One of the most important things I teach both in the physical therapy clinic and in the gym is how to find and maintain the neutral spine posture. When your mother told you to sit up straight at the dinner table, she knew what she was talking about. Most of the clients I see these days suffer from back pain, not because of a traumatic injury such as an automobile accident but rather from years if not decades of poor posture and moving incorrectly.
So just what is this neutral spine position and what is the significance for you? Our backs consist of three small spinal curves: the neck, the mid back, and the lower back (the lumbar spine). These small curves are essential for shock absorption and to minimize the loads through the entire spine. When we slouch or bend over from our backs as we often do when we lift, we are in a forward flexed position. On the other end of the spectrum when we backward bend or over arch our spines as when we look up to the ceiling we are in a position of extension. The neutral spine is a position in which we are neither in flexion nor extension , hence neutral. Basically think of military posture or sitting up straight and trying to be tall. This is the neutral spine position. It is important to keep in mind that our spines should be flexible and should be able to move freely into both flexion and extension along with other motions such as rotation. However, the problem arises when we lose the ability to maintain the neutral spine under conditions of load such as when we lift or when we fall out of neutral for a prolonged periods of time such as when we slouch sit at work for hours upon hours, day after day, year after year. These situations compromise our ability to stay in a neutral spine posture and can eventually have severe impacts on our spines health and function.
Here are a couple key points to remember about the neutral spine posture. Imagine lifting a 20 pound bag of groceries off the floor and doing so while rounding and twisting your low back. Better yet, imagine lifting a 40 pound dumbbell off the gym floor doing the same thing. On any given occurrence it is no big deal, but after a couple of decades of executing this faulty movement one day your back seizes up into spasms and the pain is excruciating. The problem is, you habitually have fallen out of the neutral spine position while loading it. The spine is up to 40% stronger and resilient to compressive load when you are in the neutral spine position. That’s a lot! The same rule holds true with sitting. Slouch day in and day out, and eventually your spine is going to buckle. That is when you start hearing about things like a “herniated disc.” The other significance of the neutral spine posture is that it optimally positions your back muscles to protect your spine. The back muscles often referred to as the “core muscles” attach to our spines on several different angles much like the cables on a suspension bridge. When the spine is in neutral these muscles can optimally support our mobile spine structure. However, when we fall out of neutral they become much less efficient and the their supportive role diminishes. That is how we get all get into trouble. We need to learn how to stay in the neutral spine, especially when we perform basic foundational movements such as squatting, lunging, rotating, pulling and pushing.
Bill Fabrocini, PT, CSC is a clinical specialist in orthopedic physical therapy and a sports performance training coach. Mr. Fabrocini has also written numerous articles that have been published in prominent journals including the National Strength and Conditioning Journal and the American Council on Exercise Certified News. Learn more about Mr. Fabrocini here.