The spine has natural curves in the neck, upper, and lower back which form an ‘S’ shape. This helps us to move flexibly, bend over, and absorbs shock to allow you to run, walk, and jump. However, occasionally, issues can arise which result in these curves becoming abnormal.
Hyperlordosis is a technical term for an exaggerated curve in the spine in the lower back area, which often leads to an increased anterior pelvic tilt. In simple terms, the condition causes the back to curve more inward than usual, and the pelvis to tilt forward.
While many hyperlordosis sufferers will report no negative symptoms, some patients can experience pain in their lower back. The excess strain the condition puts on the surrounding muscles, hamstrings, and hip flexors can lead to increased risk of muscle strains and spasm, and can cause degeneration in the facet joints of the spine.
Massage therapy can perform an important role in helping to treat hyperlordosis, and lead to marked improvement in symptoms for patients.
Hyperlordosis is often caused by a condition known as lower crossed syndrome (LCS). This occurs when the hip flexors and lower back muscles tighten and shorten, while the reciprocal muscles in the glutes and abdomen relax and lengthen. It can also be a by-product of other, more serious conditions, such as osteoporosis or spondylolisthesis.
In addition, a number of different factors can put patients at increased risk of developing the condition, including pregnancy, lack of physical activity, obesity, and poor postural habits. Hyperlordosis also occurs among certain types of athletes as a result of improper training techniques, particularly dancers and weightlifters.
Assessment of hyperlordosis can be a complex process for massage therapy students. An experienced practitioner will usually assess the lumbar curve by palpating the spinous processes in the region, which are the protruding bones at the back of vertebrae. The length of each person’s spinous process varies, which can make this a difficult task.
The therapist may also use palpation to assess pelvic tilt, as well as the angle of the sacrum and thorax. As there will not necessarily be any correlation between hyperlordosis and problems in the neighbouring structures, each of these areas needs to be assessed separately.
Assessments for hyperlordosis and other postural problems should be performed with the client standing, as the difference in gravitational pressure on the body when the patient is lying down may lead to misleading results.
Massage therapy can help to stretch and lengthen the muscles in the affected area, which can potentially reduce the severity of hyperlordosis and pelvic tilt, relive any lower back pain the patient may be experiencing, and improve the range of motion in the hips. This can be accomplished using a combination of different techniques, including trigger point therapy and Swedish massage.
Professionals with advanced massage therapist training may also choose to employ muscle energy technique in order to strengthen weakened muscles and help to retrain the neuromuscular pathways in the affected area to reduce any compensatory patterns that may have developed among the muscle groups in the lumbar region.