A balanced spinal position occurs when the trunk held upright, neither slouched or extended. The ear, shoulder, and hip are in the same plane, and there is a small inward curve to the neck and lower back. In this balanced posture, the weight of the body is well distributed throughout the spinal segments. When the postural muscles fail to maintain this position, and the spine slouches, the head falls forward, or the body leans to the side, increased strain is placed on the spinal joints, discs, and ligaments. Continuous poor posture can lead to poor recovery from injury, progressive wear and tear, and postural pain.

The postural muscles act as the support system for the spine and maintain this position actively through low intensity, prolonged contraction. The postural muscles, including the pelvic floor, lower abdominal (transverse abdominus), spinal muscles (erector spinae & multifidus), and shoulder blade muscles (scapular retractors), to name a few, are involved in keeping your spine in an optimal position when you sit, stand, walk, and do your daily activities.

Core stability training of these muscles helps to provide improved endurance and recruitment of the muscles so they can do their job every day. Research has supported that after an episode of back pain, many of these muscles loose their ability to contract with ease, particularly the lower back multifidus.

The 3-Step Deep Layer Core Contraction (DLC) is the first step in training these muscles to improve their postural support.

Step 1: Lightly contract the muscle of the pelvic floor (Kegel Exercise) and maintain a 50% contraction.

Step 2: While holding the pelvic floor muscle, contract the Lower Abdominal, by tightening your lower abdomen and bringing your belly button in and up toward your spine.

Step 3: Keeping both tight, now tighten your lower back by swelling your muscles along the spine, squeezing them together (Multifidus).

Attempt to keep all 3 muscles contracted for 10 seconds. Repeat 10 times. Work up to holding 3-5 minutes at a time and doing this while sitting, standing, walking, etc.

Progress to completing core stability exercises (not discussed in this issue) that target these muscles, 3 times a week to improve the strength and endurance needed for active balanced posture.