Scoliosis of the spine, stoop, impaired posture in children and adults - Causes, symptoms and treatment. MF.

  • Scoliosis of the spine, stoop, impaired posture in children and adults - Causes, symptoms and treatment. MF.

    Memo for parents, educators and medical workers of kindergartens, polyclinics and schools

    Ten-year-old Natasha O. discovered curvature of the spine - scoliosis .The deformation of the spine was neglected and led to the formation of a costal hump and a sharp restriction of the mobility of the trunk. If the initial forms of curvature of the spine are well amenable to correction, then in such neglected cases, the results, even with a long course of treatment, are unsuccessful. In such cases, in order to stop further progression of the curvature of the spine and costal hump, a severe spinal surgery is necessary. This difficult operation could be avoided if Natasha's parents were more attentive to their child.

    And here's another example. At eleven-year-old Jura K. doctors determined a violation of posture( one shoulder above the other, the shoulder blades were protected from the chest, walked stooped).On the advice of the doctor, Yura regularly took up special corrective gymnastics in the room of physiotherapy exercises and at home regularly and developed a correct posture.

    Posture is called the ability of a person to keep his body in different positions. Posture can be right and wrong.

    Correct posture refers to the habitual posture of a person with ease who has the ability to keep the body and head straight without too much stress. A person with a correct posture has a slight gait, shoulders are slightly lowered and laid back, the chest is forward, the stomach is pulled up, legs are bent at the knee joints( Figure 1).

    A person who does not know how to properly hold his body, stands and walks on half-bent legs, hunched over, lowering his head and shoulders, sticking out his stomach. This is not only ugly, but also harmful. With poor posture, the internal organs are difficult to work.

    Fig.1. Correct posture.

    Evenly expressed physiological curves of the spine, upper arms, nipples, awns of the iliac bones, scapula, gluteal folds are located on one level. The waist triangles are equally pronounced on both sides. The line of spinous processes of the vertebrae is straight.

    Disorder of posture( stoop, excessive deviation of the spine forward - lordosis, or back - kyphosis, flat back) and lateral curvature of the spine - scoliosis are very common among preschool and especially early school children. This is most often physically weakened children who have experienced severe illnesses in the early childhood or who suffer from some kind of chronic illness. Therefore, it is very important for these children to properly organize physical education from early childhood. This contributes to the normal development of the skeleton and muscular system of the child( especially the muscles of the back and abdomen).If there are deviations in the development of these systems, then there are various violations of posture, which can later serve as a cause of curvature of the spine.

    Posture is developed in the process of growth and development of the child. The nature of the human posture is greatly influenced by the spine. The spine provides the vertical position of the body, supports the heaviness of the head and upper body.

    In the womb of the mother, the spine of the fetus is a uniform arc. Immediately after the birth of the child, the spine straightens almost to a straight line. From this moment, the formation of posture begins. When the baby begins to hold his head in the raised position, the cervical spine forms a bend forward( cervical lordosis);when the child begins to sit, a bend is formed in the thoracic spine, facing backwards( kyphosis), and when it begins to walk, a bend of the spine with a convexity facing forward in the lumbar part( lumbar lordosis) is formed.

    Posture defects and curvature of the spine can occur even in infancy. There are many reasons for the violation of posture. Some of them are determined by the state of health and physical development of the child, others - the surrounding environment. Among all factors and causes, an important role in the upbringing of good posture is played by adequate nutrition. The lack of vitamins, mineral salts in food adversely affects the condition of the child's skeleton and muscles and predisposes to the development of poor posture.

    Fig.2.Such poses contribute to the formation of an incorrect posture.

    The most common cause of postural disorders is either weakness of the trunk muscles or uneven development of the trunk. Permanent wearing of a baby on one hand, trying to plant too early,

    put on the legs or teach the child to walk, too soft and sagging bed, keeping the child during walks for the same hand, not matching the growth of the child's furniture, clothing, improper sitting at the table, reading and drawing in bed, wearing a portfolio in oneand the same hand, the riding of children on a bicycle for adults under the frame, the habit of standing with one leg, prolonged illness( rickets) or frequent diseases that weaken the body, the unsatisfactory general regime of the child( passive rest, lack of walks, lackintramural motor mode) and many other things contribute to the formation of an incorrect posture and posture.

    The most common violation of posture is stoop. The stooped person has a head lowered, the shoulder joints are folded forward, the breast is flat, the back is round, the pterygoids are paddle-shaped.

    The kyphotic posture is characterized by the strengthening of the cervical and lumbar curvature. With lordotic posture, the curvature of the spine is pronounced forward in the lumbar region. A straightened posture( flat back) is characterized by a small expression of the bends of the spine. At first, posture disorders do not cause changes in the spine. But if the wrong posture becomes habitual, and the reasons that support the maintenance of an incorrect posture are not eliminated, then there are changes in the spine. The spine begins to bend, there is a scoliosis.

    Scoliosis is a lateral curvature of the spine. In addition to lateral curvature, in scoliosis a rib humps is formed.

    Scoliosis can be congenital and acquired. Congenital scoliosis is most often associated with an anomaly in the development of the spine( abnormal development) - superfluous vertebrae, excess ribs, anomaly of the transverse processes, fusion of the arches and processes, non-growth of the arches, wedge-shaped vertebrae, etc. Congenital scoliosis is about 5%, and the remaining 95%arise in the process of development and growth of the body.

    Fig.4. Fig.3. Fig.5. Fig.6.
    Kephotic Saddle Lordotic Flat back
    posture.posture.(straightened posture)

    Among the acquired scoliosis are:

    a) rickety, due to rickets;

    b) the usual or, as they are called, school scoliosis, arising against the background of incorrect habitual postures and incorrect posture:

    c) static scoliosis that occurs with an incorrect lateral standing of the pelvis;this is often observed with the unequal development of the lower limbs( one limb shorter than the other);

    d) paralytic scoliosis that occurs when the muscles of the trunk are affected;this is more often associated with the transferred polio.

    Other forms of acquired scoliosis( cicatricial - after surgery on the chest, after extensive constricting scars as a result of a burn, traumatic - after various injuries, reflex-painful - more often on the ground of lesion of nerve roots) are not so common. The size of the curvature of the spine distinguishes three degrees of scoliosis:

    The first degree of scoliosis is characterized by a slight lateral deviation of the spine from the midline.

    The second degree is characterized by a marked deviation of the spine from the midline and the beginning costal hump.

    The third degree of scoliosis is characterized by persistent and more pronounced deformation of the thorax, the presence of a large costal spine and a sharp restriction of the mobility of the spine.

    First degree Second degree
    scoliosis of scoliosis

    Fig.9.The third degree of scoliosis

    Diagnosis of scoliosis of the spine, stoop, posture disorder

    The method of revealing scoliosis and incorrect posture is the examination of the child. Inspection should be done in good light, with a different position of the child, with sufficient degree of exposure of the child's body. Inspection should be done slowly and in a certain sequence: the front and back of the body, from the side, with the body tilted forward, lying down.

    We should not speak out loud about the various deviations from the posture noted by the child. Hearing such remarks, the child tries to correct the wrong posture, thereby disorienting and complicating the diagnosis of the initial forms of scoliosis.

    When examining the child from the front, attention is drawn to the position of the head, the level of the shoulder and nipple, the shape of the chest and abdomen, the position of the body, the symmetry of the waist triangles( the distance between the lowered arm and the recess of the waist), and the shape of the legs.

    When examining the child from the back, attention should be paid to the position of the head, the level of the shoulder, the position of the shoulder blades( their level, the distance from the spine, the density of their attachment to the chest), the symmetry of the waist triangles, the symmetry of the spinous process, the level of the iliac bones.

    When the body is tilted( the chin should be pressed to the chest, and the hands are freely lowered), attention is drawn to the line of spinous processes, the symmetry of the relief of the chest, the presence of a muscular cushion in the lumbar region and the costal hump.

    When viewed from the side, the position of the head, smoothness or strengthening of the physiological curves of the spine in the thoracic and lumbar regions are determined.

    Fig.10.A pronounced rib hump on the right and a muscular cushion in the lumbar region to the left. The line of spinous processes is curved. The dotted line indicates the appearance with the correct posture.

    With correct posture and absence of curvature of the spine, a direct head support is detected in the examination of children, the symmetrical arrangement of the scapula, sheynopleic lines, axillary folds, iliac bones on both sides, and in the presence of scoliosis and impaired posture, their symmetry is disrupted to varying degrees, depending on the degree of scoliosisand postural defects.

    It is important to determine the length of the lower limbs( distance from the anteroposterior iliac bone to the end of the outer ankle).Normally, the length of the limbs should be the same. Our observations show that the majority of children sent for consultation in the medical and sports clinic have defects in posture and curvature of the spine due to the shortening of one limb( about 35%).Measuring the length of the limb is spent lying on the back, legs together;it should be borne in mind that the tip of the nose, navel and the line of connection of the feet are on a straight line. If this condition is observed, shortening of the limbs can sometimes be noticed by eye.

    If you find a violation of posture and curvature of the spine, you should immediately begin treatment, because the violation of posture and scoliosis can quickly progress and lead to severe consequences( costal spinal vertebrae, disability).

    Early detection of defects in posture, initial forms of scoliosis and early initiation of treatment with prolonged use of corrective gymnastics gives a more favorable effect. Scoliosis of the initial degree and violation of posture are corrected with the help of physical exercises of a special nature, which help to remove the spine from the vicious circle and strengthen certain muscle groups.

    Curvature of the spine, associated with a shortening of the lower limb, is corrected by compensating for the length of the limb. To do this, it is enough to hit the heel or to insert the insole under the heel by the amount of shortening. It must be remembered that the heel should be padded on the street and home shoes of the child.

    With late detection of scoliosis, it is often not possible to correct the vicious position of the spine and even stop the progression of the spinal curvature by physical exercises. In such cases it is necessary to resort to a serious operation to fix the spine.

    DEAR PARENTS!EDUCATORS AND MEDICAL WORKERS OF CHILDREN'S GARDENS AND SCHOOLS!In the identification and removal of violations of posture and scoliosis, an important role is played by the relationship between you. BE CAREFUL!FOLLOW THE CHILDREN!

    Only you can notice in time the initial disturbance of posture and scoliosis( omission of the shoulder and shoulder blades on one side, stoop, lateral curvature of the spine, protrusion of the ribs).

    If you find these children, immediately send them to a doctor for advice.


    Treatment of scoliosis of the spine, stoop, stiffness, posture

    Before beginning treatment of scoliosis it is necessary to obtain not only clinical, but also radiographic data on the degree of scoliotic disease. According to the roentgenogram, you can identify the cause of scoliosis, determine torsion, the magnitude of the scoliotic arch, structural changes, signs of osteochondrosis.

    Orthopedic doctors treat scoliosis. Manipulation of the spine( exercise, manual therapy, massage) can only be carried out by highly qualified specialists without harm to health. In some forms of scoliosis, manual therapy is contraindicated. Treatment of scoliosis begins with preventive measures for the correct organization of life. This includes the organization of the working space( that in the workplace the patient with scoliosis does not stoop and does not overstrained the vertebral column), the organization of sleep( soft bed is contraindicated), proper nutrition, regular walks on foot. All this is useful for the prevention of scoliosis.

    Usually scoliosis treatment consists of three stages: active influence on curvature, correction of curvature, fixation of the correct position of the spine. The third stage is the most difficult. Relaxed or not working muscles of the back should be trained with the help of special medical gymnastics, which the specialist appoints, depending on the degree of the disease and the nature of the scoliosis in this patient. To the aid comes the wearing of the deroting corset, swimming, balance training, training of the patient with scoliosis with the methods of relaxing the spine and the muscles of the back. The formation of correct posture in the treatment of scoliosis normalizes the work of internal organs.

    Scoliosis treatment methods

    Scoliosis treatment methods can be divided into 3 groups: corrective therapeutic physical therapy, application of special remedial apparatus, surgical treatment. The choice of method of treatment depends, first of all, on the degree of development of scoliosis. Operative treatment is recommended starting with grade II.Apparatus recently used much less often, becausethe use of them in the early stages of scoliosis is inexpedient, and at late stages it is ineffective. The therapeutic method continues to be aimed at increasing the tone of the muscles of one half of the back and relaxing the other, strengthening the ligament apparatus, and so on.

    Complex of physiotherapy exercises for scoliosis:

    1 - the starting position standing on the toes with the hands up and locked into the lock;produce a swinging trunk from side to side.
    2- starting position standing, feet shoulder width apart, arms lowered;Sliding movement of the arm along the trunk upward raises the arm to the shoulder and simultaneously tilts the trunk in the opposite direction, the other hand slides along the leg, then the same in the other direction.
    3- starting position standing, feet shoulder width apart, arms lowered;one arm is lifted up and retracted, while simultaneously pulling back the other hand;repeat several times, changing the position of the hands.
    4- the initial standing position, feet shoulder width apart;raise their hands up, simultaneously leaning in the opposite direction. The other hand is behind the back. Repeated several times, changing the position of the hands with slopes in one and the other side.
    5- standing sideways against the wall and holding hands( one from below, the other from above) behind the crossbeams, hold a strong slope in the side.
    6- starting position on one knee, hands on the waist, one arm lifted up and simultaneously tilted in the opposite direction.
    7- the initial position lying on the abdomen. They spread their arms to the sides and simultaneously bend.
    8- the initial position lying on the abdomen. Hands are extended forward, raise the upper part of the trunk and simultaneously one leg. Repeated several times, changing the position of the legs.
    9- the initial position lying on the abdomen. Pulling forward hands with a stick, raise their hands up, caving in, and return to their original position.
    10- the starting position on all fours. Raise one hand and simultaneously pull back the opposite leg, then return to the starting position. Repeated several times, changing the position of the hands and feet.
    11- the initial position sitting on the legs bent under themselves. They raise their hands upwards, caving in, and simultaneously pull back the opposite leg. Then they return to their original position. Repeated several times, changing the position of the hands and feet.
    12- The starting position is on all fours. Turn the body, while drawing his arm to the side, and return to the starting position. Repeat several times on and the other side.
    13-14 - standing on his knees and leaning on his hands, sliding their arms forward, then pull them to their knees.
    15 - asymmetric hanging on the wall - one arm is extended( on the side of curvature), the other is bent.
    16-17 - crawling on the knees, pulling alternately the right and left arm and pulling up the leg at the same time.
    18 - sitting on an oblique seat, the surface of which should be inclined towards the curvature of the spine, one hand is held on the waist, the other( from the side of the curvature) is led to the head.
    19 - sitting on an oblique seat, the surface of which should be inclined towards the curvature of the spine, produce the torso of the trunk in the direction opposite to the curvature.
    20( final exercise) - lying on his back, stretched, arms along the trunk.

    The most effective permanent exercise of exercise therapy with courses of physiotherapy( both aparatnoy, and balneal), manual therapy, reflexotherapy and massage. In an optimal variant such courses of treatment are conducted in sanatorium establishments.

    Nutrition in the treatment of scoliosis

    Rational nutrition of the patient in the treatment of scoliosis is given special attention, especially its protein component. After all, amino acids from protein products are plastic material for regeneration( restoration) of muscle tissue. In the diet of children and adolescents should be present proteins of animal and vegetable origin. It should be noted that proteins of animal origin are the most complete in amino acid composition, therefore meat, fish, seafood, sour-milk products, eggs should take a worthy place in the patient's nutrition with scoliosis.

    Prevention of scoliosis and postural disorders

    At school age, it is necessary to pay close attention to the child's bearing during classes, to prohibit the wearing of briefcases and bags with textbooks in one hand. Most preferred are knapsacks and backpacks, especially with suppressors that prevent stoop. The workplace of the child, both in school and at home, must be organized correctly. Exercises and rest should be properly alternated. A major role in prevention is given to physical culture and sports. Most preferred are swimming, rowing, rhythmic gymnastics. Dancing( folk, ball, sports) under the guidance of a competent leader also contributes to the formation of proper posture and the harmonious development of the musculoskeletal system.

    Associate professor GE Egorov
    Novokuznetsk city medical and sports clinic, Department of physiotherapy, physiotherapy and balneology of Novokuznetsk GIDUV.