How to fix sway back posture

What to expect in this post:

 What is Sway back posture?

 How to determine if you have Sway back posture
 What’s happening with your muscles in Sway back posture?
 Common injuries associated with the Sway back posture
 The solution: The best exercises to fix your Sway back posture

Image from FixTheNeck

BONUS download: Here is a complete list (PDF) of all the exercises mentioned in this post!
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// What is Sway back posture?

It is a type of posture. Unfortunately, it’s one of the bad postures that some people have…

To completely understand why the sway back posture is considered a bad posture, one must
first know what a good posture looks like. Check out the post: Ideal sitting posture to know
exactly what good posture is.

Do you suffer from a Sway back posture? I hope not… But if you do, please let me help you!

The sway back posture is where the pelvis is pushed in front of the centre of gravity. This
causes a chain reaction in the posture as the body attempts to compensate for the shift in
alignment.

// What are the characteristics of Sway back posture?

 Pelvis pushed forwards in front of centre of gravity (see above)

 Posteriorly rotated/neutral pelvis
 Flat lower lumbar lordosis
 Hyper extension of thoracolumbar junction (long kyphotic curve)
 Hyper extension of hip
 Hyper extension of knees
 Neutral ankle
 Head poked forward (*compensatory adaptation)
 Upper back curved forward/sunken chest (*compensatory adaptation)
 Shoulders protracted (*compensatory adaptation)
 Tight upper abdominal

*compensatory adaptation: These changes in posture are usually a direct result of the body
attempting to compensate for the forward position of the pelvis.

// What are the causes of Sway back posture?

a) Over-active/tight hamstrings:

Tight and/or over-active hamstrings drive the pelvis forwards in sway back posture. This
hamstring dominance can be as a result of genetic factors, lack of stretching, poor gluteal
muscle group function, sitting posture… the list goes on.

The good news is that we can do exercises to reverse this!

b) Ligament laxity:
Whether you are born with it, or you are someone who has excessively stretched themselves,
ligament laxity can cause sway back posture. Since the stability of the joints has been
compromised, sway back posture occurs as it allows the weight of your body to rest on the
excessive curves of the spine.

Unfortunately – there is nothing we can do to reverse the “looseness” of the ligaments. The
only option is to improve the strength and control of the muscles which support the spine.
(which we will be going through)

c) Incorrect strategy for good posture:

For some reason, your brain has learnt to hold you in a Sway back posture. This could be
attributed to bad habits such as sleeping on your stomach and poor posture in sitting.

// How to determine if you have Sway back 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 your land marks

Greater trochanter: Place your palm on the side of your hip. Feel for a bony prominence that
sticks out.
Lateral malleolus: You know that bony bit that sticks out at the outside of your ankle? That’s
the one we want.

Humeral head: This is the top of your shoulder bone.

3. Compare the alignment of these 3 landmarks

In the ideal posture, you should be able to draw a straight line between the 3 points of greater
trochanter, humeral head and lateral malleolus.

With your picture, draw vertical lines through the midpoints of the land marks. If they all line
up, great! You don’t have sway back posture.

If you have Sway back posture: the line of the greater trochanter will be in front of the other
2 points.

Is your pelvis in the correct position?

// Don’t confuse Sway back posture with anterior pelvic tilt

It is common for people to get confused between having a Sway back posture versus having
an anterior pelvic tilt. Both postures will have a sway back component where the lower back
has a pronounced arch.
The main difference being that with the sway back posture, the centre of the hips are in front
of the line of gravity. With anterior pelvic tilt, the hips are generally stacked over the ankles.

It is important to know the difference between these postures as their respective treatments
and exercises are different! Doing the right exercise for the wrong diagnosis will not help
you.

Want to know more about anterior pelvic tilt? Check the post: How to fix an anterior
pelvic tilt to find out more.

// What’s happening with your muscles in sway back posture?

Overactive/tight hamstring drives the hips forward causing:

 elongated and weak hip flexors

 end of range hip extension in standing
 weak gluteal muscles
 anterior translation of femoral head
 elongated/weak external oblique
 short internal oblique –> pulls lower ribs forward
 over-active muscles in thethoraco-lumbar junction
 upper cross syndrome

// Common injuries associated with the Sway back posture

 Hip: Arthritis, impingement, labral tears, bursitis, hip flexor tendinopathy, hamstring
strains
 Lower back: Muscular tension, facet joint degeneration, disc bulges
 Shoulder: Impingement, bursitis, tears
 Neck: Headaches, muscular tension, degneration

If you suffer from any of the above issues and have tried everything to try to get it better,
your Sway back posture may be the leading cause! The sway back posture will place your
body in sub-optimal positions which will cause excessive stress through the structures. Fix
your posture, fix your pain!

// Do not:

a) DO NOT stretch the hip flexors

In the sway back posture, the hip flexor muscle group (psoas, iliacus) is already in
a lengthened position. Stretching will further elongate your already stretched out hip flexors
and thus drive the issue further.

b) DO NOT sleep on the stomach

Sleeping on your stomach will encourage the Sway back posture. How? Have a look at the
picture above. You will see that the curve of the spine is exactly the same as Sway back
posture. That means the same muscles that hold the sway back posture will continue to drive
this posture.

c) DO NOT sit with bad posture

This one is pretty straight forward. No one should be sitting with bad posture. Your
prolonged sitting posture may be the cause!

d) DO NOT stand like this

This position is something I see it a lot of bystanders standing around. The arms crossed, hips
thrusted forward and he classic pronounced middle back arch.

e) DO NOT do abdominal crunches

Abdominal crunches may give you nice 6 pac abs, but it will also increase the dominance of
rectus abdominus which will increase the hunch of the upper back which is seen in the sway
back posture.

The solution: The best exercises to fix your

Sway back posture
Goals of these exercises:

1. Release hamstrings
2. Strengthen hip flexors

3. Strengthen gluteal group

4. Strengthen external obliques/decrease rectus abdominis dominance

5. Address upper cross syndrome (compensatory postural changes)

6. Re-train proper posture in functional positions (Neuro-muscular control)

1. Hamstring

Aim: To decrease the over-activity/tightness of the hamstring muscle.

a) Ball release

Instructions:

1. Get a ball. You can use a massage ball, tennis ball, lacrosse ball etc. Take your pick.
2. Starting from the top of your hamstrings in the buttock region, position your body
over the ball of your choice.
3. Use your body weight to apply the appropriate amount of pressure to the hamstring
muscle.
4. Gradually work your way down to the back of your knee.

Time: 2 minutes per leg.

b) Stretch
Instructions:

1. Whilst upright, place one leg straight in front of you.

2. Hinging forwards at the hip joint (and keeping the back straight), bend towards the leg
at front.
3. Ensure that you can feel the stretch of the lower hamstrings.
4. Repeat on both sides.
5. To stretch upper hamstring, repeat the previous steps with a slightly bent knee in front
instead of a straight leg.

Time: Hold for 60 seconds each. Repeat 2-3 times per leg.

2. Hip flexor group (iliopsoas)

Aim: To increase the strength of the hip flexor muscle group.

DO NOT stretch your hip flexors!… we want to strengthen this muscle group. Stretching
the hip flexors will make the sway back posture worse as they are already excessively
elongated!

a) Sitting hip flexion (on the chair)

Instructions:

1. Sit up right on the edge of a chair.

2. Lift knee as high as possible.
3. Hold for 5 seconds.
4. Alternate lifting knees.
5. Repeat 10 times.

Time: 2 minutes in total.

b) Sitting hip flexion (on the floor)

Instructions:

1. Long sit on the floor with the support of your hands behind you.
2. Keeping your leg straight, lift your leg
3. Hold for 5-10 seconds. Repeat 10 times on each leg.

Time: 2 minutes
Note: Make sure your back and pelvis stay in the neutral position whilst performing this
exercise. The pelvis should not rotate.

c) Jack knife with exercise ball

Instructions:

1. Assume a push up position with your feet on an exercise ball

2. Brace your abdominal muscles.
3. Bring your knees towards the chest.
4. Hold for 5 seconds. Repeat 15 times.

Time: 2 minutes

Note: Make sure your back arch does not collapse whilst in the push up position. This can
make sway back posture worse. Keep your core braced at all times.

3. Gluteal group (aka the “butt muscles”)

Aim: To increase the strength and recruitment of the gluteal muscle group.

a) Hip extension
Instruction:

 Whilst standing upright, extend your leg backwards until you feel your gluteals
contract firmly.
 Do not rotate your body.
 Hold for 5 seconds.
 Alternate legs for 20 repetitions each.

Note: Maintain your upright posture. You should not lean forward when doing this exercise.
Hold onto a support (eg. back of a chair) if you have issues with maintaining your balance.

b) Bridge

Instructions:

 Lie down on your back with your knees bent.

 Flatten your lower back to the ground.
 By pushing off with your heels, lift your buttocks off the floor.
  Hold for 5 seconds.
 Repeat 15 times.

// Want to know the best exercises for your gluteal muscles? Check out this post: Is sitting
destroying your butt muscles? to see the complete list of gluteal strengthening exercises (+
progressions).

4. External obliques

Aim:

 Increase strength/Decreased length of external obliques.

 Increase length of internal obliques.
 Decrease dominance of rectus abdominis

a) Side plank

Instructions:

1. Assume position as above. (either on knees or feet depending on level of ability)

2. Contract the muscles on the side of your abdomen to prevent that side for sinking
down
3. Keep your shoulders, hips and knee/ankle in line with each other,
4. Hold for 30 seconds.
5. Repeat on other side.

b) Plank with side bend

Instructions:

1. Assume the plank position (see above)

2. Brace your core muscles to maintain good alignment.
3. Proceed to bring knee to elbow of the same side.
4. Keep your hips in line with your shoulders. (…Don’t let those hips drop!)
5. Hold for 5 seconds.
6. Alternate sides for 10 repetitions.

c) Single arm weight

Instructions:

1. Hold onto a weight with one hand. (as if you were carrying a suit case)
2. Proceed to walk without letting the weight pull you down to the side that you are
carrying it on.
3. Sustain for 1 minute.
4. Keep your hips stacked on top of your ankles.
5. Progression: Increase the weight. Alternatively, you can hold the weight next to your
shoulder.

5. Thoracolumbar junction

Aim: To release the muscles of the thoracolumbar junction.

a) Ball release
Instructions:

1. Place the muscles of the lower to mid back on top of a massage ball.
2. Use your body weight to apply pressure to the area.
3. You may need to adjust your positioning over the ball to target the right area.

Time: 2 minutes

6. Addressing upper cross syndrome

As I have covered this a multitude times in several posts on the Posturedirect.com blog, I will
link to the appropriate posts to bring you up to speed.

 How to correct Forward Head Posture

 How to fix Rounded Shoulders
 How to fix the Hunchback posture

Stretches/Releases

 Anterior chest/shoulder, intercostals

 Sub-occipital/Upper cervical posterior
 Sternocleidomastoid/Scalene
 Upper abdominals
 Thoracic joints
 Fascia of the upper limb
 Latissimus dorsi

Strengthening

 Cx DNF/Retractors
 Scapula stability (rhomboid/lower trap/SA)

7. Functional training

This section is the most important part of the post. If you do all the above exercises, but
fail to do this, your sway back posture will not get better.

Functional training is all about using the right muscles at the right time, to sustain the correct
posture, in your daily activities. It’s connecting the brain, the nervous system and your
muscles together to produced a desired result.

a) Learn how to stand properly

Now that your tight muscles have been released and your weak muscles strengthened, this is
where the magic happens.

1. Stack pelvis on top of the ankles by bending forwards at the hip.

In sway back posture, the hips are driven too far forward.

The greater trochanter and lateral malleolus should be in the same line. (Click here if you
forget what these are)

2. Return hips and lower back to neutral

Using your gluteal and lower back muscles, bring the upper body in line with the rest of the
body.

3. Re-position shoulders

Gently roll your shoulders back and down.

4. Elongate/retract neck
This will prevent your neck from poking forward.

How do you feel in this new position?

Yes, it will feel weird. 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.

Practice this throughout the day. When you’re waiting in line at the supermarket, brushing
your teeth, cooking at home etc. Try to incorporate this posture throughout your day to day
activities.

b) Learn how to Sit-to-Stand properly

Bend forwards at the hip before standing up from a chair. A simple cut to remember is “nose
over toes”.

As you sit down, bend forwards at the hips before descending. Remember the cue – “stick
your bum out”

People with sway back posture tend to avoid bending forwards.