1. Risk factors
2. Invalid posture
3. Hypodynamia ...
4. Recognize on time
5. We form a posture
6. An exemplary set of exercises to strengthen the muscles of the back and abdominals

Content:

Incorrect posture is not just an aesthetic problem. If it is not corrected in time, it can become a source of diseases of the spine and not only. However, do not panic, noticing that the baby does not hold his back quite exactly. Most often, timely measures help to correct the posture, but it is very important to understand the reasons that lead to its curvature.

To the content

Risk factors

Development problems

Usually, poor posture occurs during periods of rapid growth: at 5–8, and especially at 11–12 years. This is the time when the bones and muscles increase in length, and the mechanisms for maintaining posture have not yet adapted to the changes that have occurred. Deviations are observed in most children 7-8 years old (56-82% of primary school children).

There are many factors that provoke spinal curvature. For example, malnutrition and illness often disrupt the proper growth and development of muscle, bone and cartilage tissues, which negatively affects posture formation. An important factor is the congenital pathology of the musculoskeletal system. For example, with bilateral congenital dislocation of the hip joints, an increase in lumbar flexion may be observed.

A large role in the formation of abnormalities is played by the uneven development of certain muscle groups, especially against the background of the general weakness of the muscles. For example, the shoulders brought forward are the result of the predominance of the strength of the pectoral muscles and the insufficient strength of the muscles that bring the shoulder blades together, and the “hanging shoulders” are the result of the insufficient performance of the trapezius back muscle. An important role is played by the overload of certain muscles by one-sided work, for example, the incorrect position of the body during games or exercises.

All these causes lead to an increase or decrease in the existing physiological curvatures of the spine. As a result, the position of the shoulders and shoulder blades changes, an asymmetrical body position occurs. Incorrect posture gradually becomes habitual and can be fixed.

Invalid posture

Sitting position . Be sure to pay attention to how the child sits at the table during class: does not put one foot under him. Perhaps he slouches or warps to one side, leaning on the elbow of a bent arm.

By improper position of the body when sitting should be attributed to the landing, in which the torso is rotated, tilted to the side or strongly bent forward. The reason for this situation may be that the chair is far away from the table or the table itself is too low. Or maybe the book that the kid is looking at is too far from him.

The asymmetrical position of the shoulder girdle may form as a result of the habit of sitting, holding the right shoulder high. Take a closer look: perhaps the table at which the child is engaged is tall for him, and his left arm hangs down instead of lying on the table top (the same can happen if the table is round).

Standing position The habit of standing with a bent leg set aside and a bent leg, like a curve fit, produces an asymmetrical body position. This may aggravate the lateral curvature of the spine caused by other causes (for example, an underdevelopment of the lumbosacral spine).

Hypodynamia ...

Another important factor in the occurrence of postural disorders in children should be considered the notorious way of life. It is sad, but modern children began to move less. From the age of 3 many children go to groups (first of all mental), then the process of acquiring knowledge goes on increasing, and during classes the child has to sit for a long time. In addition, children early to join watching TV, video, can sit for hours at computer games, and on the street, meeting with friends, instead of outdoor games, enthusiastically discuss the features of the passage and codes of a particular electronic "shooter." What to do, you want to be modern, follow the modern trends of life. However, a person should develop harmoniously, physical development should not lag behind. The weakness of the muscular system in our children is primarily due to the lack of adequate physical exertion, whereas with rapid growth, the strength of the abdominal muscles and back is simply necessary.

To the content

Recognize on time

In order to notice a deviation in time, parents need to pay more attention to the position of the shoulders and back of the baby. His shoulders and shoulder blades should be level. It is also important that the spine is in the correct position - whether it is bent to the right or to the left, whether the sub-folds are at the same level. These signs of lateral curvature can be seen by looking at the child from the back when he is standing. Seen from the front, it should be noted that the clavicles and nipples are at the same level.

By the side view, you can identify violations such as slouching or sluggish posture. This can be done by eye or use a special test. The child becomes with his back to the wall so that the back of the head, shoulder blades, buttocks, lower legs are in contact with the wall, and then takes a step forward, trying to maintain the correct body position. (The same test can be used as an exercise for developing good posture.)

When a curvature is detected, it is necessary to inspect the baby’s back, laying it on a flat hard surface, face down, arms along the body. If the curvature of the spinal column in the prone position is not preserved, then we are talking only about the violation of posture, which can be corrected.

Muscle test There are several simple tests to determine the state of the child’s muscular system. To do this, assess the ability of the baby to prolonged tension of the muscles of the back. The child is placed on the couch down face-down so that part of the body above the hips is outside the couch on weight, hands on the belt (the child’s feet are held by an adult). Normally, children 5-6 years old can keep the horizontal position of the body 30-60 s, children 7-10 years old - 1 - 1.5 min, 12-16 years - from 1, 5 to 2, 5 minutes. The development of the abdominal muscles is determined by the number of continuous repetition of the transition from the prone position to the sitting position and back (when the legs are fixed) at a slow pace, no more than 16 times per minute. The norm for preschoolers - 10-15 times, for children 7-11 years old - from 15 to 20 times, at 16-18 years old - from 20-30 times.

If violations of the posture and (or) weakness of the muscular system are identified, the child should be consulted with an orthopedic surgeon, a traumatologist, or a physiotherapist. The doctor examines the child, if necessary, additional research methods are performed: radiography, electromyography, etc.

Recently, a new research method has emerged - topographic photometry, which allows not only to diagnose disorders of the state of the musculoskeletal system, but also to evaluate the effectiveness of the treatment. The method is based on photographing the patient's posture after the doctor puts the main reference points on the child’s back with a marker.

To the content

We form a posture

Since one of the basic conditions for good posture is the proper development of the body, you should try to create the most favorable conditions for growth. In particular, it is very important to maintain a general hygienic regime: regularity in eating, sufficient exposure to air, the right combination of work and rest, the use of funds. hardening .

It is necessary to engage in strengthening the muscular corset from infancy, but you should not rush the physical development of the child and force him to plant when he is not sitting on his own, or force the baby to walk at 9 months or even earlier. Early axial (vertical) load can cause the development of orthopedic diseases in the baby. Let the baby move more in the prone position or crawl, until he sits or rises to his feet.

No less prophylactic is the group of activities that affect the overall physical development and functional state of the muscular system, since active retention of the body, upper and lower extremities in the correct position is possible only with the active participation of muscles. For this special exercises are used.

Lack of physical activity prevents the development of the muscular system, whereas with rapid growth, the strength of the abdominal muscles and back is necessary. Properly chosen physical activity prevents posture problems and also helps to overcome them.

Exercises are selected depending on the type of spinal curvature: children prone to slouching are recommended to bend the back with effort to the maximum straightened position, for children with shoulder joints folded forward, circular movements are simultaneously used with both hands back, retraction, bending the arms to the shoulders, on the back of the head . With the "hanging down" shoulder joints, it is useful to pull the arms through the sides up, lift the shoulders, stretch the arms up with opposition (the adult puts his hands on the child's shoulders). Balancing exercises also contribute to developing a correct posture. For example, walking on a bench or a log with the hands retracted to the sides.

In the selection of exercises should take into account the age of the child.

For kids, it is recommended to pick up exercises of a playful nature. For example, children will be happy to perform a spinal extension exercise, if you ask them to depict a mercury column in the thermometer under the rays of the sun. Doing exercise "Woodcutter", children "chop wood", performing turns of the upper body. Exercise "Jump frog" helps to fix the lumbar lordosis.

Preschool children (from 4-5 years old) are able to understand more complex gymnastic tasks and cope with them.

If the child is significantly weakened, it is desirable to combine daily exercise with physical therapy exercises to strengthen the muscles of the back and abdominal in the clinic with a physical therapy doctor.

At the beginning and at the end of each lesson, children should exercise in correct posture. (An exercise test that is performed against the wall is suitable for this.) You should be interested in their posture, make you think about it during the day, check it not only at gymnastics, but also during class at the table, on a walk. A child attending kindergarten can be invited to monitor not only himself, but also posture comrades. This usually turns into a kind of competition between children: who will find someone more often in the wrong posture. Such a competition makes children be alert and always maintain a normal back position - in the end it will become a habit.

The set of exercises given by us can be considered rather preventive. It is primarily useful for practically healthy children, and not only for those who have a poor posture (the doctor will select an individual set of special exercises for such small patients depending on the defect). Treatment of the pathology of the musculoskeletal system is always long, difficult, requiring considerable effort not only from specialists, but also from the patient himself. Sometimes serious problems with posture and medical measures make inaccessible for the child some aspects of the "public" child's life. Therefore, it is important to prevent the occurrence of impaired posture, i.e. systematically engage in adequate physical activity and regularly (annually) visit the orthopedic surgeon with the child for preventive examinations. In addition, the overall development of the baby can be improved with the help of sports sections, which can be visited from 4 to 5 years. Proper posture contributes to swimming (preferably breaststroke, on the back). In addition, volleyball, basketball and skiing (cross-country) are useful. Try to maintain the interest of the child in sports activities, and this will allow him to avoid many of the problems associated with posture.

To the content

An exemplary set of exercises to strengthen the muscles of the back and abdominals

(can be performed from 4-5 years old and up to adolescence)

1. Starting position - standing, hands on the belt. Dilute the elbows, reducing the shoulder blades - inhale; return to ip - exhale.
2. Starting position - standing, legs apart, arms to shoulders. Bend the body forward with a straight back - exhale; come back and ip - inhale.
3. Starting position - standing with a gymnastic stick in his hands. Raise the stick forward up - exhale; return to ip - inhale.
4. Starting position - standing, stick in the hands lowered. Crouch, arms outstretched forward; return to ip The back is straight.
5. Starting position - standing, stick on the shoulder blades. Lean forward, stretching your arms up (take out the stick); return to ip
6. Starting position - lying on his back on an inclined plane, holding his hands on the rail of the gymnastic wall. Bend the legs, pull up to the stomach - exhale; straighten - inhale.
7. Starting position - lying on your back, arms along the body. Cycling kicks.
8. Starting position - lying on your back, arms to the side. Extend the arms forward to raise the left leg and touch the arm, then the right leg. Accept ip
9. Starting position - lying on his stomach, arms to the side. Raise the body, bending the chest spine (reach for the ceiling); return to ip
10. Starting position - lying on his stomach, hands on his belt. Raise up the body and raise the right leg - inhale, return to the SP - exhale. Repeat the exercise, raising the straight left leg.
11. Starting position - lying on the stomach, arms bent at the elbow joints, a gymnastic stick held on the shoulder blades. Raise the body, bending it through the gymnastics stick; return to ip Breathing is arbitrary.

A set of exercises is performed daily in the morning or evening, depending on the peak of the child's activity, but not earlier than one hour after eating or 30-60 minutes before it. The pace is slow, you should start with 5 repetitions, bring up to 10, the whole complex takes 30-40 minutes.

In order for the exercises to work accurately enough, they must be performed intensively, that is, above the usual level of ability of children. First, lighter exercises are given with a gradual transition to more difficult ones. During the lesson there are several pauses for rest. It is recommended to rest in a prone position:

• lying on his back, legs slightly tucked to the stomach, hands behind his head;
• lying on his stomach, his chin rests on the hands.

Oleg Malakhov
Professor, Head of the Pediatric Orthopedics Department of the Central Institute of Traumatology and Orthopedics named after N. N. Priorova, Doctor of Medicine
Mikhail Tsykunov
Professor, Head of the Department of Rehabilitation N. N. Priorova, Doctor of Medicine
Svetlana Fedorova
rehabilitologist, employee of the Department of Rehabilitation of CITO im. N. N. Priorova

Author

Svetlana Fedorova
Mikhail Tsykunov
Oleg Malakhov

Comment on the article "Not a back, but a question mark. Infringement of posture in children"