Updated: Oct 18, 2020
Neutral spine is a term that is thrown around in the fitness industry, but sadly very few fitness professionals will actually be able to tell you what it means, let alone what it is.
Now let me start by telling you what it is NOT!
It is NOT:
Pushing your lower back into the ground.
Somewhere your body “should be”
A magic place where only good things happen.
The spine has natural curves that develop as we start to crawl and then walk. Up until this time our spines are relatively flat and of course have come from being in full flexion (fetal position).
As we develop to crawling, the spine begins to lengthen out and then as we progress to standing and walking the natural curves of the spine develop in order to load bear effectively.
We would expect to see a convex anterior curve in the lumbar and cervical spine and a convex posterior curve in the thoracic spine and sacrum.
In some cases these curves are exaggerated and more pronounced than this “ideal.”
But thats a whole other article 😂
There is so much to cover on the spine, we could chat for years! However for the purpose of this article we are only looking at the curves that occur in the sagittal plane. Or put another way looking from someone side on or laterally.
A neutral spine can be defined as the pubis symphysis and ASIS (Anterior Superior Iliac Spine) lie in the same plane. This can be in any position, standing, sitting, 4 point kneeling, etc. It’s important to remember that neutral will look different on everyone. We have an “ideal” as a template to work from not towards! Think of it as a bench mark or point of comparison.
Now this does come with a caveat, in some instances people with well developed glutes or a lordosis (increased curve of the lumbar spine), the pelvis will appear to be anteriorly tilted. Meaning that when the client is lying supine, with knees bent and feet flat on the floor, the ASIS appears higher than the pubis.
Therefore we have to look at a second variable when assessing a lumbo-pelvic region.
Is the lumbar spine relaxed?
Are the para spinal muscles in a relaxed state?
If the answer is yes, then chances are this is the client's neutral.
Think about it, if you only assess the pelvis from the anterior aspect and find that there is an anterior tilt, yet the para-spinal muscles were relaxed. You would then try to force the client into a spinal position that isn’t optimal nor comfortable for them by flattening out the natural (and necessary) curve in the lumbar spine.
So make sure you are assessing the lumbo-pelvic region, both anteriorly and posteriorly.
We would choose to exercise in a neutral spine whenever possible because its more functional and shock absorbing position for the body to be in There are, however, a handful of times I would choose to work a client or patient in an imprinted position. These may include:
Underlying pathology or injury
Decreased abdominal strength
Postural abnormalities or lack of awareness
In an open or modified open kinetic chain.
Again we could talk about each of these points all day, so Im not going to go into them now.
Educating clients that a) their pelvis can, does and should mobilize and b) how to find their neutral in a variety of positions is vital.
When explaining this to clients keep it simple and ensure the client understands what is going on in the body.