exercises to fix Sway back posture

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1. Address the muscles that push the pelvis forwards

Hamstring:

a) Release

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

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.

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Glutes:

c) 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

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.

Anterior shin muscles:

Overactive/tight muscles at the front of the shin bone will pull your legs (… and thus pelvis) forwards.

e) Release

Instructions:

• Place the outside of your lower leg on a massage ball.
• 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 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.

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a) Sitting hip flexion (on the chair)

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)

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) 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.

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a) Hip extension

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.

b) 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.

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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.

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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 increase the extension of the joints in the thoracolumbar junction.

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a) 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 specifically in the middle of your spine. (see above)
  • 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

Tightness in the upper abdominal region can lock the torso into a flexed position.

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a) Upper abdominal release

Instructions:

• Lie on the floor.
• Position your upper abdominal region over a massage ball.
• Apply an appropriate amount of body weight on top of the ball.
• 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) Intercostal release

Instruction:

• Locate ribs 6-10 at the front of your lower chest.
  • (If you place your palms on the ribs below the nipple region, you should be in the right area.)
• Locate the intercostal muscles which are situated between the rib bones.
• Firmly press into these muscles.

c) Cobra pose

Instructions:

• Lie on your stomach.
• Place your hands on the ground far in front of you.
• 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.
• To increase the stretch: Take a deep breath in and push your belly outwards.
• Hold for 30 seconds.

d)  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.

7. Core strengthening exercises

You will need a strong core to maintain good posture.

a)  Anterior pelvic tilts

Instructions:

• Sit on an exercise ball or a chair.
• Sit upright. Think long and tall throughout the spine.
• Proceed to tilt the pelvis forward.
• Aim to feel a contraction in the muscles of the lower back.
• Hold for 5 seconds.
• Repeat 30 times.

b)  Single leg balance

Instructions:

• Stand on one foot.
• Make sure that your hips are in line with the ankles.
• Maintain balance for 30 seconds.
• Repeat on other side.

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. (This can make Sway Back Posture worse!)
• Hold for 30 seconds.
• Repeat 3 times.
• Progression: Place a weight on top of your pelvis.

d) Dead bug

Instructions:

• Lie on your back with both of your knees bent in the air. (Position 1)
• Engage your core and abdominal group by gently drawing in your belly button.
• Keep your pelvis in a neutral position.
  • There should be a slight arch in your lower back.
  • Maintain this arch throughout exercise.
• Slowly lower the opposite arm/leg. (Position 2)
• Repeat 10 times.
• Progression: Add 5-10 second holds in Position 2.

8. 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.

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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.

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b) Rounded Shoulders

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

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c) Forward Head posture

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

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9. How to stand

Now that you have completed all of the exercises, is it important that you learn how to stand properly. (Otherwise the Sway Back Posture will persist!)

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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

This will prevent your neck from poking forward.

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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.

Be aware of your posture.

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

10. Address bad habits

If you have any of the following bad habits, you will need to address these as well.

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a) DO NOT stretch the hip flexors

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

Stretching the hip flexors will further lengthen an already elongated muscle 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

Sleeping on your stomach may encourage the Sway back posture.

This is particularly true if you sleep on a very soft mattress as this will allow your pelvis to sink forwards.

c) DO NOT sit with bad posture

When sitting, make sure that your pelvis is positioned right into the back of the chair.

This will reduce the amount of posterior pelvic tilt.

d) DO NOT stand like this

When standing, do not allow your hips to push forwards.

e) DO NOT over do abdominal crunches

Abdominal crunches may increase the dominance of rectus abdominus.

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

f) Dead lift technique

If you regularly perform deadlifts, make sure that you do not thrust your hips forwards at the end of movement.

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Conclusion

The Sway Back Posture is characterized by the forward position of the pelvis. (… and the torso “swaying” backwards.)

The main causes being tight hamstrings, over-active glutes, hypermobility, bad habits and slouched postures.

The exercises mentioned in this blog post will help address the muscular imbalances associated with Sway Back Posture.

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