Mississauga Chiropractor Presents: Postural Syndrome

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Here’s another blog from a Mississauga Chiropractor…

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A postural syndrome is having chronic neck & arm pain due to postural fatigue of muscles in the shoulder girdle & anterior spine.  It is usually caused by a faulty posture.

 

Faulty Posture:

a)      Slumping with forward head carriage – increased thoracic kyphosis & compensatory cervical lordosis – long term posture can result in upper cross syndrome

  • Tight upper trapezius, levator scapulae & pectoralis major
  • Weak & stretched rhomboids, erector spinae, serratus anterior & deep neck flexors.

 

b)      Anterior sagging or rounding of the shoulder girdle

 

History:

a)      Insidious onset of dull achy pain & stiffness in the shoulder girdle, upper back & posterior neck

b)      Pain may radiate to:

  • neck & occiput
  • deltoid insertion & upper triceps
  • anterior chest/pectoralis

c)      Pain is improved with activity & made worse with prolonged sitting at the desk or computer

d)      Paresthesia – Tingling over the hands & fingers

e)      Observation may reveal a hyperkyphotic posture

f)        Often tightness in the levator scapula, trapezius, rhomboids, scalenes & pectoralis major

 

Management:

a)      Correct the posture faults:

  • Avoid forward projection of the head (anterior head carriage)
  • Avoid anterior & inferior sagging of the shoulders (anything that produces increased kyphosis)
  • Use strapless brassiere; or use pads under elastic shoulder straps
  • Use small purse/backpacks; or use a fanny pack instead of a purse
  • Use a posture-correcting brace that pulls the shoulders back

 

b)      Stretch & Strengthen the shoulder girdle muscles

  • Shoulder shrugging exercise
  • WTYI & Wall Angels
  • Rowing exercises
  • Codman’s pendulum exercises
  • Upright & recumbent neck strengthening exercises & stretches
  • Latissimus pull downs
  • Corner Stretches (pecs)
  • Rotator Cuff Exercises

 

c)      Spinal Manipulative Therapy (SMT) or mobilizations to the cervical & thoracic spine.

d)      Electrotherapy: TENS, IFC

e)      Cervical Pillow/Firm Mattress

  • Don’t sleep on stomach or on chair/sofa
  • Don’t read or watch TV in bed or sofa with head propped forward – back & neck must be supported & in aligned
  • Use thicker pillow if you sleep on your side & thinner pillow if you sleep on your back; the purpose of a pillow is to support the neck, not prop the head forward

 

f)       Work Station Ergonomics (take frequent breaks)

  • Adjust chair, table, keyboard, computer screen
  • Keep feet flat on the floor, ankles at 90 degrees & knees at 90 degrees
  • Arms at sides, elbows at 90 degrees, wrists are supported and neutral
  • Gaze is straight forward to 20 degrees downward, back is straight & supported

 

g)      Automobile Seated Position

  • Avoid fully straightening legs to reach pedals
  • Move seat forward so arms are not reaching out & elbows are nearly 90 degrees, wrist is neutral
  • Back is against the seat back & headrest should be adjusted to lightly touch the back of the head, without forcing head into flexion.

 

Prognosis:

a)      With postural & activity modification & appropriate chiropractic management, there is an excellent prognosis for complete recovery.

 

 

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