Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Scoliosis and Spinal Disorders
Published in: Scoliosis and Spinal Disorders 1/2018

Open Access 01-12-2018 | Review

Non-structural misalignments of body posture in the sagittal plane

Authors: Dariusz Czaprowski, Łukasz Stoliński, Marcin Tyrakowski, Mateusz Kozinoga, Tomasz Kotwicki

Published in: Scoliosis and Spinal Disorders | Issue 1/2018

Login to get access

Abstract

Background

The physiological sagittal spinal curvature represents a typical feature of good body posture in the sagittal plane. The cervical and the lumbar spine are curved anteriorly (lordosis), while the thoracic segment is curved posteriorly (kyphosis). The pelvis is inclined anteriorly, and the lower limbs’ joints remain in a neutral position. However, there are many deviations from the optimal body alignment.
The aim of this paper is to present the most common types of non-structural misalignments of the body posture in the sagittal plane.

Main body of the abstract

The most common types of non-structural misalignments of body posture in the sagittal plane are as follows: (1) lordotic, (2) kyphotic, (3) flat-back, and (4) sway-back postures. Each one may influence both the skeletal and the muscular system leading to the functional disturbance and an increased strain of the supporting structures. Usually, the disturbances localized within the muscles are analyzed in respect to their shortening or lengthening. However, according to suggestions presented in the literature, when the muscles responsible for maintaining good body posture (the so-called stabilizers) are not being stimulated to resist against gravity for an extended period of time, e.g., during prolonged sitting, their stabilizing function is disturbed by the hypoactivity reaction resulting in muscular weakness. The deficit of the locomotor system stability triggers a compensatory mechanism—the stabilizing function is overtaken by the so-called mobilizing muscles. However, as a side effect, such compensation leads to the increased activity of mobilizers (hyperactivity) and decreased flexibility, which may finally lead to the pathological chain of reaction within the musculoskeletal system.

Conclusions

There exist four principal types of non-structural body posture misalignments in the sagittal plane: lordotic posture, kyphotic posture, flat-back posture, and sway-back posture. Each of them can disturb the physiological loading of the musculoskeletal system in a specific way, which may lead to a functional disorder.
When planning postural corrective exercises, not only the analysis of muscles in respect to their shortening and lengthening but also their hypoactivity and hyperactivity should be considered.
Literature
1.
Claus A, Hides JA, Moseley GL, Hodges PW. Different ways to balance the spine: subtle changes in sagittal spinal curves affect regional muscle activity. Spine. 2009;34(6):208–14.CrossRef
2.
O’Sullivan PB, Grahamslaw KM, Kendell M, et al. The effect of different standing and sitting postures on trunk muscle activity in a pain-free population. Spine (Phila Pa 1976). 2002;27:1238–44.CrossRef
3.
Kendall F, McCreary E, Provance PG, Rodgers M, Romani WA. Muscle testing and function with posture and pain. Baltimore: Lippincott Williams & Wilkins; 2005.
4.
Janssen MM, Kouwenhoven JW, Schlösser TP, Viergever MA, Bartels LW, Castelein RM, Vincken KL. Analysis of preexistent vertebral rotation in the normal infantile, juvenile, and adolescent spine. Spine (Phila Pa 1976). 2011;36(7):486–91.CrossRef
5.
Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis. F.A. Davis Company, 2005.
6.
McGill S. Low Back Disorders-3rd Edition with Web Resource: Evidence-Based Prevention and Rehabilitation. Human Kinetics; 3 edition, Champaign, USA; 2015.
7.
Sahrmann S. Diagnosis and treatment of movement impairment syndromes. St. Louis: Mosby; 2002.
8.
Comerford M, Mottram S. Kinetic control—e-book: the management of uncontrolled movement. Churchill Livingstone Australia; 2012.
9.
Bergmark A. Stability of the lumbar spine. A study in the mechanical engineering. Acta Orthop Scand Suppl. 1989;230:20–4.
10.
Richardson CA, Hodges PW, Hides J. Therapeutic exercise for lumbopelvic stabilization: a motor control approach for the treatment and prevention of low back pain. 2nd ed. Edinburgh: Churchill Livingstone; 2004.
11.
Richardson C. The muscle designation debate: the experts respond. J Bodyw Mov Ther. 2000;4(4):235–6.
12.
Richardson C, Bullock MI. Changes in muscle activity during fast alternating flexion-extension movements of the knee. Scand J of Rehabil Med. 1986;18:51–8.
13.
14.
Hides JA, Stokes MJ, Saide M, Jull GA, Cooper DH. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine. 1994;19:165–72.CrossRefPubMed
15.
Dilani Mendis M, Hides JA, Wilson SJ, Grimaldi A, Belavý DL, Stanton W, Felsenberg D, Rittweger J, Richardson C. Effect of prolonged bed rest on the anterior hip muscles. Gait Posture. 2009;30(4):533–7.CrossRefPubMed
16.
Hides JA, Belavý DL, Stanton W, Wilson SJ, Rittweger J, Felsenberg D, Richardson CA. Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest. Spine (Phila Pa 1976). 2007;32(15):1687–92.CrossRef
17.
Hides JA, Lambrecht G, Stanton WR, Damann V. Changes in multifidus and abdominal muscle size in response to microgravity: possible implications for low back pain research. Eur Spine J. 2016 May;25(Suppl 1):175–82.CrossRefPubMed
18.
Hides JA, Belavý DL, Cassar L, Williams M, Wilson SJ, Richardson CA. Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain. Eur Spine J. 2009;18(3):410–8.CrossRefPubMed
19.
Reeve A, Dilley A. Effects of posture on the thickness of transversus abdominis in pain-free subjects. Man Ther. 2009;14(6):679–84.CrossRefPubMed
20.
Bogduk N, Twomey LT. Clinical anatomy of the lumbar spine. 2nd ed. London: Chruchill Livingstone; 1991.
21.
Hides JA, Lambrecht G, Richardson CA, Stanton WR, Armbrecht G, Pruett C, Damann V, Felsenberg D, Belavý DL. The effects of rehabilitation on the muscles of the trunk following prolonged bed rest. Eur Spine J. 2011;20(5):808–18.CrossRefPubMed
22.
Belavý DL, Richardson CA, Wilson SJ, Rittweger J, Felsenberg D. Superficial lumbopelvic muscle overactivity and decreased cocontraction after 8 weeks of bed rest. Spine (Phila Pa 1976). 2007;32(1):232–9.CrossRef
23.
Lee DG. The Pelvic Girdle: An integration of clinical expertise and research. Churchill Livingstone; 4 edition USA; 2010.
24.
Bullock-Saxton J, Murphy D, Norris C, Richardson C, Tunnel P. The muscle designation debate: the experts respond. J Bodyw Mov Ther. 2000;4(4):225–57.CrossRef
25.
Kędra A, Czaprowski D. Sedentary behaviours of 10-19-year-old students with and without spinal pain. Probl Hig Epidemiol. 2015;1(96):143–8.
26.
Czaprowski D, Stoliński Ł, Szczygieł A, Kędra A. Sedentary behaviours of girls and boys aged 7-15. Polish Journal of Public Health. 2011;121(3):248–52.
27.
Solberg G. Postural disorders & musculoskeletal dysfunction. Diagnosis, prevention and treatment. Philadelphia: Elsevier Churchill Livingstone; 2008.
28.
Gajdosik RL, Albert CR, Mitman JJ. Influence of hamstring length on the standing position and flexion range of motion of the pelvic angle, lumbar angle, and thoracic angle. J Orthop Sports Phys Ther. 1994;20(4):213–9.CrossRefPubMed
29.
Fujitani R, Jiromaru T, Kida N, Nomura T. Effect of standing postural deviations on trunk and hip muscle activity. J Phys Ther Sci. 2017;29(7):1212–5.CrossRefPubMedPubMedCentral
Metadata
Title
Non-structural misalignments of body posture in the sagittal plane
Authors
Dariusz Czaprowski
Łukasz Stoliński
Marcin Tyrakowski
Mateusz Kozinoga
Tomasz Kotwicki
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Scoliosis and Spinal Disorders / Issue 1/2018
Electronic ISSN: 2397-1789
DOI
https://doi.org/10.1186/s13013-018-0151-5

Other articles of this Issue 1/2018

Scoliosis and Spinal Disorders 1/2018 Go to the issue

Retraction Note

Retraction Note: Brace classification study group (BCSG): part one – definitions and atlas

Research

Significant variability in surgeons’ preferred correction maneuvers and instrumentation strategies when planning adolescent idiopathic scoliosis surgery

Letter to the Editor

Supplementary Addendum to “Radiation dose of digital radiography (DR) versus micro-dose x-ray (EOS) on patients with adolescent idiopathic scoliosis: 2016 SOSORT- IRSSD “John Sevastic Award” Winner in Imaging Research”

Research

Three-dimensional reconstructions of Lenke 1A curves

Research

Systematic re-evaluation of intraoperative motor-evoked potential suppression in scoliosis surgery

Review

Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a narrative review