Combined disorders of posture

The round-concave back occurs more often than the others and is characterized by increased bending of the spine in the anteroposterior direction. The amount of lumbar lordosis depends on the degree of pelvic incline forward. The more the pelvis is tilted forward, the more pronounced will be the lordosis in the lumbar region. Intense lumbar lordosis in turn is compensated by an increased curvature of the thoracic spine, and the latter is balanced by an enhanced cervical lordosis. In this posture defect, the stomach and buttocks sometimes protrude quite significantly, while the thoracic cage seems flattened. This depends on the large incline of the ribs associated with the increased curvature of the upper thoracic spine. Due to the considerable inclination of the ribs and the enlarged lumbar lordosis, the waist is somewhat shortened and thickened. It should be noted at the same time that with this violation of posture, there are less lateral curvatures of the spine;

A flat-concave back occurs most often in women and is characterized by an increased pelvic incline forward. Outwardly it looks like an underlined pelvic protrusion posteriorly, an increase in lumbar lordosis and a flattening of the thoracic and cervical flexures.

If the posture is disturbed, attention should be paid to the constantly observed flattening of the muscles from one side of the neck and the shoulder, which is especially noticeable during palpation. One of the shoulder straps is below the other. The humerus is shifted forward, the spinous processes form a small arc (the so-called unstable scoliotic arch), the scapulae are asymmetrically, the muscles are flabby. In the position of active posture this position is corrected, the lateral curvature of the spine disappears, the mutual perpendicularity of the three main planes of the body is restored.

So, speaking of a pathological posture, one should distinguish two of its forms:

• The deformation develops in the sagittal plane;
• When the curvature develops in the frontal plane.

But such a strict geometric separation of deformations is not always possible. Mixed forms of disorders of curvature of the spine are more common.

The most significant difference between them and true scoliosis is that with various forms of posture disorder there are no signs of torsion at the site of curvature and there are no other organic or structural changes in the vertebral bodies that determine clinically detectable paravertebral asymmetry. When the posture is violated, the functional violation of muscle coordination and self-control prevails.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10],