Back Pain Medical Expert Dr. Sean Wheeler Answers, For Good Posture What Is Wrong With Drawing In Your Tummy?

The POSTURE Series, No. 3

By Sean M. Wheeler, M.D.

In part 2 of our Posture Series I explained how to get your pelvis in the correct position. This correct pelvic position is the essence of good posture, to assist in avoiding chronic low back pain.

Drawing the tummy in, pulling the pelvis into the correct position, achieves good posture and builds the endurance strength to the very muscles which stabilize the spine.

Psoas Quadratus LumborumPsoas & Quadrates Lumborum
The concept may sound simple, but so much could go wrong.

Two Muscles At Work

There are two muscles around the spine called psoas and quadratus lumborum that work to lock the low back into a fixed position.

The psoas [red pointer in the image] runs up from the hip along the front of the spine and attaches to the spine above the level of the belly button. It is a very strong muscle that helps stabilizes the hip and causes many problems when it is not functioning correctly.

The quadratus lumborum [blue pointer] is a smaller muscle that runs from the top of the pelvis to the lowest rib, and most of the time, works with the psoas to lock the spine down.

Dr Sean Wheeler Locked Down SpineCollege student to-be practices moving to campusHeavy Lifting

Most of the day your spine is stabilized using deeper muscles called bracing muscles that stabilize while allowing normal motion of the spine.

When you pick up something heavy, this is the only time you switch to the psoas and quadratus lumborum. They provide an extra level of stability needed during lifting. So in a perfect world, 99% of the day your bracing muscles stabilize you and 1% of the day the psoas and quadratus lumborum lock you down to lift something heavy.

Spasm

With back pain, sometimes the psoas goes into spasm in a failed attempt to protect the back and hip. When the psoas spasms, it pulls the pelvis into a poor position and the lumbar spine forward. 

DrSeanWheeler Pelvis Position Illustration2The quadratus lumborum is then forced to contract all day to fight this spasm and it leads to irritation of the quadratus lumborum and muscular back pain.

Some people who have back pain then have two problems, the original cause of pain, plus the body trying to stabilize them further and causing more problems.

How can you unintentionally cause psoas spasm? By drawing your tummy in too forcefully when attempting to get your pelvis in the right spot. In this case, improving your posture can actually lead to back pain.

What To Do

Here’s what you do: draw your tummy in to pull your pelvis into a correct position where your head feels comfortable over your shoulders. Then rock your shoulders side-to-side to see if your lower back feels locked down. If it does, take a deep breath and start over.

Over time this will become easier and feel much more natural. Holding this position all day is very difficult as it takes bracing muscle endurance and that endurance strength takes 6 months to achieve. So be patient and persistent.

When To See A Medical Professional

If all of this sounds like gibberish and you can’t get your pelvis to do any of these things, you may need to see a professional. If your back is locked down when not heavy lifting and you suspect your psoas is in constant spasm, you may need to see a professional. Otherwise, let’s keep following this path towards better posture.

More To Come

Coming soon, why adult posture problems are different than those of the teenager.

 

Sean Wheeler, M.D. is board certified in both Pain Management and Sports Medicine. He is a leading expert on back pain and his recently released book UPRISE is changing the way the world approaches back pain. With a new vocabulary and new medical approach, Dr. Wheeler puts patients back in charge of their health to achieve liberation from chronic back pain. His oldest son Duke tried to imagine that he was lifting the pictured box while moving to college, but at the time of this column, he still has 4 months to wait.

Apr 25 2016
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