SIGNS AND SYMPTOMS OF THE BAD POSTURE

• A balanced posture aligns the spine with the head and limbs.
• However, bad habits such as slouching and inactivity cause tension and weariness in the
muscles, which aggravates imbalanced posture.

Lumbar Pain
• One of the most widely recognized adverse effects of poor posture is the unnecessary strain
placed on the upper and lower back.
• In addition to flattening your back muscles, slouching forward compresses your shoulder
blades.
• You are most likely not sitting up straight if you experience pain after a long day at work in the
area around your tailbone and behind your neck.

Headache
• Bad posture strains the posterior muscles, which negatively impacts the neck.
• The forward head posture puts a lot of strain on the neck’s joints and discs as they try to
support the weight of the head.
• As a result, the muscles in the neck are overworked, which increases tension in the area where
the muscles attach to the back of the head.
• Tension headaches are brought on by the strain this causes.

Insufficient Sleep
• Another consequence of poor posture is sleeping too little.
• Lack of complete body relaxation can result in tossing and turning all night in an attempt to
find a posture that is comfortable for the back and neck, which can moderate to hours of sleep
deprivation.

The Curvature of the Spine

• When the three main curves of the spine are properly aligned, an “S” shape is formed.
• Although the spine is made to withstand trauma, bad posture can progressively reduce its
ability to do so by placing too much pressure in the incorrect place and making your body more
vulnerable to additional injury.
• The majority of people who have hunched back are teenagers and young adults.
• This condition typically occurs in conjunction with rounded shoulders and a forward head
posture.
Digestive Problems:
• Seated incorrectly can also influence to digestive problems.
• Compression can cause an organ’s ability to function improperly.
• Moreover, slouching puts strain on the stomach, which causes the acid to flow in the
wrong direction and results in acid reflux and heartburn.

MAIN CAUSES OF BAD POSTURE

Everyday Routines:
• It is simple to ignore how people adjust their posture during daily activities to prevent
muscle strain and spasms.
• The body is frequently compelled to employ alternative, less effective muscle
contraction and extension patterns.
• The muscles and spine are not in proper alignment, even though the person can move.

Injury:
• Following an injury, muscles often tense up to protect the damaged area.
• Because they spasm so often, the muscles weaken over time.
• Unbalanced muscles that are looking after an injury versus those that are still working
normally can also result in abnormal posture.

Genetics:
• There are situations when poor posture is only inherited.
• birth defects may affect an individual’s posture and the development of their hips and
spine.
• Fortunately, these conditions can be managed with the aid of a medical specialist

Stress:
• Poor body alignment can also be caused by sentimental factors, such as stress, in
addition to physical ones.
• Muscles that are frequently tense due to stress have a negative impact on posture.

Muscle Tension and Weakness:

• You may experience tension or weakness in your muscles when you perform daily tasks
that strain or use your muscles unevenly, like lifting heavy objects.
• Your posture may suffer when specific muscle groups become tense or weak.
Shoe Selection:
• Shoes can also have a major impact on posture, especially if they do not offer enough
support.
• Because of the uneven forces on the ankle, knee, hip, and lower back, wearing old shoes
can cause pain and poor posture.
• Because they do not offer enough support, high heels can also cause the body to become
misaligned.

Technology Use:
• Most people bow or tilt their heads forward or downward when looking at their laptops
and smartphones.
• The body may progressively become out of alignment if you spend your entire day in
front of a computer or on a smartphone.

Common Postural Problems

Forward Head:
• Having a forward head posture is when your ears are in front of your vertical midline.
• If your body is in alignment, your shoulders and ears should line up with your vertical
midline.
• This forward head posture is also known as geek neck, text neck, or tech neck.
• It commonly happens when you slouch over a phone, computer, or, if you drive a lot, the
steering wheel.
• Ageing may also be the cause, as you lose strength in your upper body muscles.
Kyphosis:
• An abnormal curvature of the thoracic spine is called kyphosis. which is the upper back,
where the shoulders are rounded forward.
• Another name for it is the person with scoliosis. As you age and lose strength in your
spinal bones, you may develop round shoulders due to osteoporosis (bone thinning). It
is common in elderly girls.
• Degeneration of vertebrae or spinal discs is another age-related cause.
• Infections, chemotherapy, radiation therapy for cancer, and diseases such as polio or
Scheuermann’s disease can all cause kyphosis in younger people.

Swayback Lordosis or hyper lordosis:

• These are other names for swayback, a disorder in which your hips and pelvis lean forward
in front of your body’s midline.
• In this position, the inward curve of your lower back is accentuated.
• Your stomach and rear end stick out as you stand up, making you appear to be slouching
back.
• Your back muscles may get tense from prolonged sitting, which may lead to mild swayback.
• Additionally, prolonged sitting can weaken the abdominal muscles and glutes.
Flatback:
• This is a condition where the normal curve of your lower spine loses some of its curvature.
• Your lower back looks straight and you stoop forward.
• It can be present at birth, or it can result from some kinds of back surgery or degenerative
conditions of the spine, including ankylosing spondylitis (inflammatory arthritis), disc
degeneration, and vertebrae compression.
• Flatback can make it painful for you to stand for long periods.
Postural Defects and Corrective Exercises
What Postural Defects?
• Postural defects refer to abnormalities or misalignments in the body’s posture, often affecting
the spine or other skeletal structures.
• Common examples include kyphosis (excessive rounding of the upper back), lordosis
(increased curvature of the lower back), and scoliosis (sideways curvature of the spine).
• These defects can result from various factors, including poor ergonomics, muscle imbalances,
or underlying medical conditions.
• Correcting posture through exercises, physical therapy, and lifestyle adjustments is often
recommended to alleviate discomfort and prevent further issues.

1. Sagittal Plane: -
Lordosis: Excessive inward curvature of the lower back.
Kyphosis: Increased rounding of the upper back.

2. Frontal Plane: -
Scoliosis: Sideways curvature of the spine, leading to an S or C shape. –
Shoulder Asymmetry: Imbalance or unevenness in the height or positioning of the shoulders.

3. Transverse Plane: -
Rotational Deviations: Twisting or rotation of the spine or limbs, contributing to an
asymmetrical appearance.
Postural Defects in Different Directions
1. Forward Shoulder Posture:
Characterized by shoulders that are rounded forward, which may lead to upper back and neck pain.

2. Swayback (Excessive Lordosis):

An exaggerated inward curve of the lower back that can cause lower back pain and affect gait.

3. Flat Back Posture:

Lack of normal lumbar curvature, leading to a flattening of the lower back, potentially causing
discomfort and decreased mobility.

4. Knock Knees (Genu Valgum):

Inward curvature of the knees, which may affect the alignment of the entire leg.
5. Bow Legs (Genu Varum):
Outward curvature of the knees, creating a bow-legged appearance, potentially causing knee and hip
issues.

6. Tight Hip Flexors:

Prolonged sitting can contribute to tight hip flexor muscles, leading to an anterior pelvic tilt and lower
back discomfort.

7. Caused by Muscle Imbalances:

These defects result from poor habits, muscle weakness, or tightness without significant structural
changes in the spine or skeletal system.
Structural Postural Defects:
Abnormalities in the skeletal system, often affecting the alignment of skeletal or soft tissue structures,
such as the spine, joints, or bones.

Examples:
Scoliosis, kyphosis, and lordosis, which may be caused by congenital factors, developmental issues,
or medical conditions affecting the spine’s shape

Scoliosis
• It is an abnormal lateral curvature of the spine.
• It is most often diagnosed in childhood or early adolescence.
• Severe cases may require medical intervention

Definition:
Scoliosis is defined by a lateral curvature of the spine exceeding 10 degrees, accompanied by vertebral
rotation.
Classifications:
1. Structural Scoliosis:
Irreversible lateral curvature often attributed to congenital, neuromuscular, or idiopathic causes.
1. Non-structural (Functional) Scoliosis:
Reversible lateral curvature due to factors like muscle imbalance or leg length discrepancy
Causes and Risk Factors:

1. Idiopathic Scoliosis:
The most common form with an unknown cause, often emerging during adolescence.
2. Congenital Scoliosis:
Present at birth due to vertebral anomalies.
3. Neuromuscular Scoliosis:
Resulting from conditions like cerebral palsy or muscular dystrophy.

Clinical Assessment
1. Visual Inspection and Physical Examination
A systematic clinical assessment is crucial for identifying scoliosis:

• Forward Bending Test (Adam’s Test):

Observing for asymmetry and rib prominence when the patient bends forward.

• Shoulder and Hip Level Assessment:

Evaluating for uneven shoulder or hip levels.

• Spinal Range of Motion:

Assessing flexibility and rotational components of the curvature.
2. Neurological Assessment:
Given the association between scoliosis and neuromuscular conditions, a neurological examination
is vital
• Muscle Strength Testing:
Assessing for muscle weakness or imbalances.
• Reflexes and Sensation:
Checking for abnormalities indicative of underlying neurological issues.

Measurement Tools
Several measurement tools aid in quantifying the degree and characteristics of scoliotic curves
• Cobb Angle Measurement:
Utilizing X-rays to measure the angle formed by the most tilted vertebrae.
• Scoliometer:
A non-invasive tool to measure trunk rotation and monitor progression.
Diagnostic Imaging:
1. X-rays :
a) Standard X-rays: Provide detailed images to measure the Cobb angle and assess
vertebral rotation.
b) EOS Imaging: Low-dose 3D imaging for comprehensive visualization with reduced
radiation exposure
2. Magnetic Resonance Imaging (MRI):
MRI is employed to assess soft tissues, rule out spinal cord abnormalities, and evaluate for
underlying conditions:
a) Congenital Anomalies:
Identifying structural issues contributing to scoliosis.
b) Neuromuscular Causes:
Assessing the spinal cord and nerve roots for abnormalities.
3. Computed Tomography (CT) Scan:
CT scans offer detailed cross-sectional images and are primarily used when assessing bony structures
a) Congenital Scoliosis:
Identifying vertebral anomalies and malformations.
b) Complex Cases:
Evaluating bony anatomy when additional information is required.
Scoliosis in Different Age Groups

Paediatric Scoliosis:
Early detection and intervention in paediatric cases are crucial for optimal outcomes

1. Adolescent Idiopathic Scoliosis (AIS):

Screening during adolescence, often in school settings, to identify early signs.
2. Congenital Scoliosis:
Detecting and addressing structural anomalies during infancy or childhood.

Adult Scoliosis
Identifying scoliosis in adults is essential, especially when degenerative changes occur
1. Degenerative Scoliosis:
Recognizing and assessing curvature progression in the aging spine.
2. Progression of Adolescent-Onset Scoliosis:
Monitoring for continued progression into adulthood.

Geriatric Scoliosis
In the elderly population, scoliosis may present unique challenges
1. Degenerative Changes:
Identifying scoliosis superimposed on degenerative conditions like osteoporosis.
2. Assessing Impact on Quality of Life:
Considering treatment options based on patient-specific factors and overall health.

Treatment Considerations

1. Conservative Approaches
• Observation:
Monitoring mild curves without progression, especially in adolescent cases.
• Physical Therapy:
Incorporating exercises to improve muscle strength, flexibility, and posture.
• Bracing:
For adolescents with moderate curves, bracing may be considered to prevent progression.
2. Medical Interventions
• Pain Management:
Nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics for pain relief.
• Orthotic Devices:
Supportive braces or spinal orthotics to manage curvature and alleviate symptoms.

3. Surgical Management
• Spinal Fusion:
In severe cases or when conservative measures fail, spinal fusion surgery may be considered.
• Growth-Friendly Implants:
In pediatric cases, the use of growth friendly implants may allow for controlled spinal growth.
Prognosis and Long-Term Management

Monitoring and Follow-Up

Regular monitoring is essential to track progression and assess treatment efficacy

✓ Radiographic Monitoring:
Periodic X-rays to measure Cobb angles and evaluate curve progression.
✓ Clinical Follow-Up:
Assessing symptoms, functional limitations, and impact on quality of life.

Lifestyle Modifications
• Exercise Programs:
Continuing tailored exercises to maintain spinal health and overall well-being.
• Education and Support:
Providing ongoing education and support for individuals with scoliosis.

Impact of Early Detection on Treatment Outcomes

Early detection significantly influences treatment outcome

• Preventing Progression:
Timely interventions, especially during adolescence, can prevent curve progression.
• Conservative Measures:
Non-surgical approaches may suffice when initiated early, reducing the need for invasive
interventions.

Exercises for the Scoliosis Deformities

1. Core Strengthening Exercises
2. Pelvic Tilt
3. Cat-Camel
4. Double Leg Abdominal Press
5. Single Leg Balance
6. Diaphragmatic breathing exercise