Poor posture in children - causes, types, prevention and rehabilitation

Poor posture (ICD 10: M53.2) – persistent deviation from normal body position.

Accompanied by strengthening or smoothing of the physiological curves of the spine.

It is not a disease, unlike scoliosis and pathological kyphosis, but in a certain sense it can be considered as a pre-disease condition, since it significantly increases the likelihood of developing a number of diseases of the musculoskeletal system.

Correction by performing special exercises is recommended. In some cases, wearing correctors is required.

General description of the pathology

According to statistics, this disease is extremely common. The percentage of cases increases as people get older. If in children under three years of age the pathology is diagnosed in only 2%, then in preschool and school age more than 33% of children already suffer from it, and among adolescents the disease is diagnosed in 67% of cases.

Pathology requires timely correction. Source: Poor posture in children of primary school age. Methods for the prevention and correction of poor posture using physical education. Gorbunova T.A. Innovative science, 2021. The health of the child as a whole depends on the correct formation of skeletal structures. Incorrect development provokes an uneven distribution of load, due to which pressure on the joints increases, bones are displaced, pathologies of internal organs occur, and malfunctions in the functioning of the nervous, respiratory, and cardiovascular systems appear. Complications include scoliosis, osteochondrosis, intervertebral hernia and other dangerous abnormalities.

How to treat spinal curvature

To correct posture, the following types of treatment are practiced in our clinic:

manual therapy;
Osteopathy - treatment by the hands of a doctor, a gentle effect on the musculoskeletal system, nervous and vascular systems, internal organs;
medical massage;
Acupuncture - exposure to biologically active points with microneedles;
laser reflexology - painless effects on reflexogenic zones and points;
tsubotherapy - a gentle effect on the reflex points of the body;
pharmacopuncture - the introduction of medicinal drugs of natural origin to the source of the problem;
plasma therapy - the introduction of the patient’s own purified blood into the site of the disease;
isometric kinesiotherapy - individual gymnastic techniques/exercises, according to indications, with elements of joint massage;
kinesiotherapy using the Exarta installation
kinesio taping;
ozone therapy - treatment with active oxygen;
physiotherapy;
physiotherapy with enzyme preparations;
medicinal droppers;
hirudotherapy - treatment with leeches;
botulinum therapy - treatment with botulinum toxin preparations;

For each patient in our clinic, the attending physician individually selects a set of treatment methods, depending on the severity of the disorder and curvature of posture.

Causes of poor posture in children

As we have already mentioned, deformities can be congenital or acquired. Moreover, 90-95% of cases belong specifically to the second group. The prerequisites for the disorder influence the symptoms and characteristics of the course of the pathology.

Congenital causes include the following factors:

incorrect position of the fetus in the womb;
intrauterine pathologies of the formation of the spine (for example, the formation of additional vertebrae, their wedge-shaped deformation, etc.);
connective tissue dysplasia;
myotonic syndrome;
injuries during childbirth (torticollis, subluxation of the first cervical vertebra, dislocation of the hip joint, etc.).

Some congenital abnormalities can correct themselves as the body grows. But only on condition that the child is absolutely healthy. Otherwise, pathologies progress, causing curvature of posture and severe forms of deformation.

The causes of acquired curvature include:

Insufficient physical activity. If parents focus only on the child’s intellectual abilities, he spends a lot of time sitting and moves little. Accordingly, the muscular framework that holds the spine in the correct position does not develop.
Unphysiological pose. If a child slouches, always carries a backpack in one hand, or sits at an inappropriate desk height, asymmetry of the musculoskeletal system will develop over time. This same group of prerequisites also includes planting the baby too early or putting him on his feet, or placing the baby on one arm.
Injuries, illnesses. Past illnesses can cause complications that affect the joints and cause curvature of the spine. At risk are children who have had polio, tuberculosis, osteomyelitis, children with diagnosed myopia, strabismus, astigmatism, and fractures. Obesity and a deficiency of nutrients in the body can also be a prerequisite.

Types of posture disorders in children

Doctors resort to the following classification of distortions:

Disturbances in the sagittal plane are an incorrect relationship between the physiological curves of the spine. These include smoothing or increasing vertebral curves, increased or decreased lumbar lordosis, thoracic kyphosis (round or flat back, stoop).
Disorders in the frontal plane - asymmetrical arrangement of the halves of the body.

Experts also distinguish three degrees of severity of curvature :

First degree – posture is slightly changed; the pathology can be easily eliminated by simply concentrating the child’s attention on the correct body position.
The second degree is more severe deformation, which is treated by unloading the spine.
The third degree is severe distortion that requires complex long-term treatment.

Preschoolers are most often diagnosed with pathology of 1-2 degrees, in schoolchildren and adolescents - more complex types of 2-3 degrees. Source: Etiology and classification of postural disorders. Levin A.V., Vikulov A.D. Yaroslavl Pedagogical Bulletin, 2013.

Symptoms

The effectiveness of combating distortion depends on how early parents recognized the presence of deviations and sought medical help. First of all, it is necessary to regularly examine the child. It is important to pay attention to the position of the shoulders and shoulder blades, which should be at the same level. If it is difficult to make a visual assessment, you can use available tools for this.

It is easy to detect abnormalities in babies by the folds under the buttocks, as well as by the position of the collarbones and nipples. They should be symmetrical and on the same level.

Viewing from the side will reveal a stooped or rounded back. The simplest test is to place the child's back against a wall. The back of the head, shoulder blades, buttocks and lower legs should touch a flat plane. After this you need to take a step forward. If there are deviations, they will immediately become visible.

The most obvious signs of pathology can also help recognize the presence of postural disorders in a child :

When you slouch, your head and shoulders move forward, and your shoulder blades protrude unnaturally back.
With kyphosis (round back), the head tilts forward, the shoulders droop, and the chest sinks. At the same time, there is flattening of the buttocks, half-bent legs and weakened muscle tone.
With kypholordotic disorders (round-concave back), the head and upper shoulder girdle tilt forward, the stomach protrudes, and excessive extension of the legs at the knees occurs.
With lordosis and thoracic kyphosis (flat-concave back), the angle of the pelvis increases, the buttocks and pelvis protrude.
With a flat back, the pelvic tilt decreases, the shoulder blades protrude back, and the stomach protrudes forward.
Asymmetrical posture is manifested by an arched deformation, which is directed to the right or left. The head tilts to the side, and the shoulder blades, shoulders and nipples are at different levels.

Children with such disorders suffer from lethargy, apathy, anemia and poor memory. They often suffer from colds, pneumonia, and bronchitis. There are complaints of pain in the back and head, poor vision.

To maintain correct posture, you need to follow certain rules

Let's list them:

- adhere to an active lifestyle;

- if work activity is associated with any monotonous movements, with prolonged muscle tension, with a load on the spine, rest the muscles more often and perform gymnastic exercises that require full movement of the spine; Even simple stretches with bending of the spine forward and backward, with turning the head to the right or left can be useful;

- from time to time lie on a hard surface (turn from your back to your side, to your stomach and back); refuse feather beds;

- use a special roller;

- if you have to work at a desk, arrange your workplace (the height of the table, the height of the chair, the curvature of the back of the chair, the presence or absence of armrests are taken into account; if necessary, there must be a footrest); the working field should not be too far from the eyes so that there is no need to bend over or reach for anything;

— if you have to stand while working, the working area should be located within arm’s reach;

- do not wear (or at least do not wear too often, every day) high-heeled shoes - 5-6 cm and above;

— when carrying heavy loads, it is necessary to load both hands evenly;

- keep your back straight when lifting weights; in other words, lift weights not with your back, but with your legs, getting up from your haunches; a similar principle must be followed when lowering weights; if necessary, put a load on the back muscles, increase this load gradually, starting with a small one;

- daily perform a set of gymnastic exercises aimed at strengthening the muscles of the neck and back (see Gymnastic exercises to strengthen the back muscles).

Diagnostics

If symptoms are detected and there are suspicions of the development of disorders, one should not delay consultation with a pediatric orthopedic traumatologist or vertebrologist. The specialist conducts a visual examination: examines the bone structures in a standing position. In this case, it is important to evaluate the position in all projections: rear, side, front. The doctor looks for deviations from the normal position of the skeleton and studies the presence of asymmetry. For maximum accuracy, the specialist measures various evaluation indicators: the distance between the shoulder blades, the length of the legs, the segment between the lower corners of the shoulder blades and the seventh cervical vertebra, etc.

One of the most effective methods for diagnosing disorders is the Adams test. To carry it out, you just need to tilt the patient's torso forward. Thanks to this, the doctor will determine the degree of twisting and the state of the vertebral curves, which help identify scoliosis.

In order to establish the diagnosis as accurately as possible and develop an effective treatment regimen, the doctor prescribes additional instrumental studies: x-rays, computed tomography or magnetic resonance imaging. Source: Diagnosis of postural disorders and deformities of the spinal column. Orlov S.A., Yukhvid E.V., Ionina E.V. Russian Bulletin of Perinatology and Pediatrics, 2021. p. 269.

How to understand that there are problems with posture

Let's go backwards and describe what correct posture looks like:

The head is positioned straight.
The shoulder blades and shoulders are located on the same line.
The spine, when viewed from the back, is straight.
In the cervical and lumbar regions, the deflection is no thicker than the palm of a person.
If you mentally draw a line from the seventh cervical vertebra to the intergluteal fold, it will be straight.
All parts of the body are strictly symmetrical relative to the spine.
The correct posture of a child under 7 years old looks like this: the shoulders are not raised or protruding, the shoulder blades look back, and the stomach protrudes slightly forward, the chest is symmetrical.
Normal posture of a school-age child: the shoulder blades protrude slightly back, and the stomach is protruded, the deflection in the lumbar region is clearly visible.
The correct posture for a teenager: the stomach is retracted, in girls there is a pronounced bend in the lumbar region, in boys - in the thoracic region.

Treatment

Clinical recommendations for identifying disorders are comprehensive. The main goal of therapy is to form a strong muscle corset and develop the correct stereotype of body position. For this purpose they prescribe:

Physical therapy, gymnastics . Adequate physical activity according to age is an important part of therapy. Exercises help strengthen muscles, form a strong frame that will fix the spinal column in the correct position. Source: Exercise therapy for postural disorders, scoliosis and flat feet. Aliverdieva M.S., Demyanova L.M., Smirnova O.S. Psychology and pedagogy: methods and problems of practical application, 2021.
Massage . The patient is selected the necessary type of massage: general, orthopedic, back, chest, lower back, etc.
Physiotherapy . Good effects are demonstrated by electrophoresis, electrical stimulation of the spinal muscles, thalassotherapy, peloid therapy and other procedures that are carried out in courses as prescribed by a doctor.
Manual therapy . Sessions help correct the position of the spine by releasing compressed nerve fibers, normalizing nerve impulses, and removing blocks.
Hydrotherapy . Involves the use of water procedures that stimulate blood circulation, relieve spasms, and correct curvature.
Therapeutic swimming . Allows you to naturally unload the spine, establish symmetrical muscle function and strengthen them, improve coordination of movements. Source: Correction of poor posture in school-age children. Danilenko L.A., Artamonova M.V., Artemyeva E.M. Medicine: theory and practice, 2021. p. 181.

Measures to prevent postural disorders in children

Therapy for postural distortions requires a lot of time and effort. It is much easier to prevent disease. After all, in order to keep bone structures healthy, it is enough to accustom the child to:

active lifestyle;
playing sports with uniform loads on the entire body;
proper nutrition, which will allow you to control weight and prevent obesity.

At the same time, it is important to regulate the time that the child spends at the computer or TV and take breaks during classes. It is also necessary to ensure that the shoes are the right size and meet orthopedic standards, and that the chair and table at which the child works are selected according to height and anatomical features. Source: Prevention of poor posture in children. Pokatilov A.B., Novak A.P., Khvorostova A.V. Chief Doctor of the South of Russia, 2021. p. 13-19.

Sources:

Prevention of postural disorders in children. Pokatilov A.B., Novak A.P., Khvorostova A.V. Chief Doctor of the South of Russia, 2021. p. 13-19
Etiology and classification of postural disorders. Levin A.V., Vikulov A.D. Yaroslavl Pedagogical Bulletin, 2013
Poor posture in children of primary school age. Methods for the prevention and correction of poor posture using physical education. Gorbunova T.A. Innovative Science, 2016
Correction of poor posture in school-age children. Danilenko L.A., Artamonova M.V., Artemyeva E.M. Medicine: theory and practice, 2021. p. 181
Diagnosis of postural disorders and spinal column deformities. Orlov S.A., Yukhvid E.V., Ionina E.V. Russian Bulletin of Perinatology and Pediatrics, 2021. p. 269
Exercise therapy for postural disorders, scoliosis and flat feet. Aliverdieva M.S., Demyanova L.M., Smirnova O.S. Psychology and pedagogy: methods and problems of practical application, 2016

How to correct your posture in 10 seconds

Correct posture ensures good health, gives confidence and even helps you visually lose a few kilograms. We present 4 simple exercises that will help straighten your back and maintain the result.

Greetings.
Place your hands behind your back and join your palms as shown in the figure. It is important that the line of the arms from the right to the left elbow is straight. The shoulder blades should move towards each other during the exercise. Stay in this position for 10 seconds.

Lock.

Place one hand behind your back, lift the other and, bending at the elbow, bring it to your shoulder blades. Clasp your palms together, extending the elbow of your raised arm upward. After 5 seconds, switch hands.

Crunches.

Without changing the position of your lower body, place your hands behind your head and rotate your upper torso to the left so that your shoulders are perpendicular to the back of the chair. Hold this position for 5 seconds, then turn to the right.

Tilts.

Sit on the edge of a chair and place your hands behind your head. Then arch your back and look at the ceiling. Slowly move your head back, still looking up, and rest it against the back of the chair.

Attention!

The information on the site does not constitute a medical diagnosis or a guide to action and
is intended for informational purposes only.