My Lumbar Lordosis

I have attempted to find solutions to a common problem I see at work, but which incidentally affects me personally. I have never dedicated too much thought about it, because of the fact that I have never suffered any symptoms from it. 

But recently I have been gaining weight, and developing a so called 'beer belly'. The reality is that the underlying problem was always there: the title of this post. My posture reveals a typical excessive lumbar lordosis, which is an increased curvature of the lower part of the spine (the lumbar spine) which consists of 5 vertebrae (L1-L5). I always had a somewhat protruding belly, and when I was really skinny, I looked like a hungry child suffering from Marasmus or Kwashirokor (which are different conditions - where you get bulging belly due to lack of nutrition). In reality it was just my posture which was the problem.

Most problems related to back pain occur at the level of L4-L5 or L5-S1 (which is the junction with the sacrum (consisting of fused vertebrae). Although I have all the necessary knowledge to advise people on how to deal with such a problem, I have failed to advocate this knowledge onto myself.

The image on the left is an X-Ray view of my lumbar spine. A person with a technical/medical knowhow could easily spot the incidence of an exaggerated curvature. Discs cannot be seen on X-Ray, but one can see how the intervertebral disc space is somewhat decreased, when compared to normal subjects. Therefore, although symptom free, I am aware that problems might arise in the future. Apart from increased pressure on the discs, there is also increased pressure on the facet joints, or zygapopheseal joints, which are prone to degenerative changes after the age of 25. 

There is also the problem with aesthetics. The beer belly mentioned earlier, is accentuated by the fact that the abdominal contents protrude further due to this posture. 

It would be interesting to investigate the causes of such posture. From a physical (and somewhat Orthodox) point of view, the causes are ultimately: 

• weakness of the anterior (deep) abdominal muscles which fail to counteract the opposing forces of the tight and shortened posterior back muscles, known as the erector spinae.
• tightness of the hip flexors, known as Iliopsoas (Psoas major and minor): these being the only group of muscles which cross the body from posterior to anterior.

 The obvious treatment would then be to exercise the anterior abdominal wall and stretch the posterior back musculature. A common mistake, however, is that most traditional abdominal exercises do not work out your inner stabilizing deep abdominal muscles, but rather the superficial ones, along with the hip flexors. Exercising the hip flexors would then work against us in that it will continue to accentuate the lumbar lordosis.

A regime of core stability exercises (which will work out the deep abdominal muscles which act like a corset) along with posture re-education (could be in the form of Alexander Technique) would be the treatment of choice. 

However there might be endless other factors which can account for the presence of this increased lumbar lordosis, and some of them are considered somewhat unorthodox. Psychological aspects have been implicated in the maintenance of a particular posture, but more interestingly, there might be more spiritual elements which can be the underlying reason for such persistence of body posture. 

Through some googling, I have come across a very interesting website: 

http://www.bodymemory.com/article_bmr_phenom.html

My idea is to investigate this further. As a clinician myself, and trained in the western medical field, I am curious to absorb more knowledge which can explain more about the human body, our mental behavior and indeed the behavior of our body's tissues.