Kyphosis is an abnormally excessive convex curvature of the spine as it occurs in the thoracic and sacral regions. Abnormal inward concave lordotic curving of the cervical and lumbar regions of the spine is called lordosis. It can result from degenerative disc disease; developmental abnormalities, most commonly Scheuermann's disease; osteoporosis with compression fractures of the vertebra; multiple myeloma; or trauma. A normal thoracic spine extends from the 1st thoracic to the 12th thoracic vertebra ...

kyphosis

_-1_0

Author: Silvia Marinova, PhD student in the Genomic Stability Laboratory at BAS

_-1_1

The article was approved by physiotherapist Georgi <a href="https://www.facebook.com/360physio.BG/about/?ref=page_internal" target="_blank" rel="noopener">Peshev</a>. The material aims to raise awareness and does not recommend self-medication.

_-1_2

_-1_3

In <a href="/p/do_kakvi_funktsionalni_izmienieniia_vodi_siediezha_chast_1_0b939629_6381_4580_96cd_750426938dbf" target="_blank" rel="noreferrer">the previous part of</a> the topic, we looked at how immobilization, as part of modern daily life, can lead to bone-joint functional changes and muscle imbalance. We explained what they are due to, namely the weakening of certain muscle groups at the expense of shortening and overworking others. The greatest attention was paid to forward head posture - one of the three most common problems associated with the wrong posture.

_-1_4

In this text we will also get acquainted with the other two - rounded shoulders and enlarged front inclination of the pelvis. &nbsp;

Rounded-shoulders-forward

Rounded shoulders forward

Rounded-shoulders-forward_0_0

Rounded-shoulders-forward_0_1

Deviations from the neutral position of the body are most often due to the action of gravity. Gravity is a constant natural phenomenon, and in order to maintain an upright and correct posture of the body, our muscles are forced to constantly resist it.

Rounded-shoulders-forward_0_2

Too often, however, gravity prevails because our muscles are not sufficiently prepared and trained. This is also reinforced by the fact that many of our daily activities are related to hunching back and down - for example, when looking at our phone or tablet.

Rounded-shoulders-forward_0_3

Usually it is the insufficient endurance of the muscles in the upper back that the phenomena rounded forward shoulders and an increase in thoracic kyphosis are due.

Rounded-shoulders-forward_0_4

<a href="https://www.bioseek.eu/en/eng/research/pubmed/Association_Between_Forward_Head_Rounded_Shoulders_and_Increased_Thoracic_Kyphosis_A_Review_of_the_Literature_29097952" target="_blank" rel="noopener">Medically</a> speaking [ref.1] rounded shoulders are characterized by a deviation from the neutral position of the body, with displacement of the blades forward and their protraction.&nbsp;One way for the attending physician to determine this is for her to assess our upright posture when we are not tense. Often rounded shoulders make us look stooped forward.

Rounded-shoulders-forward_0_5

Rotation of the arms is also observed. When they are relaxed, the thumbs are expected to point forward if our posture is neutral.&nbsp;If we have rounded shoulders forward, however, then the thumbs point towards each other.

Rounded-shoulders-forward_0_6

In terms of muscle imbalances in rounded shoulders forward, the following is observed:

Rounded-shoulders-forward_0_7

<ul>
<li style="font-weight: 400;">Overworking/shortening - some muscle groups shorten and become overloaded, pulling the body in this hunched position forward. These are the upper trapezius muscle and the pectoral muscle. In addition, there's general lack of mobility in the chest area.</li>
<li style="font-weight: 400;">Underworking - the other factor associated with rounded shoulders forward are the elongated muscles with reduced tone and strength. These muscle groups are weaker and fail to pull the shoulders back to a neutral position. Most often here we are talking about the lower and middle trapezoid, as well as the serratus anterior muscle. It is a large flat muscle which covers the lateral part of the chest.</li>
</ul>

Rounded-shoulders-forward_0_8

<a href="http://psjd.icm.edu.pl/psjd/element/bwmeta1.element.psjd-ca4738cb-a4fe-467b-b164-639a3241fba7#:~:text=Introduction%3A%20Upper%20cross%20syndrome%20is,musculature%20and%20upper%20trapezius%20musculature." target="_blank" rel="noopener">Studies in the field suggest</a> [ref.2] that not only immobilization and sedentary lifestyle can lead to rounded shoulders. Improper and uneven workouts are also a serious prerequisite.

Rounded-shoulders-forward_0_9

When our workouts are not balanced, very often we achieve the same result of excessive exertion and shortening of certain muscle groups at the expense of the weakening of others. This makes us more susceptible to shoulder girdle injuries. Therefore, it is important to build our workouts in an informed way, and aim for balance.

Rounded-shoulders-forward_0_10

The next section is dedicated to exercises for the most commonly affected muscle groups in cases of rounded shoulders.

What-exercises-should-we-practice

What exercises should we practice

What-exercises-should-we-practice_1_0

What-exercises-should-we-practice_1_1

The program of exercises to perform should include two groups of them. The first is exercises for stretching the abovementioned muscles:

What-exercises-should-we-practice_1_2

<ul>
<li style="font-weight: 400;">Stretching with a foam roller/chair - we can stretch the aforementioned muscle groups, even sitting in a chair, simply by moving the upper back backwards and down from the backrest so that we feel tension. This exercise also improves the overall mobility of the upper back. An even better alternative is to perform the corresponding stretching with the help of a foam roller, on which to lie down. We should be careful not to compensate for the movement with excessive curve int he waist.</li>
<li style="font-weight: 400;">Stretching with an elastic band - we grab an elastic band (alternatively we can use a towel or stick) at the level of the shoulders with the palms pointing down. We gently stretch the elastic to the side, forming tension. From here we put our hands above the head and twist them back, holding the elastic band at the same time.</li>
</ul>

What-exercises-should-we-practice_1_3

As you can guess, the second group of exercises is associated with an intensification of medium and lower trapezoidal and the serratus anterior&nbsp;muscle:

What-exercises-should-we-practice_1_4

<ul>
<li style="font-weight: 400;">Strengthening the serratus anterior&nbsp;muscle - it is very appropriate to make a special variation of plank. Hands are completely stretched as the wrists are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820220/" target="_blank" rel="noopener">rotated 90 degrees</a> outwards [ref.3]. When we are ready with the right&nbsp; position, we begin to push the upper back to the ceiling.</li>
<li style="font-weight: 400;">Strengthen the middle and lower trapezoid - we can again do variations of exercises with an elastic band. For example, we grab the elastic with straight hands at the height of the shoulders with the thumbs pointing upwards. We stretch slightly to the side to create tension and raise our hands above the head.</li>
</ul>

What-exercises-should-we-practice_1_5

Besides the individual exercise program, it is very important to increase our attention to the right posture and adjust every time we feel that we have moved forward.

Abnormal-anterior-tilt-of-the-pelvis

Abnormal anterior tilt of the pelvis

Abnormal-anterior-tilt-of-the-pelvis_2_0

Abnormal-anterior-tilt-of-the-pelvis_2_1

With this deformation, the pelvis is tilted forward, which leads to an increase inthe lower back ligament. This creates tension in the waist and often leads to pain. Here again we will pay special attention to the musculature:

Abnormal-anterior-tilt-of-the-pelvis_2_2

<ul>
<li style="font-weight: 400;">Overworking/shortening - usually overworked are the muscles flexors of the hip joint, erector spinae, multifidus, etc.</li>
<li style="font-weight: 400;">Underworking&nbsp;- these muscles are more familiar and easy to explain. These are abdominal and gluteus muscles. Very often they become less toned.</li>
</ul>

Abnormal-anterior-tilt-of-the-pelvis_2_3

Risk factors for increasing the anterior tilt of the pelvis are not only immobilization and sedentary lifestyle, but also, for example, the flat foot. It leads to an incorrect position of the legs, and hence inadequate muscle workload. This is just another illustration of how interconnected everything is in our body.

Abnormal-anterior-tilt-of-the-pelvis_2_4

Therefore, this article should not be taken as completely exhaistive on the topic; it is definetely necessary to consult a doctor or kinesitherapist before starting a&nbsp;treatment.

What-exercises-to-perform

What exercises to perform

What-exercises-to-perform_3_0

What-exercises-to-perform_3_1

The complex of exercises we can perform here is very diverse. Again, it should be aimed at balancing muscle groups that are affected. Some sample exercises are:

What-exercises-to-perform_3_2

<ul>
<li style="font-weight: 400;">Stretching the hip flexors - assume postion in which the back knee is on the floor and the front leg is folded, forming a 90-degree angle. The exercise is to move the pelvis forward by tightening the buttock and abdominal muscles.</li>
<li style="font-weight: 400;">Tightening of the gluteus&nbsp;and abdominal muscles - it is especially important to choose such exercises in which we do not experience pain. An example of a very suitable exercise that is easy to perform is a variation of a bridge. It is performed from a supine position, legs folded at the knees and hands on both sides of the body. The pelvis stands up to form a straight line with the upper back by pressing from the heels. Return to the starting position.</li>
</ul>

What-exercises-to-perform_3_3

The described set of exercises is not suitable for every problem, as there are many more types of bone-joint deformations. In conclusion, we will reiterate that in case of back pain it is not a good idea to postpone the consultation with a specialist just because "everyone hurts their back". This will help us to deal more quickly and effectively with the problem that has arisen. And in order not to go so far, it is good to realize earlier the need to pay attention to the correct posture, knowing what changes are due to immobilization and the modern way of life in general.

Too much sitting causes functional changes to the body. What you need to know. Part 2

https://d20hztklr4qnvi.cloudfront.net/29e15905-f04e-4bbc-a33c-8d0b2f6af5eb_middle.jpg

 Too much sitting causes functional changes to the body. What you

Силвия Маринова

Author: Sylvia Marinova, PhD student in the Genomic Stability Laboratory at BAS

Deformities of the musculoskeletal system are among the most common reasons for visiting the doctor's office in childhood. Spinal deformities and incorrect posture are a particularly serious problem [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Screening_and_Early_Identification_of_Spinal_Deformities_and_Posture_in_311_Children_Results_from_16_Districts_in_Slovakia_31007956" target="_blank" rel="noopener">ref.1</a>]. The reasons for their increasingly alarming increase are rooted mainly in the lifestyle of modern children and their families. Lack of movement together with a long stay in a sitting position lead to serious deformations.

Excessive sitting is bad for your health - learn why

The-normal-curves-of-the-spine

The normal curves of the spine

The-normal-curves-of-the-spine_0_0

The-normal-curves-of-the-spine_0_1

The spine is made up of many vertebrae held together by ligaments and muscles. Between the vertebrae are soft "cushions", called intervertebrae discs, the role of which is to absorb vibrations <a href="../../eng/p/za_bolkitie_v_krsta_roliata_na_muskulitie_i_liechieniieto_657b6259_7df2_433b_a68e_10a47e8160ab" target="_blank" rel="noopener"></a> when moving and interfere with friction between the vertebrae.

The-normal-curves-of-the-spine_0_2

In thisway, it acts as an elastic spring and thus increases its resistance and supports the three main movements - bending back and forth, tilting both sides and twisting around its longitudinal axis. Physiological curves are two lordoses (protruding forward) and 2 kyphoses (protruding backwards), forming a double S-shaped curve and corresponding to the corresponding segments of the spine:

The-normal-curves-of-the-spine_0_3

<ul>
<li style="font-weight: 400;">sheath curve - also known as cervical lordosis.</li>
<li style="font-weight: 400;">it is in a dorsal direction, i.e. backwards</li>
<li style="font-weight: 400;">clarified curve - more lumbar lordosis</li>
<li style="font-weight: 400;">cross curve - the last curve of the spine, also called sacral kyphosis</li>
</ul>

Prevention-of-spinal-distortions-in-children-is-important

Prevention of spinal distortions in children is important

Prevention-of-spinal-distortions-in-children-is-important_1_0

This will help us understand why children are particularly susceptible to spinal distortions.

Prevention-of-spinal-distortions-in-children-is-important_1_1

During intrautere development and for a short period after birth, the baby has only one primary kyfotic curve that will give rise to the thoracic and cruciate curves. The other two curves - lordotic (in the forward direction), begin to form when the baby begins to raise his head and walk. Therefore, they are very unsustainable in children and make their spine particularly susceptible to non-physiological changes in childhood.

Types-of-spinal-distortions

Types of spinal distortions

Types-of-spinal-distortions_2_0

Types-of-spinal-distortions_2_1

The S-shaped curves described above are natural when they meet certain norms. If they are larger or smaller than them, then we are talking about abnormal curvature or distortion. In addition to lordosis and kyphosis, which describe distortions in the front-reardirection, distortion can also be obtained sideways - we call it scoliosis. Some examplesof distortions are:

Types-of-spinal-distortions_2_2

<ul>
<li style="font-weight: 400;">Thoracic kyphosis - when the curve in the thoracic region becomes too large. It is also known as "round back";</li>
<li style="font-weight: 400;">Thoracic hypokiphosis - with it, the curve in the thoracic region is not large enough, and then we talk about a "flat back";</li>
<li style="font-weight: 400;">Thoracic lordosis - here we are talking about "concave back". It is characteristic that the chest curve is inverted and directed in the front direction to the chest.</li>
</ul>

Cuases-for-spinal-distortions

Cuases for spinal distortions

Cuases-for-spinal-distortions_3_0

Cuases-for-spinal-distortions_3_1

Most spinal deformities begin as so-called non-structural <a href="https://www.bioseek.eu/en/eng/research/pubmed/The_transformation_of_spinal_curvature_into_spinal_deformity_pathological_processes_and_implications_for_treatment_16759413" target="_blank" rel="noopener"></a> or functional distortions [ref.3] . These distortions are usually due to incorrect posture and misdiagnosed muscle strength . By definition, such curves return to normal when the individual is standing in a proper posture or lying down. Even when the wrong posture has become a habit or there is regular asymmetricand excessive load (such as from the school backpack), usually this type of distortion is reversible by building correct habits and appropriate exercises that can be prescribed by a physiotherapist.

Cuases-for-spinal-distortions_3_2

Functional distortions can go structural when they remain untreated and are not being worked on. Then we are talking about acquired structural changes. Unlike non-structural changes, they have a loss of flexibility in a certain segment of the spine. They may also develop due to congenital deformities (congenital).

Cuases-for-spinal-distortions_3_3

Congenital deformities can be an irregular form of the vertebrae, adhesions between them or separation, etc. It is characteristic of them that they lead to distortions that worsen with the growth of the child. However, in some cases, if timely measures are taken, the long-term effect may be reduced.

Other-spinal-problems-in-children

Other-spinal-problems-in-children_4_0

Other-spinal-problems-in-children_4_1

<ul>
<li style="font-weight: 400;">Spondylolysis - these two conditions are the most <a href="https://www.bioseek.eu/en/eng/research/pubmed/Back_pain_and_scoliosis_in_children_When_to_image_what_to_consider_28786774" target="_blank" rel="noopener"></a> common cause of pain [ref.4] in the lower back in children over 10 years of age. Probellolysis is a degeneration of the intervertebrae discs and is usually due to increased stress on them due to load and the generation of multiple micro-injuries that over time lead to wear and tear.</li>
<li style="font-weight: 400;">Spondylolysis - it develops as a result of spondylolysis in prolonged biomechanical stress and lack ofmeasures. Due to a decrease in resistance of the spine, it is possible that some vertebrae slip against each other and lead to serious complications.</li>
</ul>

Other-spinal-problems-in-children_4_2

Of course, there are other spinal abnormalities that occur in children, but they are not subject to this article.

When-to-seek-medical-attention

When to seek medical attention

When-to-seek-medical-attention_5_0

Consultation with a pediatric specialist in the field is needed when our child:

When-to-seek-medical-attention_5_1

<ul>
<li style="font-weight: 400;">begin to acquire lateral curves of the spine</li>
<li style="font-weight: 400;">begin to acquire unusual rounding in the shoulder area</li>
<li style="font-weight: 400;">begin to acquire asymmetry in the shoulders or pelvis</li>
<li style="font-weight: 400;">experiences unusual back pain</li>
</ul>

How-to-treat-spinal-distortions

How to treat spinal distortions

How-to-treat-spinal-distortions_6_0

Swimming is a sport that prophylactics spinal distortion, helping the proper development of the chest and spine. This is not a guarantee that there will be no distorting, of course. It turns out that in more flexible children, spinal distortions are more common. For this, in addition to periodic preventive examinations, in case of suspicion of this type of problem, an orthopedist and a physiotherapist should be consulted accordingly.

How-to-treat-spinal-distortions_6_1

The prognosis depends very much on how serious the spinal malformations are and on what is the root cause of them. However, most children regain the correct curves of the spine. Therefore, prevention, properdiagnosis and appropriate treatment are needed.

kyphosis

What are spinal distortions in children and adults and what to do