Robin R Varghese, PT.
A neutral pelvis (the ideal position) generally supports a mild curve (called a normal lordosis) in the low back. This small degree of arch helps the body to balance all the skeletal parts as they work together to support and move your body weight. But when you have a postural deformity, one or more bones may "deviate" from its ideal position. This deviation may lead to muscle strain, ligament sprain, and/or pain. It may also cause your spine to adjust its position in one more area. This is to make up for any pain or loss of balance created by the original deviation.
Sway-back posture shows an increase in posterior pelvic tilt and forward pelvic shift and trunk and thoracic kyphosis in comparison to neutral posture. This postural change is associated with increased activity of the rectus abdominis muscle and decreased activity of the abdominal internal oblique muscle and decreased activity of the iliopsoas and gluteus maximus muscles in the hip joint. Sway-back posture reduces contraction of the skeletal muscles, thereby applying stress to the skeletal system, which is a factor not related to contraction, and leads to an increase in stress applied to the lumbar area. It causes disturbance of physiological loading of the musculoskeletal system and can lead to functional disorder.
Swayback posture leads to:
-Erector spinae in the upper thoracic and upper lumbar part, -Scapulae stabilizers (serratus anterior, lower and middle part of trapezius and rhomboid muscles), -Abdominal muscles (their lower part), and One-joint (iliacus, psoas), and two-joint hip flexors (rectus femoris, tensor fascia latae)
-Suboccipital, sternocleidomastoid, scaleni, muscles -Chest muscles—pectoralis major and minor -Erector spinae lumbar part (lower part), -Upper fibers of abdominal muscles, -Gluteus maximus -Hamstrings
The Swayback posture exhibits as:
Head-Protracted (moved forward) Cervical spine - Upper part: extended (hyper lordosis) Lower part: flexed (hypo lordosis or kyphosis) Thoracic spine- Upper part: increased flexion (hyper kyphosis) Lower part: normal (kyphosis) Lumbar spine- Upper part: flexion (kyphosis or hypo lordosis) Lower part: increased extension (hyper lordosis) Pelvis- Shifted anteriorly, decreased anterior tilt Hip joints- Extended due to decreased anterior tilt of pelvis Knee joints- Neutral or hyperextended Ankle joints- Neutral or plantar flexed
Physical Therapy Management involves:
Educating postural concepts and postural control to the patient
Stretching tight muscles
Strengthening weak muscles.
Releasing and increasing flexibility of:
hip flexors, gluteal group, external oblique/ decrease rectus abdominis dominance. Iliacus, psoas, rectus femoris, tensor fascia latae.
Anterior chest/shoulder, intercostals, sub-occipital/Upper cervical posterior, Sternocleidomastoid/Scalene, Upper abdominals, Thoracic joints, Fascia of the upper limb and Latissimus dorsi
Scapular stabilizers - Rhomboids, lower trapezius and Serratus anterior
Functional training is all about using the right muscles at the right time, to sustain the correct posture, in daily activities. Simple activities like eg. correct standing posture, sit to stand and walking up stairs all need be addressed to ensure correct technique and muscle recruitment The brain, the nervous system, and muscles all work together to produce the desired result, so these neural pathways will need to be "reset". Postural changes can be altered with practice and correct muscle recruitment.
At Valley Healing Hands, Brownsville, Texas we provide the best physical therapy treatment for sway back posture. Our patients are completely satisfied with our services.
Our therapists are highly skilled to assess you and provide a personalized exercise regime which will help you ease your discomfort and get back to normal functioning.