Home Exercise Program for Pediatric Lordosis
For a 7-year-old with lordosis, prescribe a structured program emphasizing core strengthening (abdominal muscles, gluteus maximus, hamstrings) combined with flexibility exercises targeting hip flexors and lumbar extensors, performed 3 times weekly for a minimum of 8-12 weeks with progressive resistance as tolerated.
Core Exercise Components
The home exercise program should follow the FITT-PRO framework (Frequency, Intensity, Type, Time, and Progression) to ensure systematic progression and adherence 1.
Strengthening Exercises (Primary Focus)
Target the posterior pelvic tilt muscles specifically:
- Abdominal strengthening using age-appropriate exercises that engage external and internal oblique muscles, not just rectus abdominis, as oblique activation is critical for lordosis correction 2
- Gluteus maximus exercises to strengthen hip extensors and promote posterior pelvic tilt 3
- Hamstring strengthening to counteract anterior pelvic tilt forces 3, 4
Frequency and progression: Start with 2-3 days per week on non-consecutive days, allowing at least 48 hours rest between sessions 5. Begin with 10-15 repetitions at low resistance (bodyweight or minimal resistance), progressing to 2 sets as the child tolerates 6, 7.
Flexibility Training
Target tight hip flexors and lumbar extensors:
- Hip flexor stretching to reduce anterior pelvic tilt forces 4
- Lumbar extensor flexibility exercises to improve overall spinal mobility 4
Frequency: Perform 5-7 days per week, holding static stretches for 10-30 seconds, repeating 2-4 times per muscle group 6.
Specific Exercise Prescription
Week 1-4: Foundation Phase
- Abdominal exercises: Modified crunches or sprinter-pattern exercises (if age-appropriate), 1 set of 10 repetitions, 3 days per week 2
- Gluteal bridges: 1 set of 10 repetitions, 3 days per week 3
- Prone hamstring curls (bodyweight): 1 set of 10 repetitions, 3 days per week 3
- Hip flexor stretches: Daily, 10-30 seconds hold, 2-4 repetitions 4
Week 5-8: Progressive Phase
- Increase volume: Progress to 2 sets of 10-12 repetitions for strengthening exercises 6
- Add resistance gradually: Use resistance bands or light weights if appropriate for age and development 7
- Maintain flexibility routine: Continue daily stretching 6
Week 9-12: Maintenance Phase
- Progress to 2 sets of 12-15 repetitions for all strengthening exercises 6
- Increase frequency to 4-5 days per week if well-tolerated 5
- Continue daily flexibility work 6
Critical Safety Considerations
Avoid explosive movements and high-impact loading (jumping, running) during the initial phases, as these can exacerbate lordotic posture 6. Avoid dynamic abdominal exercises with excessive trunk flexion and twisting (traditional sit-ups) as these may not effectively target the oblique muscles needed for lordosis correction 6, 2.
Monitoring and Reassessment
Reassess at 2-week intervals initially, then monthly once stable progression is established 5. Discontinue or modify exercises if:
- Pain develops or worsens 5
- Unusual fatigue or weakness occurs 5
- The child cannot maintain proper form 6
Parent/Caregiver Education Elements
Provide illustrated handouts showing proper exercise technique and form 6, 1. Emphasize the importance of supervision during initial sessions to ensure correct technique and prevent compensatory movement patterns 6. Make the program social by involving family members or siblings to improve long-term compliance 6.
Expected Outcomes
Research demonstrates that 8-12 weeks of targeted strengthening exercises can significantly reduce lumbar lordotic angle and improve pelvic tilt in patients with hyperlordosis 3, 4. The sprinter-pattern exercises show superior activation of oblique muscles compared to traditional crunches, making them particularly effective for lordosis correction 2.
Common Pitfalls to Avoid
Do not prescribe vague instructions like "do core exercises" without specific parameters for sets, repetitions, and frequency 1. Do not neglect progression planning—the program must systematically increase difficulty as the child improves 1. Do not focus solely on abdominal strengthening while ignoring hip flexor flexibility and gluteal/hamstring strengthening, as all three components are essential for lordosis correction 3, 4.