1. Head Tilt Forward

Forward head posture (FHP) is the anterior positioning of the cervical spine. This posture

is sometimes called "Scholar's Neck", "Wearsie Neck", or "Reading Neck."

It is a posture problem that is caused by several factors including sleeping with the head

elevated too high, extended use of computers and cellphones, lack of developed back

muscle strength and lack of nutrients such as calcium.

Treatment

The treatment involves correcting the muscle imbalance.

Stretching muscles that cause neck protrusion:

Lower cervical flexors: sternocleidomastoid, anterior and medial scalene muscles.

Upper cervical (capital) extensors: semispinalis capitis, longissimus capitis,

splenius capitis, suboccipital muscles

Strengthening muscles that cause neck retraction:

Lower cervical extensors: splenius cervicis, semispinalis cervicis, longissimus

cervicis

Upper cervical (capital) flexors: longus capitis, rectus capitis, Suprahyoid muscles

FHP commonly appears as a part of the Upper Crossed Syndrome and Thoracic outlet

syndrome. Treatment of which involves stretching muscles in the front of the torso such

as the pectoralis major, pectoralis minor while also strength training muscles in the back

of the torso such as the rhomboids.

2. Dowager's hump

Dowager’s hump is an abnormal outward curvature of the thoracic vertebrae of

the upper back. Compression of the front portion of the involved vertebrae due to

osteoporosis leads to forward bending of the spine (kyphosis) and creates a hump at the

upper back. Like most osteoporotic changes, it is often preventable.

Treatment

Reducing Dowager’s hump will improve your appearance, but it also has important

health benefits as well. If your chest is continuously caved in, you do not breathe

properly because the lungs are unable to expand to their full capacity. The intestines and

other organs are also compressed, which interferes with their optimum functioning. Not

only that, poor posture can lead to pain.

Improve your posture with yoga. There are 5 easily accomplished poses, they are all done

sitting in a chair that can help to straighten the spine.

1. Seated Mountain

Sit tall at the very front edge of a chair with a firm flat bottom. Place your feet securely

on the floor. Inhale and lengthen the spine upward. Place the head directly over the spine,

and bring the shoulders down. Breathe evenly, maintaining the posture for 30 seconds to

1 minute.

2. Henpecking

Sit in Seated Mountain pose above. Now pull your head back as though making a double

chin. Repeat 6 to 10 times. Keep the head level; do not jut the chin forward or lift it up.

Emphasize the backward movement. Do not come forward.

3. Shoulder Rolls

Sit tall as above. Lift your shoulders up as you inhale, and squeeze your shoulder blades

together in the back as you exhale; bring them down and roll forward, inhaling as you lift

up again. Do 6 to 10 full circles.

4. Seated Superman

Sit tall as above. Inhale, and clasp your hands behind your back. Exhale as you hold your

arms away from your body. If you can’t reach your hands, hold a strap. Repeat 3 to 6

times. You can also stay in the pose longer by breathing continuously.

5. Rocking Horse

Sit tall in Seated Mountain pose. Place your feet firmly on the floor and draw your head

back as though making a double chin. Maintain this head posture and lean forward

without rounding the spine. Keep the abdominal muscles firmly engaged, and the

shoulders square. Lean back as far as you can, keeping the feet planted on the floor (you

probably won’t touch the back of the chair). Repeat 10 to 20 times.

3. Kyphosis

Kyphosis is a forward rounding of the back. Some rounding is normal, but the term

"kyphosis" usually refers to an exaggerated rounding of the back. While kyphosis can

occur at any age, it's most common in older women.

Age-related kyphosis often occurs after osteoporosis weakens spinal bones to the point

that they crack and compress. Other types of kyphosis are seen in infants or teens due to

malformation of the spine or wedging of the spinal bones over time.

Mild kyphosis causes few problems, but severe cases can cause pain and be disfiguring.

Treatment for kyphosis depends on your age, the cause of the curvature and its effects.

Kyphosis treatment depends on the cause of the condition and the signs and symptoms

that are present.

Medications and treatment:

Pain relievers. If over-the-counter medicines — such as acetaminophen (Tylenol,

others), ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve) — aren't

enough, stronger pain medications are available by prescription.

Osteoporosis drugs. In many older people, kyphosis is the first clue that they have

osteoporosis. Bone-strengthening drugs may help prevent additional spinal

fractures that would cause your kyphosis to worsen.

Some types of kyphosis can be helped by:

Exercises. Stretching exercises can improve spinal flexibility and relieve back

pain. Exercises that strengthen the abdominal muscles may help improve posture.

Bracing. Children who have Scheuermann's disease may be able to stop the

progression of kyphosis by wearing a body brace while their bones are still

growing.

Healthy lifestyle. Maintaining a healthy body weight and regular physical activity

will help prevent back pain and relieve back symptoms from kyphosis.

Maintaining good bone density. Proper diet with calcium and vitamin D and

screening for low bone density, particularly if there is a family history of

osteoporosis or history of previous fracture, may help older adults avoid weak

bones, compression fractures and subsequent kyphosis.

Surgical and other procedures

If the kyphosis curve is very severe or if the curve is pinching the spinal cord or nerve

roots, your doctor might suggest surgery to reduce the degree of curvature.

The most common procedure, called spinal fusion, connects two or more of the affected

vertebrae permanently. Surgeons insert pieces of bone between the vertebrae and then

fasten the vertebrae together with metal rods and screws until the spine heals together in a

corrected position.

4. Scoliosis

Scoliosis is a sideways curvature of the spine that occurs most often during the growth

spurt just before puberty. While scoliosis can be caused by conditions such as cerebral

palsy and muscular dystrophy, the cause of most scoliosis is unknown.

Most cases of scoliosis are mild, but some children develop spine deformities that

continue to get more severe as they grow. Severe scoliosis can be disabling. An

especially severe spinal curve can reduce the amount of space within the chest, making it

difficult for the lungs to function properly.

Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the

curve is getting worse. In many cases, no treatment is necessary. Some children will need

to wear a brace to stop the curve from worsening. Others may need surgery to keep the

scoliosis from worsening and to straighten severe cases of scoliosis.

Treatment

Most children with scoliosis have mild curves and probably won't need treatment with a

brace or surgery. Children who have mild scoliosis may need checkups every four to six

months to see if there have been changes in the curvature of their spines.

While there are guidelines for mild, moderate and severe curves, the decision to begin

treatment is always made on an individual basis. Factors to be considered include:

Sex. Girls have a much higher risk of progression than do boys.

Severity of curve. Larger curves are more likely to worsen with time.

Curve pattern. Double curves, also known as S-shaped curves, tend to worsen

more often than do C-shaped curves.

Location of curve. Curves located in the center (thoracic) section of the spine

worsen more often than do curves in the upper or lower sections of the spine.

Maturity. If a child's bones have stopped growing, the risk of curve progression is

low. That also means that braces have the most effect in children whose bones are

still growing.

1. Braces

If your child's bones are still growing and he or she has moderate scoliosis, your doctor

may recommend a brace. Wearing a brace won't cure scoliosis, or reverse the curve, but it

usually prevents further progression of the curve.

Most braces are worn day and night. A brace's effectiveness increases with the number of

hours a day it's worn. Children who wear braces can usually participate in most activities

and have few restrictions. If necessary, kids can take off the brace to participate in sports

or other physical activities.

2. Surgery

Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis

surgery to reduce the severity of the spinal curve and to prevent it from getting worse.

The most common type of scoliosis surgery is called spinal fusion.

In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae)

together, so they can't move independently. Pieces of bone or a bone-like material are

placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part

of the spine straight and still while the old and new bone material fuses together.

Surgery is usually postponed until after a child's bones have stopped growing. If the

scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust

in length as the child grows. This growing rod is attached to the top and bottom sections

of the spinal curvature, and is usually lengthened every six months.

Complications of spinal surgery may include bleeding, infection, pain or nerve damage.

Rarely, the bone fails to heal and another surgery may be needed.

5. Lordosis

Lordosis, also known as swayback, is a condition in which the spine in the lower back

has an excessive curvature. The spine naturally curves at the neck, upper back, and lower

back to help absorb shock and support the weight of the head. Lordosis occurs when the

natural arch in the lower back, or lumbar region, curves more than normal. This can lead

to excess pressure on the spine, causing pain.

People with lordosis often have a visible arch in their lower backs. When looking at them

from the side, their lower backs form a defined “C” shape. In addition, people with

swayback appear to be sticking out their stomachs and buttocks.

The easiest way to check for lordosis is to lie on your back on a hard surface. You should

be able to slide your hand under your lower back, with little space to spare. If you have

lordosis, you will have extra space between your hand and your low back.

Symptoms

Symptoms of this abnormality depend upon the severity of the disease. Lordosis

symptoms may include:

C-shape back when seen from a lateral aspect, with the buttocks being more

prominent

A large gap between the lower back and the floor when lying on one’s back

Pain and discomfort in the lower back

Problems in moving in certain ways

Treatment

Treatment for lordosis will depend on the severity of the curvature and the presence of

other symptoms.

- Medication to reduce pain and swelling

- Physical therapy (to help build strength in the core muscles)

- Yoga (to increase body awareness, strength, flexibility, and range of motion)

- Weight loss

- Surgery (in severe cases)

6. Pigeon Chest

Pectus carinatum, also called pigeon chest, is a deformity of the chest characterized by a

protrusion of the sternum and ribs. It is distinct from the related deformity pectus

excavatum.

Pectus carinatum is an overgrowth of cartilage causing the sternum to protrude forward.

It primarily occurs among four different patient groups, and males are more frequently

affected than females.

People with pectus carinatum usually develop normal hearts and lungs, but the deformity

may prevent these from functioning optimally. In moderate to severe cases of pectus

carinatum, the chest wall is rigidly held in an outward position. Thus, respirations are

inefficient and the individual needs to use the accessory muscles for respiration, rather

than normal chest muscles, during strenuous exercise. This negatively affects gas

exchange and causes a decrease in stamina. Children with pectus deformities often tire

sooner than their peers, due to shortness of breath and fatigue. Commonly concurrent is

mild to moderate asthma.

Some children with pectus carinatum also have scoliosis (curvature of the spine). Some

have mitral valve prolapse, a condition in which the heart mitral valve functions

abnormally. Connective tissue disorders involving structural abnormalities of the major

blood vessels and heart valves are also seen. Although rarely seen, some children have

other connective tissue disorders, including arthritis, visual impairment and healing

impairment.

Treatment

External bracing technique

In children, teenagers, and young adults who have pectus carinatum and are motivated to

avoid surgery, the use of a customized chest-wall brace that applies direct pressure on the

protruding area of the chest produces excellent outcomes. Willingness to wear the brace

as required is essential for the success of this treatment approach. The brace works in

much the same way as orthodontics (braces that correct the alignment of teeth). The brace

consists of front and back compression plates that are anchored to aluminum bars. These

bars are bound together by a tightening mechanism which varies from brace to brace.

This device is easily hidden under clothing and must be worn from 14 to 24 hours a day.

The wearing time varies with each brace manufacturer and the managing physicians

protocol, which could be based on the severity of the carinatum deformity (mild moderate

severe) and if it is symmetric or asymmetric.

Depending on the manufacturer and/or the patient's preference, the brace may be worn on

the skin or it may be worn over a body 'sock' or sleeve called a Bracemate, specifically

designed to be worn under braces. A physician or orthotist or brace manufacturer's

representative can show how to check to see if the brace is in correct position on the

chest.

Bracing is becoming more popular over surgery for pectus carinatum, mostly because it

eliminates the risks that accompany surgery. The prescribing of bracing as a treatment for

pectus carinatum has 'trickled down' from both paediatric and thoracic surgeons to the

family physician and pediatricians again due to its lower risks and well-documented very

high success results.

Regular supervision during the bracing period is required for optimal results.

Adjustments may be needed to the brace as the child grows and the pectus improves.

If the person with PC is not treated with a brace by the end of puberty, the brace

technique is not an option, as the shape of the ribcage and sternum are set for the rest of

their lives.

Surgical

For patients with severe pectus carinatum, surgery may be necessary. However bracing

could and may still be the first line of treatment. Some severe cases treated with bracing

may result in just enough improvement that patient is happy with the outcome and may

not want surgery afterwards.

7. Hollow chest

Pectus excavatum (a Latin term meaning hollowed chest) is the most common congenital

deformity of the anterior wall of the chest, in which several ribs and the sternum grow

abnormally. This produces a caved-in or sunken appearance of the chest. It can either be

present at birth or not develop until puberty.

Pectus excavatum is sometimes considered to be cosmetic; however, depending on the

severity, it can impair cardiac and respiratory function and cause pain in the chest and

back. People with the condition may experience negative psychosocial effects, and avoid

activities that expose the chest.

Pectus excavatum is sometimes referred to as cobbler's chest, sunken chest, the crevasse,

or funnel chest.

Treatment

Treatment for pectus excavatum can involve either invasive or non-invasive techniques

or a combination of both. Before an operation proceeds several tests are usually to be

performed. These include, but are not limited to, a CT scan, pulmonary function tests,

and cardiology exams (such as auscultation and ECGs). After a CT scan is taken the

Haller index is measured. The patient's Haller is calculated by obtaining the ratio of the

transverse diameter (the horizontal distance of the inside of the ribcage) and the

anteroposterior diameter (the shortest distance between the vertebrae and sternum). A

Haller Index of greater than 3.25 is generally considered severe, while normal chest has

an index of 2.5. The cardiopulmonary tests are used to determine the lung capacity and to

check for heart murmurs.

Vacuum bell

A relatively new alternative to surgery is the vacuum bell. It consists of a bowl shaped

device which fits over the caved-in area; the air is then removed by the use of a hand

pump. The vacuum created by this lifts the sternum upwards, lessening the severity of the

deformity. Once the defect visually disappears, two additional years of use of the vacuum

bell is required to make what may be a permanent correction.

Orthopedics

Mild cases have also reportedly been treated with corset-like orthopedic support vests and

exercise.

Surgery

Surgical correction has been shown to repair any functional symptoms that may occur in

the condition, such as respiratory problems or heart murmurs, provided that permanent

damage has not already arisen from an extremely severe case. One of the most popular

technique for repair of pectus excavatum today is the minimally invasive operation, also

known as MIRPE or Nuss technique

Ravitch technique

The Ravitch technique is an invasive surgery that was introduced in 1949, and developed

in the 1950s to treat the condition. This procedure involves creating an incision along the

chest through which the cartilage is removed and the sternum detached. A small bar is

then inserted underneath the sternum to hold it up in the desired position. The bar is left

implanted until the cartilage grows back, typically about 6 months. The bar is

subsequently removed in a simple out-patient procedure. The Ravitch technique is not

widely practiced because it is so invasive. It is often used in older patients, where the

sternum has calcified, when the deformity is asymmetrical, or when the less invasive

Nuss procedure has proven unsuccessful.

8. Varus Alignment of the Knee: Bow-Legged Knees

Varus alignment causes the load-bearing axis to shift to the inside, causing more stress

and force on the medial (inner) compartment of the knee. If your doctor has said you

have varus alignment of the knees (bow-legs), keep in mind that studies show that weight

plays a critical factor. With varus alignment, you are at risk for knee osteoarthritis

regardless of your weight -- but if you are overweight or obese your risk is substantially

higher than average. Varus alignment increases the risk of knee osteoarthritis 5-fold in

obese patients. Increasing degrees of varus alignment are also associated with progression

of knee osteoarthritis as well as the development of knee osteoarthritis -- especially in

overweight and obese patients.

Treatment

Braces and Surgery

A number of things can cause bow legs including rickets and Blount’s disease. It is

vitally important to ensure your child receives enough Vitamin D from sunlight in order

to lower their risk of suffering from this condition. Depending on the age that bow legs is

diagnosed, some children may be able to receive braces which are said to encourage the

bones to grow straight. In more severe cases or in older children and adults bow legs

surgery may be advised which involves breaking the bone and realigning it.

Most people who have had the surgery have said they found it more than worth it

although the recovery time can be anywhere from six to ten weeks. If surgery and braces

aren’t however an option you may want to look into bow legs correction exercises.

Bow Legs Exercises

While most of the following bow legs exercises won’t completely cure bow legs, they

will improve your posture which should strengthen your legs and reduce the severity of

the condition. Some of the following exercises can have quite good results when

performed by children so they are definitely worth trying.

Yoga – Although yoga isn’t the easiest exercise to perform if you have bow legs you can

bind your legs together using a yoga strap in order to make things easier. Yoga helps to

improve flexibility and body alignment and the moves are known to improve the

condition.

Pilates – Pilates is similar to yoga in as such that it helps to improve posture and body

alignment. Exercises like ballerina arms and roll-up in particular can help to strengthen

and tone the leg muscles.

Massage Therapy – This is usually performed on children and has been known to

alleviate the severity of bow legs when performed regularly. Massage therapy involves

having the legs moved around by a trained therapist in order to encourage the legs to

straighten as they grow. One method that you might want to try is straightening the leg

and then bending it up to your chest. You must repeat this action multiple times to see the

benefits.

Leg Strengthening – By performing leg strengthening exercises you can help to

strengthen the muscles surrounding your knees and hence alleviate some of the pressure

that is being placed on your bow legs. These are most effective in people who only have a

slight bow in their legs and generally involve placing a weight between the feet and

bending and re-straightening the legs. You have to bend your legs until you touch your

buttocks. Do as many reps as you can. Start with a light weight, could be a pillow and

gradually increase it (dumbbell) as you progress.

9. Valgus Alignment of the Knee: Knock-Kneed Legs

Valgus alignment shifts the load-bearing axis to the outside -- causing increased stress

across the lateral (outer) compartment of the knee. Valgus alignment (knock-kneed) is

not considered quite as destructive as varus alignment. Alignment not only stresses

articular cartilage but it also affects menisci, subchondral bone, and ligaments -- all of

which may play a role in the progression of knee osteoarthritis.

Treatment

The best non-surgical treatments are aimed at reducing the risk of arthritis development

in the knee. This includes maintaining a low body weight, keeping fit while avoiding high

impact activities (running, soccer, singles, tennis, basketball, etc.) and bracing. These

treatments will not change the knock knee deformity but they will help in reducing the

functional problems associated with the deformity.

Daftar Pustaka:

www.wikipedia.com

www.mayoclinic.com

www.webmd.com