Poor Posture Treatment in Fort Collins, Colorado

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Poor Posture on a patient

Poor posture is perhaps the most common spine-related health concern. People recognize that their posture may be hunched over. You can see it in the mirror. Friends and family are telling you to sit up straight. If these things are happening to you, then you likely have what doctors call hyperkyphosis. sedentary lifestyles increased usage of tablets and smartphones and years of sitting in desks during school frequently followed by a career that involves excessive time spent sitting doing computer work.

Normal Posture

Posture is how we hold our body when standing or sitting. Posture is measured in both the coronal (front) and sagittal (side) views. From the front view, in normal posture the head should be straight and level and centered over the shoulders… the head shouldn’t be bent, shifted or turned to one side. The shoulders and ribcage should becentered over the hips/pelvis. The shoulders shouldn’t be uneven or rotated. And the hips and pelvis should be centered over the feet.

From the side, the ear should line up over the shoulder, which should lineup directly over the hip, and the hip should line up directly over the ankle. Normal posture and spinal alignment allows for maximum energy efficiency while minimizing the effect of gravity on joints, muscles and ligaments. Normal posture reduces muscle tension, and decreases pressure on the joints.

Forward Head Posture

Forward head posture is when the head translates, or shifts, forward. As the head translates forward it increase stress and strain on the muscle and ligaments of the neck and upper back. For every inch of anterior head translation, the work required by the muscles doubles. So a 10 lb head that is translated 1 inch forward will effectively be like holding a 20 lb head, 2 inches would be like holding a 40 lb head. At the same time, the shape of the cervical curve changes. Instead of a normal C-shaped curve in the spine, it turns into an S-shaped curve. This causes increased pressure on the bones of the spine and discs. This increased pressure causes the bones and discs to wear out faster, leading to disc degeneration and bone spurring (osteoarthritis). Osteoarthritis makes the neck feel stiffer and can eventually cause bone spurs that pinch nerves, leading to radiating pain into the shoulders, numbness and tingling in the hands and fingers and weakness in grip strength.

Hyperkyphosis

Hyperkyphosis is excessive rounding of the spine. Hyperkyphosis is associated with neck pain, headaches, back pain, disability, lower self-esteem and decreased Health Related Quality of Life (HRQOL). Research has also shown that elderly people with hyperkyphosis don’t live as long as people the same age with more normal posture. Hyeprkyphosis effects 20 % to 40% of the population and is more common in the geriatric population. The cause is typically multifactorial and can be a combination of degenerative changes, vertebral compression fracturs, muscular weakness, and altered biomechanics or poor posture. Although hyperkyphosis is more common in aging adults, it has become more frequent in younger population do to sedentary lifestyle and the increased in slouching and hunching over while using computers, smart phones and tablets.

Nonoperative management including spine rehabilitation programs such as Chiropractic BioPhysics and bracing have been found to be effective in reducing kyphosis through improvement in the overall rounding of the spine. Chiropractic Biophysics uses precise spinal traction, or stretching, combined with exercises and spinal adjustments to reduce the rounding of the spine.

Scheuermann’s Disease

Scheuremann’s disease (osteochondrosis) is the most common cause of hyperkyphosis of the thoracic and thoracolumbar spine in adolescents. Secondary only to scoliosis it’s one of the most common spine deformities. The exact cause of Scheuermann’s is unknown but likely has both genetic and environmental influences. This condition is characterized by vertebral body wedging, vertebral endplate irregularity, decreased anterior vertebral growth, Schmorl’s nodes, narrowing of the intervertebral disc spaces and premature disks degeneration.

Scheuremann’s kyphosis develops prior to puberty and appears most prominently during adolescent growth. The onset usually begins between early childhood to 16 years, frequently between ages 12 and 15.

Normal thoracic kyphosis measurement on lateral radiographs is between 25-45° (T3-T12). To diagnosis there Scheuermann’s disease the thoracic kyphosis must bet > 45° and there must be a minimum of 3 vertebral bodies with 5° of wedging. Additionally, individuals with Scheuermann’s typically have a rigid thoracic spine compared to more flexible spines in individuals with posture kyphosis. Individuals diagnosed with Scheuermann’s have a higher incidence of back pain, lower health related quality of life and poor general health.

Treatments are typically non-operative: Adolescents with a kyphosis 45-50° can be treated with spine rehabilitation programs such as CBP. Curves 50-55° in the thoracic spine or 40° the thoracolumbar spine can be treated with intensive spine rehabilitation programs and part-time bracing. Curve >55° are best treated with intensive rehabilitative programs and full-time bracing. Surgery is usually reserved for curves >80° that have not responded to conservative treatment.

This is a case study published by Dr Chris Gubbels in improving a kyphoscoliosis in an adult with Scheuermann’s disease and scoliosis. Reduction of Scheuermann’s deformity and scoliosis using ScoliBrace and a scoliosis specific rehabilitation program: a case report. 

Sagittal Alignment

Sagittal alignment is the overall position of the spine as viewed from the side. This global spinal alignment is the measurement of the cervical spine in relationship to the pelvis and is measured by dropping a plumb line down from C7 and measuring its distance to the sacrum. This measurement is called SVA (sagittal vertical alignment). Changes in the global sagittal alignment, specifically when a person leans forward, has recently been shown to be the biggest predictors of back pain and disability.

Why is Alignment Important

Spinal alignment is closely related to quality of life, pain and disability. Several studies have shown the relationship between spinal alignment as measured on radiographs and Health Related Quality of Life scores and have details how improvement in spinal alignment correlates to improved patient outcomes. Hyperkyphosis in the thoracic spine is associated with adverse health effects including impaired physical function, pain and disability, impaired pulmonary function, increased risk of death.

Treatment for Poor Posture and Hyperkyphosis

Current evidence recommends early conservative treatment for correcting spinal alignment and improving posture. Chiropractic BioPhysics (CBP®) is a proven method of spine correction and rehabilitation using mirror image® concepts of rehabilitation. CBP methods include corrective exercises, adjustments and traction that rehabilitates the spine to normal. CBP has produced several case series and cases studies demonstrating the effectiveness in correcting spinal alignment such as reducing forward head posture, decreasing thoracic kyphosis and improving sagittal balance:

Reduction of thoraco-lumbar junctional kyphosis, posterior sagittal balance, and increase of lumbar lordosis and sacral inclination by Chiropractic BioPhysics® methods in an adolescent with back pain: a case report. 

 The CBP® mirror image® approach to reducing thoracic hyperkyphosis: a retrospective case series of 10 patients. 

 Alleviation of chronic spine pain and headaches by reducing forward head posture and thoracic hyperkyphosis: a CBP® case report. 

 Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics®: a case report utilizing a multimodal mirror image® rehabilitation program. 

 Reversing thoracic hyperkyphosis: a case report featuring mirror image® thoracic extension rehabilitation. 

 Nonsurgical correction of straight back syndrome (thoracic hypokyphosis), increased lung capacity and resolution of exertional dyspnea by thoracic hyperkyphosis mirror image® traction: a CBP® case report. 

Take Action Today!

If you are dealing with abnormal posture or rounding of the back, you should call our Fort Collins chiropractic office today. We can get you into the office right away for a free consultation and exam so we can tke toe first step at correcting your postural problems.