The document discusses the significance of posture, its causes, and the different types of postural alignment, including kyphosis, lordosis, sway back, and flat back. It highlights factors contributing to poor posture such as heredity, muscle imbalances, and repetitive motions, and outlines the symptoms and treatment options for each condition. Additionally, it covers related conditions like bow legs and knock knees, including their causes and treatment strategies.

1. DR.a.telma Priya
Physical director
Thiagarajar College of preceptors
madurai

2. POSTURE MEANING
 The position in which someone holds their body
when standing or sitting
 Posture is the form of your body, which is made
up with proper positioning of bone, joints,
muscles and nerves. Posture gives you a proper
shape and defines your personality as a whole.
However, if there are certain defects in the
posture, it can affect your health in many ways.

3. Causes of posture
 Posture can be a large contributor to neck and back
pain. Holding your body upright and with good
alignment helps to take pressure off the spine. Excess
pressure — caused by poor posture, extra weight and
engaging in high-impact sports — accelerates the
degeneration of the discs and joints in the spine that
can lead to painful conditions like arthritis and
herniated discs.

4. Specific causes and defects
 The causes of poor posture can differ from person to
person. A person working in a shipping warehouse
lifting heavy boxes every day may develop posture
problems due to lower back strain, while office workers
may have posture issues in their shoulders from
hunching over a computer desk each day.
 There are some general causes of poor posture that
can affect anyone, including:

5.  Heredity.
Some people are predisposed to conditions such as
scoliosis, or the abnormal curvature of the spine.
Uneven limbs, deformities or diseases inherited at
birth can also contribute to improper posture.

6.  Muscle imbalances.
The strength of muscle groups, like the back and
abdominal muscles, should balance each other. If the
abdominals are stronger and tenser than the back
muscles, rounding of the back is more likely to occur.
If the back muscles are stronger than the abdominals,
the lower back may pull too far forward, causing the
stomach to protrude.

7.  Weight.
Much like muscle imbalances, excess weight carried
on the body can cause lower back problems, as a larger,
heavier midsection can pull the lumbar region of the
spine forward.

8.  Repetitive motions. Driving hunched over the
steering wheel or leaning toward a computer screen
day after day may contribute to a curved spine.
 Injury. A previous injury may lead to poor posture if
the body has adapted to carrying itself in a different
way to avoid pain.

9. TYPES OF POSTURAL ALIGNMENT
 Many people do not have an ideal posture. There are four
types of postural alignment that deviate from the ideal
alignment, which we often encounter. They are known as:
‘Kyphosis’, ‘Lordosis’, ‘Sway back’ and ‘Flat back’.

10. Kyphosis
 Kyphosis is usually associated with an increase curve
of the thoracic spine. Along with this, a slightly
posterior pelvic tilt is seen along with a reduced
lumber curve and a forward head position. The client
will show a hunched over posture with a depressed
chest.

12. Other potential causes of kyphosis include:
• aging, especially if you have poor posture
• muscle weakness in the upper back
• Scheuermann’s disease, which occurs in children and has no known
cause
• arthritis or other bone degeneration diseases
• osteoporosis, or the loss of bone strength due to age
• injury to the spine
• slipped discs
• scoliosis, or spinal curvature
The following conditions less commonly lead to kyphosis:
• infection in the spine
• birth defects, such as spina bifida
• tumors
• diseases of the connective tissues
• polio
• Paget disease
• muscular dystrophy

13. Lordosis
 We speak of Lordosis when there is an increased
curve in the lumbar spine of lower back. Often
there is also an increased pelvic tilt. The client
will show a posture in which the stomach and
head are pushed forward.

14. symptoms of lordosis
 The most common symptom of lordosis is muscle pain.
When your spine curves abnormally, your muscles get
pulled in different directions, causing them to tighten or
spasm.
• numbness.
• tingling.
• electric shock pains.
• weak bladder control.
• weakness.
• difficulty maintaining muscle control.

15. Treatment
 Most patients with any sort of lordosis will not require
surgery or treatment except in the most extreme
cases. Exercises taught by physical therapy are
often very helpful for good back health and flexibility.
These exercises should be use daily and can often
replace the need for medications.
 In the most severe patients with nerve problems,
surgery is often necessary. It will stabilize the back
bones and can correct some or all of the nerve
problems with time and the right therapy following
surgery.

17. Sway back
 A Sway back posture can be seen with a neutral or
posterior pelvic tilt with the hip almost rolled upward
to the front. The client shows a relaxed posture,
leaning backwards with the upper body.
 The following image shows the typical posture of
someone with a Sway back posture.

18. symptoms
• Appearing swayback, with the buttocks being more
pronounced.
• Having a large gap between the lower back and the
floor when lying on your back on a hard surface that
does not change when you bend forward.
• Back pain and discomfort.
• Problems moving certain ways.

19. Treatment
 Treatment for swayback should be based on an
accurate evaluation performed by a licensed health
provider trained in postural assessment. Usually, this
is a physical therapist. It might also be an athletic
trainer, personal trainer or holistic provider with
advanced education in this specialized area. Ask
your doctor for a referral and for the okay to
participate in a corrective exercise program for your
swayback.
 Your therapy may consist of posture
exercises, massage therapy, biomechanics training
and/or weight control. Also, maintaining a strong
core is vital to a healthy upright posture.
Strengthening your core posture muscles will likely
provide a foundation for the other exercises you do

21. Flat back
 A Flat back is when very little or no lumbar curve is
present. There will pretty much always be a posterior
pelvic tilt of in a neutral position. Occasionally due to
the position of the hip it can be difficult to fully
straighten the knees when standing.
 The following image shows the typical posture of
someone with a Flat back posture.

23. Military type
 Although this posture is not one of the four main
types of postural alignment, the Military type posture
can occasionally be observed.
It is characterised by an increased curve in the
lumbar spine of lower back and an anterior pelvic tilt.
The client shows a posture in which the chest is
pushed forward.
 The following image shows the typical posture of
someone with a military type posture.

25. Flat Foot
 People with flat feet have a very low arch or no arch,
meaning that one or both of their feet may be flat on
the ground. A human foot has 33 joints, which hold 26
different bones together. It also has over 100 muscles,
tendons, and ligaments.
 The arches provide a spring to the step and help to
distribute body weight across the feet and legs. The
structure of the arches determines how a person walks.
The arches need to be both sturdy and flexible to
adapt to stress and a variety of surfaces

29. Bow legs
 Bow legs (or genu varum) is when the legs curve
outward at the knees while the feet and ankles
touch. Infants and toddlers often have bow legs.
Sometimes, older kids do too. It's rarely serious and
usually goes away without treatment, often by the
time a child is 3–4 years old.

30. Bow legs

31. Causes bowlegs
 Bowlegs that do not straighten as your child begins to
walk may be caused by more serious problems such as:
• Rickets, a bone growth problem caused by lack
of vitamin D or calcium
• Blount’s disease, a bone growth disorder in the shinbone
(tibia)
• Abnormal bone development
• Fractures that do not heal correctly
• Lead or fluoride poisoning

32. Symptoms of bowlegs
Bowlegs are usually easy to see, but most cases self-correct
by age 3. If your child still shows any of the following
symptoms after age 3, please see your pediatrician:
• Bowed legs that continue or worsen after age 3
• Knees that do not touch when the child is standing with feet
and ankles touching
• Similar bowing in both legs (symmetrical)
• Reduced range of motion in hips
• Knee or hip pain that is not caused by an injury

33. Bowlegs Diagnosed
Your pediatrician can usually diagnose bowlegs just by
examining your child. Other tests your physician may
recommend to diagnose bowlegs or an underlying
condition include:
• Measurement of the distance between the knees
while your child is lying on his or her back
• Observation of how your child walks to determine
any abnormalities
• Blood tests to check for a vitamin D or calcium
deficiency

34. Treatment
Children with bowlegs usually don’t need treatment
unless the condition is extreme or your child has a
more serious underlying condition. In those cases, we
recommend these options:
• Checkups at least every six months so the
pediatrician can monitor your child’s leg growth and
development
• Vitamin D and calcium supplements to treat and cure
rickets
• Braces or other orthopaedic devices for children
under age 3 who have Blount disease or other
serious conditions
• Surgery for children over age 3 who have Blount

35. Knock knees
 Knock knee is a condition in which the knees bend
inward and touch or "knock" against one another, even
when a person is standing with their ankles apart. This
places excessive force on the outer side of the knee,
which can cause pain and damage over time.
 Knock knee is usually bilateral – affecting both legs – but
in some cases, it may only affect one knee.
Temporarily knocked knees are part of a standard
developmental growth stage for most children. This
usually corrects itself as the child grows. Knock knees
that persist beyond six years of age, are severe or
affect one leg significantly more than the other may be
a sign of knock-knee syndrome.

36. Knock Knees

37. Causes knock knee
Knock knee can be caused by an underlying congenital or
developmental disease or arise after an infection or a
traumatic knee injury. Common causes of knock knees
include:
• metabolic disease
• renal (kidney) failure
• physical trauma (injury)
• arthritis, particularly in the knee
• bone infection (osteomyelitis)
• rickets (a bone disease caused by lack of vitamin D)
• congenital (inborn) conditions
• growth plate injury
• benign bone tumors
• fractures that heal with a deformity (malunion)

38. Symptoms
The most prominent symptom of knock knee is a separation of a
person’s ankles when their knees are positioned together. Other
symptoms, including pain, are often a result of the gait (manner
of walking) adopted by people with knock knees.
These symptoms may include:
• knee or hip pain
• foot or ankle pain
• feet not touching while standing with knees together
• stiff or sore joints
• a limp while walking
• reduced range of motion in hips
• difficulty walking or running
• knee instability
• progressive knee arthritis in adults
• patients or parents may be unhappy with aesthetics

39. Treatment
 For mild cases of knock knee in children or
adolescents, bracing may reposition the knees.
When this does not work, or if the patient is an adult
at the time of diagnosis, a knee-
realignment osteotomy is done to prevent or delay
the need for knee replacement.
 If knock knee is caused by an underlying disease or
infection, that condition will be addressed before any
orthopedic correction begins. Treatment for mild
cases of knock knee in children or adolescents may
include braces to help bones grow in the correct
position.
 If a gradual correction does not occur, surgery may
be recommended. In the growing child, guided-
growth minimal-incision surgery may be used to

41. Thank you