Every third Russian child today has problems with posture. They can be more or less pronounced, accompanied by additional symptoms, or proceed almost imperceptibly, but they are all quite dangerous and require mandatory correction. In this article, we will talk about what types of posture disorders exist and which correction will be most effective.
What it is?
Posture disorders are any changes in the position of the spine relative to the physiological norm. The spine can be deformed both in the frontal plane and in the sagittal one. The frontal plane is the rear view, and the sagittal plane is the side view. There are both violations in a separate plane and combined disorders, the pathological signs of which are found in two planes at once.
When the vertebrae are in an unnatural position, a great force impacts on them, and on the muscles and ligaments, which are required to keep the spinal column in a stable upright position. To maintain the necessary balance, the muscles are in constant tension, which leads to pain and discomfort.
Incorrect posture is not considered an independent disease, it is only a pathological condition that needs correction, correction. In the vast majority of cases, the problem is fixable.
If we ignore the first changes in the state of the musculoskeletal system, this can cause a variety of unpleasant consequences - the occurrence of irreversible deformations, displacement and compression of internal organs, and disruption of their functions.
A long-term and advanced problem with the spine increases the likelihood of spinal column injuries, fractures, displacements, spinal hernias, etc. The Ministry of Health statistics, current at the beginning of 2018, states that various types of posture disorders occur in about 2% of young children.
In preschool age, up to 17% of children suffer from them, in the middle school age the number of such children increases to 33%, and in senior school age - up to 65%. This suggests that in the process of bone tissue growth, the deformity tends to become aggravated if correction is not carried out in time.
Kinds
Since posture disorders can be observed in two planes, it is also customary to classify them according to this type. Frontal disorders include scoliosis and scoliotic posture.
The list of sagittal deformities is much wider. These include:
- flat back (a condition in which all vertebrae are smoothed);
- lumbar lordosis (pathological forward bending of the spine in the lumbar region);
- cervical lordosis (bending of the cervical spine);
- thoracic kyphosis (concave back);
- round back (combination of increased thoracic kyphosis with flattening of the lumbar lordosis);
- slouch;
- kypholordotic posture (increase in all bends of the spine).
Any type of posture disorder has several degrees of severity.
- At the first, the violations are usually initial and easily amenable to simple correction.
- The second degree usually requires a longer and more painstaking approach to treatment, but in most cases it is also possible to cope with the help of conservative methods.
- The third degree of violations is more serious, it is not always subject to conservative treatment, sometimes surgical methods are required.
- The fourth degree very often requires not only an operation, but also the establishment of a disabled status for a child.
In children under 10 years of age, disorders of 1-2 degrees are most often encountered, in middle school age and in adolescents, violations of 2-3 degrees are more often found. According to doctors, this is due to the fact that an accurate diagnosis was not carried out at an earlier age, therefore, a mild degree of violation went unnoticed.
Let's take a look at the most common types of deformations.
Scoliotic posture
Such a disorder differs from scoliosis in that there are no deformities in the pelvic area. Most often, curvature occurs only in one part of the spinal column and only in one plane - the frontal one. Visually, the child may have a slight asymmetry of the shoulders - one higher than the other. With scoliotic posture, changes are visible mainly only in the upright position of the body. When the child lies, his spine is even, the curvature is not visible.
A small degree of scoliotic posture does not essentially require treatment, rather often focus the child's attention on the need to keep the back straight, as well as conduct classes on the horizontal bar (hanging). The third degree of this posture corresponds to the initial stages of scoliosis and needs treatment.
Kyphotic posture
In medicine, kyphosis is usually understood as a curvature in the thoracic spine. Kyphotic posture is a condition that usually precedes kyphosis as such. At the same time, the child tilts his head forward too much, the shoulders are also lowered forward, the shoulder blades stick out like wings, which gives the back a rounded shape.
Posture disorders of this type definitely need correction. If the alarming symptoms are ignored, an independent disease develops, for example, positional kyphosis. The postural disorder described above is its very initial stage.
The danger of this type of deformity is obvious - the chest sags inward, the lungs and heart suffer, and a hump may begin to grow. Osteochondrosis gradually joins.
Round back
Thoracic kyphosis (deflection inside the chest) with this violation is very pronounced, but the bend in the lumbar region, characteristic of all people, is almost absent. The back looks like a rounded, slightly humped. But an outwardly unsightly appearance is half the trouble, because this position of the spine is extremely unstable. Due to the need to maintain balance, the child begins to walk on bent legs, which tenfold increases the load on the knee joints.
This type of violation was not common 20-30 years ago in childhood. Now, when children spend more time at home, at the computer, move less, it is this pathology of the spine that has taken a leading position and is almost "equal" to scoliosis.
Round back
With this pathology, all bends of the spinal column are smoothed out, which are due to nature and are necessary to move in space on foot. Therefore, in children with a rounded back, the gait changes dramatically - in order to maintain balance, they have to place the center of gravity on the knee joints, which already in adolescence leads to knee injuries, severe changes in the structure of the knee joint, and also to its premature wear.
The shoulders of a child with such a curved back are raised and brought slightly forward, the shoulder blades stick out, the stomach and buttocks hang down, when walking, his head is always slightly in front of the body. Depending on the degree of posture disorder, treatment is prescribed, which, by the way, is quite effective.
Flat back
This is the name for a violation of the condition of the spine, in which the vertebrae more resemble a straight line - all bends are excessively smoothed and reduced. Quite often, such a back is observed in children who are lagging behind in physical development and in those who are growing too quickly. In the first case, the muscular frame of the back is weak, and in the second, it does not keep pace with the growth rate of bone tissue.
The danger of this incorrect posture lies in the constant risk of injury and microtrauma to the vertebrae and spinal cord, since natural depreciation, even with normal walking, is significantly reduced. Such children often complain of headaches, nausea, this is due to the ongoing microscopic vertebral injuries.
This type of pathological posture is considered one of the most dangerous, with it any accompanying deviations in the state of the spine become intense and proceed very quickly, whether it be scoliosis or osteochondrosis of one of the parts of the ridge. Treatment is needed immediately.
There are other varieties, such as the flat-back, the so-called "flaccid posture", but these are less common. In addition, there are congenital forms of ridge deformity associated with such ailments, for example, as myelodysplasia of the lumbosacral spine, the presence of additional vertebrae or the absence of some of them. Some forms of impaired posture are hereditary - a stooped dad, a stooped mother rarely raise a child as slender as a cypress. In most cases, the child slouches too.
Curvatures are traumatic and post-traumatic, arising after trauma of the spine and muscles, as well as pathological. Pathological disorders are understood to be postural disorders that have become possible as a result of the body's reaction (in particular, the vertebrae) to the presence of a disease, a tumor.
The mechanism of any type of disorder is approximately the same: muscle weakness that cannot support the rapidly growing bone tissue, accompanying unfavorable factors from the outside and from the inside, deformations that are becoming increasingly difficult for weak muscles to hold. It turns out a vicious circle, which can be interrupted by doctors, parents and teachers, because most cases of anomalies lend themselves well to correction.
Causes
As already mentioned, the causes of deformities of the spinal column can be both congenital and acquired. The latter prevail. Even during the development of the fetus in the mother's womb, irregular vertebrae, for example, wedge-shaped, may form. Congenital causes may lie in myotonia, connective tissue dysplasia.
Some birth injuries can also affect the back of the child in the future - dislocation of the hip, torticollis, subluxation of the first cervical vertebra during childbirth.
Acquired forms of impaired posture most often suffer from thin children of the asthenic body type (narrow chest, sloping shoulders, long limbs, narrow pelvis). But the point, as you know, is not in the physique, but in the development of the child and external factors that affect his posture.
The most common causes of spinal disorders are:
- poor and irregular diet, calcium and vitamin D deficiency;
- low physical activity, lack of mobility;
- incorrect seating at the table;
- long sitting in the wrong position in front of a computer monitor or TV;
- carrying a knapsack or bag in the same hand;
- low chair and high table or vice versa;
- insufficient lighting of the child's workplace, where he writes, reads, draws;
- the habit of reading lying down.
At a very early age, parents themselves sometimes create the prerequisites for the development of postural disorders in a child. So, pediatricians believe that to a large extent, the deformations of the ridge are facilitated by carrying the baby on the same hand, placing it early in verticalizing devices (jumpers and walkers), on the legs. Subsequently, mothers do not attach importance to the fact that they take the child for a walk all the time with the same handle. All this, repeating from day to day, forms persistent deformations of the ridge.
There are a number of diseases and conditions that also contribute to the subsequent development of curvature and smoothing of the vertebrae. These include:
- rickets;
- polio;
- tuberculosis;
- vertebral fractures, including compression;
- osteomyelitis;
- hallux valgus;
- flat feet;
- shortening of one of the lower limbs.
Often, poor posture develops in children who have poor eyesight or hard of hearing. In order to see or hear something, they often have to take unnatural postures, which are gradually "fixed" at the level of muscle memory.
Symptoms and signs
Signs of impaired posture in a child are not always easy to notice with the naked eye at the initial stage. Usually, parents begin to pay attention to this already when the clinical picture becomes evident. This fact is a good reason to look at your child more closely. His posture should be assessed when the child is standing. Only in a standing position do some forms of pathological changes appear, which will be completely unobvious if the baby is sitting or lying.
Slouching is the easiest to define. With it, the child's head moves slightly forward, the shoulders are also directed forward, like a person who hugs himself by the shoulders. The buttocks appear flat. On the back, you can pay attention to the protruding shoulder blades, their protruding lower edge is especially noticeable.
Kyphotic posture is manifested by the displacement of the head forward and slightly downward, a strong protrusion of the shoulder blades, as well as a strong turn of the shoulders forward. The ribcage looks sunken, which makes it feel like a vertebra is bulging out in the neck. The child walks on bent legs. The muscle tone of all muscle groups is noticeably reduced, this is noticeable in the state of the press: even in thin children, the tummy is somewhat "drooping".
Such symptoms are characteristic of many types of disorders of the condition of the ridge in the thoracic and lumbar spine, and therefore it is very, very difficult to independently distinguish kyphotic posture from kypholordotic - only doctors can do this based on X-ray data. But accurate diagnosis from the parents is not required. In fact, it is only important to pay attention to the basic deviations and, in time, without delay, contact an orthopedic surgeon who will establish the type and type of pathology and give specific recommendations.
The suspicion of an asymmetric posture should creep in if the child has different heights of the shoulders, nipples and shoulder blades in a standing position with arms extended at the seams. The difference may be small, but it also cannot be ignored.
Since any curvature in the spine causes excessive tension in the muscles and ligaments, it is not uncommon for a child to develop pain. True, it comes very gradually, and even the child himself may not pay attention to the pain for a long time. Most often, aching back pain occurs after a long standing, the need to sit exactly in one place. A child may not complain, but adults should definitely check with him if there is any pain if they notice that the child slouches while drawing or writing, if during the reading process he often changes his body position.
Poor posture, which has already caused complications in the work of internal organs, is often accompanied by symptoms characteristic of certain pathologies on the part of these organs: with a decrease in the volume of the chest, it is more difficult for a child to take a deep breath, often there is a feeling of lack of air, headaches, dizziness in the background general hypoxia.
Oxygen starvation, due to a decrease in the mobility of the chest, is usually caused by a stooped back, a sunken and flat chest and other deformities in the region of the thoracic spine. Deformities of the cervical spine most often lead to severe and frequent headaches.Curvatures in the lumbar spinal column lead to numbness of the limbs, frequent diseases of the urinary system.
Usually, children with postural disorders study worse, they get tired faster, they have reduced attention and ability to remember and concentrate on important things, they often get sick with influenza and ARVI, and their viral diseases quite often occur with complications in the respiratory system and heart. Often these children have low hemoglobin levels in the blood.
With curvatures and deformities in the lumbar region, the abdominal muscles are very weak, this becomes the cause of the sagging of the abdominal cavity. The stomach and intestines are slightly displaced and lowered. In this case, the child begins to suffer from frequent constipation and other digestive problems. Pathological changes in the cervical vertebrae and the vertebrae of the thoracic ridge often lead to decreased vision.
The school physical education program is given to children with incorrect posture much more difficult, they do not want to engage in sports sections not because of laziness or "other vocation", but because they get tired faster, for them even active and outdoor games in the yard can be quite difficult due to the rapid deterioration in well-being.
Diagnostics
Parents can pay attention to possible violations on their own, but only a doctor can establish the exact view. To do this, you need to contact an orthopedic surgeon in a children's clinic or to a more rare specialist in Russian medical institutions - a vertebrologist (a specialist in the spine).
The doctor will conduct a visual examination on the first visit. The child is stripped down to underpants and T-shirts, placed in an upright position. It is important for the doctor to assess the posture when viewed from the back, side and front. In addition to all of the above signs of pathological changes in posture, other diagnostic signs should open to the doctor's experienced gaze: displacement of the processes of the spine from the central midline to either side, different outlines of the gluteal folds and popliteal hollows, as well as the asymmetry of the costal arches. In doubtful cases, the doctor will use simple and understandable measurements: he will calculate the distance from the seventh cervical vertebra to the edge of the scapula, measure and compare the length of each leg.
Also, doctors use the so-called Adams test. The child is asked to bend forward with outstretched or lowered arms. This test allows the doctor to assess the state of the curves of the spinal column, the mobility of individual vertebrae. But even an experienced doctor with such a visual examination can make a mistake in the conclusion. Therefore, he will write down all the alarming signs that he finds on examination under the question mark and give a direction for a more accurate diagnosis. It includes X-rays, MRI of the spine as a whole or a certain part of it, computed tomography, ultrasound of the cervical spine.
The results obtained will help to determine the curvature angles with an accuracy of a degree, see the presence or absence of torsion (twisting of the vertebrae), microtrauma of the vertebrae, if any. Based on the results obtained, the doctor will be able to decide on the tactics of treatment or correction of incorrect posture.
Treatment
The treatment of posture disorders is always complex. It includes several methods at once that allow you to correct stoop, eliminate muscle clamps, tension. Bringing the muscular apparatus back to normal helps the child's body to rebuild and provide proper support to the spine, as a result of which the load begins to be distributed correctly, the spine straightens.
The exact way to correct posture and strengthen muscles that are not working correctly is determined by the doctor depending on what type of disorder is present, to what extent the pathology exists at the moment. Grades 1-2 of almost all types of posture disorders do not need surgery or medication, but they will require a lot of work of the whole family to achieve the desired result.
Grades 3 and 4 of violations, in fact, are already an indication for the use of surgical methods of treatment, followed by a long period of recovery and rehabilitation. Let's take a look at how to correct posture in different cases.
Conservative methods
The most popular and deservedly loved by doctors are four main methods of correcting posture: exercise therapy, massage, physiotherapy and wearing special orthopedic devices. The best results can be achieved if all four are applied simultaneously with strict adherence to the doctor's recommendations.
Exercise therapy and gymnastics
Exercise therapy - therapeutic gymnastics, which is carried out in specialized rooms of children's clinics. The task of the doctor is to develop certain muscle groups of the little patient, which suffer the most, as well as to strengthen all other muscle groups.
Exercises for each child are compiled individually, taking into account the changes that were found in his spine. If the posture disorders are minor, then you can attend classes at the clinic 1-2 times, after which the doctor will give recommendations for homework and tell the parents about the training program.
After the course of exercise therapy, a mandatory break is made, during which parents must necessarily show the child to an orthopedist or vertebrologist to make sure that the treatment is beneficial, the disorders do not progress. With complex forms of violations and advanced stages, it is advisable to engage in a whole course under the supervision of a specialist, visiting the exercise therapy office every day. You can visit such a specialist in paid clinics, but in this case, it is important to take with you an appointment from the attending physician, in which he indicates the specific type and nature of the violation.
You should not assume that everything will be limited to classes in a polyclinic or a private clinic. Parents will additionally have to do special exercises with their child at home 1-2 times a day. It must also be approved by the attending physician, but its general principles are as follows: training should be aimed at all muscle groups, especially the muscles of the back and shoulder girdle. Effective posture correction exercises can be divided into several groups.
- General standing - these include tilting the body forward and to the sides, tilting with a gymnastic stick, with a fitball in hand.
- Common sitting - are performed on a hard chair with a firm back and include raising the arms to the sides, lifting them up, including with a gymnastic stick and a gymnastic ball.
- Common lying - are performed on a flat solid surface and include exercises to strengthen the press and shoulder girdle, also performed with and without a gymnastic stick.
Such exercises are considered more specific, during which the child will knead and strengthen certain parts of the spine. This can include hanging on the hands on a bar or wall bars, a "corner" on the wall (lifting the legs at right angles to the body in a state of hanging with the back on the wall).
Not only a horizontal bar and a gymnastic stick, but also a fitball will be useful for parents. Simple rolling on it on the stomach and back is useful for babies at 6-8 months with a tendency to curvature of the spine, and for a slouching teenager.
To strengthen the muscles of the back, swimming is useful, it is on it that it is recommended to record a child with impaired posture in order. Some clinics today make up a complex of exercise therapy in such a way that it will necessarily include water aerobics exercises to correct the back.
If there is no indication for resting, then the child should move as much as possible, this will quickly correct the violations and strengthen the back, spine and muscular corset. True, parents need to remember well that there is no need to wait for a quick result, they will have to work for several months, or even more than a year.
It is undesirable for children with impaired posture to make sharp jumps, train on a trampoline, and dive headfirst into the water from a tower. You should also avoid traumatic sports in which falling is a common thing, such as rugby, hockey, wrestling. Such exercises can provoke microfractures and even completely macrofractures of the spine in a weakened and damaged area.
When working with your child at home, remember that you should gradually increase the duration of the exercise to correct posture, starting from 2-3 minutes per exercise and ending with 10-minute sets. The duration of the lesson itself should also increase gradually, as well as the load on the body. Only in this case it will be possible to achieve a soft and stable correction.
Massage
In case of minor deviations in posture from the norm, it is recommended to carry out a general strengthening massage based on warming up, rubbing and kneading the muscles of the back and shoulder girdle. For more complex disorders, the doctor will recommend manual or orthopedic massage, which is performed only in clinics and massage rooms.
To correct posture, massage is done in courses, the duration of each is set by an orthopedist. There must be a break between courses. Even home massage should be done intermittently - the most common scheme looks like this: 10 days of massage daily - three weeks off.
Formation of correct posture by massage alone is excluded. It is imperative to combine massage with therapeutic exercises, swimming, and other recommended methods. In most cases, parents do not need large financial costs, since the techniques of massage that strengthen the back are quite simple and do not require mandatory execution by specialists. In general terms, all mothers are familiar with them: these are the same "Rails-sleepers" from our childhood, only each element must be performed for a longer time than the comic game implied.
Physiotherapy
The most popular methods include magnetotherapy and electrical stimulation of the muscles and ligaments in the back. Such sessions are carried out on the basis of a physiotherapy room in a polyclinic as prescribed by the attending physician. Both of these methods allow you to quickly achieve a muscle condition in which they will more reliably and anatomically correctly support the spine.
Treatment is carried out under the supervision of a physiotherapist, it is of course nature, in case of uncomplicated forms of posture disorders, it is enough to attend procedures 1-2 times a year.
Orthopedic aids
Teaching a child to maintain posture is quite difficult, especially if he has already formed habits of incorrect sitting and there are some violations. Special orthopedic devices can help parents.
Reclinators for children are elastic loops that, like straps, are worn on the shoulders and converge in the area of the shoulder blades. They prevent the child from hunching over by supporting the back in the correct position. There are reclinators with a beep that sounds every time a child violates a seat.
Semi-rigid and rigid chest and thoracolumbar corsets are indicated if the child no longer has initial, but rather serious postural disorders. Such products are purchased in orthopedic salons with obligatory fitting and a written prescription from the attending physician.
A reclinator-type backrest can be purchased without an appointment, but in this case it is imperative that you first consult a doctor, because all orthopedic products have a lot of contraindications.
Other methods
Other methods of complex treatment of posture disorders include a set of Pilates exercises, as well as mud therapy and hydrotherapy. If there is an opportunity to buy a ticket to a sanatorium specializing in diseases of the back and musculoskeletal system, you should not refuse such an opportunity.
Surgical methods
Surgical intervention for posture correction is rarely used. Only in cases where posture is impaired due to a tumor or injury to the vertebra, which cannot be eliminated in other ways.
If the deformities progress rapidly, one of the surgical methods of treatment may also be considered, provided that the child is already 13-14 years old. For younger children, operations are performed only for health reasons.
Surgeons have many methods of solving the problem - from replacing a destroyed vertebra to fixation transplants. A high-tech operation - vertebroplasty - is successfully used. Also, certain ligaments and muscles are sutured and corrected.
At the end of the recovery period, treatment is prescribed using the four main conservative methods described above.
Forecasts
The chances of completely correcting the incorrect posture of any type of violation, subject to the recommendations of the doctor and systematic exercises with the child, are about 98%. Only in 1-2% of cases, according to the Ministry of Health, the disorders are persistent or progressing, which requires a different approach to therapy.
How long the correction will last is difficult to answer. Some parents, according to numerous reviews, managed to align the back of the child in six months, someone in a year. In some cases, the correction can take one and a half or even two years. It all depends on what violations and at what stage were identified.
The sooner pathological changes are detected, the faster the treatment brings the result.
Prevention
To avoid problems with posture, the child needs to provide favorable conditions:
- create a comfortable workplace, you can buy “growing” furniture with age and height adjustment;
- make the right lighting of the workplace;
- make sure that there are enough calcium-containing foods in the child's diet, meals should be rich and regular;
- temper the child, encourage walks in the air, active and active games on the street, being in the sunlight (within reasonable limits);
- teach the child to control himself and his posture, for this, parents must also keep their back straight, because often children copy adults;
- play sports with your child, be sure to do morning exercises, even the simplest and fastest;
- do not rush things, do not put a small child on his feet too early and do not plant until he himself begins to sit down or crawl;
- make sure that the schoolchild's backpack is comfortable and orthopedic, with wide straps and an even distribution of weight over the entire area of the shoulder girdle.
The main thing is to closely monitor the child and his complaints. Even episodic complaints of headache can be a symptom of incipient spinal deformity. Do not disregard them.
The most dangerous age is considered to be from 1 to 3 years, and then from 5-6 to 14 years. It is during this period that the most intensive growth of bone tissue occurs. Any changes that have begun in the state of the spine can progress rather quickly precisely in primary school and middle school age. Pay special attention to prevention at this age.
Another important point of prevention is preventive vaccinations. Polio, for example, must be vaccinated against. Tuberculin tests are also important, since the transferred tuberculosis very often becomes the cause of spinal deformities. Do not refuse vaccination. Also, one should not neglect the mandatory medical examination. It is she who often helps to identify violations of the musculoskeletal system at the earliest stage.
Posture disorders are always easier to prevent than correct. The child grows up, and in adolescence it will become important for him how he looks. A crooked back forms an inferiority complex in girls and boys, which prevents them from communicating normally and building relationships.
In the next video, you will find exercises for posture disorders and scoliosis in children.
