Damage to the posture of children

Back problems cause every tenth day of sick leave in Germany - according to the new health report 2011 of the Techniker Krankenkasse. The causes of back problems often lie in childhood. Back pain in childhood is still rare. However, mistakes in posture are noticeable in adolescents and at the latest in adulthood.

This makes it all the more important that you inspect any postural defects of your child and take corrective action. During the puberty growth spurt between the age of 11 and 15 for girls and 12 to 17 for boys, the spinal column is susceptible to undesirable developments.

The most common posture error is a hunchback. This refers to the extreme curvature of the spine in the chest area. The head and shoulders are tilted forward. This puts more strain on the front parts of the spine than on the back. In children, however, the vertebral bodies still grow and therefore react to one-sided pressure load. This means: the growth on the front side of the vertebral bodies is stopped, the growth on the back side continues. Thus, the vertebral bodies develop asymmetrically and become ossified in this unhealthy form, a bony round back shape is developing which cannot be undone after a certain point in time.

Our tip: Always make your child aware of an upright posture! Regular exercise is also important because well-trained muscles on the back, buttocks, abdomen, shoulder belt and chest can prevent permanent damage. Stretching exercises are also indispensable, because our sedentary lifestyle shortens certain muscles, such as the abdominal muscles. This strengthens the unhealthy shape of the hunchback. Physiotherapy can learn special strengthening and stretching exercises and can be performed at home every day. Recommended sports include swimming and horseback riding, and dancing gymnastics for smaller children. Children with poor posture should also take part in physical education classes at school, and only children with pathological disorders are exempted.

The pathological disorders include Scheuermann's disease. This affects pubescent boys. The cause is a genetic metabolic disorder associated with a lack of exercise and excessive strain. The balanced development of the vertebral bodies is also impaired with Scheuermann's disease, which leads to flattened forward vertebral bodies in wedge form. In the the lumbar spine, a reinforced hollow back is often the result, a futile attempt to compensate for the hunchback. With the completion of growth, there is no further progress of the disease. However, the damage to intervertebral discs and vertebral bodies remains for the rest of life. According to the present state of knowledge, nothing can be done about a "Scheuermann". However, the effects of the disease can be reduced: For example, it is important to avoid sitting in a bent position for hours. A corset can show good results with heavy forms where complete self-erection is not possible. In addition, a daily physiotherapy of at least 20 minutes duration is important. In the state of Scheuermann's disease, there is no clear distinction between the transition from puberty-related malposition to normal disease progression. Both often merge. Therefore, active countermeasures such as physiotherapy are useful.

The third common form of postural damage in children is scoliosis. This is a lateral curvature of the spine. You can see them for yourself if you ask your child to bend over with his upper body exposed. Now look at the back: with scoliosis, you will see a lateral curvature. This can be caused by one-sided pressure on one shoulder side. For example, if a child carries a heavy schoolbag on one side only, this could lead to growth problems. Due to the one-sided pressure, the still soft vertebral bodies on the affected side ossify at an early stage, while on the other side the vertebral bodies continue to grow, so that the spinal column is bent sideways. The principle is that of the round back. In scoliosis, however, the vertebrae on the right and left are differently developed, whereas with a round back, the vertebrae at the front and back are differently developed. Warning signs for scoliosis are also when the head is tilted to the side, one shoulder is higher than the other or the chest appears to be bulging on one side. This is not only a "beauty flaw". Slight scoliosis can worsen and affect the functioning of the lungs and heart during life. On the one hand, it crushes the organs. The disease develops between the ages of ten and twelve. Girls are up to five times more likely to be affected than boys. Overall, about 5 percent of the population suffers from scoliosis. Besides incorrect loadings, the causes of this are unknown, sometimes heredity can be assumed.

If your child has signs of scoliosis, take him to the doctor. He prescribes physiotherapy to strengthen the muscles and need not to intervene any further. However, if the unnatural curvature of the spine increases, a corset or operation may be showed. The later an operation is performed, the more difficult it is.

Copyright: Landeszentrale fuer Gesundheitsfoerderung in Rheinland-Pfalz e.V. (LZG) Germany

Text: Dr. Beatrice Wagner, Editor: Birgit Kahl