Kyphosis:
Prevention and Correction
The natural physiological curves of the spinal column are formed in the first months and years of child’s development. With the raising of child’s head the first curve is made. That is a cervical curve – curve of a neck, and it is convex forward. With the first attempts to stand or with sitting the thoracic curve, the curve of the upper back, is made and it is convex backwards. When the child is old enough to stand, the lumbar curve, pointed forward, is made. In the first years of child’s life, if there are not any pre birth deficiencies, the spinal cord has its regular (normal) physiological position (Dunn 541). The future growth and development of individual vertebra is a long lasting process and in all periods of our life the vertebral column is adopting, getting stronger and adjusting with the other systems of our body and getting its definite shape. One of important factors for the development of spine is the individual behavior and lifestyle. There are many more inner and outer factors but the individual influence of them is very small.
There are many postural deviations that are influencing and affecting human body. I decided to write about the spinal deviation called Kyphosis, or Rounded Upper Back. The thoracic curve is, in this case, more distinct and the back is getting rounded look. The gravity is always acting on thoracic curve, trying to get it bigger. Active and passive forces of our body like muscles, ligaments, bones etc. are fighting against it and trying to keep our spine in the physiological limits. Those physiological limits when measured by Cub method on the profile x-ray of human body, are twenty to thirty five degrees (Radisavljevic 289). With the weakening of active and passive forces or by some other causes, the kyphotic curve will get bigger and lead to Kyphosis. The Scoliosis Research Society defines Kyphosis as a curvature of a spine measuring forty-five degrees or greater on a x-ray (Lucile Packard Children’s Hospital, n.pag.). Sometimes Kyphosis is followed by the curve with the different orientation in the lumbar part of the back. This is called Compensatory Lordosis because the extensive lordotic curve is made because of the unbalance in the spinal column caused by Kyphosis.
Kyphosis can be present at birth – Congenital or caused by the various conditions that may happened (Lucile Packard Children’s Hospital, n.pag.) Congenital Kyphosis usually appears due to the changes in the bone structure when the wedge-shaped vertebrae are made, or with joining of two or more vertebrae. The other non-congenital conditions appear during the life span mainly caused by metabolic problems, neuromuscular conditions, rheumatic changes, osteogenesis imperfecta, spinal bifida, Sheuermann’s disease, shortsightedness, use of the “anti pain positions” and poor posture (Lucile Packard Children’s Hospital, n.pag.). Poor posture is one of the causes of Kyphosis that should be treated more serious. More people should get involved including physical education teacher, parents and other teachers. There are three delicate periods in which the body is more likely to suffer from these changes:
– the period when the child is rising,
– the beginning of child’s formal education,
– the puberty.
Kyphosis can appear in with the old age, when it is called “senile” Kyphosis.
There are two main groups of Kyphosis:
– Functional or reducible – they can be annulled by taking particular positions like laying on the back or hanging on the pole, or just by the contraction of the back muscles.
– Structural or irreducible – advanced stage. Now, besides the muscles, bones and ligaments are changing causing insufficiency of the spinal movements (Radisavljevic 292).
We have to know that Kyphosis doesn’t only ruins our esthetical look but it causes a lot of other changes and problems like deficiency in movement ability of spinal joints, deficiency in rib movements which lead to the insufficiency of respiratory system, and changes in the bone structure.
There are many ways to diagnose Kyphosis and it is usually done by a physician. Some of diagnostic procedures are x-rays, bone scans, magnetic resonance imaging (MRI), computerized tomogtaphy scan (CAT scan), blood tests etc. (Lucile Packard Children’s Hospital, n.pag.). Prevention and early detection are of most importance in dealing with kyphotic children. Pediatricians, family physicians and even some school programs routinely look for the signs of the kyphotic posture in kids. Prevention should begin before the child arts to go to school or with the beginning of the school at the latest. As I said earlier, in this complex process of monitoring and prevention, except PE teachers and school physicians, it is necessary to involve other teachers and parents. It is important to emphasize the importance of good posture and all of the above should give positive influence and guidance. Everybody should make a contribution to accustoming a child to healthy habit of proper body positioning. Proper siting or “resting” posture and standing posture should be always recommended to the youth. Accompanying this, proper physical activities in PE classes, sport clubs and at home should be done to strengthen whole body and especially the back lower muscles, because back is important for the good posture (Radisavljevic 295).
In the process of correction, the stage (is it just at the beginning or advanced) has a big importance in choosing the right way of treatment.
The treatment of functional Kyphosis:
– the first thing can be the correction of the thoracic curve by back muscle contractions in front of the mirror. The patient can stand sideways and look especially at the positioning of the head, neck and shoulders.
– after the posture correction in front of the mirror the following complex of exercises can be done:
– axis stretching of the back,
– stretching of the chest muscles,
– stretching of the pelvic-femoral muscles,
– stretching of the hamstrings,
– developing the muscles on the thoracic part of the back,
– developing the abdominal muscles,
– breathing exercises (Radisavljevic 291).
The treatment of structural Kyphosis is done by a physician. Surgery is one of the ways and bracing is also used together with necessary exercises.
Every case of Kyphosis should be treated individually, and in the cooperation with the school physician. Then special complex of exercises can be made and it can be done during regular or extra classes of physical education. Kyphotic kids should be the part of the regular PE classes, but the special care and attention should be provided to them. There are some exercises that these kids shouldn’t do because they can be injured or increase the kyphotic curve. All exercises that stretch the back should be avoided. Usually in the class there are going to be some kids with Kyphosis but also other kids with some other disorders or posture insufficiencies. I would have one part of my class, usually after the warming up, when the students would do individually assigned drills that would strengthen their weaknesses, used for prevention and correction. PE teachers have the important role in recognizing disabilities because and should take advantage of their classes to help students, and teach them something important. They can influence them much more than the other teachers and sometimes more than their parents, and teachers should take advantage of that.
Sports and Games
