Wednesday, July 31, 2013

Kyphosis and the Office Worker


Kyphosis is a pronounced curve in the upper spine as the diagram below illustrates. The chances are if you're reading this you're probably sitting at a computer. All of us at some time will use a computer and a large majority of people will be sat at a desk and do most if not all of there work sat facing a computer. Typically people working at a computer will be slumped, leaning forward into the computer screen, the shoulders will be rolled forward and the neck will be long. Over a period of time the pectoral muscles on the front of the chest will shorten which in turn will bring the shoulders forward and tighten the muscles on the upper back. This will have several effects.

Effects of postural kyphosis

Hunchback

Tight shoulders

Compresses the lungs causing possible breathing difficulties

Compresses the internal organs leading to possible digestion problems.

Energetically obstruction of the lung channel again leading to respiratory problems

Instability of the shoulder joint

Possible cause of headaches

There are several types of kyphosis but as a massage practitioner I am mainly concerned with postural kyphosis which is a condition I see and treat on a regular basis.

Everything is connected

Everything in the body is linked so if one thing goes wrong there is going to be a chain reaction so if a muscle tightens there is going to be an effect on surrounding muscles and structure.

The client during the consultation will complain about tight shoulders and on physical examination will find that between the shoulder blades and the surrounding area feel tight. A lot of therapist will go straight to the upper back and treat there because that's where the pain is coming from and the client will expect you to start there because they believe that's where the pain is coming from. The shoulders are tight but they are tight because they are long not short. If you roll your shoulders forward and inwards towards your chest you will feel your upper back tighten. Further more in this position you will notice that this compresses the chest impairing the lungs function to expand to its full capacity and that by bending forward compression of the internal organs will occur.

If you consider how much time you spend sitting at a computer you have some idea of how serious this condition is, lets say you work a 37 hour week that means you spend 148 hours every 4 weeks in this position. At the end of the day sat at a computer, people will get in there car, get home and slump in front of the TV constantly being in a poor position.

The negative cycle

What's worse is that once this position is adapted this becomes the normal position for the body to be in. If a person slumps at there desk and then tries to adapt a correct posture by sitting correctly, pulling the shoulders back and putting the neck/head into a correct position it will cause pain because the body has adapted to a incorrect position and because when trying to correct pore posture it causes pain (mainly because the pecs are short) the person will go back to slumping because that's what feels normal. At this stage the muscles would be considered to be chronically tight.

When muscles are tight the supply of blood flow is restricted. The blood flow is responsible fro maintenance, repair and carrying away waste products from the muscles. When blood flow is restricted the muscle doesn't get nutrients and waste builds up. This is the start of the negative cycle causing the muscle to tense up more causing the fibres to harden leading to loss of movement and pain.

In this position the muscles that attach to the back of the neck are being stretched so again this will restrict the blood flow in this area which could be a possible cause of headaches.

Correct treatment

Release of the pectorals muscles thus realigning the shoulders and helping the muscles that are tight on the upper back into the correct position

Massage of the upper back and shoulder

Treatment of lower back and hip flexors

Releasing the neck with massage and stretches

Advice and Exercises

Core stability- these are the abdominal muscles and the muscles around the centre of your body which provide stability to the spine giving you strength to sit correctly

Correct posture see links below

Stretching of muscles especially pectorals, lower back, lower hip flexors. See my sheet on stretches

Pilates class

Further reading

Nhs direct- watch a video on kyphosis and read more explanations on the condition
http://www.nhs.uk/Conditions/Kyphosis/Pages/Introduction.aspx?url=Pages/What-is-it.aspx

Advice on how to sit correctly whilst using a laptop or desktop
http://www.nhs.uk/Livewell/workplacehealth/Pages/Howtositcorrectly.aspx

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