Extension pattern

Extension patterns are explained as a movement problem where the lumbar spine extends too easily compared with the hips, often producing increased lumbar lordosis, anterior pelvic tilt, and pain during standing, walking, or overhead arm use. Relief is commonly found with forward bending, slouched sitting, or side-lying because these positions reduce lumbar extension. Key features include overactivity of the erector spinae, TFL, psoas, and latissimus, with insufficient abdominal and gluteal support. The distinction between active and passive extension patterns is covered, including guarding, fear avoidance, sway-back posture, and reliance on passive structures. Assessment focuses on observing lordosis, limited lumbar flexion, poor posterior pelvic tilt control, excessive lumbar movement during arm or leg tasks, Thomas test findings, and possible hypermobility. Treatment emphasizes reducing excessive lordosis and improving hip–lumbar dissociation. Common strategies include posterior pelvic tilt training, wall-supported standing correction, glute activation, controlling the spine during limb movements, using shorter strides when walking, and encouraging hip extension instead of lumbar extension. The aim is better spinal control, less compression, and symptom relief during everyday activities.