Posture

Meaning of Posture

Body position is referred to as posture. The alignment of the head, neck, shoulders, trunk, and limbs about one another and the environment is referred to as posture. Posture is the stance that the body adopts, either with support during muscular inactivity or by the coordinated action of several muscles working to maintain stability or to build a fundamental basis that is continually modified by the movement that is superimposed upon it.

Types of Posture

Inactive Posture

Inactive postures are those that place the least amount of strain on the muscles needed to maintain vital bodily processes (such as breathing and circulation), which are preferred. These are the mindsets used for relaxing or sleeping.

Active Posture

The posture that requires the integrated action of many muscles is known as active posture.

Active posture can be of two types:

Static posture

Such a posture is maintained by the coordinated movement of a collection of muscles that act largely statically to stabilize the joint and defy external forces like gravity.

Dynamic posture

To create an effective foundation for movement, this kind of posture is necessary. When circumstances change as a result of mobility, the posture pattern is continuously updated and adjusted to fit the new situation.

Major advantages of erect posture

• The head is raised, and the area of vision has also increased.
• The upper extremities became free from bearing the weight of the body. Therefore, it became easy to carry out manipulative activities.
• Less energy expenditure.
• Proper functioning of the organs.
• Development of the anti-gravity muscles.
• Development of the gait pattern.
• Increase in the speed of gait.
• A graceful appearance.

Curves in a normal spine

The vertebral column appears as a single vertical line that bisects the trunk when viewed from the posterior aspect. From the side, it is easy to see that the column has several curves that change with age.

When the column of an adult is viewed from the side, many distinct anterior-posterior curves are seen.

Primary curves

The two curves—thoracic and sacral—that continue to have their original posterior convexity throughout life.

The main curves are in the “c” shape. The baby’s spine will initially be shaped like the letter “c” upon birth. In the uterus, this spinal alignment develops. The newborn needs to be carried cautiously because its muscles are not yet strong enough to support itself. Primary curve alignment helps to relieve pressure on the spine and hips and is also the most relaxing posture for the body since it requires less oxygen, uses energy more efficiently, burns fewer calories, and improves digestion. It works well for controlling body temperature as well.

Secondary curves

Cervical and lumber are the two curves that correct the original posterior convexity.

The baby will start interacting with his environment in the first few months following birth. He will then raise his head to look around or turn towards any noise or light that attracts his attention. As the baby moves through this experience, he is growing neck muscle, which causes the cervical curve and secondary curves of the upper spine to develop.

The final curve is lumber

The lumber curve is the ultimate spinal curve that forms in the lower back. When a newborn learns to crawl and creep, the lumber curve starts to form. To maintain good postural alignment, use the lumber curve. Between 12 and 18 months, the growth of the spine is complete.

Good Posture

A good posture accomplishes or serves all of the goals for which it was intended. Good health and cleanliness are indicated by good posture. It is connected to a person’s psychological and social standing as well. Additionally, it is associated with attractiveness and stands for perfect physical alignment.

All the muscles, bones, joints, ligaments, and internal organs are correctly aligned and operating at their peak levels when one has good posture. The spine has a typical curvature and allows for unrestricted mobility.

The requirements of a good posture

• Good physiological aspects
• Nutrition or a balanced diet
• Good appetite
• Rest and proper sleep
• Hygiene
• Stable psychological background

Values of good posture

• Aesthetic and psychological benefits
• Better alignment, which leads to fewer chances of injury.
• Better balance, agility, and overall physical performance (efficiency)
• Decrease pressure on the vital organs
• Proper and efficient functioning of the vital organs
• Independent
• Appearance: A good posture is always attractive, graceful, and pleasant to the eyes. It also represents the psychological attitude of an individual and can have some influence or relationship about the social, and economic aspects of an individual.

Bad Posture

The poor posture requires excessive physical effort to maintain or is inefficient, i.e., it does not fulfill the function for which it was intended.

A body part’s incorrect alignment in an upright posture may make it necessary for more muscle activity to keep the body balanced. Muscle tension that is needed to produce movement or maintain posture decreases both processes’ effectiveness and consumes energy.

Causes of bad posture

• Injury: injury of muscles, bones, and ligaments.
• Diseases: cerebral palsy, polio, rickets, and TB of the joints.
• Poor postural habits
• Mental attitude
• Heredity, e.g., knock knees
• Muscular weakness
• Malnutrition
• Faulty shoes
• Long term diseases
• Poor body mechanics

Drawbacks of bad posture

• Poor structure
• Instability
• Back and neck pain
• Inefficient functioning of organs
• Limited range of motion
• Chances of injury
• Stress on internal organs
• Fatigue
• Breathing difficulties, respiratory diseases and complications
• Poor aesthetics
• Increased bone problems.

Postural Defects

Defects in posture are defined as deviations from the natural position of body parts brought on by incorrect use or a congenital condition. These flaws could result from negligence or weak muscles brought on by a protracted illness. Defective habits are formed while a person is still growing.

• Some postural defects may range from mild to severe in degree.
• Some postural defects may affect the spine, while others may affect the lower extremities.
• There can be more than one postural defect in a person.
• Sometimes secondary postural defects develop to compensate for the primary postural defect.

Causes of postural defects

1. Congenital

This defect or condition is present at birth or after birth. This may develop during the first month of life. E.g., Structural scoliosis.

2. Poor postural habits

Poor postural habits might result in lower extremity and spine postural abnormalities. When performing repetitive movements like sitting, standing, walking, lifting, driving, and other tasks that require good posture, it is possible to hurt the muscles and joints in addition to the body’s systems.

3. Injury

Postural irregularities can result from any type of bone, ligament, or muscle damage. Any ligaments or muscles that are overused or overstretched may suffer an injury that later results in postural problems. Postural irregularities might also be brought on by a fracture.

3. Diseases

Muscles, bones, and joints can become weaker as a result of illnesses like poliomyelitis, cerebral palsy, TB of the bone, and osteomyelitis of the bone. Postural abnormalities might also result from internal organ diseases.

3. Malnutrition

Deficiency of vitamin D, vitamin C, calcium, or phosphorous retards the proper growth and development of the bones, which may not allow an individual to hold his/her body in a normal upright position.

4. Prolong illness

Poor muscle development might also result from a protracted bedridden illness. The body is held against gravity with the aid of the antagonist’s muscles. Poor posture might develop if the opposing muscles are weak and unable to fight gravity.

5. Heredity

Sometimes poor posture can be inherited. This is due to the characteristics carried by the genes. E.g. flat foot, kyphosis.

6. Improper footwear

If one wears unfitted footwear, postural defects can develop. Improper footwear may develop uneven weight distribution in the foot and cause discomfort.

7. Obesity

Obesity or overweight causes uneven weight over each joint of the lower extremities, which causes pain and discomfort. To maintain the center of gravity, postural defects can develop.

Types of postural defects

Common postural defects include curvature of the spine. This can be lateral, anterior, or posterior.

The defects involving the anterior-posterior curvatures of the spine are:

1. Lordosis

The cervical area and lumber. In this case, the lumber region has an accentuated forward curve.

In the cervical region, the head is projected forward. The curve in the neck is increased, and the 7^th cervical vertebra at the back of the neck becomes large and prominent.

2. Kyphosis

An exaggerated curve of the thoracic region. This causes the shoulder to be rounded, the neck to be shortened, and the chin to poke forward.

The defect involving the lateral curvature of the spine

3. Scoliosis

An abnormal curve of the spine, side-to-side deviation of the spine.

Types of postural defect

1. Functional postural defect

This type of postural defect is without any bony changes or muscular weakness. The causative factors may be the impairment of the postural reflex mechanism or the wrong postural habits. E.g., standing with stress on one leg or psychological factors

2. Structural and postural defects

This kind of postural deficit involves a bone deficiency that causes soft tissue contracture and overstretching.

Due to secondary soft tissue contracture of the muscles and ligaments, the functional postural faults may nevertheless come together to form a structure.

General corrective exercises for postural defects

• General body relaxation by using the whole body relaxation technique. The techniques that can be used are: Lying supine, Half lying, and side lying.
• The patient should be trained to feel and hold the correct posture.
• The posture should be correctly provided by the therapist.
• Repeated sessions of maintenance of the correct posture until correction becomes automatic.
• General free mobility exercises for the whole spine and strengthening exercises for the spinal extensors and abdominals.
• Deep breathing exercises should be incorporated: Diaphragmatic breathing exercises, Inspiratory breathing exercises, and cranial expansion exercises.
• e.g., walking with a book on the head in a correct posture.
• Walking sideways.
• Walking and changing direction to avoid obstacles (zigzag pattern).
• Stretching of the tight soft tissues and sustenance are the most important aspects of the treatment. Correction of contractures and shortened soft tissues can be achieved by guiding the correct posture.
• After good correction, the patient should be advised to continue with exercises. Avoiding especially the position and the activities prone to producing the exiting deformities.