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Writer's pictureDr. Nicolas Torres

What does your lower back have to do with your ribcage position?

If you know me, you know I’m a sucker for a good ribcage position. The ribcage is the center point of your mass. If this structure is not properly positioned over the pelvis. It can be bad news for your lower back.


Many patients come into my office and believe they must stretch their lower back and work on their “glutes” to cure their low back pain. What is not spoken of often enough is the necessity of ribcage alignment exercises for those with lower back pain.


Let’s discuss the different positions of the ribcage that can be compromising for the lumbar spine. One of the major faulty positions is a “flared” ribcage. A flared ribcage is one that is stuck in a position of spinal extension, so you can imagine how much of a direct influence it has on the extensor muscles of the lower back.


It’s all based off of gravity. Imagine gravitational forces pushing straight downward on your body, at all times. So if we are upright (sitting or standing), we need to have a ribcage stacked vertically over the pelvis, so that the legs into the mid-foot absorbs the force of gravity. However just imagine if the ribcage is not properly stacked. Let’s say it’s in this spinal extension position. That would mean once gravity pushes down on us, it will be the lower back that will be “forced” to absorb the force of gravity. Now imagine sitting or standing for a couple hours with the lower back doing this. You can see now how your lower back can become to feel “exhausted” very quickly, from a sitting or standing perspective. We need to stack the ribcage over the pelvis, so that our lower back muscles are able to relax.


So back to that patient that walks into my office and tells me they need to work on their pelvis, hip, lumbar spine position to help improve their lower back symptoms. You can see now why I actually start my initial assessment with the ribcage. If the ribcage is tilted backwards (extension-biased), it doesn’t matter what I do at the pelvis, hip or lumbar spine area. Those areas will continue to be biased to more extension, to support the ribcage faulty position.


So what do I do with my patients who are in this boat? I have them learn how to breathe, specifically I teach them how to fully exhale. Because the ribcage is basically stuck in a position of relative inhalation, we need to learn how to fully exhale to change the orientation of the ribcage structure. This means using a balloon, a straw or understanding how to create a deep strong and long exhale, naturally. This is by far more important than showing that same person some basic hip and lower back stretches. It all comes down to the driver of dysfunctions. And many times, it is the ribcage that is driving the lumbar spine dysfunctions I see on a regular basis.

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