Fear Not the Foward Flexion of the Spine…Just Seek to Understand…

May 14, 2014 at 9:06 pm 28 comments

Spine Stretch Forward - Forward flexion of the spine...evenly with length.  Photo Credit: Andrea Bonalberti and IdeaPilates

Spine Stretch Forward – Forward flexion of the spine…evenly with length.
Photo Credit: Andrea Bonalberti and IdeaPilates

 

Are you beginning to fear forward flexion of the spine? Let’s take a step back. Fear is not a great educator. Study is. Fear not forward flexion of the spine. Let’s just seek to understand what it’s all about and how to do it in Pilates and other modalities in a way that our bodies were meant to do it and in ways that are appropriate relative to our modern lifestyles.

Well, that sort of said it…”our bodies are meant to do it”. You are meant to do forward flexion of your spine. You absolutely are. If you were not, your body literally couldn’t do it. Can’t do forward flexion of the femur mid-femur can you? Of course not…there is no joint there. But there are joints in  your spine…that’s a huge part of why you have a spine.

Spinal Nerves relate to body parts and organs - Thank you universal-review.ca for this image.

Spinal Nerves relate to body parts and organs – Thank you universal-review.ca for this image.

Many Back Muscles - Thank you Gray's Anatomy

Many Back Muscles – Thank you Gray’s Anatomy

Let’s review the purpose of your spine (or many of them):
Your spine provides:
1 – Protection for your spinal cord
2 – Muscular attachments
3 – Pathways for your nerve endings to leave the spinal cord to the rest of the body
4 – When vertical, it aids in vertical support, the ability to be upright
5 – When vertical, it provides some shock absorption
6 – Because there are joints in the spine (your separate vertebrae to each other), it allows movement of the torso

Are there more purposes of the spine…sure, of course…but let’s go with these for a moment.

 

 

What is the “localized spinal system” comprised of? (Yes…I’ve just coined that “localized spinal system”. It is a valid image for the moment, though, it is clearly part of the whole you.)
This “localized spinal system” is comprised of:
1 – Bone – vertebrae
2 – Ligaments – connecting bone to bone
3 – Tendons – connecting muscle to bone
4 – Muscles – creating force to move bones
5 – Discs – providing easy gliding motion of vertebrae, shock absorption, space as the nerve endings leave the spinal canal
6 – Fascia – (We’re going to have to lump all different types of fascia together here. There is not nearly enough space in a “brief” article to write about the intricacies of fascia. However…) fascia: providing easy gliding motion and support of all tissues (soft and “hard”),
7 – Nerves – not just the spinal cord and nerve endings…but the ones who are feeding the muscles, tendons, ligaments, fascia, bones and all with information of what to do and what not to do
8 – Blood vessels – feeding the bones, ligaments, tendons and muscles
9 – Cartilage – at the superior and inferior faces of the vertebral bodies aiding in gliding actions of the vertebrae and hydration of the discs
10 – and even more than this list

That’s a lot of “stuff”. What an interesting part of you…this “localized spinal system”. When you move…do you see some of that or all of that? And then, can you see all that acts on it and how your body works? If you see all of it…then you will move like the organism that you are.

So…what creates or encourages movement of the spine?
1 – The localized muscles, ligaments and tendons act on the spine via nerves and fascia (Not just back extensors…but what about quadrates lumborum, posterior serratus, diaphragm, intercostals, etc., etc….)
2 – Other muscles, ligaments and tendons act on it, too. For example, the abdominals who are not even connected directly to the spine…they are connected to the spine via the thoracolumbar fascia.

What limits movement of the spine?
1 – Soft tissue that acts on it properly (abdominals, psoas, back extensors, quadrates lumborum etc.)
2 – Soft tissue that is imbalanced (like weak muscles or stiff discus that are improperly hydrated because of a lack of varied movement…it’s varied movement that fully hydrates discs)
3 – Posteriorly, the spinous process limits the back extension
4 – Longitudinal ligaments…oh, the remarkable anterior longitudinal ligaments…anterior and posterior…

Spinal Ligaments (some, not all) - Notice the Posterior Longitudinal Ligament and the Anterior Longitundal Ligament. Illustration Credit: M. Headworth via MayfieldClinic.com

Spinal Ligaments (some, not all) – Notice the Posterior Longitudinal Ligament and the Anterior Longitundal Ligament. Illustration Credit: M. Headworth via MayfieldClinic.com

Yes…the special longitudinal ligaments! Let’s take a look at them shall we?

Anterior Longitudinal Ligament provides both support and intrinsic stabilization to the vertebral column with most obviously the anterior portions of the bodies of the vertebrae and discs attached. A continuos structure along the entire front of the spinal column, it provides support to the vertebral column during spinal extension. Thereby limiting…or helping support an end-range of spinal extension. In spinal extension as discs appropriately bulge anteriorly, this anterior longitudinal ligament provides a stopping zone of sorts for the discs. A limit. However, the greatest limiter of spinal extension are the spinous processes. They are the great limiters of motion…on purpose.

And what of Posterior Longitudinal Ligament? Special structure! This one, like its anterior match provides both support and intrinsic stabilization to the vertebral column with the posterior portions of the bodies of the vertebrae and discs attached. It is continuous, again, like its anterior match. So, we see that it provides a stopping zone for the discs during forward flexion like the anterior. However (…and this is a big however…), are there spinous processes at the front of the vertebral column? No…no there are not. So, that means the range of motion for forward flexion is greater in the spine than back extension. OK…this is important because we need a lot of forward flexion in our lives. Most of what we physically do requires action at the front of the body. Our greatest abilities are in the front, though, of course, we have a range of actions in the back…but our greatest strength and versatility of movement occurs in front of us. So…we require greater range of motion. Just like in the shoulder girdle versus the pelvic girdle, greater flexibility of in forward flexion of the spine means less stability.

Stability of what? Many things, but most obviously the vertebrae and discs. Well, then, we’d better strengthen all back muscles to have posterior support of the spine during forward flexion. That eliminates the old phrase of “Don’t use your back muscles…only use your front muscles…abdominals, “Powerhouse”, whatever your style of Pilates calls them. We actually need to use our back muscles during forward flexion to assist in limiting forward flexion…because remember, there are no spinous processes in the front of the spine to limit movement. And…because that is a major action of the back muscles. In fact, all soft tissue works all of the time…and that means in forward flexion the back muscles work. Please don’t try to make them not work.

Not to mention, we have thoracolumbar fascia (TLF) and thoracolumbar complex (TLC) that will tighten/stiffen the lumbar spine to limit forward flexion if…if…if we keep the TLF and TLC healthy. (How do we do that? Another article another time…and a book. We can’t do it all in one article.)

Wait! Why do we even care to limit movement? Well, one reason, and the one most are concerned about, is that we need to protect the discs from protruding back into the spinal canal…into the spinal cord. Oh. Right. That is one major function of the Posterior Longitudinal Ligament. Oh!

And what happens when the discs are constantly jammed into the posterior longitudinal ligament (PLL)? That ligament has to try to continue its job of not letting discs go into the spinal canal and cord…it thickens up. Well, because we need movement of the lumbar spine (including forward flexion), this PLL (it’s time to abbreviate…this is a long article) is actually thinner around the lumbar spine than in other areas. So…if it thickens it will either limit movement or if it thickens far too much that leads to narrowing the space for nerves to leave through the foramen and can even impinge the easy flow of the spinal cord through the spinal canal: Central Spinal Stenosis. And ultimately, if you keep forcing a disc against a thicker and thicker ligament, the disc has to give weigh…and then we have herniations.

Oh.

Wow…there’s a lot of forward flexion in Pilates and in life. A lot. What do we do?! Do we just not do forward flexion because we’re afraid that the discs might push back into the PLL? No, no, no…of course not. We just make sure that we use all of our bodies’ natural tools to ensure good movement. That means movement with support. Do we need to collapse or crush into a rounded shape? Can’t we be rounded yet lifted?

It’s not difficult to move with support when you realize that you body is meant to move with support anyway. That is what biotensegrity is all about. Biotensegrity? Yes…your body is set up with a balance of forces: soft tissues resist expansion and bone (“harder” soft tissues) resist compression. This allows a really easy system where your bones are suspended in a web of soft tissue that moves your bones, creates support for your bones and all tissues. (Bones are really soft, by the way…just not as soft as other tissues and their chemical make up resists compression rather than resisting expansion. Amazing what a bit of calcium [and more] will do to a group of cells.) So, if we are moving well and as nature intended, then we already have great support.

However…we don’t move as nature intended, do we? No..and that is where trouble exists. In Pilates we’re supposedly seeking actions to restore our natural physical environment. We note that life is full of forward flexion and collapse in the spine. Weak abdominals, weak and overstressed back muscles, weak psoas, hip flexors and hip extensors and gluteals. Man…we’re a mess in modern life! And we lose our biotensegrity…our innate balance of tension, our natural balance of expansion and compression. We must seek to restore.

Spinal Curves - Vertical And Space for Organs1When we forward flex, there is a tendency for collapse. That collapse is possible because we don’t have those anterior spinous processes, modern life has weakened our back bodies and because we have so-called “hinges” at the transitions of the curves of our spines. As the curves alternate (a big part of being an upright being so that we have spaces for our organs and then still maintain our vertical alignment and perhaps some shock absorption built into the inherent structure of any vertical alternating curves with gravity acting upon it…but I digress…) as the curves alternate, the transition joints are hyper-flexible. They need to be, but we need to be aware of this and support the hyper-flexibility if we care about PLL and discs and spinal cords. Sure we care.

That means…we have to be wise in our repetitive movement and exercises (even Pilates has repetitive moves and exercises). Mindful! When seeking balanced movement of any joint or joints, we seek to mobilize the stiff and stabilize the hyper-flexible joints. Relative to the forward flexion of the spine, that means…move the stiff parts and support the flexible parts.

And…what sort of ideal forward flexion are we seeking in Pilates? Well…I strongly suggest that in forward flexion of the spine we are seeking a long and even curve of all vertebrae into a long and even curve of the entire spine. Oh…and that would be the same in full spinal extension, also in lateral flexion of the spine (side-bending). Evenness! That will be the ability to mobilize and stabilize. Balance!  Stretch, strength with stability and stamina. This is sounding great!

Now…that was a lot of information. How does it relate to your Pilates work?

Forward flexion of the spine:  Spine Stretch Forward

 

The magenta line is attempting to trace the curvature of the spine...not just the silhouette. See into the curvature of the spine. The top two photos are a harsh curvature of the spine that hinges at the tops and bottoms of the curves.. The bottom two photos are seeking a long, even curve of the spine. Spinal flexion with space. We're trying for that. Curved, but not collapsed.

The magenta line is attempting to trace the curvature of the spine…not just the silhouette. See into the curvature of the spine. The top two photos are a harsh curvature of the spine that hinges at the tops and bottoms of the curves.. The bottom two photos are seeking a long, even curve of the spine. Spinal flexion with space. We’re trying for that. Curved, but not collapsed.

 

Back extension of the spine:  Swan Preparation

The magenta line is attempting to trace the curvature of the spine, not the silhouette. See into the curvature of the spine. The first two stacked photos show an almost flattened spine. They don't even show enough of how the thoracic spine is still rounded outward. The 2nd two stacked photos show the attempt to reverse the curve of the thoracic spine while stabilizing the curve of the lumbar spine. The effort in the 2nd stack develops strong back muscles rather than a compression. Let's match curves and then increase curves later on...with balance. Notice...lumbar curves are different in both people. Top photo vs. bottom photo. Everyone has different curves of the spine.

The magenta line is attempting to trace the curvature of the spine, not the silhouette. See into the curvature of the spine. The first two stacked photos show an almost flattened spine. They don’t even show enough of how the thoracic spine is still rounded outward. The 2nd two stacked photos show the attempt to reverse the curve of the thoracic spine while stabilizing the curve of the lumbar spine. The effort in the 2nd stack develops strong back muscles rather than a compression. Let’s match curves and then increase curves later on…with balance. Notice…lumbar curves are different in both people. Top photo vs. bottom photo. Everyone has different curves of the spine.

 

What about Rolling Like a Ball?

Rolling Like a Ball with markings1

Now, we can find this in many and every exercise. Can you flex/round, extend/arch, side-band and rotate with space and support. Can you seek evenness. Is it contrology or a crap-shoot?

So…you don’t have to round into the tiniest ball or arch backwards into a fold or sideband in half. Big hinges happen at hips, knees, ankles, toes; shoulders, elbows, wrists and fingers. Smooth curves happen in the spine. Or at least that is what we can achieve and thereby achieve great strength, flexibility…support…stamina…movement!!!

Please move…in all directions…just with support and understanding! You don’t need to be afraid to forward flex or back extend. You just need to know what’s going on and why you don’t want to crush your discs into the PLL and/or collapse at your hinges.

You’re a mover! You’re a teacher of movement! Now…move and keep educating yourself with balance. You get scared when someone teaches an extreme statement of the body and it travels all over our social media and workshops. Extremists help with awareness, but…they are extreme. Until we are educated, we follow extremists because they are colorful and loud and then we believe and fear. It’s education and understanding that will eliminate fear. You don’t have to go all the way into biomechanics as a scientist like I am. No. But you are working with human bodies…so you have the responsibility to study. I will keep encouraging your study. Study and become a critical thinker.

Thank you for reading this! It was a lot of information. Please reach out to me when you have questions! Seek me out at workshops and such. You’ll see them listed on the sidebar of this blog page and I always list them on my website. And we can do consultations or sessions together in person or via Skype and workshops at your studio. Let this be the start of a conversation, not the end, as I am wont to say.

 

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28 Comments Add your own

  • 1. lghammerle  |  May 14, 2014 at 10:42 pm

    Great blog Shari! This insightful information is reminiscent of weekend #1. Thank you for taking the time to post this!

    Reply
  • 2. Tony  |  May 15, 2014 at 2:51 am

    Amen! Long curves help us avoid dangerous concentrations of curvature and compression.

    But we also have to consider the load on the spine. Loading a flexed lumbar spine, either axially or in shear, is a recipe for disaster. And biomechanical research (like that of Dr McGill) suggests that sit-ups of any kind result in large forces being applied to the lumbar spine.

    Fear? No, but caution–and more extensive lab research into the biomechanics of the classical repertory–would seem to be in order.

    Reply
    • 3. theverticalworkshop  |  May 15, 2014 at 11:02 am

      Indeed, Tony. I request and require the same…and that is my work: extensive research and application of quality biomechanics!
      Thank you for reading, commenting and suggesting! I appreciate it all!
      – Shari

      Reply
  • 4. Carrie Smith  |  May 15, 2014 at 10:31 am

    Thanks Sheri
    ….great information and in total agreement how education avoids extreme-ism!! Keep the information coming!!!

    Reply
    • 5. theverticalworkshop  |  May 15, 2014 at 11:03 am

      Thank you for taking the time to read this and comment, Carrie!
      Yes…extreme-ism is something to be wary of.
      And education is a must!
      – Shari

      Reply
  • 6. Pilates Andrea  |  May 15, 2014 at 11:38 am

    Thank you so much for this post Shari!! I always wrestle with the idea of “flexion is not good” or “too much flexion” that I hear in and around the Pilates universe and I think – yes flexion means to bend forward, but the manner and quality in which you do so is very important. You must have lift in your flexion not collapse.

    Excellent post and a very necessary one, thank you!

    Reply
    • 7. theverticalworkshop  |  May 21, 2014 at 1:01 pm

      Thank you for taking the time to let me know that this worked for you!
      All the very best to you!!
      – Shari

      Reply
  • 8. Emily  |  May 15, 2014 at 4:01 pm

    I am interested in your thoughts about this in regard to osteopenia and osteoporosis. I’ve been feeling like I want to include gentle unloaded forward flexion with these clients but am fearful that I am wrong to do that.

    Reply
    • 9. theverticalworkshop  |  May 21, 2014 at 1:00 pm

      Hello, Emily,

      Thank you for taking the time to read this and ask about Osteopenia and Osteoporosis. I hope you are well! I think you are traveling now?!

      Osteoporosis:
      Because you cannot see inside your client with osteoporosis and know 100% that you are not creating fractures, I strongly suggest that you do not do forward flexion of the spine with clientele who have osteoporosis of the spine. Your job in Pilates is to work around and ailment. Around. Not into. With that, the ailment with osteoporosis of the spine is at the anterior portion of the spine…the bodies of the vertebrae…and the anterior portion of them. This is where “wedge fractures” can occur and create so many problems. We must work around that in Pilates. There are plenty of exercises with natural curves of the spine. Forward flexion of the spine is not necessary in your Pilates sessions with those who have spinal osteoporosis.

      Now, will they do it in regular life? Yes. But your job is while in the studio. And bringing studio actions into the rest of life. Your client can and ought to go to a specialist in osteoporosis and manage how to do daily activities without damage. You can teach hinging at the hips, while maintaining natural curves of the spine, rather than rounding the spine to get something not he floor or some such thing. Just take great great great care.

      Does that make sense? Please reply and let me know if I can help you further.

      All the best,
      – Shari

      Reply
  • 10. Lynda Lippin  |  May 22, 2014 at 2:51 pm

    One of your best posts, Shari! I can tell the moment I do any compressive spine flexion as it hurts. I have started to view this as a plus.

    I also agree fully with your reply above regarding osteoporosis. People do all sorts of things outside of the studio that could harm them. Isn’t it our job to keep our clients out of harm’s way in the studio?

    Over the years I have had about 6 osteoporotic clients who fractured vertebrae doing flexion in a Pilates session before coming to me. They were given exercises like rolling like a ball, full tower, etc. I was just horrified!

    Reply
  • 12. jpilatesblog  |  June 3, 2014 at 12:51 pm

    Reblogged this on jpilatesblog and commented:
    Fantastic article!

    Reply
    • 13. theverticalworkshop  |  June 3, 2014 at 5:56 pm

      Thank you for reading and for sharing this!
      All the best to you,
      – Shari

      Reply
  • 14. Molly  |  June 23, 2014 at 12:01 am

    Great info Shari, thanks. Now it is the time to be able to teach on self and clients. That is the hard part, putting theory, works, studies into practice.

    Reply
  • 15. Nancy Black  |  July 27, 2014 at 1:54 pm

    This was very insightful Shari, I have been a fan of your blog for a while; hope to bring the same quality to my blog soon!

    Reply
  • 17. Susie Jacobs  |  September 16, 2014 at 4:45 am

    Your blog is very informative and I liked how you posted photos of the do’s and dont’s. Is pilates suitable for someone with scoliosis?

    Reply
  • 18. Is there too much flexion in Pilates? « paleolates  |  March 11, 2015 at 5:16 pm

    […] how safe it can be to do lots of flexion, when done properly – you can read about that on The Vertical Workshop blog (though I still take issue with the writer’s willingness to go along with the […]

    Reply
  • 19. Caitlin  |  September 5, 2015 at 10:51 pm

    Hi Shari. In the picture of the Spine Stretch exercise where the examples were “too harsh at the hinges,” I was wondering what verbal cues and hands on adjustments you could use to get your students into that more spacious, supported position as they are flexed forward. Thank you so much for your thoughts!

    Reply
  • 20. Andrea Dean  |  May 29, 2016 at 10:36 pm

    Hello Shari, this is an excellent post. Before I start asking about inversions, in a bit more advanced exercises then rolling like a ball – roll over, teaser, control balance, etc., have you already written a post about this, so I can go and read it and not waste your time? Thank you very much.

    Reply
    • 21. theverticalworkshop  |  June 12, 2016 at 11:22 pm

      Hi, Andrea,
      Thank you for asking about this.
      I have not written about inversions and such, but I am glad to discuss.
      The biggest issue is that whenever your hips go up or overhead, then you must maintain the natural curve of your cervical spine. DO NOT FLATTEN OUT YOUR NECK.
      You must roll your shoulders back strongly into the mat, and work to keep you face directly facing the ceiling and natural curve strong. Well…the curve of your neck will elongate a little bit, but must not flatten

      I have much to say about why, but I cannot write in full right now.

      Will you ask me some questions about that and I will send you more information when I can.

      As I wrote to you in some other replies, I apologize that I cannot write in full right now.

      Thank you for being patient!
      – Shari

      Reply
      • 22. Andrea Dean  |  June 13, 2016 at 7:29 pm

        Hi Shari, thank you and no problem, I will be patient, in the meantime, I will read all your blogs, they are are amazing and so helpful. Cannot wait to read them all. Andrea

  • 23. christianeebert  |  March 2, 2017 at 10:30 am

    Thank you for the amazing article. Your style of writing wants me to read and learn more and more . I love learning but living in South Africa and teaching in English but actually being German, even if that was 30 years ago , I find it still difficult to learn in English.

    Reply
  • 25. Jocelyn Nugent  |  March 5, 2017 at 11:12 am

    Thank you for this amazing article. What a great resource for teachers all over, just like an evenly distributed spine. You rock..
    The pictures are a great supplement to your incredible Blog!

    Reply
    • 26. theverticalworkshop  |  July 4, 2017 at 12:04 pm

      Jocelyn,

      My apologies for not writing earlier. I thought I had, but as I was in the midst of heavy research I seemed to have missed out!

      Thank you for your supportive words and sentiment! Thank you!!!

      All the best,
      – Shari

      Reply
  • 27. annarenwick  |  July 29, 2017 at 8:15 pm

    Hi
    Fantastic article. Can I ask how this relates to a client with osteoporosis?
    Thanks

    Reply
    • 28. annarenwick  |  July 29, 2017 at 8:23 pm

      Apologies just saw you replied to this above

      Reply

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