Share:
Hollow Cross - causes, therapy and exercises
However, the most common cause is a muscular imbalance characterized by lack of exercise and malaise, e.g. arises as a result of constant standing or sitting. Accordingly, a hollow back can often already be treated well by physical activity, individually coordinated exercises and appropriate precautions (ergonomic workplace, etc.). However, since the success is largely dependent on how quickly these measures take place, should any suspected cases, an orthopedist should be consulted as soon as possible.
contents
- definition
- Pain due to a hollow back
- Hollow back causes
- Hyperlordosis due to stress
- Cause swirling
- therapy
- Correct sitting against hollow cross
- Hollow Cross Exercise by Back School
- Treatment with vertebral gliding
definition
A hollow cross (medical: "hyperlordosis") is a malposition characterized in which the lumbar spine is curved excessively forward, while the spine in the normal case from a lateral perspective has the shape of a long drawn "S". Due to the associated displacement of the pelvis, the abdomen bulges forward, at the same time the chest is shifted behind the body axis to allow a stable posture and not tip over to the front. The musculature of the abdomen also ensures that it is not possible to fall backwards. Persons who are affected by a hollow back often have an effect on outsiders, as if they had a very heavy belly, similar to a pregnancy.
In a hollow cross, the lumbar spine is curved excessively forward. (Image: crazypixels20 / fotolia.com) Pain due to a hollow back
In many cases, a hollow cross at the beginning prepares hardly any discomfort apart from occasional tension. Over time, however, the weakened muscles in the abdomen and / or back often cause ever-increasing back pain and back pain, and there is an increasing restriction of movement due to the shortened ligaments and tendons.
Since hyperlordosis causes an uneven load on the vertebrae, inter alia the intervertebral discs become more worn than usual, increasing the risk of a herniated disc, but also of vertebral damage. In addition, a hollow back can also have a narrowing of the spinal canal (spinal stenosis) result, whereby the back pain can radiate unilaterally in the legs (Lumboischialgie). Muscle tension in the lower back area is possible in this case, emotional disturbances and abnormal sensations in the legs (burning, ants tingling etc.).
Very rarely, problems with the bladder, rectum, and / or genitalia can occur if the affected nerves are affected, which can lead to urinary disturbances such as irritable bladder or incontinence, as well as impotence.
Hollow back causes
For a hollow cross different causes come into consideration, which is not usually innate, but by permanent malpositions arises (acquired hyperlordosis). In many cases, there is a muscular imbalance that is often due to long, unergonomic sitting. The reason for this is that it rapidly relaxes the abdominal muscles, which, however, are necessary for the stabilization of the spinal column in addition to the dorsal and gluteal muscles in the area of the lower back.
In addition, there is often a general lack of exercise in people with severe hyperlordosis, through which the muscles in these areas is generally weaker. As a result, the curvature of the spine forward of the musculoskeletal system can not be compensated accordingly, causing a permanent malposition threatens.
A shortening of the so-called "hip flexor" (especially due to prolonged sitting) with simultaneously only weak extensor muscles can lead to an increased curvature of the lumbar spine to the front. As a result, the ligaments and tendons shorten and there is an ever-increasing immobility of the lower back, which in turn can end up in a hollow cross.
Constant walking on high heels increases the risk of a hollow back. (Image: Kaspars Grinvalds / fotolia.com) Other possible causes are e.g. Frequently carrying heavy loads or improperly exercising muscles. Obesity in the area of the abdomen is a risk factor because it causes the pelvis to be pulled forward more. Constant walking or long standing on high heels may favor a hollow back. The reason for this is that it pushes the body's center of gravity and pushes the pelvis forward, thereby increasing the load on the lumbar spine. As the pressure on the ball of the foot increases due to the weight of the body, muscles and tendons are more heavily stressed.
In addition to the hollow back-typical low back pain, it can lead to severe foot pain and toe deformities such as the so-called hammer or ball toes. In addition, there is a greatly increased risk of kinking, because the constant balance of the ankle joints are constantly in motion. The result may be various injuries such as sprains or torn ligaments with severe ankle pain, swelling and bruising. It is also possible a broken fibula (fibula fracture), which is an extremely painful fracture, which sometimes takes many weeks to heal.
Hyperlordosis due to stress
Stress comes as a possible cause of hyperlordosis into consideration, as this affects the posture and can therefore lead to muscular changes to a hollow back.
Rarely, the reason lies in a malposition or blockage of the first cervical vertebra (atlas), which can arise, for example, as a result of an accident, but also by permanent stress, teeth grinding (bruxism) or jaw malpositions.
Symptoms such as headache, cardiac pain without obvious cause, dizziness or tinnitus are typical for Atlas misdocking or blockage, furthermore cervical spine movement restrictions (cervical spine syndrome), palpitations or nausea may occur.
Another rare cause of a hollow back is the so-called "idiopathic toe-tiptoe" (also called "persistent forefoot" or "Pomarino's disease"), a gait disorder in which the person is either situational or permanently on the forefoot.
If there is a vertebral gliding, this can mean massive back pain. (Image: absolutimages / fotolia.com) Cause swirling
Another possible cause is the so-called spondylolisthesis (spondylolisthesis), which is an instability of the spinal column through which the vertebral bodies "slip" against each other in the area of the lower lumbar spine. As a result, back pain or low back pain often occurs during exercise. In addition, the displacement of the vertebra can also lead to nerve entrapment and correspondingly to sciatic pain or flank pain.
If the nerve roots are involved, it is possible that the pain radiates down to the legs, it can cause feelings of distress or even paralysis. In many cases, however, the spondylolisthesis remains symptom-free, so that the diagnosis is usually a mere incidental finding.
The instability of the spine can have different causes. The "true" spondylolisthesis is a congenital one or two-sided interruption of the vertebral body arch, causing the vertebral body and vertebral joint are no longer firmly connected. In many cases, this form is initially without discomfort and is discovered only by adolescents by accident, especially in children, it can also be due to growth or due to strong use of the spine (especially by competitive sports) to a pronounced spondylolisthesis with severe discomfort.
More common than congenital malformations are age-related changes of the intervertebral discs and the wear of the vertebral bodies the reason for a spondylolisthesis. Accordingly, older people are particularly affected here, with insufficiently trained core muscles or general lack of exercise being regarded as a further risk factor.
The swirling may also be due to external circumstances. Among other things, an overuse of the spine during growth, which in many cases results from constant strong hyperextension movements in competitive sports (for example, ballet, athletics, throwing sports) is possible. Likewise injury, inflammation, bone diseases or operations on the spinal column are considered as cause.
therapy
The treatment is based on the particular cause and the stage or the associated complaints. Accordingly, in any case should suspect a hollow cross first a doctor or orthopedist to be visited, instead of taking measures alone. Only in this way can further damage or worsening of the situation be avoided and individually coordinated, effective treatment steps initiated.
Timely action is important, because the sooner the hyperlordosis is detected and treated, the greater the chances that typical symptoms such as back pain and restricted mobility will not even occur or can be significantly alleviated.
Improved posture and sufficient exercise often lead to a significant improvement of the symptoms at the beginning of the malposition because the cause is often a muscular imbalance caused by a lack of exercise and a wrong posture. In this context, care should be taken to ensure proper sitting, as in this position, the abdominal muscles quickly go limp and the back is often not kept straight.
If the malpractice is detected early, the complaints can often be significantly alleviated by improved posture and regular exercise. (Image: endostock / fotolia.com) Correct sitting against hollow cross
Experts often recommend "dynamic sitting," in which the patient ideally keeps the upper body straight and alternates between a front, middle (upright) and a back (reclined) posture. In this way, for example, the muscles and the intervertebral discs can be loaded and unloaded in a natural way, as well as avoidance of stress and strain.
A good support is provided by a suitable work chair, which should have, inter alia, an adjustable or "dynamic backrest" and a synchronous mechanism, by means of which the inclination of the seat can be adapted to the inclination of the backrest. Seatballs or movable stools are also very well suited, as they can help to keep the back mobile for longer periods of sitting. Basically, sufferers should try as often as possible to compensate for hours of rigid sitting in the workplace by standing or walking.
Also risky are activities that require prolonged standing, because even then there is a risk to quickly take a hollows attitude. Therefore, as often as possible, the standing position should be changed, for example, by shifting the load alternately to the right and left leg, pushing the chest forward and back, or stretching the neck by pulling in the chin.
When standing, it is advisable to abstain from wearing shoes with high heels. The reason for this is that on high heels, the center of gravity shifts, causing the pelvis to push forward and the lumbar spine is loaded by the resulting hollow cross. High heels are generally not suitable for longer walking distances, because the permanent "downhill running" also unfavorably shifts the center of gravity and strengthens the hollow back. Here it can be e.g. be a sensible alternative to go to work in flat, comfortable shoes and to swap these there when needed for a short time through high shoes. In general, however, the feet should be relieved in between times by foot exercises or walking barefoot.
If you often have to wear pumps on the job, you should change them as often as possible with flat shoes. (Image: sebra / fotolia.com) Hollow Cross Exercise by Back School
Further treatment should always be carried out under professional guidance in order not to risk any worsening of complaints or damage to health. Concerned people in a so-called back school, which is a special concept for the prevention and treatment of back pain, which is e.g. by health insurance companies, fitness studios, physiotherapists or in the context of company sports groups.
Here, sufferers can learn, among other things exercises for body awareness and strengthening of the abdominal and back muscles and strategies for managing pain. In addition, there is the opportunity to get to know relaxation techniques, which often show as a beneficial and effective supplement to the therapy by the close linkage of stress and tension. Depending on your personal preferences and suitability, there are various exercises and procedures for stress relief, such as yoga, autogenic training, breathing techniques or meditation.
If the hollow cross has already caused complications such as If a herniated disc develops, these must be treated best by the appropriate specialist. If it is caused by another condition such as Pomarino's disease or a malposition of the first cervical vertebra, it is important to recognize it as early as possible and treat it accordingly.
Treatment with vertebral gliding
If a spondylolisthesis is present, the doctor will decide, for example, depending on age, symptoms, personal suffering and the degree of severity according to Meyerding (MD), which treatment makes the most sense in individual cases. If, for example, In the case of a child or adolescent, a slight spondylolisthesis (Meyerding 1-2) without discomfort, no therapy is usually necessary. Instead, the spine can be relieved by preventative physiotherapy, in which exercises to stabilize the abdomen and back are guided.
The learned techniques should then continue to be applied at home, also there are competitive sports such. To avoid ballet, gymnastics or rowing so as not to overload the spine excessively. If a more severe form of vertebral gliding or conservative therapies (especially physiotherapy) are not successful, an operation may be necessary in which an attempt is made to reconstruct the slight "S-shape" of the spine.
In some cases, corset immobilization can relieve discomfort, and nerve root involvement often involves anti-inflammatory drugs. (nr, updated on 1.11.2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)