Millions of people suffer from back pain, and for many, the cause is a condition known as flat back syndrome.
The flat back syndrome is caused by weakened leg, shoulder, and abdominal muscles, which leads to an abnormal curvature of the lumbar spine.
There are many exercises that can help restore natural curvature and reduce the pain associated with this syndrome.
In this article, we will discuss 19 of the best flat back syndrome exercises you can do to reduce pain and improve posture.
What Is Flat Back Syndrome and What Causes It
Flat back syndrome is a structural problem developed through the loss of lumbar lordosis, which results in an inability to arch the lumbar region. Treatment for flat back syndrome typically focuses on repairing normal curvature and improving range of motion. Spinal surgery may be necessary in some cases after a thorough physical examination from your healthcare provider.
- Imbalances: Muscle or spinal imbalance may cause the body to shift or favor weight distribution unevenly. This leads to the lumbar and thoracic spine losing their natural curvature
- Ankylosing Spondylitis: Ankylosing spondylitis is a chronic medical condition that affects the spine. Symptoms include stiffness, pain, and arthritis. The disease can cause a change in the posture of the lumbar or thoracic area, which can lead to flat back syndrome.
- Lumbar Spine Surgery: Flat back syndrome occurs when the bones in your spine don’t line up right anymore. This can happen because of how the surgery was done, or it could be from a decrease in spine resilience post-operation.
- Nerve Damage: Nerve damage can cause back pain by affecting the way the muscles and ligaments in the back work. It can also cause inflammation and pain in the spinal cord.
- Fractures: Fractures can cause back pain by damaging the spinal cord or the spinal nerve roots. The spinal cord carries messages between the brain and the rest of the body, and damage to it can cause pain, numbness, and weakness in the back and other parts of the body. The spinal nerve roots exit the spine at the level of the fracture and can also be damaged, causing distress in the back and other parts of the body.
- Human spine fractures can also damage the muscles, ligaments, and other tissues in the back, leading to pain and other symptoms. In some cases, a fracture can cause a piece of bone to press on blood vessels or nerves, which can also lead to discomfort.
The Symptoms of Flat Back Syndrome
Flat back syndrome is more common in older adults, but it can happen to anyone.
If you have this condition, you may have pain in your back and problems standing up straight.
You may also have trouble walking or moving around. Your doctor can diagnose flat back syndrome with a physical exam and x-ray imaging tests.
The following list of symptoms may be signs of flat back syndrome and abnormal curvature.
- Slouched posture due to rear shoulder muscles being pulled forward.
- Lower back pain while performing simple daily tasks due to a flat spine.
- Trouble standing upright as the lower spine loses its ability to maintain normal curvature without pain.
- Leg pain may cause the pelvis to lean forward, resulting in misalignment.
How To Do the Flat Back Syndrome Exercises
This list of stretching and strengthening exercises is designed to help loosen tight muscles, build strength, correct flat back syndrome, and create pain relief.
It is recommended to perform the following exercises in physical therapy under supervision.
1. Bird Dog
This exercise can be performed by anyone, regardless of their fitness level, and only requires a few minutes of your time.
- Get down on all fours with your palms flat on the ground and shoulder-width apart.
- Keeping your back straight, extend your right arm forward and left leg back so they are parallel to the ground.
- Hold for five seconds, then return to starting position.
- Repeat with your left arm and right leg.
- Continue alternating sides for a total of 10 reps.
Benefits: The bird dog exercise is a great way to improve core stability, spine flexibility, and overall strength. It also helps to improve balance and coordination.
- Abdominal Muscles
- Erector Spinae
2. Foam Rolling
Foam rolling is used as a form of self-massage. It is often used to help release muscle tightness or knots.
There are a few basic steps to follow when foam rolling:
- Find a foam roller that’s comfortable for you. You don’t want it to be too short or too long, and it should be the right width for your body.
- Sit on the floor with the roller in front of you.
- Position the roller under the area you want to massage. For example, if you want to roll out your hamstrings, position the roller under your hamstrings.
- Slowly roll back and forth over the roller. You can control the pressure by how much of your body weight you put on the roller.
- Stop and hold on to any tender spots for 20-30 seconds.
- Repeat the process until you’ve rolled out the entire area.
Benefits: Foam rolling helps to increase blood flow and circulation, improve joint range of motion, and break up scar tissue.
- Relieve tight hamstrings
- Upper and lower back
- Works well for most general muscle fatigue
The Superman hold is a great way to work your core and glutes.
- Lie flat on your stomach on the floor with your arms stretched out in front of you.
- Lift your head, chest, and legs off the floor while keeping your arms straight.
- Hold for a few seconds and then slowly lower yourself back to the starting position. Repeat for desired reps.
Benefits: The superman exercise has many benefits, including improving posture, increasing strength and flexibility, and ultimately reducing flat back posture.
- Erector Spinae
4. Swim Backstroke
Swimming exercises for flat back are a great way to reduce pain because the water provides added support for your body. The backstroke is just one among others to try.
- Lie on your back in the water and extend your arms overhead.
- Point your toes and press down into the pool bottom to push yourself up into a floating position.
- Keeping your arms extended, bring them back down until they are slightly wider than shoulder-width apart.
- Push off the pool bottom to start swimming, using a reciprocal (up-and-down) arm motion.
- Remember to keep your head and eyes looking up at the sky, not down at the pool bottom.
- Use a flutter kick to propel yourself forward. Keep your legs relaxed and ankles loose for maximum efficiency.
- As you swim, be sure to keep turning your head to the side so that you can breathe. Inhale through your mouth and exhale through your nose.
- When you reach the end of the pool, touch the wall with both hands simultaneously, then turn around and swim back. Repeat until you’ve completed the desired distance.
- Helps pull the shoulders back into proper positioning
- Helps strengthen core muscles
- Improved lower spine stability
- Abdominal muscles
- Lower back
- Upper back
Walking is one of the easiest and most popular exercises, and it can be done just about anywhere. It is a great way to get your heart rate up and improve your cardiovascular health, and it also strengthens your muscles and bones. Try to walk for 20-30 minutes each day, especially if you work in a mostly seated job or live a sedentary lifestyle.
- Stand in a straight-up and down, even posture.
- Place one foot in front of the other and allow your forefoot to strike the ground first.
- Roll your weight forward onto the ball of your foot as you push off with your back leg.
- Repeat steps 2 and 3, advancing forward with each step.
- To increase your speed, lengthen your stride and swing your arms rhythmically.
- To stop, simply reverse the sequence of steps 1-5.
Benefits: Walking can help improve your balance and coordination. Along with reducing flat back posture and pain since it gets the body moving and blood flowing.
6. Pelvic Tilt
The pelvic tilt is a convenient exercise to help relieve lumbar spine pain. It is safe for pretty much anyone to perform.
- Lie on your back on the floor and place your feet flat on the floor.
- Tighten your abdominal muscles and tilt your pelvis upward, so your lower back flattens against the floor.
- Hold for five seconds, then relax.
- Repeat five times.
Benefits: The pelvic tilt helps correct flat back syndrome because of how the abdominal stretches, reducing spinal imbalance.
- Transverse Abdominis
A step-up is a leg-focused movement to improve your strength, power, and stability.
- Place your left foot on top of the bench or step, with your heel hanging off
- Keeping your core engaged, press up through your left heel to lift your body to the step
- Bring your right foot up to join your left, making sure your feet are hip-width apart
- Pause for a moment, then slowly lower your body back down to the starting position
- Repeat the movement with your right leg leading for an equal number of reps.
Benefits: Performing step-ups is an efficient way to reduce muscle imbalances because they focus on one side at a time. This may reduce leg pain and improve lumbar lordosis.
8. 90-90 Hip Stretch
The 90-90 hip stretch can help improve flexibility and range of motion in the hips. This simple stretch can be done just about anywhere, and only requires a few minutes of your time.
- Sit down leaning your pelvis forward slightly.
- Position your legs at a 90-degree angle with one foot in front of you with the outer leg resting on the ground. And the other leg to the side, with the inner part resting on the ground.
- Bend your front knee while keeping the back leg extended to the rear, also with the knee bent.
- Hold this position for 30 seconds before switching sides.
Benefits: Loosen up tight hip flexor muscles to provide relief from joint pain and stiffness.
- Hip flexors
9. Prone Jackknife
The Prone jackknife is an excellent exercise for the core. It helps to reduce flat back posture by building strength and stability in the abdominals.
- Assume a plank position with your feet on a stability ball.
- Lean forward to keep weight on your hands.
- Begin with your head facing the ground, and pull your belly button in towards the lower spine to maintain an inward curve.
- Pull your knees forward.
- Then extend them back and repeat.
Benefits: This exercise requires you to hold an inward curve of the lower spine, which will assist in regaining lumbar lordosis.
- Hip flexors
- Lower abdominals
10. Cobra Pose
The cobra pose is a yoga pose that is meant to open up the spine and improve flexibility. It is also said to be helpful in relieving stress and tension.
- Lie on your stomach with your feet together and your palms flat on the floor.
- Push up onto your hands and feet, raising your torso and head off the floor.
- Look up, keeping your shoulder blades down.
- Hold for 10 to 30 seconds, then release back to the starting position.
- Repeat 2-3 times.
If you are new to yoga, it may help to practice the cobra pose with your knees bent at first. As you get stronger, straighten your legs and press your hips down to the floor. If you have any neck pain, be sure to keep your head naturally in line with your spine.
Benefits: This pose is excellent for stretching the upper abdominal muscles. It also strengthens the lower spine muscles to alleviate flat back syndrome.
11. Chin Tucks
This is an easy exercise that can help to tone the neck, face, and chin area.
- Sit up straight with your spine in neutral alignment and shoulder blades down and back.
- Tuck your chin downwards and towards your chest, so that your neck is in a straight line with your spine.
- Hold the position for 5-10 seconds, then release.
- Repeat 3-5 times.
- Chin tucks provide neck pain relief by restoring proper alignment and building strength.
- If you have trouble standing upright, having a strong neck will reduce forward neck posture.
- Reduced tension in tight muscles.
12. The Founder
The Founder is a simple, but challenging exercise that works the posterior chain. It can be done with or without weights and is a great way to start your day or to break up a workout routine.
- Begin with feet hip-width apart and knees slightly bent.
- Pull your hips back and retract the shoulder blades
- Lift your arms straight up to the sides of your head.
- Bring your upper body towards the ground while keeping your arms extending and hips back.
- Move your hands to the heels, slowly move back to the start point and go again.
- Improved mind-to-muscle connection in the posterior chain.
- Allows for better control of the back, leading to improved posture and lumbar lordosis.
- Erector Spinae
- Upper back
- Rear shoulder muscles
The Cat-Cow is a yoga move that helps to open up the spine and increase flexibility. It’s also a great way to warm up before a workout.
- Start on your hands and knees with your spine parallel to the ground. Make sure your hands are below your shoulders and your knees are below your hips.
- Inhale as you tuck your chin, pull the belly button in toward the lower spine, and curve your spine inward, like a cat.
- Exhale as you arch your back and look up towards the ceiling, like a cow.
- Repeat this sequence 10-20 times, moving slowly and smoothly with your breath.
- Stretches out tight muscles in the abdominals.
- Opens up the spine to rejuvenate natural curves.
14. Lying Hamstring Stretch
The lying hamstring stretch is a great way to loosen up your hamstrings if you sit at a desk all day. It’s also a great way to improve your flexibility and range of motion.
- Lie on your back with both legs flat on the ground.
- Lift one leg off the ground while keeping it straight.
- Grab the elevated leg with your hands, then pull it toward you until you feel a stretch in your hamstring.
- Hold the stretch for 30 seconds, then release and switch sides.
- Perform the stretch 2-3 times per leg.
- Stretching tight hamstrings will pull your pelvis up, reducing the risk of spinal imbalance, and hip or knee injuries.
- Promotes better posture as it will prevent a forward pelvis, which will deter abnormal curvature in the lower spine.
15. Elevated Hamstring Stretch
The elevated hamstring stretch is used to relieve tightness. It can be performed using a bench, box, or chair.
- Standing straight up and down, extend one leg straight out, resting it on the elevated object.
- Point the raised toe so it’s aiming upward.
- Lean into the stretch, while maintaining a straight back.
- Pain relief for tight hamstrings.
- Prevents pelvis forward lean to save the knees, hips, and lower back.
- Enhances lumbar spine curve.
16. Donkey Kicks
Donkey kicks are used to strengthen the glutes and hamstrings. They are very effective with bodyweight or additional weight.
- Assume a tabletop pose, facing the floor.
- Without allowing your back or torso to move, kick your bent leg back until it is at or above parallel to the floor.
- Move it back to the start position and switch legs.
- The unilateral motion eliminates muscle imbalance.
- Strong glutes assist in activating the hamstrings for movement.
- Strengthening these muscles creates better posture, alleviating flat back syndrome.
17. Reverse Abdominal Curls
Most people only think about abdominal curls when they are trying to get a six-pack. Reverse abdominal curls boost core strength, while also improving spinal stability.
- Lie on your back on the floor and place your hands beside you.
- Bring your knees in towards your chest with your feet together.
- Use your abs to curl your hips off the floor and towards your chest, then slowly lower them back down.
- Perform for 10-20 reps.
- Strengthen core to improve lumbar lordosis.
- Reduced pressure on ligaments and spine.
18. Dead Bugs
The dead bug exercise is a simple, yet effective way to improve your core strength and stability. It’s named for the position you assume when performing the exercise: lying on your back with your arms and legs in the air, like a dead bug.
- Lie on your back on a mat with your knees bent and feet flat on the floor.
- Straighten your arms and raise them up.
- Brace your core muscles and raise your legs so that your thighs are perpendicular to the floor and your shins are parallel to it.
- Keeping your back pressed firmly into the mat, slowly lower one leg until the thigh is parallel to the floor.
- Return the leg to the starting position and switch sides.
- Continue alternating legs for the desired number of repetitions.
- Helps train the body to resist moving into unsafe positions
- Restores the natural curvature of the spine by improving overall core stability.
- Lower back
19. Doorway Chest Stretch
When you do this stretch, you’ll open up your chest and shoulders.
- Standing in front of a doorway, place your arms on each side with your palms down, and arms bent at 90 degrees.
- Brace your core, and look straight ahead.
- Begin leaning forward by stepping with one leg, but avoid falling forward.
- You can let your arms straighten out while in the stretched position.
- This can also be performed on one side at a time if you prefer.
- Eliminates shoulders from being rolled forward.
- Provide relief for sore chest muscles.
- Improves upright posture to correct flat back syndrome.
- Back and neck pain relief.
What To Expect After Doing These Exercises
Some of these exercises will provide instant relief from flat back syndrome, while others will take longer. For instance, the stretching movements, when performed properly will loosen tight muscles quickly.
On the other hand, the strengthening exercises may take a few weeks to see any real changes. This is because building up the weakened muscles will not only take time but also cause soreness since you may not be used to engaging these muscles yet.
It is important to note, however, that doing these exercises consistently, and correctly will repair flat back syndrome in most cases.
How To Prevent Flat Back Syndrome From Returning
Once you have performed these exercises for flat back and repaired the natural curves here are some tips for preventing it from reoccurring:
- Execute these exercises for flat back consistently by assembling them as daily tasks on your to-do list. Pick 3-5 from the list and just master them.
- Work with a physical therapist to ensure your doing the exercises safely and correctly.
- Take advantage of hot/cold therapy and other forms of exercise recovery.
- If the pain is still occurring get a physical exam and see if they’ll do x-ray imaging. This may reveal a worse structural problem.
- Look into other treatment options such as operative treatments or pain medication in the worst-case scenario.
Alleviate Flat Back Syndrome With These Exercises
The Flatback syndrome exercises mentioned can help alleviate the pain and discomfort associated with this condition.
By targeting the muscles that are often weak and tight, you can improve your posture and spinal alignment, which may prevent the return of flat back syndrome.
We recommend trying a variety of these exercises to find what works best for you, and be sure to focus on proper form to avoid injury.
With consistency and dedication, you can enjoy relief from your flat back syndrome pain.