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Understanding Neutral Spine Position and the Core Muscles

July 24, 2013, 2:01 p.m. (ET)

It seems everywhere you look people are talking about the benefits of achieving and maintaining a neutral spinal alignment.

Most exercise regimens, including pilates and rehabilitation programs, encourage working with the spine in a neutral position. The neutral spine position is especially important for synchronized swimmers because there is a belief that they need to have a flat back for the vertical line. It is very important to work in neutral spine position because:

  • the natural curves help cushion and protect the spine
  • it is the optimal way to attain balance and proportion
  • it places the least amount of stress on the body’s tissues
  • it optimizes breathing and affects the circulation of bodily fluids
  • it uses the least amount of energy to maintain a desired position
  • it allows activation of the right muscles during movement


Understanding the Neutral Spine Position

There are three natural curves in a healthy spine:

1.   The neck or cervical spine, which curves gently inward (lordosis)

2.   The mid back, or thoracic spine, which curves outward (kyphosis)

3.   The low back, or lumbar spine, which also curves inward (lordosis)

It is important to maintain the neutral alignment of these curves to assist with cushioning the spine from excessive stress or strain. Learning how to maintain a neutral spinal alignment will also help to stabilize the spine during everyday activities such as walking, sitting, lifting and even synchronized swimming practice.

The natural curves of the spine are caused by muscles, ligaments and tendons that are connected to the vertebrae of the spine. These structures support the spine, which would collapse without them. 

The Pelvic Tilt

Learning how to place the pelvis in a neutral alignment will help to balance the spine. The extensor muscles of the lower back, with some help from the hip flexors, are mostly responsible for the forward tilting of the pelvis. When the pelvis is tilted backward, it is the lower section of the abdominals that are active; if the movement is performed with force, the gluteals (buttocks) assist the motion.

As the pelvis rotates forward the curve of the lumbar spine increases, alternatively when a backward tilt is performed the lumbar curve is flattened. It helps to think about the rotation of the pelvis forward and backward (anteriorly and posteriorly) as a wheel with its center at the hip joints.


Pelvic Range of Motion

If the muscles of the lower back, abdominals, hip flexors or gluteals become over active (short and tight) or under active (long and potentially weak), the pelvis will be pulled into an excessive anterior (forward) or posterior (backward) tilt.

Both of these exaggerated positions can cause changes to the structure of the spinal curves that in turn potentially cause pain as well altered movement patterns. For example: it is generally accepted that when the lower back (lumbar spine) has an excessive anterior tilt, the same will be seen in the neck (cervical spine). Consequently, in an attempt by the body to keep the eyes in the correct alignment for clear vision, the chin will be pushed forward to create what is called a forward head position. This chain reaction throughout the spine can spur much compensation, including internal rotation of the thigh bones which will place added stress on the medial (inside) section of the knee which may in turn affect the feet with dropped arches and pronation.

If the pelvis is pulled into a posterior tilt the result can be a slouch or lazy posture.


Muscles Involved – The Core

The muscles involved in this balancing act are mainly the back and the abdominals. The abdominals attach to the ribs, pelvis and indirectly to the lumbar spine to offer support, whilst the muscles of the back are layered, with each layer working to balance the spine. 

The deep abdominals, or postural muscles, are also commonly called the core. The core are the muscles that connect your lower body to your upper body. It is made up of four major muscles:

1.   The Transversus Abdominis (TA)

2.   The Pelvic Floor

3.   The Diaphragm

4.   The Multifidus

The Transversus Abdominis (T.A.)

The T.A. is the body’s natural corset. It is the muscle you use to pull in your tummy when you walk along the beach!

The T.A. connects at the left of the spine, wraps around the abdomen and attaches to the ribs and hips until it reaches the right side so the internal organs are encased. The more superficial abdominal muscles that give you a six pack are layered on top of these support muscles. 

Another important function of the T.A. is to assist with spinal stability, which is essential for good posture.

The Pelvic Floor (P.F.)

You would have located and used your P.F. when you have been in need of a toilet and could not find one. You will also be aware of them when you cough or sneeze as they tend to tense spontaneously under this pressure.

Unfortunately people generally do not pay enough attention to these important muscles.  The P.F. is the structure, like a basket that holds in and supports your abdominal organs, that stabilizes the hips in association with the core and helps with balance as well as reducing the risk of stress incontinence. 

The Diaphragm

The Diaphragm is a sheet of muscle that works with the muscles of the ribs to expand and contract the ribcage during respiration (breathing). We do not often take control of the Diaphragm. The way we control our diaphragm is usually through breathing; rate, rhythm and depth; you don’t focus on the diaphragm but rather the inhale and exhale. The stronger we make the diaphragm, however, the deeper, slower and more paced our breathing will be.

The Multifidus

The Multifidus runs the length of the spine. It has a unique design that provides support as well as keeps us upright by providing scaffolding for the vertebral column. 

Unlike most muscles, when the multifidus is on stretch (when we bend forward) it gets stronger.  Generally, if a muscle is lengthened it has a tendency to lose strength. Obviously the Multifidus is operating under different rules.


How to Find your Neutral Spine

Simply explained, a neutral spine alignment is when the pelvis is balanced between the two exaggerated anterior and posterior positions.  When the pelvis is in neutral, the bones at the top of the pelvis back--Posterior Superior Iliac Spine (PSIS)-- and front-- Anterior Superior Iliac Spine (ASIS)-- are level.


Posture

The basis of effective back care begins with good posture.  Poor posture can cause spinal pain as well as exacerbate existing pain. It can also delay rehabilitation. 

Learning to utilize the core to initiate movement whilst in a neutral pelvic alignment will not only reduce your risk of injury and lower-back pain but also go a long way towards improving your general posture.


Neutral Spine and Postural Muscles

It is obvious that once the spine is placed in a neutral position it needs to be kept there. It is the postural muscles that achieve this.

The muscles that hold the spine in correct alignment are found deep in the body-- close to the spine-- and are referred to as stabilizers because their function is to help stabilize the spine in readiness for activity.

These deep abdominals respond most effectively to a gentle contraction. Together, with a neutral pelvic alignment and a lateral thoracic (wide and full) breathe, they create the correct intra-abdominal pressure to assist with spinal stability.


Putting It Into Practice

When you are participating in Synchronized Swimming or any other activity, initiate all movement by using this simple system:

  1. Set the bones: neutral pelvis  
  2. Engage the muscles: core  
  3. Breathe: wide and full

Once you have initiated this set up, you are ready to add the more superficial muscles that will move your body into action.

The muscles of the core only need a mild contraction to become activated and function effectively; much like a light switch, they are either on or off.  Once they are on you can confidently use the large muscles for the action phase of a movement, so long as you have first stabilized the spine to reduce the effects of the activity's stress on the spine.

For more information on neutral spine and core activation, you can participate in a pilates class or watch videos on YouTube:

www.youtube.com/watch?v=oj_yEiphKYk

www.youtube.com/watch?v=dllkpoz2EcE

www.youtube.com/watch?v=2bZXYSh8eAc

www.youtube.com/watch?v=ZGlPKbfEpBA