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Ask the PT: Chronic L5-S1 Disc Problem

Back Pain in the Bronx and Yonkers


I have a chronic L5-S1 disc problem. I’m convinced it is a result of poor posture and compensation. I have forward head posture and very tight shoulder internal rotators. My body has learned to compensate by extending my lower thoracic spine. As a result I have a short pronounced kyphotic curve in my upper thoracic area. I feel like this is having a negative impact on my circulatory and lymphatic system to and from my head. It also seems to be effecting my swallowing. Have you come across any patients with this posture before, and how did you try and correct it? I live near your Yonkers location and wanted to see how physical therapy at your facility can help me.


Thank you for your great question, Tim!

Your question is a great example of how our bodies function as a whole, even though we often identify problems as a specific body part. Correct posture is the result of many components all working in harmony. Years of poor posture will often result in the manifestation of pain due to stress and degenerative changes to our body. For a proper assessment of an individual’s posture, a physical therapist will compare anatomical landmarks with respect to each other.

You may find that you are describing the “Swayback posture” which is commonly addressed by physical therapists. Additionally, you have identified the forward head posture which is very common, and can often lead to problems throughout the jaw, neck, spine and back. Correction of this issue is done through a combination of stretches, strengthening exercises, neuromuscular re-education and postural awareness education.

During treatment these interventions will be progressed as the therapist sees improvement by the patient. However, a few simple exercises to start doing daily are chin tucks, scapular retractions/depressions, and rows either with a theraband or other equipment. These exercises are designed to increase the strength and endurance of muscles located on the posterior (or backside) of the body. Chin tucks are also effective for stretching out the tight muscles on the front side of the neck. All exercises can be completed to tolerance for 3 sets of 10 repetitions. In order to correct the tight shoulder muscles a simple doorway pectoral stretch is effective, and often necessary for anyone with a forward head posture. Thoracic kyphosis often presents with decreased joint mobility within the spine. A foam roller is a useful tool for improving the joint mobility and to improve posture. Rolling the thoracic spine on a foam roller is a safe technique when done to a patient’s tolerance. Finally, the extension in your low back could also result in decreased joint mobility, which will put additional stress on your spine.

A physical assessment at our Yonkers, New York location or either of our Bronx, New York locations of your low back is important for us to provide an exercise prescription as lower back pain can be unique person to person. Mobility exercises for the low back completed within a pain-free range will start to develop increased joint motion and assist to correct your posture. An example of a low back mobility exercises to complete are the “cat/camel” positions which are completed on your hands and knees. I recommend a basic Google or Youtube search for the above exercises if you are unable to visit our Westchester facility or another medical professional. As always, exercises should only be completed when they are not painful.

Thank you,

Daniel Seidler, PT

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