This is the second post in the series related to anterior core function. The first one addressed what one might see in a static posture assessment as it relates to the pelvis and rib cage. As mentioned, most, if not all, of my clients that I have assessed have functionally been positioned with an anterior pelvic tilt, thus leaving their posterior extensor chain turned “on”. This predisposes the rib cage to also be in extension with the inferior aspect of the ribs being in a flared position.

As well, I challenged the idea about prescribing and using the Superman exercise as this would further exacerbate extension of the lower thoracic/lumbar musculature and structures and further facilitate the anterior pelvic tilt. I would rather see a Modified or All 4s Belly Lift instead to facilitate the internal obliques (IO), which depresses the rib cage and transverse abdominus (TA), which posteriorly tilts the pelvis (TA).

This post will also address another cue and exercise to help bring an individual out of the extended position and help position both pelvic and rib cage in a neutral position. I recently had a volleyball team in for a session and I had them all lie down on their backs with their knees bent and feet on the floor, and overwhelmingly I could see the inferior aspects of their rib cages flaring up through their shirts. The first thing they needed to understand was how to correct this posture, and for that I love using a full exhale.

Over the course of a 10 or 15 second count, have the clients fully blow all the air out of the lungs and to keep pushing it out beyond. It will become uncomfortable as at some point the brain will start to say, “Hey, you need to breathe in.” As the client fully exhales and pushes all their air out, you should see their ribs begin to drop towards the floor, and they should feel their lower backs come in contact with the ground. By the end, they should feel their entire anterior core engaging to force all their air out. It is important for people who are stuck in extension to feel this finished position so that they know how to get back into it.

But what about when they breathe back in? My bet is that if they are in extreme extension, or at least have been hanging out there for some time, their first breath back in will see them elevate their ribs and take a deep breath right into their chest. They have just put themselves back into extension and lost neutrality. After they have learned to fully exhale, they need to learn to inhale into their belly without having their ribs slip into extension. Encourage them to breathe in through their nose into their belly: I like to have my clients put their hands on their belly and to have them lift their hands through their belly first before lifting their rib cage.

Understanding how to exhale and drop their ribs is the first step in proper set up for every exercise thereafter. If they are stuck in hyperextension, then their ribs and pelvis will be in a sub optimal position for movement above the ribs, ie shoulder, and below the pelvis, ie hips. By getting your client to exhale and drop their ribs before they lift, press, pull, push, squat: whatever; they will allow their rib cage to be in a more neutral position, which in turn will lead to better shoulder function, and as well, allow the anterior core to stay engaged and stabilize the lumbar spine.

That’s really what the exhale is about: getting out of the thoraco-lumbar extensors from doing all the stability, and moving towards a balance of thoraco-lumbar extensors anterior core sharing the load of stability. I love Stu McGill’s analogy of a hoop stress around the entire lumbar region, with equal pressure being applied across the entire hoop. Rather than complicating cues and confusing your clients, remind them to exhale…exhale…exhale, and hold their ribs down with their anterior core.

As always, I’m interested to hear your thoughts and responses, so please, leave us a comment and keep the discussion going.