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Old 06-06-2013, 05:40 AM   #1
Phil Washlow
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Hyperlordosis Butt Wink

I have a member at my box who is hyperlordotic (confirmed by x-rays and her chiropractor). The chiropractor only does an adjustment on her and no physical therapy. I had her test her anterior hip flexibility and it is not good, quads are fairly flexible. Her hamstrings are also very flexible but quite weak, which is to be expected. She admits that she is drastically quad dominant which makes sense. I had her go through a mobilitywod anterior hip banded distraction mobilization (made sure to squeez the butt and keep the spine stiff). She said that she felt like she could stand up straight for the first time in years. That is all great but on top of that she has a butt wink issue when she squats. This is where my knowledge breaks down and I need help. Wouldn't strong quads and weak flexible hamstrings prevent butt wink, typically the prescription for butt wink is tight hamstrings but that is not her issue. My ideas are either it is a movement pattern problem or that she has weak/inactive glutes. Should I have her continue with some anterior hip mobilizations and hamstring/glute exercises (light stiff legged deadlifts, hamstring bridges, hamstring curls with a swiss ball) and see if her issue improves and possibly eliminate the butt wink. Or do I need to address both issues separately and simultaneously. Thanks in advance.

P.S. I have advised her to mention her new idea that the issue is muscular to her chiropractor and perhaps she will be sent to physical therapy where a professional can help her. Though since the chiro never even checked for tightness or imbalances they may not be helpful enough to prescribe PT.
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Old 06-06-2013, 05:05 PM   #2
Brian Strump
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Re: Hyperlordosis Butt Wink

IMO, the "buttwink" is not the worst thing in the world. Much of it depends on the depth at which it occurs. Many people when the get to the bottom depth of the squat may have some...I don't sweat that too much. If it occurs before they even get to parallel then I'm more concerned about it.

As for advice, I think you've done the correct thing. My biggest peeve with trainers in general(CF or otherwise) is they discuss things with members that are outside of their scope. Their affiliate trainers "MWODDED" them to death for 8+ weeks, with little to no improvement. Six weeks earlier a smart trainer would have recommended they see a professional.
Brian Strump, D.C., FMS, NKT
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Old 06-11-2013, 01:12 PM   #3
Daniel Pope
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Re: Hyperlordosis Butt Wink

A few thoughts off the top of my head:

1) Flexibility issue - Stretching into end range hip external rotation and flexion could help as well as stretching the adductors. If you lack this motion it will cause butt wink at the bottom of a squat

2) Motor control problem - Is your athlete adequately spreading the floor? Have you video'd the athlete and then shown him/her? Sometimes I find that if the athlete just sees the issue they can self correct. Make sure your athlete understands proper technique.

3) Stability/strength - Sometimes people don't butt wink until the weight gets too heavy. Does an unloaded squat look ok but it starts to look poorly with added weight? Sometimes it's as easy as lightening the load and gradually progressing when they can maintain technique.

This is where I'd start. Brian does bring up a great point though, have them see a trained professional if you're struggling to fix the issue. Let us know if it helps.
Physical Therapist, Coach, Athlete - My website: Injury Prevention Info so you can continue to enjoy crossfit pain free
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