Butt Winking or Sticking Your Booty Out – What’s Right? (Part 2)

This blog was adapted from its original post on https://drlaurenkeller.com by the author.

Be sure to check out Part 1 of this blog series first!

What is a neutral spine?

A neutral spine is when the position of the diaphragm is aligned with the pelvic floor. The spine and pelvis are not flexed, extended, tilted, or twisted. A neutral spine/pelvis is when the ASIS (frequently referred to as the hip bones, but truly the front part of the pelvis) is in line with the pubic crest and the lumbar spine is balanced atop the sacrum; the rib cage is lifted and supported by both the abdominal and back musculature and the pelvic floor and the diaphragm are stacked upon one another.

Benefits of a neutral spine

The following is a list explaining why a neutral spine is beneficial:

  • Maintains ideal posture
  • Prevents or decreases muscular imbalances and strain on joints (3)
  • Supports and protects the spine
  • Improves lung capacity
    • In a study released in January 2018, adding 10 degrees of anterior pelvic tilt decreased peak expiratory flow (PEF) and both anterior and posterior pelvic resulted in significantly lower forced expiratory volume in one second (FEV1). (10)
  • Increased strength and mobility (4)
  • Maintains integrity of stabilizing complex (diaphragm, abdominal muscles, pelvic floor)
    • Antagonistic trunk flexor‐extensor muscle coactivation was present around the neutral spine posture in healthy individuals. (1)
  • Decreases risk of pregnancy-related pain, including sciatica and low back pain (3)
  • Distributes load evenly through discs (3)
  • Relieves pelvic floor dysfunction including urinary incontinence (3)

How do I get to neutral?

Here are a few tips to help you achieve a neutral spine:

  • Toes/feet are pointed straight ahead or at a slightly outward direction (11 o’clock & 1 o’clock position)
    • Feet are hip-width apart
    • Weight/pressure is evenly distributed throughout the entire foot
  • Stacking is the key to stability
    • Back those hips up. During pregnancy and postpartum, it is common for moms to get a forward lean where their upper body is almost leaning forward. If you find this is happening, try to back your hips up so that the center of your hips are aligned with the lateral malleolus (outer bony part of the ankle)
    • Your shoulders are above your pelvis and your head is above your shoulders
  • Make sure your diaphragm and pelvic floor are on top of each other
    • Avoid “rib flare” by gently lowering your ribs down until the lower ribs move into the abdominal skin and musculature
    • Don’t tilt the pelvis forwards or backwards: the pelvis is neutral when it is not tilted forward or tucked. To do this think of a cup of water (or wine or breastmilk – your precious liquid of choice): you don’t want the pelvis tilted forward or backwards causing water to drip out of the cup
  • Make sure your chin isn’t jutted out and your head is squarely on your shoulders
    • To do this you tuck the chin straight back while also elongating the neck
    • Sure, you may feel like you have a double chin but we almost all do and that’s okay because it helps maintain that neutral, stacked spine

Neutral Spine, Butt Winking, & Booty Sticking Out: Is it Black-and-White?

Nope. First off, not everyone is created equal so there will naturally be some variance in what is best for each person. Constantly arching the spine is not healthy just as constantly tucking the spine is not healthy. The key is to systematically move the spine through its full range of motion with load. Therefore, we need to focus on a neutral spine for both weight-bearing and non-weight-bearing movements to help build strength and create a strong stabilizing system. Our goal is learn how to stabilize the core appropriately so when we are in non-ideal positions (butt winking or sticking our booty out) we do not get injured.


Lauren Keller, DC, DABCA

BIRTHFIT Chicago: Western Suburbs

Instagram: @birthfit_chicago_western_burbs

Facebook: @birthfitchicago


  1. Cholewicki J, Panjabi MM, Khachatryan A. Stabilizing function of trunk flexor-extensor muscles around a neutral spine posture. Spine. 1997;22(19):2207–2212.
  2. Wallden, Matt. The neutral spine principle. Journal of Bodywork and Movement Therapies, Volume 13 , Issue 4 , 350 – 361
  3. Panjabi, Manohar. (1993). The Stabilizing System of the Spine. Part II. Neutral Zone and Instability Hypothesis. Journal of spinal disorders. 5. 390-6; discussion 397. 10.1097/00002517-199212000-00002.
  4. Jagarinec, Tomi. (2017). Core Training in Football: Improve Your Players’ Posture and Unlock Their Play Potential.
  5. Bendix, T & Biering-Sørensen, F. (1983). Posture of the trunk when sitting on forward inclined seals. Scandinavian journal of rehabilitation medicine. 15. 197-203.
  6. Richardson, C, Jull, G, Hodges, P, Hides, J. Therapeutic exercises for spinal segmental stabilization in low back pain. Churchill Livingstone, Toronto; 1999.
  7. Elia, DS, Bohannon, RW, Cameron, D, Albro, RC. Dynamic pelvic stabilization during hip flexion: a comparative study. J Orthop Sports Phys Ther. 1996;24:30–36.
  8. Robinson, R. The new back school prescription: stabilization training part 1. Occup Med. 1992;7:17–31.
  9. Dumas, GA, Reid, JG, Wolfe, LA, Griffin, MP, McGrath, MJ. Exercise posture and back pain during pregnancy: part 1. Exercise and posture. Clin Biomech. 1995;10:98–103.
  10. Effects of pelvic tilt angles and forced vital capacity in healthy individuals.


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