Is Neutral Spine safe for people with Herniated discs?

by Kimball

A trainer mentioned to me that neutral spine was bad for patients with herniated discs.

He said that the position of the pelvis in neutral spine is a bad position for these patients because they often have tight hips and hamstrings.

Is this true?

If so/not, then what anatomically makes neutral spine/pelvis good or bad for herniated disc patients?



Jennifer's Response:

You have a very good question. Patients with herniated discs are more comfortable with a flexed spine or slightly tilted pelvis when they are exercising, however, if you were to walk around with the pelvis tilted all the time you would start to develop other problems. Possibly sciatic pain, which I see in many of my own clients who developed this posture to protect themselves from their back pain by tilting the pelvis.

This overly tightens the gluteal muscles possibly pinching the sciatic nerve deep in the buttocks.

If you strengthen your abdominal muscles in
neutral spine
(this is just strengthening the already natural curvature of the spine) then you will protect and prevent yourself from developing different back injuries.

There are definitely times when you are exercising that you want to flex the spine or flatten the back as you are lying and doing abdominal exercises like many of the Pilates Classic Mat exercises such as the Hundred, Single and Double leg stretches.

For general everyday movement and strength training I would suggest keeping neutral spine with just a very slight pelvic tilt.
When I talk about tilting the pelvis it is just a very subtle tilt from neutral, which means you pull the tailbone down just enough to engage the abdominals and bring the pubic bone level with the hip bones.

While weight training make sure to use an appropriate amount of weight that doesn't compromise your back. It will help you strengthen the abdominal musceles, and, in turn won't compromise your spine position and herniation as much.

Check out some of these pages to help with back pain:

Exercise to Strengthen Lower Back

Exercise for Back Pain

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