Pelvic tilt

There are a lot of exercises that help against a hollow back. First of all, however, it is important to train the patient’s perception that he can feel in which position his body is. How does a hollow back feel, like a hunchback?

For this purpose, the posture should be controlled in a mirror and various extreme positions should be taken. The best way to do this is to palpate your pelvic bones and place your fingers on the protruding bony projections. Now imagine that the pelvis is a bowl that is poured forward.

The pelvic bones are now pointing forward and down, the lumbar spine is straightening up, the hollow back is getting stronger. The counter movement, tilting the pelvis backwards, causes the lower back to bend, it becomes round. This movement should be well practiced and easy to follow.

These movements can be practiced in different starting positions. For example, a towel can be held with the lower back on the floor while lying down and the physiotherapist tries to pull it away. The exercise can also be performed while sitting on a chair or stool.

Once the patient has gained a good feeling for his body, he should avoid the increased hollow back and concentrate more on the counter movement. With the hollow back there is increased muscle activity in the lower back, while the abdominal muscles lose strength. It is important to reactivate these muscles to counteract the shortened tension.

Training against a hollow back always includes targeted abdominal training. Especially the deep and lower abdominal muscles should be strengthened. Here for there is a variety of exercises. More good exercises for at home can be found in the article “Physiotherapy for a slipped disc“.

The hollow back

When lying down, the person concerned can feel the effects of his or her static well. In the supine position the lower back does not rest on the floor and it is difficult to push it down without moving the legs. A hollow back does not only change the statics of the lower back.

A hollow back also affects the overall posture of the body and the load on the joints. For example, the increased extension in the lumbar spine (lumbar spine) often leads to a straining over-extension of the knee joints in order to keep the body’s statics level. Another frequent symptom is the so-called hollow round back, in which the increased extension of the lumbar spine is accompanied by increased kyphosis (flexion/rounding) of the thoracic spine.

This often has consequences for the shoulder and neck area. A hollow back causes certain muscle groups to become active in order to keep the body in an upright position. The muscles in the lower back are hypertonic, i.e. they have too much tension, while the abdominal muscles are constantly being stretched and reduced.

In most cases, increased muscle activity will also occur in the thoracic spine (BWS) to maintain the upright position. This can lead to tension and adhesions of the overstrained tissue. Joints will be overstrained.

In the long run, there is increased wear and tear of the structures and consequential damage in other joints, e.g. the knees. The risk of a slipped disc also increases due to a strong hollow back, since the discs are now more unilaterally loaded. A hollow back can lead to joint blockages and pain in the lower back but also in surrounding joints. In any case, it makes sense to train and reduce the hollow back by specific physiotherapeutic and gymnastic exercises in order to avoid consequential damages caused by the changed load. Exercises against the effect on the statics can be found in the articles:

Exercises for spinal canal stenosis in the lumbar spine
Exercises against neck pain