If you have ever had lower back pain or been in physical therapy for treatment, you most likely heard the term ‘Neutral Spine.’ Neutral spine refers to the position of your spine where all three curves are in proper alignment and there is the least amount of stress placed upon the structures. Not only is there the least amount of stress on the spine, the neutral spine position is also the strongest position. When doing daily activities, it is very important to observe good body mechanics in order to minimize the force through our spine. Good body mechanics begin with a good neutral spine posture.
There are three natural curves that occur in your spine. These include the cervical (neck), thoracic (middle back) and the lumbar (lower back) curves. Your cervical and lumbar spine should curve gently inward whereas the thoracic spine should curve slightly outward. This is the proper alignment that you want to see in your neutral spine position. Here is an exercise to help you find your neutral spine position:
1. Sit in the middle of a sturdy chair. Do not use a couch or recliner for this exercise since they naturally promote slouching. Place your feet flat on the floor shoulder width apart with your knees at a 90 degree angle.
2. Slouch forward by letting your chest fall towards your knees, then sit upright by accentuating the inward arch of your back. Pay attention to how your hips are moving. When you slouch, your hips should rotate backwards, or into a posterior pelvic tilt. When you sit upright, your hips should rotate forward, or into an anterior pelvic tilt. It may help to place your hands on the top of your hips to feel the difference in movement. See what a posterior and anterior pelvic tilt look like in the pictures below:
3. Rock your pelvis back and forth by alternating between a posterior and anterior tilt, as described above. First go all the way backwards, then all the way forwards. Perform these motions again but only about 75% of the full motion the second time. For the third time move your hips only 50% of the motion. Continue this way until you find the middle point of halfway between a full posterior tilt and a full anterior tilt. You should feel like you are sitting on your butt-bones. This is considered your neutral spine position.
Notice in the picture above the position of the head in relation to the lower back and hips. Your ears should line up with the tips of your shoulders and the lower back. You can help to maintain this position with the use of a small pillow in your lower back or by sitting on a wedge that is thicker in the back and thinner in the front. If you sit for long periods of time, remember this simple exercise to help you find the correct position to help minimize back pain.