PDA

View Full Version : Summary of responses to the question 'Is there really such athing as an "Excessive Lordosis"?'



dmcfarlane
10-31-2007, 02:45 PM
Dear Colleagues,

Here is a summary of the responses to my question on excessive
lordosis.

James Wickham (of Latrobe University, Melbourne) commented that merely
from the name lumbar lordosis sounds like a bad thing as "osis" implies
a pathology (as in kyphosis and scoliosis). He suggested that maybe
"hyperlordosis" would be a better term when denoting a problem
condition.

David Smith (a Podiatrist) suggested that a lumbar lordosis should only
be termed excessive if it causes internal stresses that are excessive
and hence pathological (and not merely when the change in position lies
outside the usual range). He mentioned a literature review of this topic
("The Effects of Posture on the Lumbar Spine" by A. Adams and W. C.
Hutton, an Editorial in the British Society of Bone and Joint Surgery,
1985).

Beverly Burke (of Reed College, Portland) commented that an excessive
lordosis would effect lower extremity health because the quads work less
with increased lordosis. She mentioned that she has seen a photo of
"Swayback" that suggests that such a posture would affect the spinal
loading on the L4 and L5 vertebrae. However, she noted that the idea of
casting someone to change the posture seems extreme and was probably a
bias of that era.

Kenneth Learman (of Youngstown State University) said that from a
practical clinical perspective, too much lordosis overloads the
posterior structures and may contribute to spondylolysis and
spondylolisthesis. He provided two references in the literature that
support the contention that these conditions can be associated with LBP;

* Iwamoto J, Abe H, Tsukimura Y, Wakano K, "Relationship between
radiographic abnormalities of lumbar spine and incidence of low back
pain in high school and college football players", Am J Sports Med,
2004; 32:781-786.

* Iwamoto J, Abe H, Tsukimura Y, Wakano K, "Relationship between
radiographic abnormalities of lumbar spine and incidence of low back
pain in high school rugby players: A prospective study", Scandinavian
Journal of Medicine and Science in Sports, 2005;15:163-168.

He said that McKenzie has described an anterior disk derangement from
excessive lordosis and said that he had personally treated a few of them
in the last 20 years. He said that it seems that "too much lordosis
places the facet in a closed packed position for too long reducing the
IV disks capacity to absorb energy which may create too much shock
through the segment" so that while lordosis in general is a good thing,
it is also possible to have too much of a good thing. He also mentioned
that Gymnastics and sports that require full spinal extension in a
loaded position have been linked to back pain (Hardcastle, Journal of
bone and joint surgery, 1992; 74B (3) 421).

In summary it appears that in some situations an extreme lumbar lordosis
can indeed be excessive (in the sense that it can be a risk factor for
certain activities).


Regards,

David McFarlane MAppSc (Ergonomics)
Ergonomist, WorkCover NSW

Disclaimer

Any recommendation concerning the use or representation of a particular
brand of product in this document or any mention of them whatsoever
(whether this appears in the text, illustrations, photographs or in any
other form) is not to be taken to imply that WorkCover NSW approves or
endorses the product or the brand.

************************************************** ************************************************** ************************************

This message, including any attached files, is intended solely for the addressee named and may contain confidential
information. If you are not the intended recipient, please delete it and notify the sender. Any views expressed in this
message are those of the individual sender and are not necessarily the views of WorkCover NSW. Please consider the environment
before printing this E-mail.

************************************************** ************************************************** ************************************