Teaching Neutral Spine – Part I

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Lets start things off with a few simple facts:

  • The spine contains over 120 individual muscles, 220 specialized ligaments and over 100 joints.
  • Cartilage makes up roughly 25% of the spine’s total length.
  • It can be sub-divided into three main “sections,” the cervical spine (neck), thoracic spine (mid-back), and lumbar spine (lower back).
  • The lumbar spine consists of five vertebrae  (L1-L5), and each one elites roughly 1-2 degrees of total rotation, for a total of 10-13 degrees of total motion.  Conversely, the thoracic spine consists of twelve vertebrae (T1-T12) that can elicit 7-9 degrees per segment.  Rounding up the numbers, our t-spine accounts for roughly 70 degrees of spinal rotation.
  • In terms of the lay population:  men have roughly 3-5 degrees of anterior pelvic tilt (APT), whereas women generally hang out at around 5-7 degrees of APT.

Sorry to jump straight into hard-core spinal biomechanics talk without buying you dinner first.  But there’s a lot of  “stuff” going on in our back and this serves as a great primer for today’s topic, which is:  how to teach trainees to achieve (and maintain) a neutral spine.

So, what the heck is neutral spine anyways?  Well, it’s a bit of a misnomer, because many people believe that a neutral spine means that it’s completely straight, which couldn’t be further from the truth.  As alluded to above, the spine has an acceptable range of anterior pelvic tilt; or lordotic curve.  Similarly, it also has an acceptable range of kyphosis (or rounding) in the upper back.  And, of course, the cervical spine also has a certain degree of lordosis as well.

So, in essence, a more appropriate term might be to say “normal” spine rather than neutral spine, but you get the idea.

Unfortunately due to the fact that we’re a much more sedentary society compared to just a generation ago – it’s not uncommon to hear about people spending 15-18 hours per day sitting in front of a computer – it’s often a challenge for someone to actually attain (let alone maintain) a neutral spinal position.  What’s more, it could stem from a multitude of reasons, ranging from either a structural abnormality (scoliosis), a functional abnormality (hyper-lordosis or hyper-kyphosis), or even from a lack of kinesthetic awareness.

My job as a strength coach is to figure out the root cause, and fix it.  Like a ninja.  Here’s how.

Disclaimer:  I’m going to skip over the whole structural abnormality business (scoliosis) because it’s a fairly deep topic and something that deserves much more than just one simple blog post.  That said, with scoliosis, almost always, it really comes down to managing the issue at hand and trying not to make it worse.  Some can handle spinal loading, some can’t.  Some need a little more TLC, others don’t.  Single leg work will obviously be prioritized, as will core stability.   Moreover, we’re most likely going to be aggressive on the manual therapy side of things which is outside of my scope, and why I refer out to people smarter than myself.

Either way, much of what we do is still going to be covered in the pointers below.

Functional Faux Pas

In this category will be those with just plain bad posture – plain and simple.  Here, in order to teach neutral spine, it’s imperative to hammer away at the root cause, which for many, will consist of trying to improve either their hyper-kyphotic upper back, hyper-lordotic lower back, or both!  In the end:  unless you take strides to improve their posture, neutral spine ain’t gonna happen.

Oh, before I continue on, it’s important to note that the spine is going to compensate.  Meaning, for those who have significant kyphosis in their upper back, the spine will often compensate by going into more lordosis in the lumbar spine; and vice versa.  So, much of the time, by addressing one aspect, you’ll invariably address the other as well.  But, just to cover our own basis, lets go over a few drills for each.

Kyphosis – Upper Back

It goes without saying that some aggressive foam rolling is in order.   Mike Reinold actually put up a video the other day which demonstrates how to go about doing this, so I’ll defer to him here:

Once you’ve broken up any trigger points or grimy tissue that exists, it’s crucial to mobilize that area in both extension AND rotation.

In terms of drills that promote t-spine extension, I love the Bench T-Spine Extension Mobilization:

Note:  you don’t necessarily need the dowel rod in order to do this drill.  I  just wanted to show off the guns, I suppose (shrugs).

As far as rotational type drills, the possibilities at endless.  Some of my favs include:

1.  Side Lying Windmills

2.  Quadruped Extension-Rotation

3.  Side Lying Rib Rolls

4.  Bent Over T-Spine Rotation

Those should be a good place to start for many.  And, as a corollary, not only will will most see vast improvements in their posture implementing these drills into their repertoire, but they also see marked improvements in scapular kinematics which will pay huge dividends in terms of their ability to perform any overhead pressing without making my eyes bleed.  It’s a win-win, really.

Lordosis – Lower Back

While I should have mentioned this above in the upper back section, I’d be remiss not to comment on Janda’s Upper/Lower Cross Syndrome to some capacity.

Cliff Notes Version?   You stretch what’s tight; or, more appropriately, what’s stiff or short – in this case the hip flexors for the lower body.  Likewise, you also strengthen/activate what’s weak or inhibited – in this case the glutes and anterior core.

While some dedicated stretching and activation work is in order in the hip flexors (stretch) and glutes (strengthen) respectively, I do feel there’s an often vastly overlooked area that many trainees (and coaches) tend to dismiss altogether.

In terms of dealing with a hyper-lordotic back, I like to take the same path as Mike Robertson and use more of a bottoms-up approach, where I try to teach improved pelvic control through diaphragmatic breathing techniques, as well as hammering the external/internal obliques.

It’s true, one of the main roles of the rectus abdominus is to posteriorly tilt the pelvis, but it does so at the expense of pulling the sternum closer to the pelvis, which, as we all know, is a big no-no (most of the time).  In that vein, things like crunches and sit-ups are probably the last thing I’d do with a client.

Instead, and this is something we’ve been using more and more with our athletes at Cressey Performance, you can hammer the external/internal obliques (which also posteriorly tilt the pelvis) with reverse crunches.

Again, here, we can still get all the benefits of trying to bring someone back to “neutral,” albeit without all the drawbacks of performing a traditional crunch or sit-up.

In addition to those, we can still utilize many of the exercises I’ve highlighted here in the past.

Pallof Press Variations

Split Stance Cable Lifts

And even things like Slideboard Bodysaws would be fantastic options (although, this one can be considered fairly advanced)

And that covers at least some of the things we can do from the functional side of things that will help teach someone how to get to a neutral spinal position.  I’ll be the first to admit that it’s not an all encompassing list, and it definitely doesn’t cover all the bases, but it definitely gets the ball rolling.  Not bad for under 1300 words.

Tomorrow, in part II, I’m going to cover the coachification (made up word) side of things.  Or, to put it another way:  sometimes it’s not one’s posture that’s the issue, but rather they just have poor kinesthetic awareness (body control) and are unable get into proper position in the first place.

Check back tomorrow.  Until then, feel free to comment below and let me know if this was helpful!

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Comments for This Entry

  • Wordsmith42

    @Tony: As someone who has done (and continues to do) everyone of the drills and exercises you highlight, I can attest to how invaluable they are. Thoracic mobility was NOT something I appreciated before--yep, you guessed it--my visit to CP. Yet, upon realizing the deficit I was working from, I started hammering the drills and exercises; now I move astoundingly better AND neutral spine is my natural state.

    November 3, 2011 at 9:08 am | Reply to this comment

  • Benjamin

    WRT the bench Tspine mobilization don't you need the dowel to ensure that your humerus doesn't go into internal rotation and compensate for the poor Tspine mobility?

    November 3, 2011 at 10:52 am | Reply to this comment

      • Benjamin

        Just makin' sure I understand it properly! Plus dowel = gunshow and if you can look good doing it you might as well :). I have read some of your other stuff on upper back and the tip you gave about hugging yourself when you foam roll the upper back (don't know which post) is one of the best little tweaks I have heard, thank you!

        November 3, 2011 at 11:26 am | Reply to this comment

        • Anonymous

          Well, to give credit where it's due, I first learned this exercise from Joe Bonyai and never really understood why he used the dowel rod - but your explanation made perfect sense. Kind of like a "why the hell didn't I think of that moment." Thanks for making me feel stupid.....;o)

          November 3, 2011 at 7:19 pm | Reply to this comment

  • Gaurav Kapil

    This is a good one. I hope you can also cover Spine Neutrality to avoid butt wink during squats, and flatness during Deadlift. Those cues are worthy repeating time and again.

    November 3, 2011 at 11:03 am | Reply to this comment

  • Raymccarthy3rde

    Hate to mention this but is that Eric! (Reverse Crunch Vid) He is losing his hair.... Now if you guys can come up for a corrective exercise for that> that would be WAY COOL! Just kidding nice job here Tony..... Ray Mccarthy

    November 4, 2011 at 1:19 pm | Reply to this comment

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  • Raymccarthy3rde

    Tony, ever try the bretzle > A Brett Jones move similar to the side lying rib roll. I love it for myself but I have modified it by doing it with a med ball. Also with older clients I have been using something other than a med-ball, like a reebok step to push down with the up leg. They seem to be able to press down better on a more stable surface. Again like this compilation.

    November 7, 2011 at 5:46 pm | Reply to this comment

  • hooch turner

    What a great article. I look forward to trying these exercises. The key point I learned is that the spine compensates. I've been reading for years that more thoracic rotation is worth pursuing, but never quite understood why

    December 22, 2011 at 8:23 pm | Reply to this comment

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