Sports and Orthopedic Leaders : Physical Therapy and Rehabilitation

Neutral Spine Position

by Jamie Faison, ATC

What is Neutral Spine?

Neutral Spine is the normal position of your spine that occurs when the appropriate muscles are allowing it to maintain its natural curves. Your spine has certain arches built into it to provide stability and shock absorption. When you sit, stand or exercise, you should be mindful of your neutral spine position and use your muscles to keep these arches in your back.

When talking about your Lower Back (lumbar spine), neutral spine position is a slight forward arch of your spine. When you place your hand on your lower back, you should feel a slight forward curve in your spine. This is what we call “Lumbar neutral.” In this position all of your vertebrae are aligned and stacked perfectly on top of each other. In lumbar neutral position, your spine and discs work together to shock absorb and cushion your spine. When out of this position, the shock absorption and stability is decreased.

How do I find Neutral Spine?

Neutral Spine position (lumbar neutral) is a safe position for your spine and it is different for every person. Neutral Spine position can also be described as a mid point between the two extreme positions: Arched and Flexed. Arched position means that your spine has too much forward curve to it and your abdominals aren’t stabilizing your spine enough. Flexed position means that your back is flat, and that it has lost its curve. This position puts extra stress on your discs and could be a result of weak lumbar musculature.

Arched ---------- NEUTRAL ---------- Flexed

To find Neutral Spine you may need to find these two extremes first. Lying on your back or sitting in a chair, arch your low back forward (sticking your belly out). We call this an Arched position. Remember this Arched position. Next flatten out your back by rolling your pelvis back (tucking your tailbone under) and flexing your spine. We call this position a Flexed position (or Flat position). Remember this position. Now, remembering how both Arched and Flexed positions felt, try to find a mid point between the two. In this position you should have a slight forward arch in your lumber spine, and the position should be completely pain-free and comfortable. This is your Neutral Spine. It is not an Arched or Flexed position; Neutral Spine is the position right in between the two extremes.

What exercises are good to increase Neutral Spine Stability?

Now that you have found Neutral Spine position, you must strengthen your body to stabilize your spine in this position. To keep your spine in Neutral Spine position, your body uses your CORE muscles. These muscles are your abdominals, obliques, and lower back muscles that wrap around your trunk. Your CORE muscles create a “corset” that circles all the way around your body, and these muscles are responsible for providing stability and movement to your vertebrae. It is crucial to train these muscles to provide stability to your spine and hold your low back in Neutral Spine position.

Exercise #1: Neutral Spine Abdominal Tightening

Lying on your back with your knees bent, find neutral spine. This should be a pain free position and you should have a slight forward curve of your spine with a small amount of room in between your low back and the ground. Place your hands on the front of your hips and find your pelvis bones with the tips of your fingers. Roll your fingers in from your pelvic bones and gently press. The muscle directly under your fingers is your ‘Transverse Abdominal’ muscle. Keeping your low back in ‘Neutral Spine,’ tighten the muscle underneath your fingers using a ‘bracing’ or ‘stabilizing’ contraction. It helps to engage your pelvic floor muscles when stabilizing by trying to ‘block the flow of urine.’ You should feel the muscles underneath your fingers tighten. AT NO TIME SHOULD YOUR LOW BACK GO OUT OF NEUTRAL WHEN YOUR ARE DOING THIS EXERCISE!