Types of posture disorders in children and effective exercises for correction

The general health and development of a child are greatly influenced by their posture. But as technology use rises and physical activity declines, a growing number of kids are experiencing posture-related problems. It is essential to identify and treat these disorders at an early stage in order to prevent long-term health issues.

The severity and effects of posture disorders can vary, ranging from scoliosis to round shoulders. Comprehending the various categories of postural problems in children enables parents and caregivers to initiate appropriate remedial measures.

Thankfully, there exist efficient exercises that can greatly enhance a child’s posture. These exercises guarantee a healthier future for the child by improving posture habits and helping to correct pre-existing issues.

Type of Posture Disorder	Effective Exercises for Correction
Scoliosis	Side stretches, plank, yoga poses like child"s pose
Kyphosis	Chest stretches, back extensions, cobra pose
Lordosis	Pelvic tilts, abdominal strengthening, bridge pose
Flat Back	Hamstring stretches, core exercises, seated forward bend
Rounded Shoulders	Shoulder blade squeezes, wall angels, chin tucks

What is it?

Posture disorders are any changes in the position of the spine relative to the physiological norm. The spine can be deformed both in the frontal plane and in the sagittal plane. The frontal plane is considered to be the rear view, and the sagittal plane is the side view. There are both disorders in a separate plane and combined disorders, the pathological signs of which are detected in two planes at once. When the vertebrae are in an unnatural position, a great deal of force is exerted on them, and on the muscles and ligaments that are required to hold the spinal column in a stable vertical position. To maintain the necessary balance, the muscles are in constant tension, which leads to pain and discomfort.

Incorrect posture is merely a pathological condition that needs to be corrected; it is not regarded as a separate disease. Most of the time, there is a solution available.

Ignoring the early signs of musculoskeletal system changes can have a number of unpleasant effects, including the development of irreversible deformations, internal organ displacement and compression, and disturbance of organ functions.

A chronic, untreated spine issue raises the risk of spinal column trauma, fractures, displacements, hernias in the spinal column, etc. As of early 2018, data from the Ministry of Health indicated that roughly 2% of young children had some form of posture disorder. Up to 17% of preschool-aged children experience them, up to 33% of middle school-aged children, and up to 65% of high school-aged children. This suggests that deformation tends to worsen during bone tissue growth if correction is not made in a timely manner.

Types

• flat back (a condition in which all vertebrae are smoothed out);
• lumbar lordosis (pathological forward curvature of the spine in the lumbar region);
• cervical lordosis (curvature of the cervical spine);
• thoracic kyphosis (concave back);
• round back (a combination of increased thoracic kyphosis with smoothing of the lumbar lordosis);
• slouching;
• kypholordotic posture (increase in all curvatures of the spine).

There are various levels of severity for any kind of posture disorder.

• At the first, the disorders are usually initial and can be easily corrected with simple correction.
• The second degree, as a rule, requires a longer and more painstaking approach to treatment, but in most cases it is also possible to cope with the help of conservative methods.
• The third degree of disorders is more serious, it is not always amenable to conservative treatment, sometimes surgical methods are required.
• The fourth degree very often requires not only surgery, but also establishing the child"s disability status.

Grades 1-2 are the most frequently violated when a child is under ten years old; violations of grades 2-3 are more frequently found when a child is in middle school or an adolescent. Doctors claim that this is because a mild degree of violation was overlooked because an accurate diagnosis was not made at an earlier age.

Let’s examine the most prevalent kinds of distortions.

Scoliotic posture

This disorder is distinct from scoliosis in that the pelvic region is not deformed. The curvature most frequently only affects one area of the spinal column and one plane, the frontal. The child’s shoulders might appear slightly asymmetrical, with one slightly higher than the other. Changes in scoliotic posture are primarily limited to the body’s vertical position. The child’s spine is straight and the curvature is hidden when he is in a laying position.

Treatment for mild cases of scoliotic posture is usually not necessary; instead, the child should be made aware of the importance of maintaining a straight back and be given exercises using the horizontal bar (hanging). Treatment is necessary for the third degree of this posture, which is equivalent to the early stages of scoliosis.

Kyphotic posture

In the medical field, kyphosis is commonly interpreted as a thoracic spine curvature. Kyphotic posture is a condition that typically comes before actual kyphosis. In this instance, the child’s excessive forward head tilt, forward lowered shoulders, and outward-pointing shoulder blades give the back a rounded appearance.

This kind of posture disorder definitely requires treatment. Unsettling symptoms, like positional kyphosis, can lead to the development of a separate illness. This posture disorder you just read about is in its early stages.

The risk associated with this kind of deformity is clear: the lungs and heart suffer, the chest bends inward, and a hump may start to form. Osteochondrosis progressively integrates.

Round back

This disorder exhibits a very clear case of thoracic kyphosis, or inward bending of the chest; however, the common lumbar bend is almost nonexistent. Such a back appears somewhat hunched and rounded. However, because the spine is in such an unstable position, looking unsightly is only half the problem. The child starts to walk with half-bent legs as a result of having to maintain balance, which puts ten times more strain on the knee joints.

Twenty to thirty years ago, this kind of disorder was rare in children. These days, as kids spend more time indoors, using computers, and moving less, spinal pathology has taken center stage and has nearly "caught up" with scoliosis.

Round-concave back

The pathology in question smoothes out all of the spinal column’s natural curves, which are essential for upright gait and space travel. Children with a round-concave back therefore have a very different gait because they have to shift their center of gravity to their knee joints in order to maintain balance. This causes severe changes in the structure of the knee joint as well as premature wear and tear on the knee joint by the time the child reaches adolescence.

A child with such a curved back has slightly elevated and brought forward shoulders, protruding shoulder blades, and hanging stomach and buttocks. His head is always slightly ahead of his body when walking. Treatment is recommended based on the severity of the posture disorder; it is, incidentally, highly successful.

Flat back

This is the term for a condition affecting the spine where the vertebrae more closely resemble a straight line due to an excessive smoothing and reduction of all curves. Such a back is frequently seen in children who grow too quickly or who fall behind in their physical development. The back’s muscular structure is weak in the first instance, and it is unable to keep up with the rate at which bone tissue is growing in the second.

Because there is less natural cushioning, even during normal walking, the danger of injury and microtrauma to the vertebrae and spinal cord is constant when walking in this incorrect posture. These kids often complain of headaches and nausea, which is because their vertebrae have microscopic injuries.

This particular pathological posture is regarded as one of the most dangerous because any accompanying deviations in the condition of the spine, such as scoliosis or osteochondrosis of a specific spinal segment, become severe and occur very quickly. Therapy is required right now.

Other variations exist, such as the so-called "sluggish posture," which is characterized by a flat-concave back, but they are less typical. Furthermore, congenital spinal deformities can also be linked to conditions like myelodysplasia of the lumbosacral spine, which is characterized by the presence or absence of some or all of the vertebrae. Certain types of postural abnormalities are inherited; a stooped mother or father is unlikely to produce a child with the slender build of a cypress. Usually, the child bends down as well.

In addition to being pathological, traumatic and post-traumatic curves can result from injuries to the muscles and spine. Pathological ones are those that result from abnormalities in posture that are caused by the body’s response to an illness or tumor, specifically the vertebrae.

The mechanism underlying all disorders is essentially the same: weak muscles that are unable to sustain the rapidly growing bone tissue, concurrent external and internal factors that are detrimental, and deformations that become more difficult for the weak muscles to tolerate. It turns out that most cases of anomalies are easily corrected, so doctors, parents, and teachers can break the vicious cycle.

Causes

As was previously mentioned, there are two types of causes for spinal column deformities: congenital and acquired. The latter ones come out on top. Even while the fetus is still developing inside the mother’s womb, it may form aberrant vertebrae, such as wedge-shaped vertebrae. Myotonia and connective tissue dysplasia may be congenital causes.

Some birth injuries, such as hip dislocation, torticollis, and subluxation of the first cervical vertebra during childbirth, can also have an impact on the child’s back later in life.

The majority of thin children with acquired forms of posture disorders have asthenic body types, which include long limbs, narrow pelvis, sloping shoulders, and narrow chests. However, as you can see, the focus is on the child’s development and outside variables that impact his posture rather than body type.

The following are the most frequent reasons why spine disorders develop:

• poor and irregular nutrition, calcium and vitamin D deficiency;
• low physical activity, lack of mobility;
• incorrect posture at the table;
• sitting in the wrong position for a long time in front of a computer monitor or TV;
• carrying a backpack or bag in the same hand;
• a low chair and a high table or vice versa;
• insufficient lighting of the child"s workplace, where he writes, reads, draws;
• the habit of reading while lying down.

Sometimes, even at a very young age, parents set the groundwork for their children to develop posture disorders. Therefore, pediatricians think that carrying a baby on the same arm, starting him off on his feet at a young age, and placing him in verticalizing devices (walkers and jumpers) all contribute to the deformities of the spine. The fact that mothers consistently walk their child by the same hand is therefore not regarded as significant. When all of this is done repeatedly over time, the spine develops permanent deformities.

The subsequent development of curvatures and smoothing of the vertebrae can also be attributed to a variety of illnesses and disorders. Among them are:

• rickets;
• poliomyelitis;
• tuberculosis;
• vertebral fractures, including compression;
• osteomyelitis;
• valgus deformity of the feet;
• flat feet;
• shortening of one of the lower limbs.

It is common for children with low vision or hearing to develop poor posture. They frequently have to adopt awkward positions in order to see or hear things, which eventually "fix" at the level of muscle memory.

Symptoms and signs

Early on, it’s not always easy to identify a child’s poor posture with the unaided eye. Parents typically don’t start to notice this until the clinical picture is clear. This fact should make you take a closer look at your child. When the child is standing, his posture should be evaluated. Certain pathological alterations are only noticeable when the infant is standing; when they are sitting or lying down, they are completely invisible.

The easiest to spot is slouching. When using it, the child’s shoulders and head are oriented forward, resembling a person giving himself a shoulder hug. The buttocks appear swollen. You can observe the protruding shoulder blades on the back; their lower edge is particularly noticeable.

The head is shifted forward and slightly downward, the shoulder blades protrude, and the shoulders turn strongly forward when in kyphotic posture. Because of the sunken chest, it appears as though a vertebra is sticking out in the neck region. Legs half bent, the child walks. All muscle groups have significantly less tone, as evidenced by the press: even in children who are thin, the stomach "hangs" a little.

It is extremely difficult to independently distinguish between kyphotic posture and kypholordotic posture because these symptoms are common to many different types of spine disorders in the thoracic and lumbar regions; only doctors are able to make this determination based on X-ray data. It is not necessary for parents to provide a precise diagnosis, though. Essentially, the only things that need be considered are the basic deviations and prompt, timely contact with an orthopedic surgeon who can identify the specific type and kind of pathology and provide recommendations.

If the child is standing with arms extended at the seams and the heights of their shoulders, nipples, and shoulder blades differ, suspicion of asymmetrical posture should begin to arise. Even though the difference might not seem like much, it still matters.

The child frequently develops pain syndrome because any curvature in the spine results in excessive tension in the muscles and ligaments. It is true that the pain develops gradually, and even the child may take a long time to notice it. The most common symptom of prolonged standing is a throbbing back pain that makes it difficult to sit still. Although the child might not express complaints, it is important for adults to inquire about any pain the child may be experiencing, if they notice that the child slouches when writing or drawing, or if he frequently shifts positions while reading.

When a child has a postural disorder that has already impeded the functioning of their internal organs, they may experience symptoms typical of specific pathologies of these organs, such as headaches, dizziness, and difficulty breathing deeply when their chest volume decreases. These symptoms may exacerbate their overall hypoxia.

In most cases, oxygen starvation brought on by reduced chest mobility results in a sunken and flat chest, a hunched back, and other thoracic spine abnormalities. Cervical spine deformities are the most common cause of severe and recurrent headaches. Lumbar spine curvatures cause frequent urinary tract diseases as well as limb numbness.

Children with posture disorders typically perform worse in school, tire more quickly, pay less attention, have trouble remembering and concentrating on important things, are more likely to contract the flu and acute respiratory viral infections, and frequently experience heart and respiratory complications from viral diseases. These kids frequently have low blood hemoglobin levels.

The abdominal cavity sags as a result of the lumbar region’s curvatures and deformations weakening the abdominal muscles. There is some displacement and lowering of the stomach and intestines. In this instance, the child starts experiencing other digestive issues as well as frequent constipation. Reduced vision is frequently the result of pathological alterations in the cervical and thoracic vertebrae.

For kids with bad posture, the school physical education program is much harder. They don’t want to go to the sports sections not because they’re lazy or have "another calling," but rather because they tire out more easily. Because of their rapidly declining health, even active games in the yard can be challenging for them.

Diagnostics

While parents are able to be aware of potential violations on their own, only a physician can determine the specific kind. In order to accomplish this, get in touch with an orthopedic surgeon at a children’s clinic or a vertebrologist, a specialist that is less common in Russian medical facilities (spine specialist).

During the first visit, the doctor will conduct a visual examination. The child is undressed down to his underwear and a T-shirt, and placed in a vertical position. It is important for the doctor to assess the child"s posture when viewed from the back, side, and front. In addition to all the above signs of pathological changes in posture, the doctor"s experienced eye should also notice other diagnostic signs: displacement of the spinal processes from the central midline to either side, different outlines of the gluteal folds and popliteal fossae, as well as asymmetry of the costal arches. In questionable cases, the doctor will use simple and understandable measurements: he will calculate the distance from the seventh cervical vertebra to the edge of the scapula, measure and compare the length of each leg.

The Adams test is another tool that doctors use. The young person is asked to bend forward and either lower or extend his arms. Using this test, the physician can evaluate the health of the spinal column’s curves and each vertebrae’s degree of mobility. However, a visual examination of this kind can lead even a highly skilled physician to draw the incorrect conclusions. As a result, he will make a referral for a more precise diagnosis and note all concerning signs discovered during the examination under a question mark. This includes computed tomography, ultrasound of the cervical spine, MRI of the entire spine or a specific section of it, and X-rays.

The findings will be useful in determining the curvature angles to within a degree of accuracy, as well as whether or not there is microtrauma present in the vertebrae or torsion (the twisting of the vertebrae). The doctor can decide on the best course of action for treating or correcting bad posture based on the results.

Children who have poor posture may experience a number of physical issues, but these problems are frequently reversible with the appropriate exercises. Exercises that target common posture disorders such as kyphosis, lordosis, and scoliosis and strengthen core muscles, increase flexibility, and promote proper alignment can be an effective therapeutic approach. Parents can assist their children in forming better posture habits that enhance their general health by including these exercises into their daily routine.

Treatment

Posture disorders are always difficult to treat. It uses multiple techniques at once to release tension, release muscle clamps, and correct stoop. Restoring the child’s muscular system to normal aids in the body’s reconstruction and proper support of the spine, which causes the load to be distributed correctly and the spine to straighten.

The specific technique for reestablishing proper posture and strengthening weak muscles is decided by the physician based on the kind of disorder and the degree of current pathology. Surgery or medication are not necessary for posture disorders that are 1-2 degrees; however, achieving the desired outcome will require a lot of work from the entire family.

Disorders rated as 3 or 4 are practically already indicative of a need for surgery, along with a protracted period of recuperation and rehabilitation. Let’s examine how to adjust posture in various situations.

Conservative methods

The four primary methods of correcting posture—exercise therapy, massage therapy, physiotherapy, and the use of specialized orthopedic devices—are the most widely used and, understandably, the most adored by physicians. When all four are used concurrently and strictly in accordance with the doctor’s instructions, the best outcomes can be obtained.

Physical therapy and gymnastics

In dedicated rooms of children’s clinics, physical therapy is administered as a therapeutic activity. It is the doctor’s responsibility to strengthen all of the patient’s muscle groups and to target the areas of the child that hurt the most.

Each child’s exercises are customized based on the specific changes identified in his spine. If your posture problems are not too severe, you can attend clinic classes one or two times. Following that, the doctor will recommend at-home classes and inform the parents about the schedule of classes.

Following physical therapy, there is a required break during which the child’s parents must take him or her to see an orthopedist or vertebrologist to ensure the treatment is helping and the condition is not getting worse. When dealing with more complicated disorders and advanced stages, it is best to complete the course under the guidance of a specialist and make daily visits to the exercise therapy room. Such specialists are available in private clinics; however, in this instance, it is crucial to bring a prescription from your physician specifying the precise kind and severity of the ailment.

It’s not realistic to think that taking classes at a public or private clinic will suffice. Additionally, parents must practice special gymnastics at home with their child one or two times a day. The doctor’s approval is also required, but the general guidelines are as follows: training should target all muscle groups, with a focus on the back and shoulder girdle muscles in particular. Posture correction exercises that work well can be categorized into multiple groups.

• General in a standing position — ​​these include bending the body forward and to the sides, bending with a gymnastic stick, with a fitball in your hands.

• General while sitting — are performed on a hard chair with a hard back and include spreading the arms to the sides, raising them up, including with a gymnastic stick and a gymnastic ball.
• General lying down — performed on a flat, hard surface and include exercises to strengthen the abs and shoulder girdle, also performed with and without a gymnastic stick.

Exercises that target specific areas of the spine and help the child warm up are more targeted. This involves hanging by your hands from a horizontal bar or wall bars, or from a "corner" on the wall—a hanging position where your legs are raised at an angle to your body and your back is supported by the wall.

Parents will find a fitball as well as a horizontal bar and a gymnastic stick to be helpful. Both a slouching teenager and a 6–8 month old baby with a propensity for spinal curvature can benefit from simple rolling on it on the stomach and back.

Enrolling a child with poor posture in swimming is highly recommended as it helps strengthen their back muscles. These days, some clinics design a set of exercise therapy exercises that, in order to treat the back, inevitably include aqua aerobics exercises.

The child should move as much as possible if there are no signs that they should rest. This will help you quickly treat any disorders and strengthen the child’s back, spine, and muscles. On the other hand, parents should keep in mind that working for several months or even more than a year will require patience and not expecting immediate results.

It is not advised for kids with bad posture to exercise on a trampoline, perform abrupt jumps, or jump off towers headfirst into the water. You should also stay away from stressful sports like rugby, hockey, and wrestling where falls are frequent. In a weak and damaged area of the spine, such activities may cause microfractures or even quite large macrofractures.

Remember that the length of the exercises to improve posture should be increased gradually when working out with a child at home. Start with two to three minutes per exercise and work your way up to 10-minute sessions. Both the length of the session and the amount of strain on the body should increase gradually. A gentle and stable correction can only be made in this situation.

Massage

It is advised to perform a general strengthening massage based on warming up, rubbing, and kneading the muscles of the back and shoulder girdle for minor deviations from the norm in posture. The doctor will advise manual or orthopedic massage, which is only done in clinics and massage rooms, for more severe conditions.

Massage therapy is used in courses to correct posture; the orthopedist determines how long each session should last. There must be a break in between courses. Even massages at home should be done in spurts; the most popular schedule looks like this: Ten days of daily massages followed by a three-week break.

Correct posture formation through massage alone is not included. It is essential to combine massage with swimming, therapeutic gymnastics, and other suggested practices. Parents typically don’t need to spend a lot of money because back-strengthening massage techniques are fairly basic and don’t require the use of specialists. These are the same "Rails-sleepers" that most mothers are familiar with; the only difference is that each task requires more time than the comic game suggests.

Physiotherapy

Magnetic therapy and electrical stimulation of the back’s muscles and ligaments are the most widely used techniques. According to the attending physician’s instructions, these sessions take place in the clinic’s physiotherapy room. With the help of these two techniques, you can rapidly bring your muscles into a condition where they will support your spinal column more consistently and anatomically.

When treating mild cases of posture disorders, it is sufficient to see a physiotherapist 1-2 times a year. The treatment is administered under the guidance of a physiotherapist.

Orthopedic devices

Teaching a child to maintain proper posture can be challenging, particularly if he has already developed bad sitting habits and has committed some infractions. Parents can benefit from specialized orthopaedic devices.

Children’s recliners are made of elastic loops that are placed on the shoulders and converge near the shoulder blades, much like straps. They maintain the child’s back in the proper position by preventing hunching over. Certain recliners have an auditory alert that sounds each time a child slumps out of position.

If the child has significant posture violations rather than just initial ones, then semi-rigid and rigid thoracic and thoracolumbar corsets are recommended. Orthopedic stores sell these products, which require a fitting and a written prescription from the attending physician.

You can buy a backrest fixator, like a recliner, without a prescription, but since orthopedic products have many contraindications, it is essential to see a doctor first.

Other methods

Pilates exercises, mud therapy, and hydrotherapy are a few more sophisticated techniques for treating posture disorders. If there’s a chance to purchase a ticket to a sanatorium that specializes in back and musculoskeletal disorders, you shouldn’t pass it up.

Surgical methods

Extremely rarely is surgical intervention used to correct posture. Only in situations where a tumor or spinal injury that cannot be treated with other means causes postural abnormalities.

If the child is already 13 or 14 years old, one of the surgical treatment options may be taken into consideration if the deformities worsen quickly. Only vital indicators are used for operations on younger children.

Surgeons can replace a damaged vertebra or use fixators-grafts as one of several techniques to solve the issue. A successful application of a high-tech procedure is vertebroplasty. Additionally, some muscles and ligaments are repaired and sutured.

The four primary conservative methods that were previously discussed are used to prescribe treatment at the conclusion of the recovery period.

Prognosis

If the doctor’s recommendations are followed and systematic classes are taken with the child, there is approximately a 98% chance that incorrect posture of any kind of disorder will be completely corrected. The Ministry of Health reports that only 1-2% of cases have persistent or progressing disorders, necessitating an alternative therapeutic approach.

Determining the duration of the correction is a challenging task. Several reviews claim that while some parents were able to straighten their child’s back in six months, others needed a year. The correction may require one and a half or even two years in certain cases. Everything is dependent upon the disorders and the stage of identification.

Results of treatment are obtained more quickly the earlier pathological changes are identified.

For children’s long-term health and wellbeing, it is imperative that they receive help maintaining proper posture. Early diagnosis and treatment of posture disorders can significantly impact future complications and development.

A daily routine that includes easy-to-do exercises can help your child with many posture-related problems. These exercises enhance confidence and physical comfort in addition to improving posture.

Parents can support their child’s healthy growth and help avoid future posture-related issues by being proactive and modeling positive habits.

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