Tuesday, October 20, 2015

Neutral Spine - What is That?

By Dr. Greg Lusk, DC

The concept of a "neutral" spine is quite well known these days.  You need to spend little time in a gym, the office of a chiropractor or physiotherapist, or reading about the next wave of amazing core exercises online before hearing or reading the words "keep your spine neutral."  This is sound advice but many people, particularly those not doing any of the aforementioned things, don't know what or where this elusive neutral position is.  Why is this important you may ask.  Well, considering that 80% of us will get back pain at some point in our lives and that a neutral spine position has been found to be the least straining position on the spine, there is value to be gleaned by those currently experiencing back pain and those looking to prevent it.

If you take a look around you'll see many examples of what neutral spine is not.  Your office colleague slumped over a desk with their chin jutting forward, your classmate slouched in a chair, or the athlete with an exaggerated low back curve and a pelvis that is tipped forward.  All poor displays of neutral spine positioning!  On the other hand, if you view someone from the side and can draw an imaginary vertical line through the front of their ear, the point of their shoulder and the side of their hip, while appreciating smooth and gradual spinal curvatures from neck to low back, you are witnessing a good model of neutral.  In this position, the ever present force of gravity imposes more balanced forces on the body versus leveraging it in any one direction.

Now, all activities and life in general cannot and should not be spent in neutral.  You would look rather silly and rigid trying to make that happen.  Just imagine a football wide receiver stretching out to make an acrobatic catch...that is not neutral.  However, from a risk management point of view, in addition to the advice of keep moving as much as possible as the body does not like sedentary positions, staying in neutral is the safest position while doing many common daily activities.  Sitting, for example, is less straining on the neck, mid, and low back if that imagined plumb line aligns where it should.  Adjust your position, desk set-up, chair, etc. to facilitate that posture.  When lifting, bend with your hips and/or knees and maintain the curves of your spine while you stiffen your abdominal muscles.  This spares the spine and uses our much larger lower body muscles.  A simple drill you can perform to assess your ability to do this is the hip hinge.  Stand upright with a broomstick along your back with one hand holding it behind your neck and the other behind your low back.  Then, while keeping the broomstick in contact with your head, mid back, and tailbone, bend forward as far as possible while maintaining the 3 contact points.  It's often not as easy as it sounds!  Practice this and get a sense of how it feels so you can replicate it throughout the day.  On a final note, if you need to twist your body follow the rule "keep your nose between your toes."  Pivot at your hips and feet/ankles to direct motion there, allowing the spine to stay straight.  Think of it this way.  The spine should resist twisting forces, not create them.

This article is for general information purposes only and is not to be taken as professional medical advice.