Introduction
Posture refers to the alignment of the body parts, whether standing, sitting, or lying down. A good posture is when the joints and body segments are correctly aligned, and proper balance between the muscles crossing the joints is maintained. Faulty posture can lead to various impairments of the joints and muscles and also causes functional problems in day-to-day activities. Habitual faulty postural alignment of the body, repetitive movements, and sustained stress over the joints and muscles can cause musculoskeletal disorders. Physiotherapy plays a vital role in posture disorders. This article will discuss various physiotherapy interventions for correcting bad postures.
What Are the Relevant Anatomical Factors?
Proper stabilization of the spine is the key to good posture. The spinal column acts as the central supporting system of the body, with 33 small vertebral bones interlocked with each other. They are divided into seven cervical vertebrae (neck region), twelve thoracic vertebrae (mid-back region), five lumbar vertebrae (the region between the mid-back region and the pelvis), five fused sacral vertebrae and four fused coccygeal vertebrae. They are interconnected with their respective intervertebral discs.
What Are the Possible Causes of Bad Posture?
Several factors contribute to impairment in body posture since the head, neck, trunk, pelvic bone, and lower extremities are all interrelated for a proper posture; any deviations in these areas affect the body's posture. Some of the possible causes include
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Post-injury.
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Muscle tension and weakness.
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Habitual faulty postures.
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Mental stress.
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Hereditary.
What Are the Primary Aims of Posture Correction in Physiotherapy?
A bad posture is often corrected by eliminating the underlying postural stress. Before developing a care plan and selecting the appropriate interventions, the physical therapists will adequately assess the patient, including detailed history taking, review of systems and specific tests and measures, and documenting the findings. The primary aim of posture correction in physiotherapy management includes
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To develop awareness and control of the spinal posture.
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Educating the patient about the relationship between the bad posture and their symptoms.
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To increase restricted mobility in joints, muscles, and fascia.
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To develop neuromuscular control, strength, and endurance in muscles that support the body's posture.
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To teach safe body mechanics.
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To assess the ergonomic stress at work, home, and recreational environments.
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To relax the tense muscles and relieve postural stress.
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To implement and progress on aerobic exercises.
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To promote healthy exercise habits for self-maintenance.
What Is the Role of Therapeutic Exercises and Stretches in Posture Correction?
Therapeutic or physical therapy exercises are essential in managing bad postures. Stretching and flexibility exercises and manipulation techniques are used to increase the restricted mobility of joints and muscles that support postural alignment. The ultimate goal is to increase the range of motion of specific structures that affect the postural alignment and increase mobility in the neck and trunk region. Stretching Techniques for the Cervical and Thoracic and Lumbar Region are as follows:
Exercises for Mid-Back Region:
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The patient is in the hook-lying position with hands behind the head and elbows resting on the mat. Both arms are elevated overhead while maintaining the back flat on the mat. A rolled towel is placed in the upper back region to increase the stretch. Begin by bringing the elbows together in front of the face; this position is held for a second, and the elbows are brought down to the mat.
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The patient is sitting on a straight-backed chair with hands behind the head. Then, the patient brings the elbows to the side. By taking in a breath, the patient takes the elbows to the side, and while breathing out, the elbows are brought in front of the face.
Exercises for Neck Region:
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The patient in a supine or sitting position is asked to perform a chin tuck and nod the head, trying to bring the chin towards the chest to feel a stretch in the suboccipital region (posterior region of the neck below the occipital bone).
Exercises for Lower Midback and Lumbar Region:
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The patient is in the hook-lying position. They are asked to bring both knees towards the chest and clasp hands around the thighs by elevating the lower body off the mat. This places stress on the knee joints as the stretch force is applied.
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On all four positions, the patient brings the pelvis posteriorly without rounding the thorax. Concentration is given on bending the lumbar spine, not the thoracic spine. The patient moves the lower back region over the feet for a more significant stretch. This position is held for a second and relaxed.
What Are the Various Other Physiotherapy Exercises for Posture Correction?
1. Strengthening the impaired postural muscles that support the spine is necessary for posture correction. For example,
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Dynamic Cervical Flexion Exercises: The patient is in a supine position. They lie over a slant board to reduce the effects of gravity. The patients are asked to practice tucking their chins and curling their heads up.
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Lower cervical extension exercises.
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Scapular retraction and shoulder rotation exercises.
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Hip abduction exercises.
2. Functional exercises for safe body mechanics include upper extremity pushing and pulling, wall slides, lunges-later progressing lunges with lifting and pushing and pulling.
3. Adductor muscle strengthening exercises.
4. Abdominal muscle strengthening exercises in which the patient is supine with their knees raised upwards. They are asked to lift their upper body slowly and to wrap their knee with their arms. This position is held for five seconds and slowly relaxed to the original position.
5. Lower muscle-static strengthening exercise in which the patient is seated with the knees bent and ankles crossed. The patients are asked to push their ankles in opposite directions to create contact. This position is maintained for ten seconds and slowly relaxed to a normal position.
6. Based on the patient's aerobic capacity, the therapists will incorporate various aerobic exercises for the patient.
Conclusion:
Maintaining a good posture is necessary for the long-term health of a person. Good posture is when the body is aligned correctly while sitting and standing. A faulty posture can lead to various musculoskeletal disorders and pain in the back region. Therapeutic exercises can help correct posture by improving the flexibility of the muscles supporting the spine and increasing muscle strength and endurance, supporting postural alignment. The physical therapist will develop an individualized exercise program for patients with faulty postures based on the severity of the condition and the patient's functional limitations.
