What is Sway back posture?
The Sway Back Posture is where the pelvis is pushed in front of the vertical line of the ankle.
As a result – the torso will “sway back” in the attempt to compensate for the forward shift of the pelvis.
characteristics of Sway back posture
Note: This is the general presentation of someone with the typical Sway Back Posture. It is not uncommon to see slight variations.
Characteristics
- Pelvis pushed forwards relative to line of Ankle
- Posterior Pelvic Tilt
- Hyper Extension of Hip
- Hyper Extension of Knees
- Slight Dorsiflexion of ankles
- Pronounced Thoracic curvature
- Sunken chest with upper Abdominal tightness
- Early flexion in upper part of Lumbar Spine
- Loss of Lumbar Lordosis
- Upper back shifted backwards
- Rounded Shoulders
- Forward Head Posture
What causes Sway back posture?
Here are the 5 main causes. Which one relates to you?
1) Tight Hamstrings
Tight Hamstrings can tilt the pelvis backwards (Posterior Pelvic Tilt) and drive the pelvis forwards.
Do you have tight Hamstrings?
Instructions:
- Lie down on your back.
- Hold the back of the knee.
- Bring your hip to 90 degrees of flexion.
- Whilst keeping your toes pointed, straighten your leg as much as possible.
Results: If you are not able to straighten your leg in this position, then you likely have tightness in your Hamstring muscle.
2) “Butt Gripping”
“Butt Gripping” refers to the over use and reliance of the glute muscles to stabilize the pelvis.
This can result in the pelvis being pushed into a forward position.
3) Hypermobility
Sway Back Posture can result from the hypermobility/excessive laxity of the joints.
This is due to the body resting on the end ranges of the joint and ligaments as opposed to the muscles holding it in the correct position.
Do you have Hypermobility?
Answer these questions:
- Can you place your palms on the floor whilst standing with knees completely straight?
- Do your knees hyperextend?
- Do your elbows hyperextend?
- Can you pull your thumb to touch the front of your forearm?
- Can you pull your little finger backwards to 90 degrees?
Results: If you answered “Yes” to most of these questions, it suggests that you may have a degree of Hypermobility.
(Note: The best way to address Hypermobility is to focus on strengthening the muscles that support the joints.)
4) Slouched Thoracic spine
If the upper back is locked in a hunched position, your pelvis may compensate by driving the hips forwards.
This is the body’s attempt to keep the head in a more up right position to maintain a horizontal line of sight.
5) Poor sleeping position
Sleeping on your stomach can encourage the development of a Sway Back Posture.
How do you know if you have Sway back posture?
Follow these 3 simple steps to determine if you have this type of posture.
1. Take a side profile shot of your standing posture
Make sure that:
- Your clothing attire allows clear vision of your body.
- The photo is taken at hip level.
- The head to the feet are completely visible.
2. Locate these land marks
Greater Trochanter (Hip): This is the bony prominence that sticks out on the side of your hip.
Lateral Malleolus (Ankle): This is the bony bit that sticks out at the outside of your ankle.
3. Compare the alignment of these 2 landmarks
In the ideal posture – you should be able to draw a vertical line between the Greater Trochanter and Lateral Malleolus.
Results: If the Greater Trochanter is in front of the line of the Lateral Malleolus, then you have Sway Back Posture.
Sway back posture vs Anterior pelvic tilt
It is very common for people to get confused between having a Sway Back Posture versus having an Anterior Pelvic Tilt (and Hyperlordosis).
Know the difference:
It is important to know the difference between these 2 types of posture as their respective exercises are completely different!
(Performing the right exercises for the wrong diagnosis will not help you!)
The 3 main differences being that in a Sway Back Posture:
- The pelvis is in a Posterior Pelvic Tilt relative to the upper leg bone.
- There is a loss of normal lordosis (Decreased arch) in the Lumbar Spine.
- The hips are in front of the ankles.
- Whereas with Anterior Pelvic Tilt, the hips are generally stacked over the ankles.
- (However – it is still possible to have an anterior pelvic tilt with your hips in front of the line of gravity.)
muscles involved with sway back posture
There is a muscular imbalance involving the following:
a) Tight muscles:
- Hamstring
- Gluteal muscles
- Internal Obliques
- Upper Abdominals
- Anterior Shin muscles
b) Elongated muscles:
- Hip Flexors
- External Oblique
- Erectors Spinae muscles in the Thoraco-Lumbar junction
Exercises to fix Sway back posture
Goals of these exercises:
1. Stretch/Release muscles that push pelvis forwards
2. Activate Hip Flexors
3. Strengthen Gluteal group
4. Eccentric strengthening of Hamstring
5. Address Thoracolumbar Junction
6. Address tight Upper Abdominals
7. Strengthen the core
8. Address other posture issues
9. How to stand properly
10. Address bad habits
1. Address the muscles that push the pelvis forwards
Tightness in the Hamstring, Glutes and Anterior Shin muscles will push the pelvis forwards
HAMSTRINGS:
a) Release
Instructions:
- Place your hamstring muscles on top of a massage ball.
- Use your body weight to apply an appropriate amount of pressure.
- Make sure to cover the entire length of muscle.
- Duration: 2-3 minutes per leg.
b) Stretch
Instructions:
- Whilst upright, place one leg in front of you.
- For Upper Hamstring: Knee slightly bent.
- For Lower Hamstring: Knee straight.
- Maintain the arch in the lower back throughout this stretch.
- Hinge forwards at the hip joint.
- Aim to feel the stretch at the back of your leg.
- Hold for 30 seconds.
- Repeat on both sides.
Want more stretches?
See post: Hamstring Stretches
GLUTE MUSCLES:
a) Release
Instructions:
- Place your Gluteal muscles on top of a massage ball.
- Use your body weight to apply a suitable amount of pressure onto the ball.
- Make sure to cover the entire muscle.
- Do this for 60 seconds.
- Repeat on other side.
b) Stretch
Instructions:
- Lie on your back with your knees bent and feet on the floor.
- Place your left ankle on top of the right knee.
- Grab your right knee and pull towards your chest.
- Aim to feel a stretch on the back of the left hip.
- Keep the arch in the lower back throughout this stretch.
- Hold for 60 seconds.
- Repeat on other side.
ANTERIOR SHIN MUSCLES:
Overactive/tight muscles at the front of the shin bone will pull your legs (… and thus pelvis) forwards.
a) Release
Instructions:
- Place the front/outside of your lower leg on a massage ball.
- Place hand on top of leg.
- Apply a downward pressure over the ball.
- Make sure to cover the whole front/side of the lower leg.
- Draw circles with your ankle to increase release.
- Duration: 60 seconds
- Repeat on other side.
b) Front of Shin Stretch
Instructions:
- Sit down on a chair.
- Place your ankle on top of the other knee.
- Place one hand on top of the ankle and the other on the forefoot.
- Whilst anchoring the ankle joint down, pull the fore foot towards you.
- (Include the toes!)
- Aim to feel a stretch on the out side of the ankle.
- Hold for 30 seconds.
- Repeat on the other side.
(For more ways to stretch the front of the shin, see post: Tibialis Anterior Stretches.)
2. Activate hip flexor group (iliopsoas)
Aim: To increase the strength of the hip flexor muscle group to help bring the pelvis into a more neutral position.
a) Sitting Hip Flexion (on the chair)
Instructions:
- Sit up right on the edge of a chair.
- Without moving your pelvis or torso, lift the knee as high as possible.
- Aim to feel a contraction in the front of your hip.
- Hold for 5 seconds.
- Repeat 10 times.
- Repeat on other side.
b) Sitting hip flexion (on the floor)
Instructions:
- Long sit on the floor with the support of your hands behind you.
- Keep your leg straight throughout this exercise.
- Without moving your pelvis, lift up your leg as high as possible.
- Hold for 5 seconds.
- Repeat 10 times on each leg.
- Note: If this exercise is difficult, lean your torso backwards slightly.
c) Hip push backs (Standing)
Instructions:
- Stand up right.
- Wrap a resistance band around your hips and anchor it to a stationary object in front of you.
- Step away from the anchor point.
- Make sure there is an adequate amount of tension in the band to pull your hips in the forwards direction.
- Practice pushing your hips backwards.
- Do not allow for the resistance band to pull your hips in front of the line of the ankles.
- Repeat 30 times.
3. Activate Gluteal muscles
Aim: To strengthen the Gluteal muscles in a more neutral to flexed hip position.
a) Hip Extension
Instruction:
- Stand slightly leaning forwards.
- Extend your leg backwards until you feel your Gluteal muscles contract firmly.
- Do not rotate your body.
- Hold for 5 seconds.
- Alternate legs for 20 repetitions each.
- Hold onto a support (eg. back of a chair) if you have issues with maintaining your balance.
b) Bridges
Instructions:
- Lie down on your back with your knees bent.
- By pushing off with your heels, lift your buttocks off the floor.
- Do not thrust your hips too high.
- The shoulders/hips/knees should be in line at the end position.
- Hold for 5 seconds.
- Repeat 15 times.
c) Squats
Instructions:
- Start from a standing position.
- You can hold on to something for support.
- Perform a squat.
- Make sure to drive your hips backwards as you descend.
- Return to starting position.
- Repeat 15 times.
- Progression: Hold onto a weight.
d) Lunges
Instructions:
- Perform a lunge.
- Make sure to drop as low as possible.
- Return to starting position.
- Repeat 15 times.
- Progression: Hold onto a weight.
Do you have weak Gluteal muscles?
See post: Glute Exercises.
4. Eccentric Strengthening of Hamstrings
Eccentric strengthening involves the contraction of a muscle whilst it is ELONGATING.
In other words: It is a combination of strengthening + stretching at the same time.
a) Hinge Exercise
Instructions:
- Whilst standing, hold onto an appropriate amount of weight.
- (… it should be a moderately heavy weight that you can control)
- And yes, I do realize I am holding a yoga mat (haha)
- (… it should be a moderately heavy weight that you can control)
- Upper Hamstring: Place a slightly bent knee in front of you.
- Lower Hamstring: Place a straight knee in front of you.
- Shift most of your weight to the front leg.
- Slowly lower the weight by hinging at the hips.
- Keep your lower back completely straight.
- Aim to feel a pulling sensation in the hamstring region before returning to the starting position.
- Keep the weight close to your body.
- This lowering phase should take 3-5 seconds.
- Return to starting position.
- Do not thrust your hips forwards.
- Perform 10 repetitions.
5. Thoracolumbar junction
Aim: To increase the amount of extension available in the joints of the Thoracolumbar junction.
a) Lower Thoracic spine Extension
Instructions:
- Lie on your stomach.
- Prop your torso up onto your forearms.
- Lift up your torso as high as you can whilst keeping the belly button in contact with the floor.
- Aim to feel tension specifically in the middle of your spine. (see above)
- Do not arch back too far as you will feel the tension at the base of the lower back.
- Repeat 20 times.
6. Upper abdominal tightness
Tightness in the upper abdominal region can lock the torso into a flexed position.
a) Upper Abdominal release
Instructions:
- Lie on the floor.
- Position your upper abdominal region over a massage ball.
- Apply an appropriate amount of body weight on top of the ball.
- Whilst positioning the massage ball in the upper abdominal region, place your body weight on top of the ball. (see above)
- Make sure that you keep your abdominal muscles relaxed.
- Tip: Taking deep breaths in/out will help keep your abdominal region relaxed.
- Hold each position for at least 30-60 seconds.
- Proceed to move the massage ball over to the other areas as indicated above.
(Note: DO NOT place excessive amount of pressure into your abdominal region! There are many sensitive organs in the area which can be subject to damage when too much pressure is applied.)
b) Intercostal release
Instruction:
- Locate ribs 6-10 at the front of your lower chest.
- (If you place your palms on the ribs below the nipple region, you should be in the right area.)
- Locate the intercostal muscles which are situated between the rib bones.
- Firmly press into these muscles.
c) Upper Abdominal Stretch
Instructions:
- Lie on your stomach.
- Place your hands on the ground far in front of you.
- Lift up your torso as high as you can whilst keeping the belly button in contact with the floor.
- Take a deep breath in and push your belly outwards.
- Aim to feel a stretch in the upper abdominal region.
- Hold for 30 seconds.
d) Lower rib upward tilt
Instructions:
- Sit down on the edge of a chair.
- Lock your pelvis in a neutral pelvis.
- Without moving your pelvis, tilt your lower ribs upwards.
- Create extension in the upper lumbar region.
- Hold for 5 seconds.
- Repeat 30 times.
7. Core strengthening exercises
You will need a strong core to maintain good posture.
a) Anterior Pelvic Tilts
Instructions:
- Sit on an exercise ball or a chair.
- Sit upright. Think long and tall throughout the spine.
- Proceed to tilt the pelvis forward.
- Aim to feel a contraction in the muscles of the lower back.
- Hold for 5 seconds.
- Repeat 30 times.
b) Single leg balance
Instructions:
- Stand on one foot.
- Make sure that your hips are in line with the ankles. (Side view)
- Maintain balance for 30 seconds.
- Repeat on other side.
c) Plank
Instructions:
- Get into the plank position.
- Position your pelvis in a neutral position.
- Engage the core and glutes to stabilize the pelvis.
- Make sure your pelvis does NOT drop towards the floor.
- Keep the shoulders/hips/ankles aligned.
- Hold for 30 seconds.
- Repeat 3 times.
- Progression: Place a weight on top of your pelvis.
d) Dead bug
Instructions:
- Lie on your back with both of your knees bent in the air. (Position 1)
- Engage your core and abdominal group by gently drawing in your belly button.
- Keep your pelvis in a neutral position.
- There should be a slight arch in your lower back.
- Maintain this arch throughout exercise.
- Slowly lower the opposite arm/leg. (Position 2)
- Repeat 10 times.
- Progression: Add 5-10 second holds in Position 2.
8. Addressing other postures
If you still have Sway Back Posture after trying out all of the mentioned exercises, you may need to address other parts of your posture.
a) Hunchback Posture
A Hunchback posture (also known as having a Thoracic Kyphosis) is where the upper back is excessively rounded forward.
For more information:
See post: Hunchback Posture
b) Rounded Shoulders
Having Rounded Shoulders is when the resting shoulder position is in front of the mid line of the torso.
For more information:
See post: Rounded Shoulders
c) Forward Head Posture
A Forward Head Posture is where the position of the head is in front of the mid line of the torso.
For more information:
See post: Forward Head Posture
9. How to stand
Now that you have completed all of the exercises, is it important that you learn how to stand properly. (Otherwise the Sway Back Posture will persist!)
Step 1: Stack pelvis on top of the ankles
Push your hips slightly backwards.
This aim is to keep the Greater Trochanter and Lateral Malleolus in line with each other.
Step 2: Return pelvis to neutral
If your pelvis is still in a bit of Posterior Pelvic Tilt, you will need to tilt your pelvis forwards until it is in a neutral position.
The neutral position of the pelvis is when the Anterior Superor Iliac Spine (pointy bone at the front of hip) is slightly lower than the Posterior Superor Iliac Spine (pointy bone at the back of hip).
Step 3: Re-position rib cage
Without moving your pelvis, tilt your lower part of the front rib cage upwards. (… but not too far that you flare out your ribs!)
Step 4: Re-position shoulders
Gently roll your shoulders back and down.
Step 5: Elongate/Retract neck
This will prevent your neck from poking forward.
How do you feel in this new position?
Yes, it will feel a bit strange at first.
But just remember – you have most likely been standing with your Sway Back Posture for many years and any change to the norm is going to feel different.
Be aware of your posture.
Try to incorporate this new posture throughout your day to day activities. (But don’t force it!)
10. Address bad habits
If you have any of the following bad habits, you will need to address these as well.
a) DO NOT stretch the Hip Flexors
In the Sway Back Posture, the hip flexor muscle group is already in a lengthened position.
Stretching the hip flexors will further lengthen an already elongated muscle and potentially make the issue worse.
If you are feeling tight in this area, you are most likely feeling “stretch tension”.
(Think of “Stretch Tension” like an over-stretched rubber band.)
In this case – you will most likely benefit from strengthening the hip flexors rather than stretching them!
b) DO NOT sleep on the stomach
Sleeping on your stomach may encourage the Sway Back Posture.
This is particularly true if you:
- Sleep on a very soft mattress as this will allow your pelvis to sink forwards.
- Tuck your arms underneath your chest.
How do you sleep with a Sway Back?
Recommendation: Sleep on either your Back or Side.
c) DO NOT sit with bad posture
When sitting, make sure that your pelvis is positioned right into the back of the chair.
This is to prevent your body from “sliding down the chair” into a bad sitting posture.
d) DO NOT stand like this
When standing, do not allow your hips to push forwards.
e) DO NOT over do abdominal crunches
Abdominal crunches may increase the dominance of Rectus Abdominus.
This may increase the forward curving of the upper back which is seen in the Sway Back Posture.
f) Dead lift technique
If you regularly perform deadlifts, make sure that you do not thrust your hips forwards at the end of movement.
11. questions
Have a question? Feel free to leave me a message in the comment section.
a) How long does it take to fix Sway Back Posture?
You should see improvements within 6-12 weeks of performing the suggested exercises on a consistent basis.
If you have not seen any changes in your posture, it is very likely that you will need to address other parts of your body that may be contributing. (See Section 8: Addressing Other Postures)
b) Can Sway Back cause back pain?
Yes.
This is due to the fact that the neutral position of the pelvis and spine is not maintained with this type of posture.
Conclusion
The Sway Back Posture is characterized by the forward position of the pelvis. (… and the torso “swaying” backwards.)
The main causes are tight hamstrings, over-active glutes, hypermobility, bad habits and slouched postures.
The exercises mentioned in this blog post will help address the muscular imbalances associated with Sway Back Posture.
what to do next:
– Any questions?… Leave me a comment down below.
– Follow me on Facebook. (Let’s keep in touch!)
– Do the exercises!
Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. For more information: Medical disclaimer.
Hi Mark, what an amazing resource you have created – I am very grateful for this information! I seem to have anterior pelvic tilt, with a sway back posture that is particularly pronounced when I have to stand for any length of time. This seems to be causing me inner knee pain, as my knees are braced in an outward-rotated position. Could you advise on the best exercises to help the knees in this case? Many thanks, Jane :)
Hey Jane,
It sounds like you might be placing more pressure on the inside of your knee in this standing position.
In addition to correcting your sway back posture with the exercises mentioned on this blog post, consider checking out this blog post: Inner Knee Pain.
Mark
If you are avoiding abdominal crunches due to sway back, what are some other good ab workouts. How to make a strong core with exercises that won’t make sway back worse.
Thank you so much for your blog and your time
Hi Anie,
You can still perform ab crunches. I would just follow it up with a stretch to the upper abdominal region.
See post: Abdominal Stretch
If you would like to do the traditional core exercises where you keep the pelvis and spine in a more neutral spine, I’d recommend these exercises: Core Exercises.
Mark
For someone that has sway back, hunched back, scoliosis, and forward head posture, will bicycling help or hinder? Does the type of bike make a difference (e.g. upright, cruiser, etc.)?
Hi Angie,
I am not too familiar with the different types of bikes but in regards to posture, the more up right you are (that is, your not hunching forwards), the better it is.
Handles which are too far forward may encourage your upper back to hunch forwards.
Mark
Hey, Mark.
Really appreciate the routine as there is not much info attacking all angles of sway back posture. Do you think sway back posture can cause pelvic floor dysfunction as it’s shifting the hips forward and putting the pelvic floor in possibly a shorten state?
Hi AKJ,
I personally believe that the positioning of the body can influence how a muscle functions.
If your pelvis is pushing forwards (as seen in sway back posture), it can cause gripping of the posterior pelvic floor muscles. I believe this may affect pelvic floor function in some.
In addition to specific pelvis floor exercise, Addressing the pelvis position may be required too.
Mark
Hi Mark,
My quads cramp when I do the Sitting hip flexion exercise. Should I keep doing this exercise and does this support a sway back posture diagnosis or something else?
Thanks
Hey Dan,
Most likely some weakness in the abdominal region and/or deep hip flexors.
Try to make the exercise easier by having your knee bent.
Mark
Hi Mark!
I stumbled upon this article coming from your other article on hyperlordosis. I’m that article you state that swayback can be a result of hyperlordosis. But what confuses me is that for hyperlordosis you have internal obliques as a weak muscle and in a swayback you have them as a tight muscle. Can you elaborate how they go from a weakened to a tight muscle? Thanks!
Hey Mike,
If you have Hyperlordosis (with the usual flared ribs), then the internal obliques will be in an elongated and weakened position. The role of the internal obliques in this sense is to depress the lower part of the front rib cage downwards.
With sway back posture – (which I describe as the pelvis shifted forwards, Posterior pelvic tilt, LOSS OF LUMBAR LORDOSIS, Thoracic Kyphosis), the lower portion of the rib cage at the front is depressed. This would mean the internal obliques are in a relatively shortened position.
Mark
What if I have multiple postural issues I don’t even know where to start!
Hi Danielle,
This is a very common question.
To avoid getting overwhelmed, just pick one thing to focus on. Get the most out of it before proceeding onto the next.
It is very difficult to tackle all issues at once.
Mark
Hi Mark,
Can you share your thoughts on doing reverse crunches with sway back.
Hey Jack,
It’s fine to do in the general sense, but I do not feel it directly addresses Sway Back Posture as the pelvis is generally in a posterior pelvic tilt already.
Mark
Can i replace long sitting hip flexion with lying hip flexion?
Hey Mert,
Should be fine to do that.
Mark
Hi,
I was just wondering how you’d advise fitting this in alongside a normal 3 day a week workout routine? Do it before? Do it on off days?
Thanks
Ryan
Hey Ryan,
You can mix it in with your normal workout routine. No hard and fast rules here.
Personally- I would do it on the off days.
Mark
Hey Mark, thanks for these awesome exercise protocols!
Can you make a guide or comment on what to do about uneven legs? I notice that when I bend one knee to even the legs out, my upper back straightens out. So weird!
Hi Audrey,
Do you know if you have one leg that is longer than the other?
The other thing to check is to see if you have a Lateral Pelvic Tilt.
These 2 points might explain why you upper back straighten out when you bend one of your legs.
Mark
Hi Mark,
I’ve looked into your fantastic content, and I’ve noticed what I think is both sway back posture, and hyperextended knees.
The actions seems to be very different depending on this. Do you have any guidance regarding this?
Kind regards
Hello August,
Try addressing the Hyper extended knees first and see how it affects your sway back posture. Sometimes this might be enough to improve your whole body posture!
Keep in mind, you can split the hamstring exercises into UPPER and LOWER regions. In sway back posture, the upper hamstring region is tight, whereas in hyperextended knees, the lower hamstring is elongated. I think this is where you are getting a bit confused?
Let me know!
Mark
I will try this angle, thank you yet again for your tremendous help and amazing content.
Kind regards
What other ab Exercises can i do
Hi. I have a big problem when doing these exercises. Is there any order or routine to these exercises. I have bad posture and I cant keep my back straight during these exercises.
Hi Carol,
I have listed the exercises in order. However – some people might need to just focus on releases and/or stretches for a few weeks before moving to the strengthening exercises.
Mark
Hi mark,
I want to know that I have posterior pelvic tilt and hyperextended knees so If I stretch hamstrings for my posterior pelvic tilt will it going to worse up my knee hyperextension since hamstrings are knee flexors so if i stretch them will quads extend my knees more.
Hi Rahul,
Good question.
If you have tight hamstrings – You might be better of performing UPPER hamstring stretches instead to address the posterior pelvic tilt.
For exercises for your knees: Exercises for Hyperextended Knees.
Mark
Hi, thank you so much for your advises. I was wondering if I could do knee raises (and when I’ll have the strenght leg raises) hanging from a bar to strenghten my rectus abdominis while engaging also hip flexors that I have to train because of my sway back posture
Hi Luca,
It’s fine do that exercise.
Mark
You are fantastic. Understanding Sway back has actually been helpful to get out of anterior pelvic tilt. In addition to the conventional recommendations, its feels great to engage the biceps femoris to get both hip extension and counter nutation. Do you agree counter nutation is generally part of Sway back posture?
Very well structured update! thanks. Following your guide I meet every requirement for a sway back posture. The thing is I struggle a lot with the thoracolumbar strengthening part. What exact muscles are we trying to contract? I can only feel from my lumbar spine to mid back which I think are not what we are trying to achieve. Thanks !
Hey Eric,
Which specific exercise are you referring to?
If you are referring too the “Lower rib upward tilt” exercise, you do want to feel the muscular contraction of the erector spinaes in upper lumbar region.
Mark
So to understand this “lower rib upward tilt” is like trying to aime a flared rib?
Hey Eric,
Not to cause a flared rib, but to go in the same direction.
In sway back posture, the lower ribs are usually tucked downwards.
Mark
welldone sir. i really love your article, God bless you.
i have been having swayback posture since my childhood and am now 23years.
please how many years can it take me to correct this posture.
Mark,
Very in depth guide. Thank you.
As far as the external Obliques. Is that a major part of correcting this issue or less important ? Should I do Side Plank / Side bends ?
Really bad low back pain from Swayback. Hip pain and clicking when doing leg extensions.
Also it’s interesting…popping floating rib (no pain) when I do ab Bracing , however this does not happen when I ” fake ” an anterior tilt temporarily. So I definitely want to get thia fixed.
Hey C Pallotta,
The External obliques are addressed in “6d) Lower rib upward tilt” exercise. So you can just focus on this exercise to address that.
All the best.
Mark
Do any of these come as a PDF so I can print them and work on them away form the computer.
Hi Kelly,
I don’t have a pdf but it is something I’ve been meaning to do. Thanks for letting me know your interest in it!
Mark
Great article. I can’t keep my back and legs in a 90º angles doing Sitting hip flexion, is it ok? why is it? should I do a regression? thansk!
Hey Manuel,
If I were to take a guess, I would think you either have very tight hamstrings and/or limited hip flexion.
You can perform the same exercise, just lean back a little bit whilst having your hands supporting behind you.
Mark
I don’t understand how the tibialis anterior cuold cause issues. I always assumed it wuold be weak since my calves are super tight.
What do you mean when you say that the anterior shins muscle cuold pull the legs foreward?
And what is the relationship between tibialis anterior and hyperextended knees/ flexed knees ?
Hey P,
If for some reason you tend to over use your anterior shin muscles, this can pull and angle your tibia forwards (via ankle dorsiflexion). This can bring the pelvis in a more forwards position relative to the feet.
It is also possible to have hypertonic calf muscles along side this especially if your weight is shifted to the fore foot.
Mark
Hi Mark,
Thank you very much for making a well thought and complete guide on how to fix my bad posture.
I hope you have a successful and happy life and reach every wish of yours in life.
Thanks.
Hey Mahdi,
What a lovely comment!
Thank you so much.
Mark
Hi mark, i have read that sometimes people with swayback even if they have tight upper abs , their lower abs cuold actually be weak. I feel a lot of tighness in that area, but how can i figure out if they need stretching or strenghtening?
Also should i strenght my lower back?
Hey Pippo,
Lower abs could be weak with sway back. If you are unable to do a reverse curl, this might suggest lower abdominal weakness.
Strengthening is always important (no matter what kind of posture you have)
Mark
Hi Mark,
Aside from planks and oblique exercises, do you recommend any other movements which strengthen the abdominals (Hanging Leg Raises, Hollow Body Holds, Mountain Climbers, etc)? If so, which ones?
Hey Samuel,
All of the exercises you mentioned are completely fine to do.
In the context of the sway back posture, just make sure that your ribs in a more neutral position.
Mark
Hi Mark
Excellent website. !!
I know I have had severe swayback….and lower back is flatter w flatter butt.
The rectus abdominus muscle is too active or strong and has caused some discomfort at the base of rib cage. Is this due to the iliopsoas being contracted? if so, more the iliacus or p. major? if not, what else could cause this? I want to be able to get this somewhat resolved before doing much else.
Thanks Sam
Hi Sam,
In sway back posture where the pelvis is pushed forwards (hip extension), the hip flexors are actually in a relatively lengthened position.
The lower torso then starts to lean backwards. This forces the anterior abdominal muscles to contract to prevent the body from falling backwards.
Addressing the pelvis position may help with your rectus abdominus overactivity.
Mark
I use to weight lift and suddenly I have shoulder impingement but overtime I feel that I have sway back posture and throctic rotation problems what you suggest me to do ?I have looked at your shoulder impingement post but never about what could happen below as side effect of shoulder impingement any advice?
Hey Amer,
If you have tried the exercises for shoulder impingement, I would encourage you to have a look at the position of the shoulders.
Do you have rounded shoulders?
Mark
Heya Mark!
Is it possible to have shortened / weak hip flexor muscles and elongated but feel tight hamstrings? This accompanied with non-existent glutes, weak lower abdominals, tight upper abdominal and pecs, with weak upper back extensors? Also with a slight forward head posture?
This is the posture I feel that my swayback has turned into. This has been a battle for quite some time. Any insight is appriciated, Thank you.
Hi Morgan,
Yes – it is possible to have short and weak hip flexors muscles and elongated hamstrings that feel tight.
Although this would be more characteristic to an anterior pelvic tilt than a sway back posture presentation.
Mark
Hello Mark,
Is it possible to have swayback only on one side?
Best,
Hello Mert,
Do you mean one side of your lower back is more extended?
If so, yes. But I would think it would be related to a rotated pelvis or a twisted torso. (or both)
Mark
Mark
Your website is excellent, very detailed. However, some exercises are complex. Do you have YouTube videos? Thanks
Hey Rich,
No videos as of yet!
Mark
Hello,
I believe I am suffering from sway back posture although I have a posterior tibial problem instead of anterior tibial. Could this be possible? Going to give this program a try.
Thanks
Hi Charlie,
Yes, it is possible to have an issue with tibialis posterior and have sway back posture at the same time.
If you have flat feet, check out this post: Exercises for Flat Feet.
Mark
hi Mark
I have swayback posture. How often should i do your exercises?
Hi Harry,
Try for 2/week to begin with and see how the body responds.
From here – you can increase to 3/week if able.
Mark
How does swayback show during gate cycle? I tried walking without fully extending my knees and immediately I felt a release in my upper back. My hip joints also loosened up.
Im losing hope with my swayback posture. People laugh at me because of the way i walk. I tried the exercises you recommended but maybe it will take a long time because my posture is still the same. Can you include a picture of some of the exercises coz i dont know how to perform them without example.
Hey there .. my advice to you is to keep a close eye on your day to day habits and modify any movements/sitting posture that may help contribute to your bad posture. Also, you need to work on your lower abdominales and stretch the upper part as this a natural response to a body with swayed back posture.. make sure you have good curve (not too excessive) when you perform leg raises for example to strengthen your lower abdominals. Finally be patient about it nothing changes without consistency. It takes 22 days to make a new habit so make sure you keep doing stretching and strengthening for the whole if you want to see changes. Best of luck! ?
Hey Mark.
Why yogis ( people who do yoga ) haven’t any posture problem?
Their hamstring and hip flexors are loosen, so they must feel imbalance. Isn’t it?
Hey Hamid,
I am not too sure of your question.
Are you asking why people who practice yoga don’t have postural problems?
I have come across quite a few yogis with postural issues.
Mark
Can u come here and fix me please my back is so messed from my misagligned body been to chiro amd physio and they dont know what to do they tell me I’m fine but I’m in chronic pain everytime I try and do any of their excersise I am in more pain cuz my body doeant move that way. Please help me. Or by video chat. My limbs are basically coming out of my body from posture and bad adjustments. I will then give u my phone number nobody knows what’s going on my chiropractor makes things worse and I’m scared to go back getting more injured.
Hey Jasmine,
Have you been screened for any inflammatory or nerve conditions in the body. Or hyperlaxity issues?
Mark
hey i love your site keep up the good work! my low back hurts every day i feel like its the muscles. i cant stand too long. in the past i was sitting for years in a slouch position.
if im in a dead hang i feel excatly this sharp pain in my low back. my hip flexors arent tight.
is my low back to weak or to tight? or can my hamstriings be the cause of the pain in deadhang?
thx
hello
do you think that the paraspinal muscles could be weak?. basically i think my spine as a whole has bent forward like camptocormia. and the hips have shifted forward to allow my head to look forward. im really stressed out rn because it’s affecting me too much in my life. the scapula must be out of place it hurts to use a pencil or a mouse. do you think what im sayinng might be correct?
Hey Marco,
Weakness (and most likely over use) of the paraspinals could definitely be a factor.
It sounds like your hips have pushed forwards as a compensation for the curve.
Have you had the chance to look at this blog post? Hunchback posture
See if this applies to you.
Mark
Was jacknife with exercise ball not effective? Its not on your updated ways to fix swayback anymore
Hey Jill,
It is still a great exercise to do.
(Just a bit difficult for some people!)
I would encourage you to continue with it if you find it helpful.
Mark
hi and what should i do if my lower back is sensitive to lower back flexion?
thx
Hey Andy,
Avoid flexion for now.
Once things settle, try to slowly introduce flexion by doing this:
Lie on your back, slowly bring your 1 knee at a time to your chest, If possible, hug both knees to chest and oscillate in this end range.
Mark
why does my low back hurts in deadhang?is it because of tight hamstring or tight hip flexors? when i completly relax when im hanging my pelvic goes in slight posterior tilt this is when its starts to hurt.what can be the cause? thx so much
and sry for bad english
Hey Andy,
If your lower back hurts when your pelvis is in a posterior tilt, then it is likely your back may be sensitive to lower back flexion.
In terms of which muscle would be relatively tighter? The hamstring would be in this case.
Mark
hi i have sway back and low back pain do you think streching the lowback is helpful? or is the low back already streched in this posture? thx
Hey Sway back Andy,
Nothing wrong with stretching the lower back!
Mark
thx for reply and another question why does my low back hurts in deadhang?is it because of tight hamstring or tight hip flexors? when i completly relax when im hanging my pelvic goes in slight posterior tilt this is when its starts to hurt.what can be the cause? thx so much
and sry for bad english
Mister Mark I have two questions, in sway back posture we have pronated foot or supinated? And rib flared out or not? Thank you
Hello,
You can have either pronated or supinated feet with sway back posture.
The lower ribs tend to be more depressed than flared, but this can go either way as well.
Mark
Hi Mark,
I have been reading and learning from your posts but cannot figure out which type of posture I am. Can you please help. I can upload some photos for assessment.
Please let me know. Thank you.
Hi Marium,
I run a free postural assessment contest almost every week or 2 on the facebook page.
Click here to go to the facebook page.
Mark
Im 100% certain my swayback was due to weak hamstrings and not tight hamstrings. I followed this routine for a couple weeks now mixed with some weight training and my problems were getting worse. I did more research and a good way to learn to contract the hamstring was to do bridges with your feet further away and ankles dorsiflexed and i got an insane cramp almost like a charley horse. Followed it with the hip flexor and glute exercises and i finally felt a neutral pelvis and having a tight lowerback. I honestly wish i could talk to you personally and tell you my story and symptoms because i tried looking for help and my life was just spiraling into a mess. And im also worried about the integrity of my spine now because i was in this posture every single time i squatted, deadlift, pull up, push up, press, you name it. I really am woried as to how much i mightve damaged my body and i dont want to go back to see another PT or chiro at this point
Just to name some of the symptoms i had that were literally ruining my life. Chronic fatigue, Not necessarily fatigue but the feeling of laziness and not wanting to move much. EXTREME shoulder weakness. Weak grip, i did a set of chin-ups with a 25 pound dumbbell between my knees and after i finished to drink water, the bottle literally dropped from my hand, my hand still look like it was grasping it and i thought i was gripping it but it literally fell from my hand. The absolute weirdest feeling i has ever felt, especially in the middle of a gym. I also usually drop things thats thrown to me (sadly). And my breathing would never get better no matter what i did, whenever i did cardio or played basketball I literally felt like i couldnt breathe enough air into my body no matter how hard i tried, also sometimes id even be too lazy to speak or say things. There were so many times i wanted to go to a doctor but from all of my past experiences and the thousands of dollars i wasted seeking help there was no way i was going to so i took into my hands. Doing that ive gone pretty much obsessed with the idea of “fixing myself” so i can finally be strong and functional. But doing that ive lost track of my goal of becoming a physician assistant and fixated on this im failing all of my courses this semester, im losing all of my friends because i dont ever want to leave my house, im completely self conscious because i look strong from the front but from the side and back i look like a malnourished boy and im physically not able to speak with my chest. My life is destroyed because of this. I know this is a public post and i dont even know if youll read this but i need to say this to someone, i cant talk about this with anyone because no one would understand, somehow i look like im normal because im pain free but the way i move is so weird, im scared people notice. I dont even know what im expecting if you do respond but i just have to get this off my chest
Hi Luis,
Tight hamstrings can come from weak hamstrings.
People who don’t usually work on their hamstrings will tend to get hamstring cramps. (esp. if weak)
In regards to a sway back posture, it is possible to have tight AND weak hamstrings.
Perhaps you will need to strengthen the hamstrings in their lengthened state? A good way to do this is the straight leg dead lift.
Mark
Thank you Mark. This is fantastic information! I will use and share with a client and friend. We’ve been working on posture but now with your expertise we will take it to the next level. Cheers!
Sounds good Aura Lee!
Mark
Hello,
I tried to make contact with you via FB but unfortunately you don’t respond to messages.
I’ve had a physio tell me I’ve ATP and said I was standing in sway extension (is it the same as swayback?), I was wondering if you could tell me if it really is swayback?
I can upload images via imgur and provide link here.
Thanks
Hey Har,
The “sway” is the prominent inward curve of the lower back.
This is found in both APT and sway back posture.
If your physio has assessed that the APT is the main finding and related to your issues, I would be doing these exercises:
How to fix Anterior pelvic tilt.
Mark
Hi Mark,
What exactly do you mean by this :Stack pelvis on top of the ankles by bending forwards at the hip.? So you want us to lean forward? or bring the hips back so that is inline with with ribs and ankles?
Hey Kevin,
This just means to bring the vertical alignment of your hips over the ankle joint.
Mark
Hello Mister Mark, in sway back posture we have internal rotated hip or external rotated?
Hey KKcho,
It can be either.
It really depends on how your hips sit in the hip socket.
Generally speaking,
If your feet/knees points:
– outwards, then it is more likely going to be externally rotated.
– inwards , then it is more likely to be internally rotated.
Keep in mind, if you have a posterior pelvic tilt (as characteristic in the sway back posture), the hip joints are already oriented outwards.. so a small degree of out turned foot would actually be quite neutral in terms of hip rotation.
Mark
Hey Mark- I have this issue only on one side where I sway in that specific side (right side).
All this happen due to a foot injury that messed up my gait.
Should I do the exercises just for that side which includes glute strenthening as my glute on the same side is weak.
Thanks again :)
Hi,
How does the order for strengthening the weak muscles work. Should I get some basic strenght in my hip flexors, like training them for a couple of weeks and then move on to the glutes?
Or do them all in one training session?
Hey Jaden,
You can do them all at once.
It really depends on how much time you have!
Mark
How many times per week should I perform this?
When doing any kind of hip extension exercises my hamstring take over drastically. What you recommend to do? Should I stretch/foam roll hamstring prior to doing any glute exercises to reduce recruitment.
Thanks
Hey Cam,
You can roll the hamstrings out. That might help.
I would also recommend you learning how to do a posterior pelvic tilt prior to doing a hip extension exercise. This will help engage the glutes more.
Mark
Should we be carful not to stretch the hip flexors during the cobra pose?
Hey Jo,
If you are addressing the hip flexor with strengthening, that should be fine.
However- with the cobra pose in context of addressing the sway back posture, try to keep your belly button in contact with the floor. This should stop the hip flexors from stretching.
Mark
Hi Mark, Thanks for this site! I am working on sway back posture. If I don’t have an exercise ball what can I do instead?
Hey Dani,
You can just focus on the stretches instead.
That should be fine.
Mark
hi.mark
I search in your blog and I did not find torso tilt exercise.please help me
Hey Abouzar,
I copied and pasted it for you:
b) Lower rib upward tilt
Instructions:
– Sit down on the edge of a chair.
– Lock in neutral pelvis.
– Tilt up your lower ribs.
– Create some extension in the upper lumbar region.
– Hold for 5 seconds.
– Repeat 30 times.
It is the same movement as creating a Rib flare.
Mark
Hey mark, with swayback is it okay to do pigeon pose or hip stretches that do not directly stretch psoas. Thanks.
Hey Cam,
It’s fine to do.
Just make sure you balance it out with the strengthening exercises as well.
Mark
hi mark
ı am abouzar.i have pain in R shouder and i can`t do plank and side plank for swayback posture and anterior pelvic shift correction.Do you suggest any other practice?
thanks
Hi Abouzar,
You can focus on the doing the torso tilts instead. (mentioned in blog post)
Mark
hi.mark
I search in your blog and I did not find torso tilt exercise.please help me
Doing abs exercise with abs wheel is a good exercise for swayback posture?
Yes, that is fine to do.
Mark
Hi mark, doing the sway back routine but i dont have time to address uppercross syndrome, should swayback be addressed first then once corrected work on uppercross forward head etc
Thanks mate
Hey Dan,
You can start on any area.
Persist with the area until you find that the exercises have taken you as far as they can.
From here – move on to addressing the next area.
Mark
hi Mark. ive been reading your posts on posture direct recently. For 3 years Ive had chronic lower backpain after squatting too low one day and my lower back has been killing me ever since (when standing and walking).
I went for an MRI test last month and it concluded I have a SCHMORLS NODE on L1 and a loss of lumbar lordosis. I have no idea which one is causing constant lower back pain when walking or standing but I suspect its both. I am desperate for any help. have you ever encountered schmorls node on L1 before? ive been reading your posts about flat back but I am lost as to what to do.
any help would be greatly appreciated thank you so much from the UK.
Hey Elliot,
It sounds like there is a bit of “Wear and tear” (aka degeneration) of the L1 vertebra. This may imply that your body is placing more pressure in this region. (as opposed to being spread out equally throughout the spine).
I’ve seen quite a few people with Schmorls nodes… but it is important to understand that it is more important to treat the dysfunction, and not findings on scans.
The first step for you would be to make sure you are able to move your spine properly.
Here are 2 exercises that I would recommend starting with:
1. Segmented spinal cat/cow
2. Rotation
Your main focus is to get each individual vertebra to move as much as possible.
After you master these movements, the next step is to start to address your postural dysfunction.
Also – L1 is more so middle of the torso, is this where your pain is? Or is it lower back?
Mark
Mark thank you so much for helping me. I will begin those exercises ASAP. What do you recommend I tell the physio when I see them?
Also the pain is definitely in the lower back, lower down than L1. When I flex or round my lumbar spine the pain is especially sharp. So the cat camel is hard for me to do as It is a sharp pain when I do the cat part. The pain is constantly there in the lower back like a pressure building up when I stand or walk and when I bend over it turns into a sharp pain in the same area.
Ah ok – So the L1 finding is probably not generating your pain.
It can still be a factor of the pain further down though.
Sounds like you are flexion sensitive. This may mean there might be going on with your disc (maybe L4/5 or L5/S1) and/or perhaps the muscles are tight.
Either way, the physio should be able to easily identify what is happening.
best of luck!
Mark
Hi Mark,
I have had right QL pain for the past 9 months. Since the injury I’ve realized I have a swayback, PPT, muscle tightness (from right lower quad all the way up the right side through hip, back, up to right neck perhaps originating in very tight mid-back), tight hamstrings, tight pirformis, and non-existent glutes. It’s painful to sit on my angular sitbones due to lack of glutes (which only makes my PPT worse).
Which of your exercises plans would you recommend – swayback or PPT (or both)? And do you think they would help heal my QL muscle?
Many thanks in advance.
Hello Sue,
To address your sway back posture, I would do the exercises mentioned on this blog post.
It might help with your right QL, but there might be some specific exercises that you might need to do for it.
If it is tight, stretch the QL may help.
View post: Quadratus lumborum stretches.
Mark
Hi Mark, apologies for posting here i had no idea how to actually put this in the right spot on your website. I tried messenger however it referred me to your blog post. i assume this is it?
My issue is a comes from my L5/s1 disc bulge and facet of the L5. I have a minor portrusion at that disc level, but i have so much pain when i go into flexion. When i put my finger on my right hand side facet of the L5 it feels thicker and swollen almost. I also have referral tingling pain down the right leg. Note: my disc protrustion is on the left with no left side leg symptoms. So im fairly confident its a facet issue? bothering the nerve? Any flexion of the lower back gives me a dull pulling achy sensation throw the entire low back itself.
Please help,
Harry
Hey Harry,
Facet joint pain tends to hurt with extension of the lower back. (but not always)
If you are getting flexion pain, it may also be your muscles/ligaments in that area of the Right L5 area.
If you believe it is the nerve being squash by the joints on the right side, try laterally flexing to the opposite side to see if that helps.
Here are some stretches you can try:
Quadratus lumborum stretches.
Mark
Hi Mark!
I’m a chiropractor who works with pregnant women.
What are your opinions on pregnancy with this posture as this becomes a posture many pregnant women adopt. I noticed a few exercises that I may not recommend to mom due to the belly, but found many others that I think would be useful in helping pregnant women have pain free and healthy pregnancies. Thanks for the informational post.
Cheers :)
Hello Chiropractor Brooke!
As the Centre of gravity changes with the development of the tummy, the posture will automatically compensate in one way or another.
In most cases, pregnant women will tend to adopt the sway back posture. This would use the lumbar paraspinals to support the belly weight.
I’d advise to :
– Maintain good thoracic spine position
– Address any rounded shoulders
– Keep core strong to encourage alignment of the thorax/pelvis
– Cue to keep hips stacked over ankles.
Mark
Hello Mark. What do you think about posture support (like corsets) etc? Is it helpful or useless?
Hey Eugene,
For short term use – they are fine to be used.
In terms of long term use, I am not the biggest fan of posture braces.
Reason behind that is excessive use will make your posture muscles more reliant on the brace and eventually get weaker.
Mark
Hi Mark
Would you suggest strengthening the hamstrings rather than stretching, as the reason they are elongated is due to their overall weakness, rather than them being too strong and pulling the pelvis into that position?
Cheers
Jack
Hey Jack,
Yes – you will definitely want to strengthen the hamstrings. (Eccentrically)
Mark
Hi Mark,
An excellent article, thank you!
Apologies in advance for the length of this post!
I am a regular gym goer (including deadlifts and squats) and around 14 months ago I diagnosed myself with anterior pelvic tilt. I then spent around 10 months doing all the things suggested to fix that, with no success. It then dawned on me that I actually had POSTERIOR pelvic tilt and I’d been actively worsening it. I have recently (the last 3-4 months) being trying to fix that Posterior Tilt and have seen some minor improvements, but I still find it difficult to squat properly for example, (I just can’t get that feeling of my butt sticking out anymore), or properly engage my core. Anyway today I started to think that there was something else going on, and realised my weight was mostly over my toes (this mostly showed itself when I was squatting, deadlifting, or just standing up without moving). I found this article and it seems to me that I do in fact have back sway, with associated posterior tilt.
The crux of my post is – In the past, until I had this problem, the best core progress I ever had was when I was using the cues ‘stick belly button to your back’ and if lying down ‘stick lower back to floor’. Essentially, to draw in the belly button and flatten the arch in the lower back (think for example of the hollow body hold, which involves removing the arch in lower back).
These cues led me to engage my core like never before and make great progress.
However, since I’ve had sway back/posterior tilt I have lost the ability to create that feeling in my core (or indeed to create any real core tension).
My working hypothesis was that it was due to the fact that posterior tilt was doing the forcing of the back into the floor by itself, ie, a slight ANTERIOR (or neutral) tilt would mean there was a lower back arch that I would use my core muscles to flatten, hence getting a good workout, but a posterior tilt would be doing that work for me.
Could it be though that those cues led in part to the sway back/post tilt issue? Or perhaps the fact that I now cannot do those cues is a symptom of sway back/post tilt?
It seems on the one hand that flattening the lower back arch during core work (by contracting the core, not by rolling the hips) would be bad for sway back and posterior tilt, but on the other hand when I didn’t have sway back/post tilt I was able to ‘stick belly button to back’ and ‘Stick back to floor’ quite easily.
My concern is, if I can again engage my core in that way (once I’ve fixed the sway/tilt) will that eventually again lead to/contribute to Posterior tilt/sway back?
Sorry if that’s a bit incoherent!
Thank you
Whoa Ryan, this is a long comment! :P
It is common for people with a sway back posture (hips shifted forward + posterior pelvic tilt) to think they have an anterior pelvic tilt.
However- exercises are quite different!
It is possible to over cue your self into another postural dysfunction. (this might be you)
Once you have regained your neutral pelvis, you will want to still engage the core using the mentioned cue that works for you… however you will need to make sure you don’t move your pelvis into a PPT as you do it.
Basically – engage your core whilst maintaining neutral pelvis. This will prevent you from developing the sway back again.
Mark
Hi Mark! Your website is godsend for me!
I’d like to ask two questions. I have scoliosis in addition to my swayback and my PT told me some confusing things. He basically told me not to change my sleeping posture because I’m unlikely to get good night’s rest. I sleep on my stomach with “rotational” position and apparently it’s because it’s the most ergonomical position in my case. My PT said that sure sleeping on my back is better but I’m unlikely to fall asleep easily that way and because sleep is more important I shouldn’t force myself to do so. Does it sound reasonable? It seems to go against what most people advise on the Internet. Moreover do you think that sleeping with a pillow underneath my abs / pelvis could make my stomach sleeping not reinforce my swayback posture so much?
Another thing he told me is that I should increase my strength in general (I’m a skinny guy) and I shouldn’t force myself into “good” standing posture either. He told me that later on I might want to start working on thoracic mobility and habitually slightly contract transverse abdominal muscle (but not to the point of pushing on diaphragm). I tried this in front of the mirror and it seems to work pretty good. If I do this my pelvis seems to go back to a neutral position, my hips go over my ankles etc. If I pair it with thoracic spine extension then it looks very similar to a “normal posture”. Do you think it’s a good way to attack it? It seems like these two steps start chain reaction of other muscles which seems to give very similar effect to what you described in your functional training section.
Best regards!
Hi Tomasz,
If your sleeping posture is directly affecting your issues, then you need to eventually change it.
You do not need to force your sleeping position (and I would advise against you), but making gradually changes over time so that the body can naturally adapt would be the way to go.
Your standing posture should be as relaxed as possible. Once again – you should not be generate excessive amounts of tension in your body to force good posture.
Mark
Can you demonstrate the Lower rib upward tilt with a gif, video or picture? It’s missing a visual, unlike the other exercises. Thanks.
Thanks for the suggestion, John.
Will need to get a video of this movement.
Mark
Whats the difference between sway back and posterior pelvic tilt?
How can I find out which one I got?
Hi Samuli,
The main difference between the two is that with sway back posture, the pelvis is in FRONT of your ankles.
Mark
Hi , how can I find out which one I got?
The best exercises to fix your Sway back posture are the same for PPT
Hey Mark,
I have sway back posture. I’d like to know your opinion if feeling pain in the mid back (near scapulaes) could be related to sway back or if it is due to other problems like scapulae winging. Thank you
Hey Lucas,
Pain between the shoulder blades can come from a sway back posture.
But if you have winging as well, that could also be a factor.
Check out this post: 14 Steps to completely get rid of your shoulder blade pain.
Mark
Hi Mark,
Thank you for this in depth description and and instructions, this is super helpful. One thing that I am having a hard time with is that when I try to follow the steps to stand up correctly with everything stacked on top of itself in a straight line, I feel like I am leaning back and am all the way on my heels, almost to the point where my toes are coming off the ground and I feel like I am going to fall back. Do you think this is just because I am not used to standing like this?
Thanks,
Nick
Hey Nick,
It sounds like your hips are aligned, but perhaps somewhere in the torso, you are extending backwards.
This will cause your centre of gravity to shift behind your feet which can make you feel like you are going to fall back.
The main area the comes into mind is the upper lumbar spine. If you have an excessive lordosis there,you might need to address that first.
Mark
Hello Mark,
I was wondering what are the thing that i should avoid if i have sway back posture? For example is running or taking long walks one of those things?
Hi Anthony,
Walking and running are completely fine to do in conjunction with these exercises.
Mark
Oh mark this is great, i never looked at this one because every other ressources shows sway back more as ATP.. I thought i had severe posterior pelvic tilt but from your perfect explanation it seems more like sway back thats causing a bit posterior tilt when bending/sitting as when standing up i can move my pelvis easily front to back and cat/cow does nothing! (and i hurt myself badly thinking my posterior tilt switched to ATP but that was just sway back, hip flexor stretches are evil even if they feel good)
Everything on this page feels amazing, the sitting extension is so hard i can barely move an inch and my whole body is shaking!
I have a question concerning my glutes. I can’t ever feel a stretch in them. On your rotated pelvis page, i cant feel the seated one or the one lying down. The highest i can feel is upper hamstring. Could it be my sway back causing this? I see that theres no glute stretch so my pelvis probably gets pushed in a position where my bendy back doesnt allow me to stretch them directly right? Every glute stretch hurts in my internal hip, feels like im pushing bones.
Hey Max,
Glute stretches might be great if you have Duck foot posture (feet that are facing outwards) in conjunction with sway back posture.
If you can’t feel your glutes stretch in any of the exercises, you might need to APT whilst performing the stretches. This alone might help!
Mark
I heard from Ms. Hu about the swayback posture that those who have this problem should avoid the following: 1.breast stroke2.cobra pose3.supermanpose.Is it correct?
I just found out that I actually have this problem, could it be the cause that my knees cant fully straigthen? the area around my hip to knee is too far forward and the area below the knee is too far backward. Can it still be corrected? I am 21 years old now
Hey Adam,
It could be a factor.
But even so, you should still be able to straighten it whilst you are sitting down? If not, you may need to get a scan to check out what is happening structurally.
Mark
Hey Mark,I’m 17 and recently discovered that I have swayback. I imagine that the cause is slouching, as I have spent almost every day of the past 2 years slouching in a chair and always have done anyway. Because of this I’m attempting to always sit uprights d provide back support of nesccesasy. I have been trying your exercises over the past few days and whenever I’m standing or walking, tried to ensure I pushed my shoulders and pelvis backwards in line with my ankle. However I’m experiencing a lot of lower back pain from doing this. Just wanted to know if I’m doing anything wrong or affecting my back negatively.
Thanks, Max
Hey Max,
Try not to force the posture. This will cause increased tension into your muscles.
The exercises are designed so that you fall into better posture. (But this takes time)
Gently guide your body into a more neutral resting position.
Mark
Thanks for be advice! Would probably be good to ask how many times a day I should be doing them? (i.e all the steps).
Hey Max,
If you could do it every day, that would be good.
But realistically – aim for 2-3/week and see how you go from there.
Mark
Hey Mark,
I recently became aware that I have a swayback posture. When standing, I tend to rely on my hamstrings. I have tight hamstrings and hip abductors while my quadriceps and hip adductors are weak and over-lengthened. I am currently doing the proper exercises and stretches to fix my hip and leg issues, but I’m a bit confused when it comes to the obliques. Although I am 5’10” and 155 lbs, I have a large gut. Also, I have noticed that there is excessive pressure under my sternum/upper abdominal area. This pressure is much more noticeable when my stress increases. If I sit for too long, my lower back begins to hurt and my abdominals feel like they are being overexerted. My abdominals begin to flare and I sweat more than normal. I have read online that the internal obliques are responsible for increasing abdominal pressure. Do I need to stretch my internal obliques while strengthening my external obliques? And how would I go about this? Thanks!
p.s: I’m currently doing my under grad in Kin Exercise Science and hope to be a future PT. Love the website.
Hey Leo,
It is common to have tight internal obliques with a sway back posture.
I would stretch them out in the cobra pose and then practice lower ribs tilts whilst sitting.
Mark
Hi,
My natural posture is Swaybcak however when I stand up tall and hold good upper body posture I have hyperlordosis. This has cased me to have flared ribs.
To fix flared ribs it’s suggested that you get stronger abs, however it’s not wise to to abs with swaybcak. Help
Hi Ben,
You still want strong abs even with sway back posture. If you are training your static standing posture, You just want to train them in a more neutral position.
Mark
Hi Mark.
I have pain in my lower mid back and neck. I have checked my posture and I have hips swayed forward and noticeable anterior pelvic tilt. Upper back – thoracic kyphosis and forward head (curved neck). Since the exercises for these postural issues (sway back and anterior pelvic tilt exclude each other (are opposite), I would really appreciate your advice what exercises to do to fix swayed hips with anterior pelvic tilt.
Thank you in advance!
Hey Matija,
I actually have a blog post coming out on this very soon!
Stay tuned!
Mark
Is there a fool proof way to figure out posture deficiencies? Or an article to figure it out?
I’m having trouble figuring out if I have sway back, ATP or a combo of both. Just saw you are posting an article on that soon and curious if it has been posted.
Thanks
Hey Joe,
Check out this post: Anterior pelvic Shift.
Mark
Hi Mark
Thanks for sharing this great information. I have pretty severe sciatica-related pain (I think) and it’s probably piriformis related (at least that’s what I’ve concluded) – maybe inflammation of the muscle. I’ve had shooting pain for the last 8 years. It begun after I had some lower back stiffness following some exercise one day and it has got progressively worse over the years. Now it’s so bad I can’t sleep at night and the pain is chronic. Not a great story. Anyway, I’ve read about sway back now, and ive read your blogs. Could you take a look at a picture of me and let me know if you think I have sway back? (If you provide your email I could send you a photo) To me it doesn’t look like sway back too much, or maybe it is? I would greatly appreciate your advice. I’m willing to pay for any consultation you provide. Please let me know. Thanks
Hey George,
Feel free to send a photo of your posture in the facebook chat!
Mark
Thanks Mark, I sent you a message on your Facebook page :)
Hey Mark, can you explain to me how the upper abdominals are tight because of the internal obliques, or do the internal obliques run into the upper abdominals somehow?
Hey Rabelle,
In sway back posture, the lower back over arches which places the whole upper torso leaning back.
As the body will always try to keep the eye sight parallel to the horizon, the mid torso will then flex forwards to maintain balance.
Due to their attachments to the front lower ribs, the muscles responsible for this are mainly the upper abdominal and internal obliques.
Mark
Hi Mark thank you for this information it’s amazing however I’m. Not sure if I have sway back orr APT would you please look at this photo and tell me
m.imgur.com/a/nQL7D
Hey Ali,
I will need to see a full body shot from the side to determine if you have APT or Sway back posture.
Mark
Hey Mark,
Thank you for your time.
Here it is
Hi Mark!
I am confused about the “groin” muscles like the ones stretched in a butterfly stretch. Are those hip flexors as well? I can’t find info on whether I should stretch these or not.
Hi Elli,
The groin muscles which are situated more towards the front of the body can act as hip flexors as well.
With sway back posture, it is fine to stretch out the groin muscles.
Mark
Hi Mark,
Could you please tell me by looking at this picture if I have a sway back posture, anterior pelvic tilt or posterior pelvic tilt?
So I can make sure I choose the appropriated exercises.
Thanks a lot in advance Mark :)
Hey hey,
Looks like you have a degree of knee hyper-extension which may be causing your pelvis to shift forward a bit.
Do you have tight calves?
Mark
Here is a picture of my maximum calf flexibility (around 10cm from the wall):
1) Do you think these calves are flexible enough?
2) I struggle to understand the link between the calf lack of flexibility & the knees hyper-extension. Could you please explain it? :)
Hey Sodraguy,
1) 10cm from wall is good! Click here for more info on ankle mobility if you would like.
2) If you are hyper extended at the knee, this will mean the ankle is in more of plantarflexion. If the ankle rests more in plantarflexion, this can lead to or be caused by tight calves at the distal end (and more elongated nearer to the knee).
Other than that, looks like a slight case of sway back posture.
Mark
Hi Mark,
Thanks for the explanation!
So I need to focus mainly on my hamstrings flexibility, I have only a mobility of approx. 60/70% as you can see here:
Left leg:
Right leg:
I have another problem linked to this sway back posture. The pelvis being shifted forward, that’s put a lot of pressure on my bladder and my rectum during the day. That’s more problematic during the night because I need to wake up to pee or poo.
Do you have any good posture to recommend when I sleep to avoid the pelvis to put too much pressure on the bladder and rectum ?
I just read this post and I seem to have a lot of these problems. I sit in a slouched position all day where my pelvis seems to be posteriorly tilted. I have a long history of injuring my hamstrings when sprinting or doing explosive work. I notice during squatting or any leg pressing exercise my quads are doing all of the work and sometimes I develop pain right above the knee. I find when I do bridges that my hamstrings do all of work no matter how hard I try to extend the hips with the gluteal muscles. I believe that my hip flexors are weak because when flexing the leg above 90 degrees muscles like my TFL tend to cramp up. My quads are overdeveloped which I believe is because they are compensating for my weak psoas major. Some other things that I have noticed is that the inner part of my calf muscle is really overdeveloped and the outer seems to be nonexistent. Also whenever I try to strengthen my external oblique muscles by doing anti-rotational work or side planks I get no activation in this muscle group at all. My question is would strengthening the psoas major feed slack to overdeveloped muscles like my quads? Also what are some ways that I can better activate my external obliques and stretch my internal obliques?
Hello Mark,
Thanks for all of your sound advice. I am quite sure I have APT. It could probably be corrected with these exercises, but to be honest, I’ve never been able to stick with anything even remotely athletic or physical activity related. So question number one is: what is the most important thing to takeaway from all of this? Is there one exercise that is more important than the rest?
Also, I have upper back pain on one side from carrying my toddler around all day (She is very big; I am rather small). I tried carrying her on the other side to even out the strain, but it just doesn’t work. Is there anything you can recommend as far as stretches or ways I should be carrying her/ picking her up?
Hi Bri,
The most important to understand is that every one is different. Each person will respond differently to different exercises and will usually will require a mixture of them. This is why I encourage people to do all of them (…to begin with) until you can see/feel/understand the effects that each exercise has on your body.
Carrying toddlers is hard! But here are some of the most important things you need to consider:
– always brace your core muscles before any lift and during any carry. Here are some examples.
– keep your shoulders neutral. You will need to engage your shoulder blades muscles to prevent them rounding forwards. (see post: rounded shoulders)
– Get strong arms. Resting your toddler on a hitched pelvis will eventually take its toll on your body. (… and it doesn’t help when the babies only get bigger with time!). Biceps and back training is the way to go here.
– only lift when you really have to. Don’t give in to the cries! (This one may be the hardest of them all)
Mark
Thank you, Mark! I just now found your a response, nearly a year later. Hah. I appreciate you taking the time to reply! She definitely has gotten waaay bigger. I will be following your advice. Time to get ripped biceps. :D
Help!!! When I slouch I form a swaybck posture, however when I stand up tall I have an excessive curve in my lower back. For fixing swayback you suggest strengthening the hip felxors, however to fix lordosis you suggest stretching them instead. What would be more beneficial for me to do, so I can improve my posture?
Hey Ted,
If sway back posture is your natural posture, then I would focus on that.
You would stretch hip flexors if you have hyperlordosis with an anterior pelvic tilt.
Mark
Ok, many thanks. Will focus on fixing my swaybcak. Also, many thanks for the help fixing swaybcak I would be lost without this.
when I slouch I form a swaybck posture, however when I stand up tall I have an excessive curve in my lower back. For fixing swayback you suggest strengthening the hip felxors, however to fix lordosis you suggest stretching them instead. What would be more beneficial for me to do, so I can improve my posture?
Hi Mark,
Very informative read, thank you! I definitely have APT (The front of my belt is lower than the back of my belt, when I look at my boxer waistline the front is lower than the back, and my butt sticks out. I also believe I have a little kyphosis, I have always had a slight hump in my mid/upper back when I bend over to stretch. This had led to years of acute lower back pain, poor posture, and neck pain. As a result, I recently have been working on my APT by stretching my hip flexors, quads, strengthening my core with planks and bridges (I squeeze my butt in both instances), and also activating my glutes by flexing them when I walk, etc. I have been working on my kyphosis by doing shoulder dislocations, stretching my chest, prone-ys. I have also been getting back into strength training my back, chest, arms, glutes (squats) and other prominent muscle groups. With that being said, I have a few questions:
-Does this appear to be an appropriate approach? I know I can’t do everything out there, there is so much good info!
-Could focusing on fixing APT result in swayback overtime? Or in other words, can my front pelvic tilt reverse? That is my worry by focusing on my APT at the moment.
Thanks so much,
Ben
Hi Ben,
In regards to your exercises, you are definitely on the right track to addressing your APT! All that you have mentioned sounds good to me.
If you over activate your glutes and cause your pelvis to shift forwards so that the hip sit in front of your ankle joint, then yes, you can in fact over shoot the correction. You will need to make sure that you keep an eye out for this so that you don’t develop the wrong posture.
Mark
Hi, so I think I developed this from overstretching my hip flexors since I thought I had APT, um I’m just wondering if it is a good idea to sleep on the floor on your back, but I feel like my hips are stretching even more when I’m lying down on the floor, I dont know if it’s a good idea. I have been confused from trying to stretch out stiff muscles such as my quads and around the hip area but I think I made things worse. Like I feel some tension in the hamstring and glute. I dont know if there is a proper mattress to sleep on or whatever, I usually sleep terribly due to past problems with posture and strained my right foot from basketball which caused a lot of things since
Hey Kevin,
Doing the exercises for fixing an anterior pelvic tilt may make people with a sway back posture even WORSE!
Sleeping on your back is fine… You can consider placing a thick pillow underneath your knees as you sleep if it is more comfortable.
Mark
With the hip hinge I can barely reach below my knee caps.
On my back I can hardly get 45 degrees of hamstring range of motion before my lower back rounds.
I get Pain when jumping and deadlifting fro the floor and squatting. However as long as I keep a neutral spine and only go to my knees with RDLs and do Box Squats to a high box and keep a neutral pelvis, I won’t get pain.
Is this Pain from tight hamstrings?
Would doing good form loaded RDLs help stretch me out? I know my hamstrings and glutes are pretty weak. I ask because I’ve heard some people say go for static stretching and some go for loaded.
Same with my back in relation to my chest.
Do you have a ratio of Bench Press to Barbell Row strength I can shoot for?
I think I can Bench around 300 and Row around 190. Probably not a good ratio.
Do you use a lacrosse ball for the hamstrings or a bigger ball?
I can’t seem to get them to release.
My right shoulder is also more rounded than the left. Is there a way to tell if it’s from the chest or shoulders or back?
Hey Max,
Tight hamstrings can cause premature lower back rounding when you are hinging forward.
Dead lifts are great to improve hamstring mobility. Focus on lowering the weight in a slow and controller manner. Only lower as far as you can go as long you are maintaining neutral spine/pelvis.
You can use either a ball to release the hamstrings. If you can’t feel the release, perhaps try the bigger ball and get as much of your body weight on top of it. (Alternatively – you can go for a massage)
I am not sure of a solid push:pull ratio.
If your pelvis/torso is not rotated, then it is likely the right shoulder itself that is causing the rounding.
Mark
How does abs can make sway back? When u sway back – your abs are stretched and relaxed and it takes efforts of abs as well to bring body in normal posture.
All articles except yours actually recommend abs exercises. Very weird. But for all other tips – big thanks!
Hey Eugene,
Thanks for the question.
With a sway back posture (in general), the upper abdominal muscles tend to shorten as to bring the upper torso more forwardly tilted.
You still want to train the abdominal musculature, but in a neutral and/or functional way.
Mark
What do you mean by neutral or functional way?
Hi, Mark. First off I just wanted to say thank you for making this wonderful website. You are a really wonderful person for making such a great resource available for free and you have helped so many people, including me.
I’ve scoured over your website and I’m fairly certain I have both posterior pelvic tilt AND sway back posture. I have reeeeeally tight hamstrings and my hip mobility is terrible. However, I’m not sure what to do for one thing. For sway back you advise to strengthen the glutes, and in the PPT article you advise stretching them. Should I both strengthen and stretch them?
I hurt my knee 6+ months ago playing basketball (i was sooo stupid and thought I had APT, so I was stretching my quads and hip flexors and that’s what caused the injury I’m sure) and haven’t been able to squat since then. However, when I was squatting my butt would always get really sore afterwards and I got a bit of a bubble butt while I was squatting regularly because I guess they were doing a lot of the work. I’m not sure if that info is relevant or not, but I’m just writing it because I believe it means I have no problem activating my glutes (which would contradict the sway back posture symptom).
Hey Matt,
You ultimately want to strengthen your glute (tight and weak) muscles with a neutral pelvis.
You can still stretch them if they are tight.
You can still have a sway back posture if your glutes are strong. In fact – if you over activate them , they can push your pelvis forward. (Think of how some power lifters finish their dead lifts)
Mark
Hi Mark,
I found your post after suffering from pelvic floor dysfunction and pain for one year. All the female health specialists I saw were sure my hip flexors were tight and had me constantly stretching. This caused me to become horribly weak and also caused my psoas to knot up near my spine.
After three days of following your routine the knot near my spine left and after six weeks – my hip flexors are “shrinking” and strengthening and my low back is getting a curve. My sleeping butt has also finally woken up! So, thank you for all of this!
A few of my issues that I didn’t see a way to address are a complete lack internal hip rotation, both legs externally rotate, and I have one “duck foot”. I’m assuming my external rotators are tight as a compensatory measure and I think that’s the source of my pelvic pain.
Do you have any exercises or suggestions on how to target strengthening weak internal rotators?
Thank you so much!
Hey Steph,
I am happy to hear you are finally getting some promising results with these exercises!
For your lack of hip internal rotation,
– Stretch your hip external rotators
– Mobilise into hip internal rotation:
– Strengthen your internal rotators:
Please note: As you improve your pelvis position, you may also find that your rotation improves as well!
Mark
Good afternoon,
To start, sorry for my English … This is not good at all.
I’m dealing with a big problem that goes with this article … And explain you:
I am a 33-year-old man and have had a scoliosis from childhood. Since my 20 years I have been struggling with my back and I have a lot of pain … There is a difference in leg length and my pelvis are crooked … My legs are measured and they are the same length, so the problem is in the pelvis or back.
My pain is situated at the bottom right of the back. There have been many diagnoses, but now I’m probably close to it. I went to a scolios clinic, and there they told me that my Iliopsoas on the right side is shortened and therefore my Si joint is blocked so that I am constantly blocked. For example, I can not lay my right leg completely flat on the floor. It is shortened but it may also be tense? Since I have constant pain?
They taught me to slide my pelvis to the right and keep the tailbone low (ie tilting the pelvis backwards). This is because I have a hollow back at the bottom, and push it to the right as my pelvis is higher on the left. I have to pay attention to my breathing during the exercises (4 counts in, 8 counts out). The problem is that in this posture I contract my abs, but apparently that is not possible …
The exercises consist of opening the weakside and point through breathing.
But since I have no pain on my back myself, they pose stretching.
Important: my back is hard on the right side, can not be released … My lower back is hollow and my upper back is leaning backwards.
I feel the pain when I walk or straight away (immediately). When I sit or lie I do not feel it …. When I sit down after a long walk or stand for 10 minutes I feel like it when I sit down, and I can mobilize the pain (by moving with hip).
My questions:
– would you recommend me to do these stretch exercises?
– What else can you recommend to me?
– I read somewhere that it is better to let the iliopoas muscle relax first and then stretch them (after a while)? Direct stretching of a shortened muscle would work badly? and relax by doing the following exercises:
– as I tilt my pelvis to the right and to the back (through the hollow back) my stomach muscles … But apparently this is not allowed. How can I avoid this?
– how can I do breathing correctly in daily life?
– Does massaging the Iliopoose muscle have any use?
– what is your vision about my situation?
My big shock is that it will never disappear, I will remain an unhappy for the rest of my days …
Yo Bart,
Sounds like you would benefit from more specific help.
Please feel free to contact me on the Facebook page and I will try to assist you there.
Mark
Hi Mark,
I have sent you a message on Monday on your Facebook page.
Thanks!
Too easy.
See you there!
Mark
Heya, im confused to what i have even tho ur website is freaky awesome. Can you have posterier pelvic tilt but also have a lower back arch when lying down? It hurts to lye on the floor too long i gotta put my knees up to make my back flat. I lay on my tummy when i sleep if my back hurts but i have all the symptoms of posterier, couch potato sitting, rounded shoulders, slight forward neck, lower back pain, hip pain if i dont exercise for a longtime. I also use my shoulders to hold me up and clench my butt to bend over stead of stickin my arse out n using my legs when im a zombie lol. Can you have slight knee inward bend from posterier? My back bone which i sit on when in full potato mode sticks out when im standing but my butt is flat (im a thin build) thats fully posterier a? Cheers 4 ur time
And thanks SO much for makin this info free. Badass.
Hey 10,
With sway back posture, you can have a posterior pelvic tilt with a lower back arch when lying down on your back.
You can also have knees that collapse inwards with a posterior tilt.
If you are a skinnier build, it is quite normal to have the bones in your spine stick out.
Hope this answers your questions.
Mark
Amazing Post!
Would an upright low lunge be ok if you were pulling the back knee forward, and the front foot back isometrically?
Hey Krista,
I like how you are thinking.
Combining strengthening with stretching is the way to go!
Although I would still avoid passive hip flexor stretching if one indeed still has elongated hip flexors to begin with.
Mark
Hi Mark,
I’m a dancer who has been trying to navigate fixing my sway back and one of my biggest concerns is that I kind of need to stretch my hip flexors for splits, etc. consistently. Would stretching them prevent any progress from your exercises or is there a way around this? Thanks.
Hey Joe,
If it is required for your sport, keep stretching those hip flexors.
However, I would encourage you to make sure you have strong hip flexors (especially in the outer ranges).
Here’s one I like to do:
Mark
If I sit,
don’t my hip flexors get shortened. How can I open them, if i can’t stretch them and I have posterior pelvic tilt / sway back (I don’t know what’s the difference).
How about rectus femoris, TFL. They are all hip flexors and require little different positions.
Hi Samuli,
In sitting, the hip flexors are in a shortened position, however, in standing, it can be in a lengthened position. (It just depends on how you are standing)
If you are unsure if your hip flexors are short, you can test them out individually with muscle length tests.
Mark
This is very helpful. I have been having a lot of tightness in my hip flexors and kept stretching it for months without any improvements. A chiro did a postural assessment and my sway back seems to be very obvious. However, the chiro only focused on “Adjustments” which i often find to be a temporary fix since they dont really correct the muscular imbalances.
I started doing these exercises for the past 3 days I already feel some relief. How often do i need to do them? More specifically, can I do the “hip flexor” drills throughout the day. I feel that my posas is very weak which might be the root cause of my pain.
Hi Alec,
Adjustments are great, but like you said, are only temporary!
Start the exercises 1/day. And increase/decrease as appropriate to your individual situation.
You can do the hip flexor strengthening exercises throughout the day if your body can handle it.
Mark
Ive corrected my posture as you’ve said but it seems that I also have atp. So basically when I pull my hips back my back goes into an anterior pelvic tilt. Should I still try to hold this posture even while walking or would this be pushing it. Is there some kind of lower back support I should get?
Hi Samuel,
You would want to focus on releasing your quad muscles and lower back.
After this, focus on core strengthening to lock in correct neutral pelvis position.
With your day to day activities, try not to overly force the pelvis into position. You want it to become natural.
Mark
Hi Mark, Thank you for this amazing website, so informative, clear and so easy to go through. I’m so glad for all effort and time you put here, keep doing this great job! I already shared in my Facebook page that other people could get access to your knowledge. I’m 25 years old and I have a really bad posture but I’m a lit confuse to set up what kinda of bad posture do I have (flat back, sway back, posterior pelvic tilt….) Could I send you a picture? I know you went through How to determine if you have this or that bad posture, but I’m not confident if I got the right one, so I’m afraid of working this out in the wrong way. Thank you for your time
Hi Maira,
Thanks for your comment. And big thanks for sharing the page! You rock.
Feel free to send me your posture through Facebook private chat. Click here to go there.
Mark
Hey, thanks for this, it’s great.
I am a bit confused by #6, however. Are we supposed to incorporate all the exercises from those other articles in too? That seems a bit unmanageable.
Hi Lorne,
You don’t have to do them if you don’t have those postural issues.
However – if you do have them, you should aim to do them as well.
You do not have to do ALL of them. I try to put everything that you may need to do in these posts to help fix your posture.
Hope this helps!
Mark
Hi Mark,
I am a physcial therapist and just saw a 9 yr old boy with a sway back posture. Can you think of any fun exercises or games to improve his posture?
Thank you.
Hi Annie,
I’ll be the first to admit that I find it quite difficult to make the exercises fun when prescribing them to children.
Some things that you can do are
– Only focus on 2 or 3 exercises.
– Incorporate some sort of reward/positive re-enforcement
– Try to make it a game to see how many repetitions they can do . (And emphasise how good it will be if they can beat their last score)
– Link the postural exercises to one of his interests (eg. you can say fixing the posture will help him play soccer better etc)
Hope this helps!
Mark
Hi Mark
I don’t really get why I should strengthen the gluteal group while wikipedia says they’re hip extensors… or is wikipedia wrong here ?
Hi Arne,
You want to strengthen your gluteal group (but with your pelvis in a neutral position) to reduce the over activity of your hamstrings driving your hips forward.
Hope this makes sense :)
Mark
Hi Mark, I’m pretty sure I have sway back, rounded shoulders, hunch back, and definintly forward head shoulder, you have separate exercises for each. Should I do them all or just start with a certain area to start? Thanks !
Hey Laine,
You can do them all. Or you can do them one area at a time.
The question is – how much time do you have to spare?
If you are short of time, I would start with the sway back posture exercises.
Get your pelvis in the right position, then everything else can be based on a good foundation.
Mark
Hi Mark!
I am so grateful that you have provided the world with such an incredible set of resources. I am sure that I will be using them long after my issues are a thing of the past.
I just have a quick question for you, you mentioned on this post that in order to sort out my Sway Back posture I shouldnt be doing any sit ups. Are other types of abdominal exercises alright, or should I stop working on my abs altogether until I’m all fixed up?
Thanks so much!
Hi Gibrael,
The best exercises are core related exercises. I am a big fan of the Dead Bug exercise.
If done correctly, you will get a great work out for your abdominals as well.
Mark
Just a note of great appreciation .. that Hip Extension for gluts really does help me as I could barely stand up straight at times and now feel confident to try out your other exercises. When in pain we go to physiotherapists, massage, acupuncture etc but I have never been shown what movements to strengthen or help to reverse my pain. Many thanks indeed.
Hi Sylvia,
Exercises are the key!
Mark
Hi Mark,
Years ago I visited a physiotherapist because of my bad posture. The exercises we did were superman for lower back and cat and camel. The stretches I should do were harmstring stretch and the piriformis stretch. When I stay relaxed my pelvis pushes forward, it looks like in the picture. When I stay for a long period of time my lower back starts to hurt. But Im confused, if I have sway back, why did my physiotherapist showed me exercises for my lower back and stretching my pirifomis? Seems more like exercises for a posterior pelvic tilt, but I dont have it, I can even squat quite deep without a butt wink. Can you have tight abs, piriformis (gutes?) and harmstrings and weak elongated hip flexors and lower back with a sway back posture? Hope you can help.
Hey Daniel,
It sounds like you may have your hips pushing forward, but your pelvis may be tilting anterior. This would result in tight upper abs, tight piriformis, weak long hamstrings.
You can have sway back posture or anterior pelvic tilt with your hips pushed forward. They are slightly different in looks but treated differently.
Check out the anterior pelvic tilt post to see if that fits you (+ the hips being pushed forward).
Mark
Hello,
Thank you for this. How often do you recommend these exercises?
Hi Leigh,
If you can do 1/day, that would be great.
But if you can do more, even better!
Mark
Hi Mark. I have Osteonecrosis in both of my hips and both of shoulders. I have had both of my hips and one shoulder replaced. I have a really bad “trunk sway” as a result of surgeries. What do you suggest I do to stop or minimize that?
Hi Gena,
Is your trunk sway coupled with a sway back posture (hips in front of ankles)?
If so – then you would follow the above mentioned exercises.
If you have a trunk sway, (or a posterior rib tilt), then you would want to work on strengthening your abdominals to hold your lower rib cage down.
You can try doing this exercise –
The Dead bug
Your focus is to keep your lower back fairly flat to the floor as you bring your arms and legs down towards the ground.
On top of that, you will need to re- position your shoulders. You can check out this post here to see some great exercises.
Mark
I’ve heard that if your ligaments shorten you can’t fix them. Is that true? And if it is how are you supposed to fix it?
Hi Megan,
Tight ligaments are much easier to release than over stretched ligaments.
Which ligament did you want to stretch?
Mark
ohmygod omg omg
I have been struggling and in pain for so long, my hips hurt, my legs hurt, my ankles, even my back. i thought it was posterior pelvic tilt although that’s only a part of it
your hip flexor exercise works so well. i’m gonna do the shit out of that now. i feel better already after two sets. that’s what my problem is! weak hip flexors. your exercise worked very well thanks for the info
Hey Hey,
Glad you finally found you solution.
It can only get even better from now on.
Mark
Great article!! Thank you for sharing such informative knowledge. Besides doing these exercises, would a lumbar support seat cushion help? I sit at a computer all day. Does the triangle cushion help with bringing the pelvis back or make it worse?
Hi Steven,
Lumbar support is great for prevent rounded of the lower back, but you need to make sure that you place it in lumbar curve (… and not to high in mid back region as this will encourage the sway back).
Also – it is very important that if you use a lumbar support cushion, make sure you sit all the way back into the corner of the seat. Otherwise your pelvis will slide forwards.
Triangle cushion tends to tilt your pelvis forward which can be beneficial in sitting. If you use it, just make sure your torso is correctly aligned on top of your pelvis.
Let me know how it goes!
Mark
Thank you sooooo much for these helpful hints! I’ve been in pain on and off for months dealing with sway back. I felt almost immediate relief doing some of these techniques. Do you have an suggestions on stretches for people who are multi ligimented?
Hi Crystal,
Awesome!
Great to see you are getting immediate relief from the exercises.
I am not too sure what you are referring to when you say Multi-Ligamented. Please let me know so that I can help out :)
Mark
Mark,
Thank you for taking the time to share this information. I’m however confused. I think you have shown the posture of “kyphosis” as opposed to “Lordosis”. Would your recommendations be the same for both forms of swayback?
Thanks kindly,
Trip
Hey there,
There can be (and often is) kyphosis associated with a sway back posture. And that’s the same with anterior pelvic tilt (or hyper lordosis).
Both are treated differently.
Check the post on Anterior Pelvic tilt to see the exercises for that.
Mark
Should I do half squat? Please reply..
Yes, that is fine.
Just make sure you are performing it with the correct technique.
Mark
Amazing information! Helped a lot. Thank you so much.
My absolute pleasure, Lina!
Hope you find the rest of the website helpful too!
Mark
does holding the stomach in for the whole day help this situation? because it helps the pelvic to go backward a little.
Generally, is it good to hold the stomach in for the whole day, and does it do any good for body posture?
Hey there,
Initially, you might need to consciously hold your core to get an idea of what good posture feels like.
But the end goal is for your core muscles to engage automatically and appropriately without you having to think about it.
Mark
I’ve started to notice that my lower back pain when I’m standing for long periods of time, and now that I’ve read this article I’m guessing that’s because my center of gravity is not centered. These exercises look like they would help me strengthen my back muscles! I’m trying to be better about standing up straight, and I bet seeing a physiotherapist would also be really helpful with that.
Hi Georgia,
Definitely seeing a physiotherapist will help!
Mark
What if you have swayback and ATP at the same time? How should I go about fixing it?
Hi Cam,
If you have both a sway back and anterior pelvic tilt, the priority would be to correct the sway back posture first.
It is important to get the hip joints directly over the ankle joints.
If then, you still have an anterior pelvic tilt, you can start to do the ATP exercises.
Hope this answers your question.
Mark
Hi Mark,
I’ve been performing these exercises for a little while now, and they have been working, but something I’ve come to notice is that my knees have began to hurt which is probably the result of my body adjusting to the new position of my hips stacked over my knees themselves. Is there anything I can do to alleviate this?
Hi Cam,
Very normal response. Your knees are trying to get used to new posture.
There are heaps of things you can do for knee pain. But that really depends on what exactly is hurting.
Are you doing any form of exercise/sport that may be aggravating it?
Mark
Hello Mark! This post makes so much sense. I always though I had APT but I have literally every single thing you described here.
I’m going to PT now for a shoulder injury but I was wondering if you had any idea for how often to do all of this? Is this a daily routine, or every other day, or what?
Also, do you have a sub for side planks? I cannot put weight on my shoulders at that angle right now.
Hi Mikaela
Try to do it everyday (if your body allows it). More the merrier.
If your shoulder hurts, don’t worry about doing them for the time being. Focus on the dead bug exercises.
Mark
Thanks I’ll look into selling my current mattress, and getting a firmer one.
Appreciate your quick responses!
Sounds good!
Hey Mark,
Obviously there is a lot to work on with improving posture. What incorrect posture should I focus on first. Because obviously I’m sure a lot of people have Sway Back or Anterior Pelvic Tilt, Upper Cross Syndrome or a combination along with improper sitting and sleeping habits. It’s not feasible to spend 3 hours everyday doing these exercises and keeping everything in mind, so what you suggest first. I’m addressing my Sway Back and my Forward Head Posture first, while paying attention to my posture whilst sitting and walking. After that should I focus on Rounded Shoulders? Or where do you recommend I start?
Hi Pree!
I definitely know where you’re coming from.
You can go about it in many different ways. (And there is no right or wrong way really)
I would suggest you start with your pelvis.
This is your foundation. Everything will be based on where the pelvis is.
However – if you also suffer with pain, it might be an idea to start with the area where it hurts the most to give you a bit of relief.
Whatever you choose, stick to it, do it well, be consistent and you’ll see good results :)
Mark
Hey Mark,
I have been sleeping on my stomach for my whole life, if I can’t sleep on my stomach, what position do you recommend? I also read on your rounded shoulders section, which I may have, that it’s not advisable to sleep on my side either. So I guess by default that leaves me to sleep on my back.
Also is the floor still recommended over bed? Over time will I be able to sleep comfortably in that position for 6 – 8 hours? Because I’ve tried falling asleep for that long but I’m currently unable to.
Thank you for sharing this vast amount of information!
Hey there Pree,
The general rule is to sleep on as firm mattress as you comfortably can.
However, sleeping on the floor may be too big of a jump from your mattress.
Try to do small changes over a longer period of time to allow your body to adapt and get used to the new positions.
Mark
Hi Mark thank you for your comprehensive post. What is your take on using posture braces to fix sway back posture? I am including a link on posture correction tips for reference
Hi Sandra,
Posture braces alone will not fix a sway back posture. However, it can help serve as a reminder to keep an upright posture.
Mark
Hello Mark,
My 7 year old son seems to have both swayback and lots of pronation and flat feet.
Can I send you the photos to get your opinion on what to begin with first? Where could I send them?
Thanks for your advice.
Kristina
And get a bit relief after doing rotator cuff exercise but return after few hours later and its distrubs alot sometime.
Hello , after going through your site i think i have sway back with round shoulders but in one image which you said dont stand like hand folding in front of you at mid chest region my pelvis shift towards left side ( x ray of my lumbar spine showed little curve ) am i having lateral pevic shift also.
Right side of shoulder back and upper traps are very tight after i stand in a upright position
is this sway back or lordosis or what ???
Hi Adam,
Looks like it is more of a sway back posture with a very slight anterior pelvic tilt.
The thing that stands out to me the most is your Posterior Rib tilt (where the lower ribs are pushed forward).
Try to do this exercise:Wall angel
The main aim is to keep your whole back FLAT against the wall. If this is too difficult, place your hands down and repeat. Do not let your ribs flare up.
Mark
Hi Mark,
first i’d like to thank you for your interest.
i’m 23 years old… so will exercises help me ?
i’m ready to do exercises for one or two years but at last i’d like to have a normal posture
sorry,
another question
does i have Kyphosis ?
Hi Adam,
Yes – it looks like you do have a degree of increase Kyphosis. (Comes hand in hand with your posterior tilted lower ribs).
Check out this post to help you address it.
Mark
i’m 23 years old is this too late to fix my posture ?
Hey Adam,
It’s never too late to make improvements in your posture! But the later your leave it, the harder it becomes to fix!
Mark
Hi Mark,
My son, who is very active, has been demonstrating poor posture. I’ve noticed that when he takes off running he sometimes stumbles as if he is going to fall forward.
Even after reading your whole article, I’m having trouble diagnosing him. At first, I was thinking sway-back posture but now I’m thinking he has APT with a rounded back (head forward) posture. Is this possible? He is asking for some exercises/stretches to do and I don’t want to steer him wrong.
Thanks,
Josh
Hey mark, I dont have swayback or anterior pelvic tilt but still I do have a bigger lower back curve than normal maybe due to tight lower back muscles. Can you please suggest some lower back stretches?
Hi Arthur,
Try doing these exercises:
1. Knee to chest
2. Sitting back stretch
3. Ball release
If you do not have a sway back posture or an anterior pelvic tilt, do you have a rounded upper back?
Hi Mark,
Thanks for this great post. As I proceed, I want to make sure I’m doing the right things with my hip flexors. I’m not sure if I’m:
a.) Both kyphotic and lordotic. In addition to the curvature in my upper back and my pelvis shifting forward, I also have: internal rotation of femurs, a bit of a “false curvature” shape to my legs, and a pouch like shape of a protruding stomach. In my limited research, these traits are often associated with anterior pelvic tilt. I also have tightness/discomfort in my levator ani region when sitting for what it’s worth.
or
b.) Standard sway back, as described in your post. Maybe the other symptoms I described are common in sway back without lordosis, or a result of the higher-up concavity in the mid-back region that people with sway back have. I’m not sure.
Some sites suggest stretching/lengthening/relaxing the hip flexors (esp. the psoas) for kyphotic-lordotic people, and I just wanted to get your take. Thanks again!
Hi Frank,
Thanks for the question!
By the way you are describing your situation, I feel that you may have both Sway back posture AND an anterior pelvic tilt.
Fixing, the sway back posture, however, should take priority over the anterior pelvic tilt.
Stretch/Release the rectus femoris and tensor fascia lata muscles. (both hip flexors), but strengthen your Psoas (also a hip flexor, but more of a stabilising muscles more than anything).
Hope this answers your question, Frank!
Mark
Thanks for the response! How often should we be doing the above routine? Curious to know if the iliopsoas, glute, and oblique exercises warrant recovery time. I’ve been doing 2 days on, 1 day off…but can probably do everyday if time permits.
Hi Frank,
Try to do the exercises as often as you can, provided that your body has recovered from the previous session.
As your body becomes familiar with the exercises, your muscles should recover quicker as well!
Mark
No not all, but it feels very soft and it is on the inside of spine, it does not feel like a piece of extra meat or tumour or anything, there is no visible presentation of it on my back. It feels like a muscle that you were never aware of before but after you read about it you can feel it. That’s how it is. And I feel it sometimes for a few hours like in a week or two I think mostly after squatting.
Hi Joe,
I’m not too sure what else it could be without seeing you. It’s likely some sort of extension of your soft tissue in the area.
You might need to get it checked out by your local health practitioner just to make sure it isn’t anything serious.
Hey Mark,
Thanks for writing this article and the one for forward head as well. Very informative and easy to understand but I am a little bit confused as I work at a desk 8-12 hours daily on a computer and somehow ended up with pelvis dragging forward, I also came to know that I have a very weak core. I’ve started doing the excercises mentioned above but I am also doing core strengthening excercises which mostly include strengthening the abdominals and as you’ve warned in your article not to strengthen abdominals it is making me wonder what to do?
Hi Joe,
Good question!
Try not to get confused “core exercises” with “abdominal exercises.
Your core muscles are the deep muscles that wrap around your mid section.
Your abdominal muscles are the superficial muscles (essentially your 6 pac muscles.)
So it is possible to do core strengthening without exercising your abdominal (6 pack) muscles.
Hope this clarifies things!
Mark
Thanks for answering, Mark.
I also have a very soft and spongy feeling in my mid back probably 2-3 inches above lower back right in the middle of the spine. Any idea what this could be?
Thank you very much.
Hi Joe,
Look up: Lipoma
Does this look like what you have?
Mark
very cool website. Hello from new york :-)
Hi Mark.
I am male, 26, and I have over pronation of the feet and inward knee rotation. Please suggest me some stretches or excercises to correct it.
Thanks.
Hi Mark,
Thank you so much for writing this great guide. I have searched online for fixing swat back for a long time but most of the articles I find focus on lordosis. Your article is very helpful.
I am 26, have sway back, however, my trunk tend to tilt to the right side. My right lower back is way stronger than the left one. So I am wondering for the side plank and single arm weight, is it appropriate that I strengthen the left side for a while and stretch the right side, and then I will start to do these exercise for both sides? Thank you very much!
Hi Liya,
What a great question.
Here are some tips for you specifically to address your tilt.
1. Stretch the right side (Google: stretches for Quadratus lumborum and Psoas)
2. Strengthen the left side (Side planks with variations)
3. When sitting, make sure you are not leaning on one side more.
4. Sleep on your right side.
5. When standing, do not favour one leg. Stand evenly.
You are exactly right with regards to doing one side first. When you are even, then you can do both sides.
Hope this helps.
Mark.
Hi mark, I am 19 male and I have swayback too, I did too many forward lunges which caused my swayback posture. I’ve been doing these excercises and wanna ask you that my ribs and my pelvis are not aligned My lower ribs are falling forward. Please suggest excercises for bringing ribs backward.
Hi Graham,
Try these exercises to get your pelvis and ribs aligned.
https://posturedirect.com/advanced-anterior-pelvic-tilt-exercises/
It says it is for Anterior pelvic tilt, but you can also use it for Sway back posture.
Mark
Thanks for replying Mark, as the article says ligament laxity irreversible, I am worried as I have done forward lunches in the past sometimes holding one stretch for 1 min also. I wanna ask If I may have overstretched my ligaments? And I wanna ask if I can do these excercises and squat as well without weights to engage glutes more will that be okay?
Thank you for this generous information sharing. I’m hoping that this might be able to help me.
Thanks again!
Sandy
Hey Sandy B,
Let me know if you need more specific help.
Mark
Hi Mark
I have sway back does copra exercise or position help me to correct sway back
thank you
Hi Areej,
I would not recommend the cobra exercise as this position may make your sway back posture worse.
Mark
I am 49 and have lots of knee, back, neck issues probably caused by sway back posture.
A few months ago I tried to be persistent with sitting and standing correctly throughout the day, and I was also laying on my back on the floor & doing leg lifts every day, too. I did this every day for a month, but my back/neck pain became worse and worse. I finally gave up & went back to slouching, and my back pain improved.
Am I a lost cause? Am I just too old & messed up to fix this? I’m so tired of my ugly posture and I’m worried that it is causing longer term issues, but now I don’t know if I should even try to fix it.
Please help!
Hi Emily,
It’s never too late to make improvements in your posture!
Here are some possible reasons why your symptoms may be aggravated whilst doing the exercises.
1. You may not have sway back posture. Doing sway back posture correction exercises for someone who does not have it can make symptoms worse.
2. Incorrect exercise technique. Doing the right exercise the wrong way can also make things worse!
3. The amount/intensity of exercises that you are doing may not be appropriate for your current level of tolerance. You might need to modify some exercises so that you can do it more effectively/comfortably to suit your current capacity.
4. It takes time. It can get worse before it gets much better.
5. Combination of everything.
Please let me know how it goes. I’m here to help! :)
Hi Mark,
I emailed you as well! My hubby needs some help with a full workout plan that takes into consideration his swayback/forward head and duck foot postural problems! Can you help?
Nicole
Hi Nicole,
I have received your email.
Looking forward to your reply.
Mark
Hi Mark,
your post is fantastic. I fully match all the features of a sway back position…I started to follow your program and had great relief from my patellar hypertension syndrome which caused me a lot of pain after running or cycling sometimes. I believe that my PHS is due to my bad posture: you think that the sway back position can also affect the knee?
Many thanks,
Andrew
Hi Andrew,
You bet Sway back posture can definitely affect your knee issue.
Your body works its best when everything is in optimal alignment. It very hard for knee to be moving properly if your pelvis isn’t.
Mark
I have swayback /lardosis had it for as long as I can remember, im now 45. Even as a 16 year old my stomach was sticking out and it look like I had a big stomach. I found a book when I was about 25 in the library on the Alexander technique, but I never followed up on it. I think its too late for me. too much work and behavior to keep track of and continuously do exercises.
I read somewhere that putting babies /young kids to sleep on their stomach causes it.
I was a stomach sleeper, up until about 9 years ago.
Also it threw up my body out of whack and my clothes don’t look proper when I wear them. jeans are always tighter at the thighs, and one of my shoulder is higher than the other.
Hey Mark, Great Post!
I have this bad posture and have started doing this exercises but my question is what time of the day should we do this? Morning adter waking up, before bed or afterworkout.
Also before doing this exerciss do we warm up or anything you recommend?
This is the best post I have seen on the internet on sway back posture! And trust me, I have searched everywhere,
Thanks mark!
Cheers for dropping by, Garry!
Hi Mark, is it possible to have an anterior pelvic tilt combined with a sway back posture? I mean that the backside of the hip is (significantly) higher than the frontside of the hip, as wéll as the hip is in front of the ankles and shoulderbone. My feet are also pointing outwards.
If so, what would be the best course of action? I’m anxious to start training because swayback and anterior pelvic tilt diagnoses and excercises seem quite contradictory.
Great website by the way, keep up the good work!
Hi Justin,
It is definitely possible to have both sway back posture with an anterior pelvic tilt. However, note also that you may just have pointy bits at the back of your pelvis which may naturally appear to sit higher than the front due to the shape of it.
If you have both, correcting sway back posture takes priority over an anterior pelvic tilt. Focus on getting your hips aligned over your ankles by strengthening/engaging hip flexors (iliopsoas muscle).
Let me know how it goes, mate!
What a great post! I’ve had sway back for as long as I can remember (I’m 26 now) and I never gave it much thought until it started causing me problems a couple years ago. You pretty much covered all of the issues I’ve been having, but I have one major deviation from your description: my pelvis tilts forward, not back (like I’m sticking my butt out) and it doesn’t shift forward, it just rotates forward in place. Have you seen this variation of sway back and do you have any alternate recommendations? Thanks!
Hi Jane!
It sounds like you may have an anterior pelvic tilt as opposed to a sway back posture.
Head over to this post: How to fix an anterior pelvic tilt/.
In an anterior pelvic tilt, there is also a hyper extension of the lower spine which can be commonly mistaken for a sway back posture.
Mark
Hello Mark, this is a great guide!
I am 22, but when I was 10-12 I started to develop pectus excavatum. Eventually the condition got so severe that it is now clearly visible from the side, even when wearing a t-shirt, and I believe that it significantly affects my sports performances (e.g. I can’t do a 200m sprint without feeling very nauseated afterwards. The same applies to playing basketball or football (soccer) for 15 minutes. And those are stories from when I had actually been sporting competitively (playing badminton) for years, so it’s not like I was a couch potato, but I could just never improve my physical endurance, no matter how much I sported).
Now I am not sure, but I believe that this condition may have caused my hunchback posture (and forward head posture and forward shoulders, etc.). I don’t appear to have anterior pelvic tilt (or maybe very slightly), but now I was wondering if it is also possible to completely fix the swayback posture even if you have a pectus excavatum.
I don’t know if it’s useful information for you, but I also do have those hamsting issues and the other stuff that comes along with a swayback posture. E.g.: my hand palms can barely get past my knees when correctly bending forward with stretched legs.
Also, other than issues with maybe endurance, does a pectus excavatum affect your centre of gravity in a way which negatively affects any strength-training/weight-lifting routine?
Hope to hear from you soon and thank you for writing this!
Hi there Jamie,
Any deviation in your rib cage alignment can definitely affect your centre of gravity. This in turn can make your body inefficient in movement which may lead to problems like premature fatigue as you stated. Depending on the severity of your pectus excavatum, it can even affect how efficiently your lungs can function.
Since pectus excavatum is a structural issue, there is nothing you can do to change that, however, in regards to fixing your sway back posture, it can definitely be improved with the exercises.
It can also affect your lifting routine such as imbalances, asymetrical loads on posture, uneven growth of musculature, tightness of chest muscles. etc All of which can be addressed with a specific training program.
Hope this helps you Jamie!
Hey Mark,
Thank you for getting back to me. Good to know that my pectus excavatum doesn’t make it impossible to fix my posture. I still have one question about the exercise programme, though.
Is there perhaps an alternative for the exercise “Jack knife with exercise ball” or is that exercise ball really necessary?
Hope to hear from you soon!
Hi Jamie!
No – the Jack Knife exercise does not have to be conducted. I like it because it incorporates both your deep core muscles and hip flexor muscles together.
Is there a reason why you don’t want to do it?
Mark
Mark
Sorry for the very late reply, I’ve been quite busy with university. The simple reason for not doing that exercise is because I don’t have a ball, that’s all. So nothing to worry about.
I do have another question, though: What exactly are the ball release exercises for? For example, for the hamstring, is that purely for massaging, loosening the muscles?
Kind regards,
Jamie
Hi there Jamie,
Ball releases help loosen up the tight muscle.
I suggest doing the ball releases before you do the stretches.
Mark
Hello Mark, thanks for this website, its extremely helpful!
I had some injuries on my legs, and it caused me to be sit most of the time for 8 months. I didn’t know I was sitting in a very bad posture. Now I have sway back because of that.
I’m already fixing it thanks to you! But I wonder, could 8 months of very bad posture cause some irreverisble changes on the bone structure?
Hi Hugo,
The longer you have had bad posture, then the longer it is going to take to fix it. As long there is no structural damage (like arthritis, disc bulges, fusion etc), I find that there is always something that you can improve on.
Keep up the good work and let me know if you have any other questions.
*And also what about Mckenzie press-up. Should I avoid this type of exercise?
Hi Rafal,
It is fine to do the McKenzie Press up (especially if you have lower back disc bulges), but I wouldn’t do it excessively or have it as your main exercise if you have a sway back posture.
Hi Mark, great article. Can You tell what this type of posture should do with piriformis? Stretch?
Hi Rafal,
You can do the piriformis stretch with any posture, especially if you have tight/overactive glute muscles. If you tend to walk with your feet facing outwards (duck walking), then you might have tight glutes.
Thanks for this post!!!! I’ve had swayback forever because of hypermobile joints, nice to be correcting it now. With this posture, is it common for one side to be stronger? My barbell squats are asymmetrical, as I rise from the bottom of the movement, my right glute rises first and sways to the right. My left glute always lags behind. How can I correct this? I can’t ‘feel’ this happening, so it’s really hard to correct this as I do the squat. I also have lower back pain on my right side, but that has gotten better due to weightlifting and this post.
Hi Emily,
Cheers for the comment!
There are multiple reasons why you might shift to the right side in a squat. (Tight right groin, Right leg dominance, Weak Left glute muscle, Tight Left glute, Poor mobility in your left ankle… just to name a few).
I would have to observe how you squat to determine what might be causing it.
I am happy to have a look at a video you squatting if you would like an assessment.
Mark
This guide looks fantastic! I’m self concious about my posture and its long term effects so I’m going to start incorporating these exercises into my daily routine, as they look really nice and simple to do.
Hi Jake.
Wish you all the best with the exercises. Drop me an email if you have any issues.
Mark
Hello Mark,
When i stretch my lower hamstring and upper hamstring i do not feel hamstring but only feel calf and this place marked on green
second problem is when i strenghten my hips i feel no hips but quadriceps femoris and Tensor fasciae latae. Its a normal? Sorry for my english :)
Krystian.
Hello Krystian,
With the hamstring stretches, make sure you tilt your pelvis forward (“stick your butt out”). This should emphasis the hamstring stretch.
If you feel the stretch behind the knee only, it may mean that you are stretching your hamstring TENDON, which is good! You may just be tighter in your tendon rather than your muscle in your hamstring.
With hip exercises, try these exercises: https://posturedirect.com/is-sitting-destroying-your-butt-muscles/
Hey Mark,
Thanks for the article. This is the clearest outline of all the symptoms I have, and I’ve been to two different therapists.
My main issue besides back and spine discomfort is headaches. I get them whenever I exercise or after a long day of work. Icing my upper trapezius muscle helps but I wish I could get to the root of the problem. Do you know of anything I could do specifically to reduce headaches?
Thanks again,
Scott
Sorry for the duplicate post, just saw your response
Hey mark,
Thanks for the post. First time I’ve seen most of my symptoms combined into one overarching issue. And that’s after going to 2 physical therapists.
I have neck and thoracic pain but my worst symptom is headaches. They are the worst when I workout or play basketball.
Do you recommend anything specific for headache relief? Icing my upper trapezius helps afterwards but I’d like to treat the cause.
Thanks,
Scott
Hey Scott,
If you have sway back posture, then you probably have a degree of Forward Head Posture. This has been the cause of headaches in many of my patients.
Check out this post: https://posturedirect.com/forward-head-posture-correction/
When your head is poked forward, it makes all the muscles around your neck and shoulder region work very hard (esp. when playing a sport like basketball or working out). When muscles work too hard over a long period of time, they can start to cause pain, or present as headaches.
Hope this helps
Thanks for the link. I’ll try out those exercises.
Hey man! Awesome post, extremely informative… Can swayback be caused soley because of tight, inflexible hamstrings? I’ve got swayback and my symptoms seem to drastically improve with stretching of upper hamstrings and don’t really think Muscle weakness is the root cause. Years of playing volleyball at a high level with very minimal stretching might have been the recipe here, again very good post!
Hey Kyle,
Tight hamstrings can definitely be the root cause of your sway back posture. (Esp. if you have played a sport for many years like volleyball)
Thanks for the comment, mate!
I have always had bad posture and sway back for the past few years. As a result I have been living with frequent lower back pain for years and hip pain over the past several weeks. After trying these stretches and exercises for the first time, my back pain has eased substantially and my hip pain is gone. I am amazed!
Hi Kate,
Glad the exercises have helped you. Keep up the great work!
I wish you worked out of Texas! I’ve had away back posture (I’m definitely a rib thruster) my whole life. I’m 32 now, is it too late to correct?
Hi Christina. It’s true that it gets harder to change the longer you have had it, but it’s never too late to take action!
Try out these exercises on the post. It takes time. But persist!
Please let me know if I can be of any assistance.
Mark
Hi Mark,
Do u recommend how to sleep with this posture?