Hunh back, Rounded shoulder

How to fix Poor Posture?

We hear it all the time…”Keep your shoulders back! Stand straight!  Posture has become an ever present issue within healthcare circles but why exactly is posture so important? As renowned Doctor of Science Vladimir Janda explains,

“Human movement and function requires a balance of muscle length and strength between opposing muscles surrounding a joint.”

 

Poor posture results in  muscle imbalance at a joint, in which opposing muscles (the agonist and the antagonist) on opposite sides of a joint provide differing amounts of tension, due to muscle weakness or tightness. Muscle imbalances can then result in abnormal stresses applied to the joint.

 

While a muscle imbalance might not directly be a source of pain, many musculoskeletal pain syndromes are a result of chronic muscle imbalances. One musculoskeletal pain syndrome often diagnosed within the medical community is called upper cross syndrome.

Upper cross syndrome is characterized by forward head posture, increased thoracic kyphosis (rounded back), excessive mid-upper cervical spine extension, and scapular protraction (forward shoulders).

This results in tight upper cervical extensors and anterior thoracic muscles, as well as weakened (elongated) deep neck flexors and scapular muscles.
Tight muscles can impact joint movements in a variety of ways. Moreover, tight muscles tend to adapt  a consistently shortened position. Conversely, elongated muscles become weak when they are lengthened  their optimal length. Every muscle has an optimal length in which it can produce the most tension (force). The amount of crossbridging between the myosin (thick) and actin (thin) filaments is directly correlated with the amount of tension the muscle can produce. Therefore, an elongated muscle does not have as much overlap between myosin and actin filaments so it cannot produce as much active muscle force. Overtime period of time, these muscle imbalances of tight and weak muscles can lead to abnormal movement patterns, movement dysfunctions, and ultimately predispose your body to a host of other potential issues.

We found that when patient came with neck pain or shoulder you should check out the below muscles box which can help you in your assessment.

Via Dr. Dan Kirages

References :

  • Biondi, David M. “Cervicogenic Headache: Diagnostic Evaluation and Treatment Strategies.” Current Science Inc Current Pain and Headache Reports 5.4 (2001): 361-68.
  • Bullock, Michael P., Nadine E. Foster, and Chris C. Wright. “Shoulder Impingement: The Effect of Sitting Posture on Shoulder Pain and Range of Motion.” Manual Therapy 10.1 (2005): 28-37.
  • Chiu, Tai-Wing. “The Efficacy of Exercise for Patients with Chronic Neck Pain.” Spine 30.1 (2005): 1-7.
  • “What Is Muscle Imbalance.” Muscle Imbalance Syndromes RSS. N.p., n.d. Web. 19 Aug. 2015.

Cervicogenic Headache : What’s the Evidencebase treatment?

How many of your patients with neck pain suffer from headaches as well, or vice-versa? Cervicogenic headaches are characterized by unilateral headache radiating from the posterior to anterior head, unilateral upper cervical pain and facet “locking,” which is often aggravated by sustained neck positions. 

For cervicogenic headache patients, modalities such as TENS, cryotherapy, or low-level laser therapy can be helpful. Spinal manipulative therapy has been shown effective for cervicogenic headache patients in several studies. Other manual therapies such as instrument-assisted soft tissue mobilization and kinesiological taping can be helpful adjuncts.

Therapeutic exercise including muscle stretching and specific strengthening exercises can help address muscle imbalances seen in cervicogenic headaches. Several studies have shown that cervical strengthening exercises with  elastic resistance can help reduce headache and neck pain symptom.

In summary, management of cervicogenic headaches begins with an accurate diagnosis.  A multi-modal approach including Thera-Band exercises, modalities and manual therapies can help to reduce  symptoms of cervicogenic  headache.

Cervicogenic headaches: An evidence-led approach to clinical management.  

  2011 Int J Sports Phys Ther. 6(3):254-266.