You may have heard that when astronauts return from space, they can be up to 2 inches taller. How is this possible? Due to the absence of gravity, they tend to lose the natural curvature of their spine. While being taller might sound like a good thing, the loss of their spinal curves, in addition to having weaker bones, makes them especially vulnerable to injury.
In its optimal position, your spine should have several natural curves between your head and your pelvis. The neck (cervical region) and the low back (lumbar region) each have a reverse curve known as a lordosis, while the curve of the upper back is referred to as kyphosis. Physical therapists and trainers refer to these natural curves as “neutral spine” posture. Maintaining neutral spine posture is critical because it helps to distribute your weight when standing while also cushioning the impact and ground reaction forces of exercise.
Why is Neutral Spine Posture Important?
When your spine is in its neutral posture, your body and muscles are in the strongest, most stable, and injury-resistant position for two main reasons:
1. Your low back muscles are at the optimal length. In physiological terms, when the low back is in slight lordosis, the low back muscles have maximum sarcomere overlap and can produce the most force.
2. The facet joints of the spine are in their middle position, which allows them to help distribute compression forces away from your discs. The more pressure you have on your discs, the more likely they are to herniate or become injured in another way.
Neutral Spine Posture & Injury Risk
You move your spine out of neutral any time you flex forward or extend backwards. This movement is completely normal and natural and when there are only light forces being applied, you are generally safe.
Problems can occur when you continue to exercise or lift heavy loads with a sub-optimal spinal position. The farther out you are from neutral spine, the more forces you are putting on your discs and vertebrae. When poor form is compounded with heavy weights or high repetitions, you exponentially increase your risk of incurring a back injury.
Sustained postures outside of neutral spine (as in, poor posture) can also be harmful. For example, chronic excessive flexion (for example, slouching when you sit) can stretch out your supportive ligaments such as the ligamentum flavum. When this ligament is overstretched, you are at a greater risk of overflexion in the lumbar spine, which increases the likelihood of straining a low back muscle and herniating your lumbar discs.
Excessive extension is also harmful as it puts a lot of compression on your facet joints, and can also contribute to stenotic symptoms by pinching your lumbar nerves.
How to Check for Neutral Spine
The easiest way to check your standing spinal alignment is with a stick or PVC pipe. Stand tall with a stick along your back touching your head, upper back, and tailbone. Ideally, you should be able to fit your hand between the stick and your low back while keeping all three points of contact (head, upper back, and tailbone). Alternatively, you can also stand with your back against a wall.
If you are unsure whether your spine is at neutral, you can rock your pelvis all the way forward and all the way backward and then settle in the middle position. This should be your neutral curvature, and you should perform all of your strengthening exercises in this spinal position.
When we sit, especially without support, most people tend to slouch – which means they have a posterior tilt of their pelvis. This causes a flattening or loss of the lordotic curve. This posture can be ok if it’s only sustained for short periods of time, however, your ligaments can get stretched from prolonged and excessive slouching.
If this position were to carry over into any strength training or functional exercises, you would be at an increased risk of injury. This is why all health practitioners and ergonomic experts recommend adjusting your seated posture so that your spine can be closer to, if not at, neutral.
When sitting, you can try using a wedge to tilt your pelvis anteriorly. You can also use a chair with lumbar support to help keep you in a neutral posture. For either of these options, you are more likely to rest in a comfortable and neutral position.
When supine (laying on your back) and doing exercises, you’ll still want to keep a neutral spine. Sometimes a trainer or physical therapist will cue you to fully flatten your back. While you’re not completely rounding your spine, this is not ideal because you’re still positioning it out of neutral.
I recommend most of my beginning clients to strengthen their core in neutral first, as this is the position you always want to default to. The “dead bug” exercise is great at helping to emphasize correct abdominal engagement. Perform it with a small folded towel underneath your low back and make sure that your back doesn’t flatten or over-arch.
Neutral Spine When Exercising
Once you have a good feel for how to maintain a neutral spine in static positions, you’re ready to try to exercise and move with a neutral spine.
If you’re unsure whether you’re keeping a neutral position, have a friend apply tape to your low back while you stand with your natural curve. Now, if you flex (round) or hyperextend your back during your workout, you’ll feel the tape pull or buckle on your skin, respectively. If you keep a neutral spine, the tape shouldn’t pull or buckle.
Basic Neutral Spine Exercises
1. Bird Dog
Instructions: Start in a tabletop position on hands and knees. Your shoulders should be over your wrists and your hips over your knees. Keeping your hips and shoulders completely square, reach your right arm forward and your left leg back. Hold for 5 seconds, then return to the start position before switching sides. Perform for 2 min straight, alternating sides every 5 seconds.
2. Hip Hinge with Dowel
Instructions: Here, you want to emphasize the movement of the hips while your spine stays in neutral.
Stand tall with shoulders over hips over heels. Holding a dowel or a broomstick along your spine (touching your head, upper back, and tailbone), push your hips back towards the wall behind you while keeping your knees over your ankles. When you feel a stretch along the back of your legs, drive through your feet and squeeze your glutes to stand all the way back up. The dowel should stay in contact with your head, upper back, and tailbone the whole time. Continue to hinge and then stand tall for a total of 10 reps. Complete 2 sets.
Instructions: Your goal with squats is to perform a full range-of-motion without letting your “butt wink”. Basically, don’t let your tailbone tuck under.
Stand tall with your feet slightly wider than your hips, feet slightly turned out. Keeping your chest tall and your core tight, bend your knees and reach your butt back as if you were sitting in a chair. At the same time, drive your knees out over your second toe (don’t let your knees collapse in). Your spine should remain neutral the entire time. From the bottom position of the squat, push through your feet to bring yourself all the way back to standing. Keep your chest high and your shoulder blades packed as you squat down. Complete 2 sets of 10 reps.
When initially learning a new movement or lifting heavy loads, it’s critical that you’re able to maintain a neutral spine posture. This position minimizes the stress on your back and decreases your chance of getting hurt. Repeated exercise with poor posture puts you at a greater risk of incurring a herniated disc or other weight lifting injury. Emphasize proper posture with all movements and all sustained postures to protect your spine from excessive wear and tear.