Definition hollow back

A bad posture of the Lumbar spine designated.

The Spine naturally runs in four curves. It is mainly stabilized by the Move- and Abdominal muscles, as well as in the area of ​​the lower spine through the Glutes.

A hollow back is caused by a muscular imbalance between these different muscle groups. The lumbar spine arches excessively in the direction of the abdomen and the pelvis tilts forward.

This can lead to lower back pain and serious secondary diseases such as a herniated disc in the lumbar spine.

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Read more on the topic: pain in the back

With sufficient exercise, a healthy posture and the strengthening of special muscle groups, a hollow back can be prevented and treated well if the back is already formed.

Appointment with a back specialist?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Further information about myself can be found at Dr. Nicolas Gumpert


The cause of the hollow back can be, among other things, a muscular imbalance.

A hollow back can be congenital or, more often, acquired. Most cases arise because of one muscular imbalance.
The Spine is not, as the name suggests, a straight column, but naturally runs in four vaults. She is through the Move- and Abdominal muscles stabilized. In the area of ​​the lower back is also the Glutes involved in the stabilization of the spine. In general, when performing movements, muscles or muscle groups working in opposite directions must always work together. It is therefore important that these muscles or muscle groups should always be trained as well as otherwise an imbalance can arise. Too strong one Hip flexors If the hip extensor muscles are weakly trained at the same time, for example, this can lead to a permanently stronger bulging of the lower spine. This can lead to a shortening of ligaments and tendons, which is associated with an increasing immobility of the lower back and can ultimately lead to the formation of a hollow back.
Also a weak one overall Move-, Belly- and Glutes negatively affect the formation of a hollow back. These muscular changes are mainly caused by a lack of exercise, especially by long and / or unergonomic sitting, as well as by a wrong posture.
Heavy physical work or carrying heavy loads, obesity and incorrect muscle training can also contribute to the development of a hollow back.
By influencing posture, stress also seems to favor the development of the muscular changes that promote hollow back.
Obesity, especially in the abdominal area, also has a reinforcing effect, as the abdomen pulls the pelvis further forward.
Other rare causes of a hollow back can be a misalignment of the uppermost vertebral body (Atlas) or a Pomarino's disease, a gait disorder in which the person concerned only appears on tiptoe or ball of the foot.
Also Vortex sliding (Spondylolisthesis) can stand out through a hollow back. It is important to recognize whether one of these rarer hollow back causes is present, as only then can the cause be treated accordingly.

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Therapy of the hollow back

The therapy of a hollow back depends on the cause.
The most common cause is a muscular imbalancewhich occurs as a result of lack of exercise and incorrect posture.
At the beginning of the hollow back you can sufficient exercise and the correct posture already lead to a sufficient improvement. The correct sitting posture is particularly important, the so-called "dynamic sitting". This means that the upper body is kept straight and is often switched between a leaning forward, an upright and a leaning back sitting position.

Please also read our topic: Exercises for strengthening and improving posture at the desk

This stimulates the blood circulation, reduces muscle fatigue and the Band washers relieved. Can be helpful too special ergonomic seating furniture be. In general, attention should always be paid to sitting regularly Stand and Go to interrupt. Due to the close connection between stress and tense muscles Learning relaxation techniques can also help improve.

You might also be interested in this topic: Exercise examples for loosening up and relaxing while sitting at the desk

As soon as the hollow back is recognized, it is important to counteract it. The faster a therapy is given, the higher the chances that no symptoms will occur or that the symptoms will improve and there will be no development of secondary diseases. Further therapy of a hollow back should be carried out under professional guidance so as not to aggravate it through incorrect execution of exercises.

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In special Back school courses, for example from Physiotherapists, Fitness studios or health insurance companies are offered, the person concerned learns exercises for Strengthening and stretching the muscles. These should also be done at home on a regular basis.
It is important that short, frequent, ideally daily, units are better than rare, but long exercise units, 5-10 minutes per day are already sufficient. This regular training can significantly improve the symptoms and thus lead to an increased quality of life for those affected.
Since the hollow back arises as a result of a muscular imbalance, it is also important to note that the Muscles not loaded on one side becomes. This means that when doing the exercises at home, you should always make sure to train the various muscle groups and not just the back muscles, for example. Certain sports, such as tennis or squash, tend to train the muscles on one side, so that you move around, which is always helpful, but for the sake of your back, additional balancing training is recommended.

Can you train a hollow back away?

Basically, a hollow back can be healed through certain exercises or other orthopedic therapeutic measures.
The appropriate therapy plan depends on the severity of the hollow back and the age of the patient and should be drawn up in advance by an orthopedic surgeon.
That's enough in the early stages often off, to move more, to consciously pay attention to a healthy posture when sitting and to stretch the shortened muscles again through stretching exercises. To do this, other muscle groups that counteract the formation of the hollow back should be strengthened. These muscles belong the lower abs, glutes, and hamstrings.
However, in order to learn correctly performed stretching exercises Appointments with a physiotherapist or a back school perceived, as the symptoms can be exacerbated by incorrect exercise / incorrect execution of the correct exercises.
In more severe cases (such as the hollow back as a sign of a chronic Vortex sliding) surgery or an orthopedic corset can be used to restore the original S-shape of the spine.

You might also be interested in the following topic: Strengthening the back muscles

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Exercises against a hollow back

Simple, straightforward Hyperlordosis can basically be corrected through exercises and training. It is important to know that you are not training the hollow back or the spine per se, but always neglected muscles and, through this training, the posture changed. This change in posture leads to the disappearance of the hollow back.

To correct a hollow back, a extensive training of abdominal and back muscles just as indispensable as straining the gluteal muscles. Above all, they are decisive lower abdominal muscles.

  • Reverse Chrunches: With the upper body fixed, the legs are led upwards and back again at a 90 degree angle from the floor.
    How a Reverse Chrunch works can be found on our page: Reverse crunch
  • The scissors: To do this, lie on your back and cross your legs alternately. The purely static holding of the stretched legs just above the floor from the supine position also puts maximum strain on the lower abdominal muscles.
  • The most recommended exercise, however, is that simple forearm support, the plank: When done correctly, this exercise works the entire core and improves overall body tension.

Also the move one should strengthen with some exercises. For this, it is advisable, for example, in the prone position Upper body and arms take off as if you were "flying".

But also while standing, lowering the straight back towards the floor and holding this position using only the strength of the lower back challenges the back of the body.
Trained people know this exercise in combination with additional weights as "Dead Lift" respectively "Deadlift". In the beginning, all exercises should always be done without additional ones or with little weight are executed.
The number of repetitions can also be a little lower, especially at the beginning. It is important that the body of the person concerned learns the new movement sequences safely and correctly executes them. The perfect technology is crucial!

In addition, it is recommended that the Hip flexors (M. iliopsoas) to stretch thoroughly. Often it is due to Tension or shortening the cause of pain in the back. People who sit at their desks all day often neglect these muscles and risk wasting them.

To correct a hollow back, a individual training plan be created by an experienced trainer or physical therapist. The latter should also take the time to guide all exercises and the Correct the exerciser.
Despite optimal guidance, one cannot of course expect a hollow back that may have existed for years to disappear immediately and permanently within one training hour. Correcting a hollow back with the help of targeted exercises is a long process, of great patience and regular exercise requires.

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You can find many more exercises against the hollow back on our partner site: MedOn - exercises against a hollow back


In certain, very special cases, there is also one surgical correction of a hollow back possible and advisable. These are primarily Posture errorsthat on other, pre-existing Diseases of the spine are due.
For example, surgery can be performed on patients with very pronounced scoliosis or less frequent changes in the context of a ankylosing spondylitis be useful.
Affected patients usually know about their illness and are already receiving medical treatment.

There are also some surgical techniques in use for extreme forms of "normal" hyperlordosis, although they all have one thing in common rarely used and cannot have absolute success rates. Unfortunately, only a few patients benefit from these procedures.

For patients with an uncomplicated hollow back who are otherwise healthy, surgical correction of the hollow back is not a solution.

Arched back and lower back pain

The tension that accompanies a poor posture of the spine often leads to lower back pain in those affected.
These tensions develop due to excessive or improper strain on the trunk and pelvic muscles and tend to increase as the disease progresses.
Here you can Pain relievers like Voltaren or ibuprofen Provide relief.
That being said, the hollow back also increases that Risk of herniated discs and spinal canal stenosis.
In the case of a herniated disc, one or more of the cartilage discs, which are located between the vertebral bodies, “fall” forward and lead to them painful nerve entrapment with radiation to the legs. In spinal canal stenosis, nerves are constricted by the narrowing of the spinal canal (often caused by sclerosis), which leads to unilateral pain radiating to the legs can lead.

You might also be interested in this topic: Lower back pain

Diagnosis of a hollow back

The diagnosis of a hollow back can usually already be made by the so-called inspection, the viewing of the undressed patient as part of a physical examination.

The typical posture of the person concerned, the tilted pools and the Curvature of the spine towards the abdomen, are mostly unique.

In order to assess the extent of the hollow back and to assess any consequential damage that has already occurred more precisely, you can do another X-ray examination respectively.

Since the treatment can differ depending on the cause, a detailed orthopedic examination is carried out with the aim of identifying the cause of the hollow back.

In addition to the muscular imbalance, a misalignment of the uppermost vertebral body (Atlas), a Pomarino's disease (Forefoot gait / equinus foot gait in children) and Vortex sliding (Spondylolisthesis) cause a hollow back.

How can you recognize a hollow back yourself?

A quick look is enough to get an overview of his back: You stand sideways in front of a sufficiently large mirror and look at your own posture in the most natural position possible. This means that you should not make any particular effort or pay attention to a straight posture.
If you have the feeling that you are always in a particularly straight position under observation, it can help Asking a friend or acquaintance to take a picture of their profile while doing something else. The picture then emerges spontaneously and inconspicuously, while one no longer thinks about it and is therefore much more meaningful.

You should pay particular attention when looking at the Shape of the back: Is the body axis straight? Is the head in a line above the pelvis? Where is the center of gravity of the standing body?
The hollow back is characterized by one strongly arched lower back and a pelvis tilted forward and down. There are clear Indentations in the course of the spine?
Of course, all of this is only a first overview. The fact that you don't see any special features in the mirror or in pictures does not necessarily mean that they cannot be there.
Lighter forms of the hollow back, in particular, often require an experienced doctor's eye to be recognized. So it is advisable to have one if you have back pain or suspect a hollow back doctor to seek out.

Frequency distribution

Due to the influencing factors, more and more people are affected by a hollow back. A lack of exercise and bad posture, especially sedentary activities, as well as stress lead to postural damage in 60% of school beginners. In addition to the hollow back, this also includes the Hunchback (Hyperkyphosis), of the Flat back and the Hollow backthat are also caused by unnatural stresses on the Back muscles and the Spine can arise.

Symptoms of the hollow back

At first, a hollow back usually does not cause any discomfort apart from tension. Over time, the weakened ones express themselves Move- and Abdominal muscles increasingly in Back pain. The shortened ligaments and tendons also lead to an increasing immobility. In general, the less movements are "cushioned" by the back muscles, the more stress is placed on other surrounding structures. With the hollow back, the load is unevenly distributed over the vertebrae, which leads to increased wear and tear, especially the Intervertebral discs of the lumbar spine, can lead. Therefore, people with a hollow back have an increased risk of other spinal diseases such as Vertebral damage and Herniated discs in the lumbar spine. This risk depends on the extent and duration of the hollow back.
A hollow back can also be used to Narrowing of the spinal canal to lead. Important nerve tracts are located in this canal, and for protection it is surrounded by bones and ligaments of the spine. If this canal is narrowed by a hollow back, the affected person experiences pain, mostly from lower back in the legs radiate.


The prevention of a hollow back is relatively easy and is based on two large pillars. For one is sufficient exercise of utmost importance: everyday movements such as cycling instead of driving and climbing stairs instead of using an elevator are already helpful. In addition, regular physical activity such as swimming, walking or fitness training should be carried out. In order to prevent as much as possible, value should be attached to it in childhood and adolescence.
The second major pillar in preventing a hollow back is one healthy posturewhich is also encouraged by sufficient exercise. It is important to always pay attention to your own body position and to correct bad posture. This can be exhausting at first, but you get used to it quickly. Particular attention should be paid to when sitting "dynamic“To sit, so don't stay too long in a sitting position and sit by regular Go and Stand to interrupt. This can be supported by ergonomic seating, because you often do not notice yourself that you are adopting an increasingly worse posture. In addition, the optimal posture can be promoted through special training. This training corresponds to what is also recommended for therapy for hollow back, so that professional guidance is required here too. The special exercises for Move-, Belly- and Glutes should be carried out regularly in order to strengthen the muscles permanently. If a hollow back is suspected, an orthopedic surgeon should be consulted as soon as possible to determine the exact cause of the hollow back. In addition, therapeutic measures should be initiated as soon as possible in order to prevent the symptoms from worsening and the occurrence of secondary diseases.

Forecast of the Holhkreuz

The prognosis of a hollow back depends on whether and how quickly counteracting measures are taken. The earlier and more consistently the corresponding muscle groups are trained, the higher the likelihood that no complaints or secondary illnesses will develop. With early detection and well-performed therapy, the prognosis of a hollow back is very good.

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