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Spine diseases are a large group of diseases that affect more than 85% of the population. If half a century ago, back problems were mainly among elderly people, then a sedentary lifestyle and the computerization of society significantly "rejuvenated" back diseases. Let's briefly consider each pathology separately.
Arthritis is an autoimmune inflammatory disease characterized by connective tissue damage and the involvement of synovial tissue in the process. The most common place of localization of the disease is the area of the cervical spine. Its danger is that in the early stages arthritis does not manifest itself in any way and is diagnosed already with multiple joint damage. Women get sick 4 times more often than men.
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Spondyloarthrosis is a degenerative lesion of the intervertebral joints, which entails a malfunction of the functions of the spinal column. The disease spreads to the ilium, sacrum and rib bones, causing premature wear of the cartilage and weakening of the paravertebral muscles and ligaments. A person with arthrosis of the spine will be disturbed by discomfort when moving, he may feel stiffness and.
With the progression of destruction of cartilage tissue, more serious problems may arise, up to the disability of the patient.
Ankylosing spondylitis is a chronic systemic disease of the intervertebral joints, in which they become inflamed and can completely grow together with each other with a complete loss of mobility. Also, the disease can affect the costal-vertebral and sacroiliac joints. Most often, ankylosing spondylitis is diagnosed in men aged 20-30 years. Among all rheumatological diseases, ankylosing spondylitis occupies the last position.
- See also:.
Schmorl's hernia
Schmorl's cartilaginous node - certain structural and anatomical changes in the vertebral bodies, in which the cartilaginous tissue is pressed into the corpus spongiosum below or above the lying vertebra. Shmol's hernia entails severe pain in the area of damage, and can only be traced during an X-ray examination. Sometimes the disease is congenital, but most often it is acquired back problems that arise as a result of posture disorders, after bruises and injuries.
Spine fracture
One of the most serious injuries that can occur to the human body is a spinal fracture. Trauma is characterized by a violation of the anatomical integrity of one or more vertebrae and compression of the bodies of muscle segments, blood vessels, and nerve endings. Distinguish between compression (squeezing the vertebrae) and decompression (stretching the vertebrae) fractures, both of which are extremely dangerous in case of spinal cord injury.
A pathological process in the cervical spine, in which the annulus fibrosus loses its strength, and the nuclei of the intervertebral disc are displaced into the spine. Excessive physical exertion, many other back diseases (injuries, weak muscles and curvature of the spine, scoliosis, osteochondrosis), infectious diseases and somatic pathologies contribute to the appearance of protrusion.
Radiculitis
Radiculopathy is a compression and inflammatory lesion of the spinal cord roots entering the intervertebral foramen. In 90% of cases, the cause of radiculitis is the advanced stage of osteochondrosis, the remaining 10% are other problems with the spine (injuries, hernias, wear and tear and deformation of the spinal column and intervertebral discs). Painful symptoms of sciatica, popularly called "lumbago", can affect the cervical and thoracic spine. In severe cases, numbness, muscle cramps, and loss of movement may occur.
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If we consider all diseases of the spine, then its primary and secondary are the most serious problems. Primary spinal cancer, when the tumor directly affects the spinal cord, is relatively rarely diagnosed. More often, neoplasm metastases initially develop in other organs - these are secondary tumors of the spine.
Rapidly progressing back problems of an oncological nature are solved not only by a radical method (surgery to remove a tumor), chemotherapy sessions can be prescribed.
Scoliosis
An unnatural curvature of the spinal column to the right or left, resulting in deformation of the spine and chest is called scoliosis. Usually the disease is acquired in nature, in rare cases it is congenital. Pathology is actively developing during the period of intensive skeletal growth in childhood and adolescence, as well as with constant tension of the back muscles and uneven distribution of the load on the joints in adults.
The disease is classified according to the angle and plane of the curvature of the back into: cervicothoracic, thoracic, lumbar-thoracic, combined scoliosis.
Even with a slight deformity, posture disturbances are always visible, with the development of pathology, a rib hump appears, wedge-like vertebrae appear, the pelvis is tilted, nerve endings are clamped, which interferes with the high-quality work of the nervous system, and the normal functioning of internal organs is hampered.
Stenosis
Spinal stenosis is a disease that affects the human spinal cord. It is characterized by narrowing of the spinal canal and pinching of the nerve vertebrae. Symptoms of stenosis are pronounced: cramps, pain, numbness in the shoulders, neck, upper and lower extremities, loss of sensation may occur. Most often, stenosis is diagnosed in the elderly or is a complication of osteoarthritis.
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Spondylosis is the involutionary process of wear and tear of the anatomical structures of the spine, which is characterized by the growth of bone tissue near the vertebrae. The disease is asymptomatic or with mild symptoms. With a prolonged course of spondylosis, additional diseases of the spine may develop, since the lumen of the intervertebral canal decreases, tendons and nerves are injured, and the vertebrae are fused together.
Chondrosis
Chondrosis is a pathology of a degenerative-dystrophic nature, in which individual sections of the cartilaginous tissue that make up the intervertebral discs are reborn into bone. The symptoms of the disease are mostly observed in elderly people, therefore, for a very long time, a decrease in the mobility of the vertebrae was associated with irreversible age-related changes. But modern medicine has made it possible to thoroughly study all the subtleties of the spine and find ways to combat the disease.
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Treatment of diseases of the spine
Diagnosis and treatment of the disease should be carried out under the strict supervision of a specialist. Depending on the nature of the complaints, the problem can be dealt with by an orthopedic surgeon, traumatologist, endocrinologist, neuropathologist, rheumatologist, oncologist, manual or simple family therapist.
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There are a lot of treatment options for the back and spine: medical drugs and blockades, physiotherapy procedures, massages, exercise therapy, manual therapy, and surgery.
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For almost all diseases of the spine, patients are advised to perform special physical exercises. Usually this is exercise therapy or therapeutic exercises for a hernia of the spine, with sciatica, etc.
The cause of almost all problems of the joints (and the spine, as well) is their poor blood supply and nutrition, combined with excessive stress.
The reason may be physical inactivity, hard physical labor or too active sports.
But the cause of most problems is still a sedentary and sedentary lifestyle - in this case, the muscles gradually weaken and lose the ability to perform their immediate tasks, including supporting the spine.
As a result, he receives too much stress, which becomes the main cause of the vast majority of diseases of the spine.
That is why, regardless of other appointments and prescriptions (massages, medications, in extreme cases - surgery), all patients are prescribed therapeutic exercises for a hernia of the spine or any other problems of this kind.
For your information
Do not overload the painful area; it is better to perform all movements with a small amplitude, at a slow pace. If pain occurs or increases, classes should be discontinued. It is necessary to alternate active actions with complete muscle relaxation.
What is the main task of such gymnastics?
As we have already said, the main problem is almost always the weakening of the muscular corset of the spine, which leads to diseases such as a hernia of the lumbar spine.
Gymnastics in this case is aimed at strengthening the muscular corset of the spine, bringing it back to normal.
Exercises for the lumbar spine
1. Lie on your back, arms along your torso, legs slightly bent. Without holding your breath, contract your abdominal muscles until they become firm. Place your hand on your stomach to control.
2. Lie on your back, arms at your sides, legs extended. Keeping your feet on the floor, lift your upper body. After 10s, slowly return to the starting position and rest for 15s.
3. Lie on your back with your legs bent. Place your right hand on your left knee. For 10 seconds, slowly pull your knee towards your head, resting your hand on it, but at the same time not allowing it to come close. Return to the starting position and rest for 15 seconds, relaxing the muscles. Then place your left hand on your right knee and repeat all over again.
4. Lie on your back, arms along your torso, legs slightly bent. Place both legs on the floor to the right of your torso, while turning your head and upper torso to the left. After 5s, return to the starting position, and then repeat the exercise in the other direction.
5. Kneel in front of the support, rest your head and hands on it. Arch your back upward as much as possible and remain in this pose for 5c. Then bend your chest down as much as possible. Stop doing the exercise immediately if you experience pain or discomfort.
6. Kneel in front of the support, rest your head and hands on it. Arch your back as far as possible to the right and remain in this pose for 5c. Then bend your back as far as possible to the left. Stop doing the exercise immediately if you experience pain or discomfort.
7. Hanging from the bar, gently turn your torso to the right and left. Try not to strain your neck, shoulders and back: they should be as relaxed as possible. Do the exercise for 1-3 minutes.
8. Lie on your stomach, arms alongside your body, legs slightly apart. Raise your right leg as high as possible and hold it for 5-10s. Then return to the starting position and repeat the exercise for the left leg.
Exercises for the cervicothoracic spine
For your information
For maximum effect, each exercise should be repeated at least 10 times.
1. Stand straight with your feet together and your arms at your sides. Bend your head, bringing your chin as close to your chest as possible, and then slowly, very smoothly, tilt it back so that your gaze is directed to the ceiling. Stay in this position for at least 10 seconds. If you do this exercise 45-50 times daily, you will forget about the pain in the neck for a long time.
2. Stand straight with your feet together and your arms at your sides. Bend your right hand, place your palm on your forehead, press hard and stay in this position for at least 10 seconds. Then take a deep breath, rest for 5s and repeat the exercise for the left hand. This exercise works well for strengthening weakened neck muscles. The forehead can be resting not only on the palm, but also on any hard surface.
3. Stand straight with feet shoulder-width apart, arms down at your sides. Raise your right hand and place your palm on your right cheek, firmly resting on the cheekbone bone. Within 10s. press hard with your palm on your head, and with your head on your palm. Then take a deep breath, rest for 5 seconds and repeat the exercise for the left arm. This exercise is great for strengthening the lateral muscles of the neck.
4. Lean your back against the end of the door so that it is between your shoulder blades. Legs together, arms along the torso, chin down on the chest. Put your back firmly on the door and, while inhaling, slowly straighten your head and pull your shoulders back as much as possible. As you exhale, return to the starting position and rest for 5s. This exercise strengthens the muscles in the back, increases blood circulation and improves the mobility of the shoulder joints.
5. Sit on a chair and place your hands on your lap with your fingers locked. As you inhale, tilt your head and torso to the right, and as you exhale, return to the starting position. Now do the same, but in the opposite direction. This simple exercise, which can be performed without difficulty in any environment throughout the day, not only strengthens the lateral muscles of the back and neck, but also increases blood circulation and improves the mobility of joints and ribs.
When performing exercise therapy, you need to take into account the following contraindications:
- you can not do exercises when osteochondrosis is at the stage of exacerbation;
- the postoperative period, when the spine needs restoration;
- if the patient has a lack of coordination of movements;
- it is prohibited to do exercise therapy if there are violations of the vestibular apparatus;
- it is not recommended to perform exercises, for any acute and chronic diseases, when the patient complains of poor health;
- high blood pressure
- Heart arythmy
- too high intraocular pressure and severe myopia.
Nutritional therapy: prevention of spinal diseases
It is not for nothing that popular wisdom says: "Eat simply - you will live to be a hundred." Unfortunately, in our time, porridge is rapidly losing its former popularity. Meanwhile, if you want to have a healthy spine, this primordially Russian dish that our ancestors regularly consumed for many centuries must be included in your menu ...
Attention! the information on the site is not a medical diagnosis, or a guide to action, and is for informational purposes only.
MOSCOW STATE UNIVERSITY OF PRINT
Department of Physical Education and Sports
Topic: "Physiotherapy exercises for diseases of the spine"
Completed: student of group DKidB2-1
Faculty of Publishing and Journalism
Teacher:
head of department
Moscow 2012
Introduction ………………………………………………………………… 3
The structure and functions of the spine …………………………………… 4
Consequences of the disease ................................................ ........................5
Scoliosis................................................. .................................................. ...5
Causes of the disease ................................................ ............................... 6
Structural scoliosis ................................................ ..........................9
Treatment................................................. .................................................. ...10
Some facts ................................................ ......................................eleven
Correct behavior in scoliosis .............................................. ........12
Exercise therapy ................................................. .................................................. ....... .14
Conclusion................................................. ..............................................nineteen
Literature................................................. ...............................................twenty
Introduction
Spinal problems can affect the functioning of other organs, which can lead to various diseases. But regardless of age, this can be prevented or suspended by observing a balanced diet and performing simple exercises for the spine. Strengthening and stretching the spine, you can preserve the youth and health of the spine and the whole body.
Sports for diseases of the spine is not contraindicated. For those who suffer from back pain, you can walk at a brisk pace, ski, jog, swim, and bike three times a week. But you should not get carried away with activities associated with heavy loads (weightlifting, high jumping, wrestling, tennis, badminton, golf, hockey, football).
Performing remedial gymnastics, first of all, you do not need to overestimate your physical capabilities, overexert yourself or make too sweeping movements.
Therapeutic gymnastics (LFK) is a set of exercises carried out to get rid of many chronic human diseases related to reducing muscle strength and limiting joint movements. If during his life a person does not care about the health and work of muscles, ligaments and joints, then many body functions cease to be performed:
- musculoskeletal;
-cardiovascular microcirculatory;
- lymphatic microcirculatory;
- immune.
The structure and function of the spine
The vertebral column is the dorsal solid axis of the body of humans and many animals, made up of a number of separate short joints of bones, called vertebrae, almost its entire length contains a canal containing the spinal cord. From above it is articulated with the bones of the skull, from below with the bones of the pelvis. In humans, it is divided into the cervical part (7 vertebrae), thoracic (12), lumbar (5), sacral (5 accrete vertebrae) and caudal (5 underdeveloped vertebrae). The SPINE is the basis of the skeleton and performs two important functions in the human body. The first function is musculoskeletal. The second is protective. The spine protects the spinal cord from mechanical damage. Numerous nerve endings are suitable for it, which are responsible for the work of all organs in the human body. Figuratively speaking, each vertebra is responsible for the work of a specific organ. If the functions of the spine are impaired, it becomes difficult to conduct a nerve impulse to tissues and cells in different parts of the body. Over time, it is in these areas of the body that various diseases will develop. Most often, there are curvatures: 1) scoliosis (lateral), rickety (in children from 3-4 years old, 2) kyphosis (behind), habitual in rickety children, anemic girls due to humpback posture when reading, in old age; 3) lordosis (in front), less common, with hip dislocations.
Scientific works have shown that 86% of school-age children show symptoms that indicate the presence of disorders in the spine. Throughout life, some of these symptoms disappear, others transform into scoliosis, kyphosis, poor posture, any additional trauma to the body can intensify these painful manifestations.
People have suffered from diseases of the spine at all times. These diseases are so common that almost everyone suffers from them at some time.
Spinal diseases are almost as common in the young as in the elderly. Men suffer from them almost twice as often as women. This can be explained by the anatomical and physiological features and the fact that many men are engaged in heavy physical labor.
The consequences of scoliosis
Close attention to scoliosis is explained by the fact that in severe forms of this disease, significant disturbances occur in the most important systems of the body, leading to a decrease in the life expectancy of working capacity and disability. In the literature, changes in the respiratory, cardiovascular and autonomic nervous systems in severe forms of scoliosis are clearly outlined and well studied. Data on the presence of disturbances in the function of external respiration, heart rhythm and metabolic processes in the myocardium, insufficient adaptation of the cardiovascular system to physical activity, a decrease in a number of indicators of physical development, a later onset of puberty in schoolchildren of 7-16 years old, patients with scoliosis I and II are presented. degree. Unfortunately, there is practically no data on changes in the vital systems in case of posture disorders and in the initial degrees of scoliosis in preschoolers and primary schoolchildren.
Scoliosis
The term "scoliosis" refers to the lateral curvature of the spine. Moreover, this term is used both in relation to the functional curvature of the spine in the frontal plane ("functional scoliosis", "scoliotic posture", "antalgic scoliosis"), and in relation to a progressive disease leading to a complex, sometimes severe deformity of the spine ("scoliotic disease" , "structural scoliosis").
Scoliosis can be simple or partial, with one lateral curvature of the curvature, and complex - in the presence of several curvature arcs in different directions and, finally, total, if the curvature involves the entire spine. It can be fixed and non-fixed, disappearing in a horizontal position, for example, when one limb is shortened. Simultaneously with scoliosis, its torsion is usually observed, that is, rotation around the vertical axis, with the vertebral bodies facing the convex side, and the axial processes in the concave side. Torsion contributes to deformation of the chest and its asymmetry, while the internal organs are compressed and displaced.
Causes of the disease
The initial phenomena of scoliosis can be detected already in early childhood, but at school age (10-15 years) it is most pronounced.
Etiologically, congenital scoliosis is distinguished (but they occur in 23.0%), which are based on various deformities of the vertebrae:
* underdevelopment;
* their wedge-shaped form;
* additional vertebrae and. etc.
Acquired scoliosis includes:
1. rheumatic, usually arising suddenly and caused by muscle contracture on the healthy side in the presence of symptoms of myositis or spondyloarthritis;
2. rickety, which are very early manifested by various deformations of the musculoskeletal system. Bone softness and muscle weakness, carrying a child in his arms (mainly on the left), prolonged sitting, especially at school - all this favors the manifestation and progression of scoliosis;
3. paralytic, often occurring after infantile paralysis, with unilateral muscle damage, but can also be observed in other nervous diseases;
4. habitual, on the basis of habitual bad posture (they are often called "school", since at this age they get the greatest expression). The immediate reason for them may be improperly arranged desks, seating schoolchildren without taking into account their height and number of desks, carrying school bags from the first grades, holding the child by one hand while walking, etc. etc.
Of course, this list does not cover all types of scoliosis, but only basic ones.
It is generally accepted that training overloads are the cause of lower back injury. Meanwhile, pain in the lower spine is much more often caused by normal daily activities of a person. This is the explanation of the seemingly strange contradiction, when people who have never known sports complain of lower back pain. The most harmful thing is to sit. Surprisingly, while sitting, the spine is more loaded than when we are standing! However, the increased load is still half the battle. For many hours we have to sit in the most harmful position - leaning forward. In this position, the edges of the vertebrae come together and pinch the intervertebral disc from the cartilaginous tissue. In general, this fabric is remarkable for its elasticity, allowing it to successfully resist compression. However, it should be borne in mind that when sitting, the force of pressure on the outer edge of the disc increases 11 times! Moreover, it continues not only during the working and school day, but often at home.
The spine should be straight when viewed from behind. In some, however, it takes on an S-shape (scoliosis). In mild cases, this does not lead to any complications. With a significant curvature of the spine, when it turns around its axis, sometimes pain occurs and its ability to function normally decreases. From the point of view of biomechanics, the process of scoliotic deformity formation is the result of the interaction of factors that violate the vertical position of the spine and adaptive reactions aimed at maintaining an upright posture.
The term "scoliotic disease" is used to combine congenital, dysplastic and idiopathic scoliosis (ie, scoliosis of unknown origin). Congenital scoliosis is caused by gross malformations of the skeleton, such as accessory lateral cuneiform vertebrae. In congenital scoliosis, the shape of the curvature is directly dependent on the location and nature of the anomalies.
Scoliotic disease, or scoliosis, in contrast to functional curvature of the spine in the frontal plane, is characterized by a wedge-shaped and torsional deformity of the vertebrae progressing in the process of growth, as well as deformation of the chest and pelvis. Structural scoliosis develops in some metabolic diseases, leading to functional inferiority of connective tissue, rickets. In these diseases, scoliotic deformity acts as structures. Static scoliosis is usually called structural scoliosis, the primary cause of which is the presence of a static factor - an asymmetric load on the spine caused by congenital or acquired asymmetry of the body (for example, asymmetry in the length of the lower extremities, pathology of the hip joint, or congenital torticollis). In static scoliosis, the rate of progression and severity of deformity depend on the ratio of the severity of the static factor and the factor of functional failure of the structures that ensure the maintenance of the vertical position of the spine. With a good functional state of the musculo-ligamentous apparatus and intervertebral discs, the curvature of the spine may remain functional for a long time or not at all lead to the development of progressive scoliosis. As long as the nucleus pulposus of the intervertebral disc maintains a central position, the body weight pressure transmitted to the disc is distributed evenly over the entire area of the supporting site of the underlying vertebra, without causing progressive wedge-torsion deformity. If, in the presence of a slightly expressed static factor, compensatory mechanisms are weak or there is a functional inferiority of the connective tissue structures, the scoliotic factor forms and causes the progression of deformity. With functional muscle failure, most of the load to maintain an upright posture is transferred to the ligaments. A sufficient degree of ligament tension is achieved due to a significant increase in the angle of curvature of the spine, leading to an increase in the load on the intervertebral discs, persistent lateral displacement of the nucleus pulposus, and thus the formation of a scoliotic factor. Static compensation for gross asymmetry of the body can be achieved through significant curvature of the spine. In this case, the intervertebral discs are subjected to a large asymmetric load, which leads to the formation of a scoliotic factor even in the absence of dysplastic changes, muscle weakness and constitutional weakness of the connective tissue structures. With scoliotic disease, allocated in a separate nosological form, curvature of the spine is the main symptom.
Treatment
Scoliosis belongs to the group of diseases of the musculoskeletal
locomotor system associated with changes in posture. These diseases are dealt with by orthopedists, who, after examination, recommend treatment (individually selected physiotherapy exercises, massage, FTL, visiting the pool, wearing a corset, manual therapy, if indicated, etc.).
It is necessary to sleep on a rigid basis, and for softness use cotton or woolen mattresses, but not spring mattresses. You need to find a competent sports doctor, and under his guidance, do physical therapy.
Scoliosis treatment consists of three interconnected links: mobilization of the curved spine, deformity correction and stabilization of the spine in the position of the achieved correction. Manual therapy techniques are very effective for correcting spinal deformities. The preservation of the achieved correction with their help can be promoted only indirectly, due to the formation of a new static-dynamic stereotype, adapted to the changes in the shape of the spine. The change in the static-dynamic stereotype is carried out by means of a targeted impact on the upper and lower levels in relation to the main curvature of the links of the musculoskeletal system and the regulation of the tone ratios of the conjugated muscle groups participating in the formation of posture. However, the main and most difficult task, the solution of which determines the success of treatment in general, is not the mobilization and correction of the curvature, but the stabilization of the spine in the corrected position. Deformity correction that is not supported by measures to stabilize the spine is ineffective.
Conservative treatment methods cannot have a direct effect on structural changes in the spine. Therefore, attempts to mechanically "straighten" the curvature of the spine caused by the structural rearrangement of the vertebrae and intervertebral discs are senseless. The essence of conservative treatment consists in correcting the curvature of the spine by reducing the functional component of the curvature and stabilizing the achieved correction by improving the functional state of the musculo-ligamentous apparatus or using corsets
The most important point of the therapeutic effect in the treatment of scoliosis is the restoration of muscles in a state of fascial-muscular rigidity, or, more simply, in a state of local spasm. This is achieved with the help of post-isometric relaxation and special exercises. The implementation of special exercises for each patient is individual and depends on the nature of the scoliotic manifestations.
Some facts
The amount of load compressing two vertebrae is largely determined by the position of the body. It is smallest when the body is in a horizontal position. In the standing position, the pressure between the vertebrae increases. In the lower part of the lumbar spine, it is 4 times more when a person is standing than when he is lying. The total load in this case is equal to the total mass of the upper body.
When leaning forward from a standing position, the total load increases enormously, due to the effect of the leverage formed between the part of the body that leans forward and the vertebra itself. A similar effect leads to the fact that the pressure between the two vertebrae in the lower part of the lumbar spine when tilting is 2.5 times more than when we are standing upright, and 10 times more than when we are just lying down.
Correct behavior in scoliosis
The pressures on the intervertebral discs (as a percentage of the standing position) are given in Table 1.
Table 1
Lying on your back ....................... 25%
Lying on its side ........................ 75%
Standing ................................ 100%
Standing, leaning forward ............. 150%
Standing, leaning forward, in the hands of the weight. 220%
Sitting ................................ 140%
Sitting forward bend .............. 185%
Sitting with an inclination forward, in the hands of the weight. 275%
If you work while sitting, periodically "press your back and lower back into the back of the chair, and if there is a high headrest with effort, rest your head against it.
The same strong pressure between two vertebrae occurs when a person sits leaning forward, not leaning on their hands. If you lean on your hands, placing them on a table or the back of a chair, the load on the upper body is reduced, and thereby the pressure on the vertebrae is reduced.
The pressure between the two vertebrae increases when a person picks up an object by leaning forward with their legs straight. In this case, the load on the intervertebral disc is several hundred kilograms.
When stretching the spine, for example, when a person hangs on his hands without support on his legs, the pressure is less than in the prone position. In this case, a stretching may even occur in the intervertebral disc. This circumstance is sometimes used in the treatment of certain diseases of the spine.
The weight of the head puts pressure on the cervical vertebrae. Even the arms are a strain on the cervical spine, as the shoulder muscles that lift the arms up are attached to the back of the head and neck. When you raise your arms up, these muscles tense and thereby weigh down the vertebrae. Many knowledge workers unknowingly raise their shoulders, which puts additional stress on these vertebrae. The cervical vertebrae are exposed to great stress when working with arms raised up (for example, when washing windows), especially if there are heavy objects in the hands.
When the head is tilted down in a sitting position, the load on the cervical vertebrae, according to the principle of the lever, will be many times greater than if you sit with your head up. To keep the head tilted, it is necessary to tighten the neck muscles. Holding this position for a while, you can feel pain in the back of the head, the reason for which is muscle tension.
The cervical vertebrae are exposed to a particularly strong load during prolonged work with arms and head raised up (for example, for school teachers during long-term work at the blackboard). Many people involved in this type of work suffer from constant pain in the back of the head.
Exercise therapy
One of the leading means of conservative treatment of scoliosis is physiotherapy exercises. Exercise has a stabilizing effect on the spine, strengthening the muscles of the trunk, making it possible to achieve a corrective effect on deformation, improve posture, the function of external respiration, and give a general strengthening effect. Exercise therapy is indicated at all stages of scoliosis development.
The complex of remedies for exercise therapy used in the conservative treatment of scoliosis includes:
· Medical gymnastics;
· Exercise in water;
· massage;
· Position correction;
· Elements of sports.
Exercise therapy is combined with a mode of reduced static load on the spine. Exercise therapy is carried out in the form of group sessions, individual procedures, as well as individual tasks performed by patients on their own.
The exercise therapy technique is also determined by the degree of scoliosis: with scoliosis of I, III, IV degrees, it is aimed at increasing the stability of the spine, and while in scoliosis of II degree, it is also aimed at correcting deformity. Exercises of therapeutic gymnastics should serve to strengthen the main muscle groups that support the spine - muscles that straighten the spine, oblique abdominal muscles, square muscles of the lower back, iliopsoas muscles, etc. increased visual control, etc.
One of the means of exercise therapy is the use of elements of sport:
· Swimming in the "BRASS" style after a preliminary course of training. Volleyball elements are shown for children with a compensated course of scoliosis.
Prevention of scoliosis involves maintaining correct posture.When sitting for a long time, the following rules must be observed:
· Sit still for no longer than 20 minutes;
· Try to get up as often as possible. The minimum duration of such a "break" is 10 seconds.
While sitting, change the position of your legs as often as possible: feet forward, backward, put them side by side, then, on the contrary, spread and. etc.
· Try to sit "correctly": sit on the edge of the chair so that your knees are bent at exactly right angles, ideally straighten your back and, if possible, take some of the load off the spine by putting your straight elbows on the armrests;
Periodically do special compensatory exercises:
1) Hang and pull your knees to your chest. Do the exercise as many times as possible.
2) Take a kneeling position on the floor with outstretched arms.
Try to bend your back up as much as possible, and then bend it down as much as possible.
Morning gymnastics, health-improving workouts, active rest - the minimum motor necessary for every person and it consists of walking, running, gymnastics and swimming.
In addition to general strengthening, health-improving exercises, there are many special ones, for example, to strengthen the muscles of the abdominal press, chest, improve posture ... These exercises allow to some extent correct figure flaws, allow you to better control your body.
The following exercises will significantly strengthen your back muscles and keep your body in the correct position:
1) I. p. - standing, hands behind the head. With force, move your arms to the sides, raising your arms up, bend. Freeze for 2-4 seconds and return to and. p. Repeat 6-10 times. Breathing is arbitrary.
2) I. p. - standing and holding a gymnastic stick behind his back (the upper end is pressed to the head, the lower to the pelvis). Sit down, return to and. n. Lean forward, return to and. etc. and finally lean to the right, then to the left. Perform each movement 8-12 times.
3) I. p. - lying on his stomach. Leaning on your hands and without lifting your hips from the floor, bend. Freeze in this position for 3-5 seconds, then return to and. P.
4) I. p. - standing one step from the wall. With your hands touching the wall, bend back, raising your arms up, and return to and. p. Repeat 5-8 times. Standing against the wall, press against it with the back of your head, shoulder blades, buttocks and heels. Then move away from the wall and try to hold this body position as long as possible.
Physical exercises that increase the flexibility of the spine and lead to overstretching are contraindicated.
In addition, it is good to take baths with sea or aqua salt for 20 minutes.
Passive self-extension is necessary: for this, the head end of the bed needs to be raised by 10-15 centimeters and lie on your back and on your stomach for 40-50 minutes, relaxing. You can add hangs on the gymnastic wall with your back to the wall for 1-5 minutes.
Conclusion
With scoliosis, you cannot sit for a long time, make sudden movements, lift and carry more than 3 kg, you need to play sports only with a qualified doctor, the recommended sport is swimming, you need to use a back support, fixing a belt to relieve the load from the vertebral discs, but only on the recommendation of a doctor, you should take a multivitamin with calcium to strengthen bone tissue.
Literature
1., Isaac production and graphical analysis of frontal radiographs of the spine in scoliosis. Guidelines. Omsk - 1974.
2. Kotesheva technique for Scoliosis.
3., scoliosis and kyphosis. M. "Medicine", 1973, 75
4. Great medical encyclopedia.
3.4. Exercise therapy for diseases of the joints and osteochondrosis of the spine
3.4.1. Diseases of the joints and their types
Joint diseases are etiologically divided into two main groups: inflammatory (arthritis) and degenerative forms (arthrosis, or osteoarthritis).
Arthritis – inflammatory disease of the joints.
Symptoms accompanying arthritis: pain in the affected joint, an increase in the temperature of the tissues above it, a feeling of stiffness, swelling, restriction of mobility. In some cases, especially with acute development and significant severity of arthritis, arthritis may be accompanied by symptoms such as fever, general weakness, and leukocytosis.
Natural changes in arthritis occur in the joint itself (Fig. 23). Normally, the synovial membrane lining the articular capsule from the inside secretes a lubricating (synovial) fluid that provides good lubrication of the rubbing articular surfaces of the bones forming the joint. In the joint affected by arthritis, erosion (ulceration) of the surface of the cartilage is observed, the synovium thickens and becomes inflamed. As a result, the joint becomes swollen and stiff.
Rice. 23. Changes in a joint affected by arthritis
Inflammatory changes occur primarily in the inner - synovial - membrane of the joint. In the articular cavity, inflammatory effusion, exudate often accumulates. The pathological process can spread to other structures of the joint: cartilage, epiphyses of the bones that make up the joint, the joint capsule, as well as to the periarticular tissues - ligaments, tendons and bursae. There are: arthritis of one joint (monoarthritis), two or three joints (oligoarthritis) and many joints (polyarthritis).
Arthritis can start right away and be accompanied by severe joint pain (acute arthritis), or it can develop gradually and last long enough.
Inflammatory phenomena in arthritis are accompanied by the release of synovial fluid, which stretches the joint capsule. This leads to pain and swelling of the joint, as well as muscle spasm, which, in turn, causes limitation of movement in the joint. With recovery, these changes disappear without a trace. In case of progression of the disease, the articular cartilage is destroyed, the joint cavity is overgrown with fibrous tissue, which can lead to joint ankylosis, contractures and dislocations.
Rheumatoid arthritis, is commonly believed to be associated with a focal infection (the exact causes are not known), and physical or mental stress is a predisposing factor. Nevertheless, the most common cause of rheumatoid arthritis is chronic tonsillitis, in which the disintegrating tissue of the palatine tonsils entering various organs with the blood stream can cause the development of rheumatism in those of them that have a significant proportion of connective tissue 16. One of these organs is the joint.
The disease begins with acute joint pain and fever.
Symmetrical joints of the limbs are usually affected. In the joints, effusion is noted, the capsule and tissues around them thicken sharply. The expanding synovial membrane destroys the articular cartilage, the cartilaginous tissue is replaced by scar tissue. As a result, joint stiffness develops and its ankylosis may even develop. The disease proceeds for a long time, now exacerbating, then subsiding, and often becomes chronic.
Arthritis treatment is complex. In primary forms, drug treatment is used, which helps to eliminate the infectious focus and reduce inflammatory changes, diet therapy and balneotherapy (mud therapy, hydrogen sulfide and radon baths), exercise therapy, massage. In secondary arthritis, special attention is paid to the treatment of the underlying disease. Sometimes they also resort to surgical treatment of arthritis.
Arthrosis - degenerative diseases - are the most common joint diseases; their frequency increases with age.
Arthrosis occurs as a result of metabolic disorders leading to degenerative changes in the joint.
The main research method for arthrosis is radiography, which allows you to diagnose arthrosis, establish the stage of the process, and conduct differential diagnostics.
Depending on the absence or presence of previous pathology of the joints, arthrosis are divided into primary and secondary.
To primary arthrosis includes forms that begin without a noticeable reason (over the age of 40) in the articular cartilage that has not changed until then. They usually affect many joints at the same time.
Etiology and pathogenesis primary arthrosis is not fully understood. Among the etiological factors contributing to the development of local manifestations of the disease, the first place is taken by the static load, which exceeds the functional capabilities of the joint, and mechanical microtraumatization (this factor is especially significant in athletes). With age, changes in the vessels of the synovial membrane occur. An important role is also played by some endocrine disorders, as well as obesity, when there is not only an increase in the mechanical load on the joints of the lower extremities, but also a general effect of metabolic disorders on the function of the musculoskeletal system. In addition, the importance of infectious, allergic and toxic factors is not excluded.
Primary arthrosis is often accompanied by impaired fat metabolism, arterial hypertension, atherosclerosis and other diseases. Not all patients with arthrosis develop equally quickly: the slower it begins and proceeds, the less pronounced the clinical symptoms, since the body has time to use all compensatory adaptations.
Secondary arthrosis develop at any age due to trauma, vascular disorders, static anomalies, arthritis, aseptic bone necrosis, congenital dysplasia.
Secondary arthrosis is characterized by the development of changes in the articular parts of the bones against the background of the primary process, which can be radiographically manifested in the form of bone deformation and changes in its structure. As a result of the main process, one of the bones involved in the formation of the joint changes most dramatically. The articular end of the bone is deformed, flattened and often destroyed. The normal structure of the cancellous bone changes. In the future, the pathological conditions of the bones that form the joint end with the development of secondary arthrosis, the severity of which depends on the nature of the main process. In secondary arthrosis, a narrowing of the joint space and a thickening of the surfaces of the bones due to the marginal bone growths are determined.
In the etiology and pathogenesis of secondary arthrosis, the main role is played by injuries that violate the integrity or congruence of the articular surfaces. Other causes of secondary arthrosis are congenital dysplasias and acquired static disorders, previous arthritis, diseases of the pineal glands, metabolic diseases (for example, gout), endocrine diseases (hypothyroidism, diabetes mellitus, etc.), etc. Congenital and acquired defects of cartilage and other elements of the osteoarticular apparatus are also important.
The articular symptoms of arthrosis consist of pain, a feeling of stiffness, rapid fatigue, stiffness, deformities, crunching, etc. Pain is usually dull. They are unstable, intensified in cold and damp weather, after prolonged exertion (for example, in the evening) and during initial movements after a state of rest ("starting pains"). Very often, especially with senile arthrosis, instead of pain, only aches and a feeling of heaviness in the bones and joints are noted. True limitation of mobility in arthrosis is rarely observed, more often it is a question of stiffness and rapid fatigability of the joints. All these symptoms are due to a violation of the congruence of the articular surfaces, changes (thickening, calcification, sclerosis) in the joint capsule, tendons and other soft tissues, and muscle spasm. Joint deformities are especially common in the distal interphalangeal joints of the hands, in the hip joint, and in the knee joints. Rough crunching of the joints (most often the knee) is caused by unevenness of the articular surfaces, lime deposits and soft tissue sclerosis.
Clinical and radiological three stages can be distinguished in the course of arthrosis. First stage characterized by minor changes. A barely noticeable narrowing of the joint space occurs, especially in places of greatest functional load (for example, in the medial part of the knee joint gap), and minor bone growths (osteophytes) appear, mainly along the edges of the joint cavity. Their appearance is usually caused by damage to the articular cartilage, one of the functions of which is to restrict the growth of bone tissue. Therefore, in the place of damage to the articular cartilage, where it ceases to play the role of such a limiter, and bone tissue begins to grow.
Second stage differs in more pronounced changes. The narrowing of the joint space and the restructuring of the articular surfaces on the radiograph become clearly visible. The surfaces of the pineal glands become uneven; bone growths reach significant sizes and lead to deformation of the articular ends of the bones, accompanied by a violation of congruence, up to the development of subluxation and dislocation in the joint.
V third stage development of the process, changes occur in the deeper parts of the bones. Often in the second and especially in the third stage of arthrosis, intra-articular bodies are detected, which are formed as a result of the separation of bone growths and calcification of necrotic cartilage.
As a result of prolonged increased and even normal stress on the joints with a simultaneous deterioration in the nutritional conditions of the articular cartilage, the cells of its surface layer die, as a result of which the cartilage loses its elasticity, and small cracks form on its surface. At the same time, the acidity of the joint environment increases and the composition of the synovial fluid changes, which, to a lesser extent, now plays its role as lubrication of the rubbing articular surfaces of the bones, which also contributes to the development of arthrosis.
Osteoarthritis although they represent an independent group of diseases, they can be considered as a kind of arthrosis, since they are characterized by degenerative-dystrophic processes in the joints. In this case, the processes of regeneration of the cartilaginous surfaces that are erased during movement are disrupted, cracks, roughness and marginal bone growths appear on the cartilage. Pain and signs of inflammation develop in the joint.
In the etiology of osteoarthritis an essential role is played by previous infectious diseases, chronic intoxication, metabolic disorders, excessive physical activity. The joints of the lower extremities are more often susceptible to the pathological process, since they carry a significantly greater load, especially in obese people. Osteoarthritis of the joints of the upper extremities limits motor activity, which ensures the performance of labor and household activities, often leads to disability.
Intervertebral osteochondrosis – the most common type of osteoarthritis, which is based on degenerative-dystrophic changes in the most loaded intervertebral discs.
There are many theories of the origin of intervertebral osteochondrosis (infectious, rheumatoid, autoimmune, traumatic, involutive, muscular, endocrine, hereditary and other theories). However, the main focus in the onset of the disease is given to the incorrect loading of the intervertebral discs.
The intervertebral discs, along with the ligaments, connect the vertebrae to each other. The disc itself (Fig. 24) is a fibro-cartilaginous plate, in the middle of which there is a nucleus surrounded by a fibrous ring (tissue resembling tendons). The intervertebral disc does not have its own vascular system and therefore feeds on other tissues. An important source of nutrients for the disc is the back muscles, which are important for the discs to function well.
Rice. 24. Intervertebral disc structure
1 - annulus fibrosus, 2 - nucleus pulposus destroyed by degenerative processes
The roots of the spinal cord, containing sensory and motor nerve fibers, extend between each pair of vertebrae. When the spine is flexed, the intervertebral discs are somewhat compacted on the side of the slope, and their nuclei are displaced in the opposite direction. Those. intervertebral discs play the role of shock absorbers that soften the pressure on the spine during stress.
The transition of a person to an upright position significantly increased the load on the spine and intervertebral discs. With improperly performed motor activity, accompanied by significant instantaneous (jumps, dismounts, jerking movements, etc.) efforts associated with frequent changes in the position of the trunk (flexion and extension, turns), prolonged static (sitting, standing) loads, lifting heavy loads and Carrying them, when playing sports without controlling the influence of large physical exertion, the disk loses the ability to perform its function. In this case, the power supply to the disk is disrupted and its structure is destroyed. After some time, the height of the disc decreases, and the vertebral bodies come closer together, squeezing the blood vessels (which leads to impaired spinal circulation) and the roots of the spinal cord, and sometimes the spinal cord itself. As a result, the disease leads to quite significant health consequences and limitations in everyday life.
Osteochondrosis of the spine is characterized by the defeat of many vertebrae, often even all. First, there are degenerative changes in the nucleus pulposus (gelatinous) and the replacement of dead areas with fibrous connective tissue. In the intervertebral disc, the collagen content increases and the amount of fluid decreases. The disc loses its turgor, flattens, the function of the joint is sharply impaired.
With degenerative changes in the intervertebral discs, physical activity can lead to an increase in intradiscal pressure, protrusion of discs (disc hernias), fractures of the annulus fibrosus and ruptures of the nucleus pulposus. The protrusion of the disc and a decrease in its height cause convergence of the vertebrae, the development of edema in the intervertebral joints, compression of the roots, and sometimes the spinal cord with corresponding neuralgic disorders. If an intervertebral hernia has affected the nerve processes or roots of a certain segment of the spine, then this leads to disruption of the functioning of the organ, the innervation of which is provided by the damaged segment of the spinal cord. So, intervertebral hernia in the lumbar spine most often causes pain in the legs, in the thoracic spine - disturbances in the respiratory system, in the work of the heart, in the cervical spine can cause headaches and pain in the hands.
With osteochondrosis, degenerative changes occur in the intervertebral discs, which leads to a change in the osteo-ligamentous apparatus of the spine, a decrease in the spring function, limitation of the mobility of the spine and the appearance of pain caused by compression of the roots of the spinal cord.
With osteochondrosis of the spine, improperly selected or performed physical activity leads to muscle and headache, sleep disorders, and depressive disorders.
The clinical picture of intervertebral osteochondrosis is characterized by a chronic course of the disease with periods of exacerbation and remission. Usually exacerbations are manifested by severe pain and a sharp restriction of the mobility of a certain part of the spinal column; atrophy of the superficial and deep muscles of the back may develop.
The disease usually begins gradually after static stress or hypothermia.
Quite often, degenerative changes in the vertebral cartilage are accompanied by the development of inflammation of the spinal roots emerging here with their edema - it develops radiculitis. In this case, the roots are affected by a double mechanical effect: on the one hand, due to the destruction of the intervertebral disc, the lumen of the holes through which they leave the spinal cord decreases, and on the other, their own sizes in diameter increase due to edema, and now the root itself presses on the edges of the hole.
The reason for the development of sciatica can be hypothermia, infection, congestion, excessive consumption of table salt, alcohol, etc. That is why most often exacerbations of osteochondrosis are provoked either by sharp mechanical influences (for example, lifting a lot of weight with a load on the spine), or the development of inflammatory processes in the spinal roots, or a wrong lifestyle (for example, drinking alcohol).
Distinguish osteochondrosis of the lumbar and cervical spine (less often thoracic).
To cervical osteochondrosis can lead to systematic muscle strain when performing labor operations associated with long-term fixation of the working posture. Of particular importance in this regard for knowledge workers (including schoolchildren and students) is the long-term maintenance of a posture associated with reading, writing, working on a computer, in which the head is tilted forward and, therefore, the cervical lordosis is smoothed out. It provokes the development of cervical osteochondrosis (as well as lumbar osteochondrosis), the reclining posture, which is familiar to many people, in which the head is tilted forward and literally lies with the chin on the sternum (the cervical lordosis is also smoothed out), and the whole body is slightly tilted forward (the lumbar lordosis is smoothed out). In all these cases of smoothing of lordosis, the pressure on the anterior segment of the intervertebral disc increases, the nutrition of which is limited due to the many hours and daily maintenance of this position, and degenerative changes develop in this particular area. It is not by chance, therefore, that it is the cervico-brachial and lumbar localization of osteochondrosis that are most diagnosed.
The main manifestations of cervical osteochondrosis are:
Increase in pathological proprioceptive impulses coming from the cervical spine with smoothed lordosis and causing sharp pain along the entire course of the corresponding nerve roots;
Edema in the tissues of the intervertebral foramen area;
Sharp soreness in the upper part of the trapezius muscle;
Dysfunction of the vestibular analyzer.
With osteochondrosis of the cervical spine, the blood supply to the brain may deteriorate and vestibular disorders may appear.
Lumbar osteochondrosis(lumbosacral radiculitis syndrome) ranks first among all the syndromes of osteochondrosis of the spine. Every second adult has a manifestation of this syndrome at least once during his life. The majority of patients are men of the most efficient age (20-40 years). As a rule, the first clinical manifestations of discogenic lumbosacral osteochondrosis (often combined with radiculitis) are pain in the lumbar region. These pains can be sharp, suddenly arising (lumbago) or arising gradually, prolonged, aching nature (lumbodynia). In most cases, lumbago is associated with acute muscle strain.
Since, under normal conditions, the greatest load falls on the lumbar spine, it is in it that intervertebral hernias are most often formed. Especially often, a hernia is formed during the simultaneous tilt and turn to the side, especially if there is a heavy object in the hands. In this position, the intervertebral discs are very stressed; vertebrae press on one side of the disc, and the nucleus is forced to move in the opposite direction and press on the annulus fibrosus. At some point, the annulus fibrosus cannot withstand such a load and the disc protrudes (the annulus fibrosus stretches, but remains intact) or hernias (the annulus fibrosus breaks, and the nucleus "flows out" through the break).
In compression syndromes, pain resembles the passage of an electric current ("shooting" pain) along the entire course of the spinal root (for example, when the sciatic nerve is pinched, the pain can radiate up to the heel); there is a sharp tension in the tone of the anterior tibial muscle.
Pain in the lumbar region is strictly localized, aggravated by physical exertion, prolonged preservation of a forced posture. Sometimes, due to pain, the patient cannot turn from side to side, stand up, etc. In addition to pain, the mobility of the lumbar spine is limited, sensitivity disorders and trophic disorders appear. The pains are burning in nature, stitching, shooting, breaking. Their localization is possible in the lumbar region, in the area of the buttocks, hip joint, back of the thigh (sciatica), lower leg and foot. Often, pain is accompanied by protective tension in the muscles of the lower back. The sitting position is especially dangerous during attacks (when, as already noted, there is significant pressure on the spine), therefore, when trying to get out of this position, the patient experiences severe pain.
Since lumbar osteochondrosis most often affects the L5 - S1 segments, the muscles innervated by the nerves emanating from these segments (sciatic nerve and its branches) atrophy, respectively: gluteal muscles, flexors of the lower leg, feet, extensors of the foot and toes. Possible lesions of the femoral nerve and atrophy of the quadriceps femoris muscle.
Treatment osteochondrosis is complex. The leading method is conservative, when the main importance is attached to rest, immobilization and unloading of the spinal column and manual therapy, which allows unblocking the movable elements of the vertebral segments. Of undoubted importance is the normalization of the lifestyle, which makes it possible to optimize motor activity and exclude those influences that can lead to the development of inflammatory phenomena in the roots of the spinal cord. In the acute period, drugs are used to reduce pain and muscle tension, physiotherapy, warm baths, massage.
Joint diseases - degenerative and inflammatory - have different manifestations, but they also have common features: joint pain, limitation of movement, muscle wasting caused by them, and a decrease in the density of the bones that form the joint.
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Ministry of Education of the Russian Federation
Saint Petersburg University of Service and Economics
on physical education
on the topic: "Diseases of the spine and physiotherapy exercises for diseases of the spine"
Work performed by: Promyshlyanskaya E.A.
Moscow 2014
Introduction
1. Curvature of the spine
2. Osteochondrosis
4. Treatment of scoliosis
Introduction
Any person, at least once in his life, has experienced discomfort or pain in the spine, discomfort when moving. Back pain is one of the most frequent complaints of patients in medical practice and is a greater cause of illness and disability than any other illness (except colds). 70-80% of the adult population constantly or intermittently suffer from back pain.
Back pain can be caused by a large number of very serious diseases of the spine or internal organs that can lead to disability.
Most people nowadays spend their lives in a sitting position. We sit on the way to and from work, sit in the office for eight hours or more, plus a lunch break. Home rest is also not always active. In addition, in our life there are loads that arise in the spinal column when running, walking, lifting weights. It is not surprising that by the age of thirty or forty we earn a whole bunch of spinal diseases: osteochondrosis, herniated discs, sciatica, lumbago, sciatica, myositis, intercostal neuralgia, spondylosis and other back diseases.
1. Curvature of the spine
The main function of the spine is supporting, allowing to provide rigidity of the skeleton and maintain the usual shape of the body.
Our spine is very strong, has a certain amount of flexibility to ensure balance of the body, and has four natural bends (physiological bends) that act as a spring, which mitigate sudden vertical loads on the spine (jumping, etc.), allowing us to respond to the stresses associated with body weight and movement, and absorb shock and shock while walking.
Bends that bulge forward are called lordoses (cervical and lumbar), and bends that bulge back are called kyphosis (thoracic and sacral).
Kyphosis is the primary bend present at birth. Lordoses are secondary bends that form as the spine grows. Physiological bends can be deformed due to illness, or improper posture associated with a weak muscle corset and a lack of maintenance of muscle tone in the back, so the spine starts to work poorly, the muscles and ligaments become unnecessarily stretched or compressed, and the vertebrae and their joints begin to wear out, in As a result, back pain occurs.
Normal spine: back view, side view
Scoliosis
Scoliosis is a genetically determined disease of the musculoskeletal system, characterized by lateral curvature of the spine (in the frontal plane), with the twisting of the vertebrae in the process of their growth (it is a pathological condition). Scoliosis can be congenital and acquired.
The causes of scoliosis (most cases of scoliosis occur for reasons that are not entirely clear):
congenital scoliosis (abnormal development of the vertebrae) is associated with congenital disorders of the connective tissue structure with weakening of the ligamentous structures in all body systems, i.e. the ligaments designed to hold the vertebral column upright are too weak for this. Congenital (primary, hereditary) scoliosis can be accompanied by various congenital changes: developmental disorders (dysplasia) of the hip joints, maxillofacial anomalies (bifurcation of the lip, non-union of the hard palate), flat feet, biliary and urinary tract anomalies. Acquired scoliosis occurs most often in children (idiopathic adolescent scoliosis) between the ages of 5 and 15 (due to poor posture) as the child learns to hold his head and sit, especially in schoolchildren, facilitated by inappropriate posture during class, which leads to uneven stress on the spine and back muscles, tires and weakens them. In the future, there are changes in the ligaments of the spine and the shape of the vertebrae themselves. Also, scoliosis in children can be the result of rickets.
Scoliosis in adults can develop as a result of prolonged asymmetric loads on the muscles of the back (professional scoliosis of violinists, seamstresses, porters, etc.). In these cases, the curvature develops slowly and rarely, as in childhood and adolescence. Scoliosis can also be a consequence of congenital metabolic disorders, the result of lesions in certain diseases, accompanied by the destruction of the lateral parts of the vertebral bodies over a greater or lesser extent, for example, with tuberculous spondylitis, tumors, osteoporosis, degenerative disc disease (osteoarthritis), etc. In patients with injuries of the spine and spinal cord, curvature of the spine may occur due to paralysis of the muscles of the back (paralytic form of scoliosis). And functional scoliosis can occur when a patient has one shortened leg.
Kyphosis
Kyphosis can be arched, when one or another part of the spine is evenly curved posteriorly, and angular, when the spine is sharply curved in a small area (in the area of several vertebrae). Arcuate kyphosis occurs mainly in the thoracic spine (round back). The reasons for the development of the arcuate form of kyphosis can be congenital weakness of the back muscles, severe rickets suffered in childhood, prolonged flexion of the body (at the machine, at the desk, etc.). The presence of arcuate kyphosis not only disturbs a person's posture, but also leads to a decrease in the respiratory capacity of the chest (since a full inhalation requires maximum extension of the spine), and respiratory failure can adversely affect blood circulation. Often, with an arcuate kyphosis, there are shoulders pushed forward and lowered down, a protruding or somewhat sagging belly. Angular kyphosis occurs mainly in the thoracic spine and in this case is called a hump. The reason is the defeat of the vertebrae by the tuberculous process (spondylitis) and their flattening under the weight of the overlying parts of the body, which is accompanied by a pronounced shortening of the trunk and a sharp protrusion of the chest. This deformation severely affects the function of internal organs, work and personal life of the patient.
Lordosis
Lordosis is usually observed in the lumbar spine. Basically, it develops with congenital dislocations in the hip joints, in which the center of gravity of the body when it is upright is shifted anteriorly and, in order to maintain balance, the body deviates backward, bending in the lower back. Also, physiological lumbar lordosis can be exacerbated by excessive deposition of fat on the abdomen.
Lordosis is manifested by deformity of the spine and pain caused by the redistribution of the load on the vertebral bodies and overstretching of the musculo-ligamentous apparatus of the spine. Active movements of the affected spine are limited. Lordosis is often accompanied by prolapse of internal organs (stomach, intestines, kidneys), which explains various disorders in their work.
2. Osteochondrosis
Osteochondrosis is a degenerative-dystrophic disease of the intervertebral discs, accompanied by biochemical changes in the vertebral tissue. With osteochondrosis, the fixing ability of the spine worsens, that is, the condition of the paravertebral muscles and ligaments, especially during exercise.
Under the influence of many factors (mechanical overload of the spine, its constant trauma in unfavorable working and living conditions, poor posture, metabolic disorders), the intervertebral disc is destroyed and disintegrated. The elasticity of the cartilage decreases, it seems that the intervertebral disc is drying out, as it were. This process progresses especially rapidly with insufficient mobility of the spine, as local blood circulation deteriorates. As a result, the components of the intervertebral disc undergo degeneration and are gradually destroyed, and around them an inflammatory reaction develops and subsequently the so-called marginal osteophytes are formed. All this causes a decrease in the distance between the vertebrae. But the arches of the vertebrae form a spinal canal and therefore the bundles of nerve fibers (roots) extending from the spinal cord are damaged.
Compression of blood vessels and nerve roots, firstly, is the cause of acute pain in the spine itself (the so-called radicular syndrome), especially with a sharp turn or tilt of the head or trunk, or during physical exertion, and, ultimately, leads to the development of secondary radiculitis. Secondly, due to the compression of the nerve roots that emerge from the spinal cord, the function of the internal organs is disrupted, which are also partially innervated from the roots.
Most often, osteochondrosis begins in the cervical and lumbar spine. This is explained by the fact that the intervertebral discs are usually damaged at the boundaries of the movable part of the spine with its relatively motionless part (lumbar in relation to the sacral, cervical in relation to the thoracic).
The neurosurgeon A.I. Osna proposed a classification of the stages of osteochondrosis (1971) on the basis of a long experience of its study and surgical treatment:
Stage I - intradiscal movement of the nucleus occurs more than normal. which leads to stretching or constriction of the annulus fibrosus.
Stage II - cracks in the annulus fibrosus and instability of the affected segment occur.
Stage III - there is a complete rupture of the disc with prolapse of a hernia, an inflammatory process with possible compression of nerves and blood vessels.
Stage IV - there is a dystrophic lesion of other components of the intervertebral disc with the addition of spondylosis, spondyloarthrosis and other compinistor changes.
Spondyloarthrosis (arthrosis of the joints of the spine) occurs from an incorrect distribution of the vertical load due to a decrease in the height of the intervertebral disc. The flattened disc reduces the distance between the facet joints. They are overloaded, destroyed with the development of arthrosis. The result of osteoarthritis is the infringement of the menisci of the joints of the spine, which blocks the joint and causes pain.
Spondylosis is a calcification of the anterior longitudinal ligament of the spine. Spondylosis fixes the overloaded area, causing irritation of the nerve endings of the ligament. Patients experience dull, aching local pain and heaviness in the spine. Spondylosis is accompanied by muscle tension around the motor segment, and then these two fixing mechanisms not only aggravate pain, but worsen the damping function of the spine, straightening its physiological curves. In the early stages of osteochondrosis, the muscles tense, immobilizing and protecting his spine, creating a local muscle corset. In the later stages, immobility is supported by already irreversible changes in the muscles, surrounding tissues and spondylosis.
Muscle syndrome in osteochondrosis is associated with the fact that pathological irritating impulses go from the affected motor segment to the muscles, which, along with their dynamic overload, causes a tonic spasm. These nerve impulses cause vasospasm, and pain first occurs, and then the muscles themselves change due to a violation of their blood supply. Compacted cords appear, containing dense and painful nodules (Cornelius), areas of hypertonicity (Müller) and dense myogelosis. Trigger zones are formed, pressure on which causes sharp, widespread pain.
In osteochondrosis, the fixing abilities are weakened at first, if further unfavorable factors continue their destructive effect, then the compensatory capabilities of the fixing elements turn out to be insufficient. In this case, in the later stages of the disease, muscle fixation decreases, the ligaments stretch, and excessive mobility is formed in the spinal motion segment.
Excessive mobility causes more than normal movement of adjacent vertebrae in relation to each other (for example, at the moment of extension of the trunk, the overlying vertebra is displaced posteriorly, which does not happen in a healthy spine). This pathological mobility of adjacent vertebrae due to osteochondrosis is called pseudospondylolisthesis.
Due to the pathological mobility, traumatizing the vertebral bodies, and the roughly stretching the ligaments, the endplates of the vertebral bodies become denser and their sclerosis develops. As a result, there is a chronic overgrowth of the bone tissue of the vertebral bodies, which compensatory increases their surface and reduces the load. These overgrown bone spines are called osteophytes.
Spondyloarthrosis, spondylosis, pseudospondylolisthesis and osteophytes testify to the late stages of osteochondrosis.
Herniated discs. Initially, there is dehydration of the nucleus pulposus and metabolic disorders in the cartilage. As a result, the disc loses its elasticity, shrinks, shrinks and cannot resist physical exertion. The annulus fibrosus also loses its elasticity, which causes it to crack and break. In the resulting defects, the pulp nucleus protrudes and then falls out (partially or completely). This is a herniated disc.
If the nucleus extends towards the annulus fibrosus, then middle and lateral disc herniation is formed.
Anterolateral hernia irritates the sympathetic trunk of the autonomic nervous system, which lies on the anterolateral surface of the vertebral bodies, which leads to dysfunction of internal organs and vasospasm.
A lateral hernia in the cervical spine causes compression of the vertebral artery that feeds the brain.
If the nucleus pulposus penetrates the vertebral body, going up or down through a gap in the hyaline plate, then a central Schmorl hernia is formed. With Schmorl's hernia, no structures of the nervous system are compressed, therefore, it manifests itself only in awkwardness, pain and discomfort with limited mobility in the area of the affected spinal motion segment.
The above processes of dystrophy of the intervertebral disc in the course of the further development of osteochondrosis entail compensatory changes in bodies, joints, ligaments with the involvement of vessels, muscles and nerves in the pathological process.
3. Classification and types of scoliosis
There are 5 main groups of scoliosis, according to the Cobb classification (1958), the most common in the world:
· Group I - scoliosis of myopathic (muscle) origin. At the heart of these curvatures of the spine is the lack of development of muscle tissue and ligamentous apparatus. This group can also include rickets scoliosis, which occurs as a result of a dystrophic process not only in the skeleton, but also in the neuromuscular tissue.
Group II - scoliosis of neurogenic origin: - on the basis of poliomyelitis; - spastic paralysis; - neurofibromatosis; - syringomyelia. This group can include scoliosis due to radiculitis, back pain and scoliosis caused by degenerative changes in the intervertebral discs, leading to compression of the roots and causing radicular syndromes.
Group III - scoliosis due to anomalies in the development of the vertebrae and ribs. This group includes all congenital scoliosis, the occurrence of which is caused by bone developmental disorders.
Group IV - scoliosis caused by diseases of the chest (cicatricial due to empyema, burns, plastic surgery on the chest).
Group V - idiopathic scoliosis, the origin of which is still not studied.
Determination of the severity of scoliosis. To determine the severity of scoliosis, the doctor must determine the magnitude of the curvature in numerical terms. In our country, the most common method for measuring scoliosis curvature, developed by V. D. Chaklin, abroad is the method of American orthopedist John Cobb. The principle of measuring scoliosis curvature in these two methods is practically the same, the difference is that according to Chaklin, the more degrees, the easier the severity of scoliosis, and according to Cobb - vice versa. To measure the S-shaped double curvature, the doctor must take an X-ray of the spine. Then, in the upper section of the curvature, using a ruler, two horizontal lines are drawn: one - under the upper vertebra from which the curvature begins, and the other under the lower. When two other lines are drawn perpendicular to the first, an angle is formed, which is measured in degrees. The lower section of the curvature is also determined in the same way.
According to the severity of the deformity, scoliosis is divided into 4 degrees:
Scoliosis of the 1st degree is characterized by a slight lateral deviation (up to 10 °) and the initial degree of twisting, revealed on the roentgenogram. Twisting is defined as a slight deviation of the spinous processes from the midline and asymmetry of the roots of the arches. The angle of the primary arc of curvature is not more than 10 °.
Scoliosis of the 2nd degree is characterized not only by a noticeable deviation of the spine in the frontal plane, but also by pronounced twisting, the presence of compensatory arches. The X-ray image clearly shows the deformation of the vertebral bodies at the level of the apex of the curvature. The angle of the primary arc of curvature is within 10 ° -25 °. The muscle cushion is clinically determined due to torsion (twisting) of the spine.
Scoliosis grade 3 - persistent and more pronounced deformity, the presence of a large costal hump, a sharp deformation of the chest. The angle of the primary arc of curvature is within 25 ° -40 °. On the roentgenogram, at the apex of the curvature and adjacent areas there are wedge-shaped vertebrae.
Grade 4 scoliosis is accompanied by severe disfigurement of the trunk. There are kyphoscoliosis of the thoracic spine, deformity of the pelvis, deviation of the trunk, persistent deformity of the chest, posterior and anterior costal hump. The radiograph shows a pronounced wedge-shaped deformation of the bodies of the thoracic vertebrae, severe deformation of the bodies of the vertebrae and vertebral joints in the thoracic and lumbar spine, calcification of the ligamentous apparatus. The angle of the main curvature reaches 40 ° -90 °.
Types of scoliotic curvature of the spine. Upper thoracic or cervicothoracic scoliosis In this type of scoliosis, a short primary arch with a long and gentle secondary arch is formed. Upper thoracic scoliosis is a rare form. The clinical picture of this type of scoliosis is very characteristic and, first of all, is determined by the involvement of the cervical spine, and the main curvature changes not only the cervical spine, but also often the bones of the facial skull. On examination, a pronounced torticollis, an asymmetric arrangement of the eyes, an oblique position of the nose, etc. are found. The upper chest and shoulder girdle are deformed. The neck seems to be shortened, the edge of the trapezius muscle protrudes sharply. These defects are difficult to correct, especially when the process is neglected and the treatment is started late.
Thoracic scoliosis. In this type of scoliosis, the most pronounced deformities of the spine and chest are observed, in many patients - with the formation of a large muscular hump. The curvature arch covers 6-7 vertebrae and is located between Th3-Th9. In addition to the steep primary curvature of the curvature, two secondary arcs are formed: one above the main curvature, the other below, in the lumbar region. A sharp twisting leads to a mismatch between the plane of the chest and the plane of the pelvis. On the convex side of the curvature, the scapula sharply moves back and protrudes; on the concave side of the curvature, the chest is flattened. When the body is tilted, the rib hump is revealed. The average age of manifestation of thoracic scoliosis is 9-10 years. If the development of this type of scoliosis cannot be stopped at an early age of 20-21 years and the formation of the spinal column is already completing, treatment becomes very difficult. and sometimes a hopeless affair.
Combined scoliosis. In this type of scoliosis, both arches - thoracic and lumbar - manifest themselves both clinically and radiologically at the same time. This is the only type of scoliosis in which the curvature of the spine takes the shape of the Latin letter "S" and therefore they are called S-shaped. Combined scoliosis occurs most often in girls. In this type of scoliosis, the bulge of the thoracic arch is often directed to the right side, and the lumbar - to the left. The average age of the manifestation of this type of scoliosis is very difficult to treat, and sometimes, in advanced cases, when this type of scoliosis was not treated in childhood, it acquires disfiguring forms that practically cannot be cured.
Thoracolumbar scoliosis. This type of scoliosis, like the previous one, is more common in girls than in boys. The curvature arch at this localization usually captures the thoracic vertebrae at the Th6-Th12 level. The most common age at detection of this scoliosis is 9-10 years. A curvature of more than 50 ° according to Cobb is more common in those patients in whom the disease manifested itself before the age of 10. Clinically, this type of scoliosis is characterized by a protruding vertebral crest on the side of the concavity of the curvature; two secondary arches are often found. It heals well, especially at an early stage.
Lumbar scoliosis. Five vertebrae are usually involved in the formation of lumbar scoliosis. The arc is most often located between Th12 and L5 with apex at L2. Lumbar scoliosis with low localization is often compensated for by the sacrum; therefore, on examination, a sharp deepening of the waist triangle with a protrusion of the iliac crest on the concave side of the curvature stands out. When the torso is tilted, twisting manifests itself in the form of a muscle roller. There is no rib hump. The course of these scoliosis is more favorable. Functional disorders usually do not occur. With lumbar scoliosis, the deformity of the chest is weak, there is no rib hump, and the internal organs suffer little. Lumbar scoliosis is less prone to progression than others and therefore it is relatively easy to treat. It should be noted that the benign course of lumbar scoliosis does not subsequently guarantee against the development of pain syndrome associated with the phenomena of the lumbar spine.
spine scoliosis exercise therapy
4. Treatment of scoliosis
Treatment depends on the patient's age, the type of scoliosis and the degree of spinal deformity.
Children's scoliosis with I and II degrees of curvature of the spine is treated conservatively. The main condition for successful treatment is complete nutrition, rich in vitamins, regular stay in the fresh air, and outdoor games. The bed must be firm, for which a wooden board is placed on the bed. The chair and table in the workplace should be appropriate for your height. It is necessary to ensure that the child sits straight at the table, and at the same time his legs reach the floor. The correct setting of the light is also important, and in case of visual impairment, its correction is required. Therapeutic exercises are systematically carried out and corsets are often prescribed.
Conservative treatment is also carried out in special boarding schools for children with scoliosis, in which the necessary round-the-clock treatment regime has been created along with training in the usual program.
One of the best means of conservative treatment of scoliosis is physiotherapy exercises. Exercise has a stabilizing effect on the spine, strengthening the muscles of the trunk, making it possible to achieve a corrective effect on deformation, improve posture, the function of external respiration, and give a general strengthening effect. Exercise therapy is indicated at all stages of the development of scoliosis, but it gives more successful results in the initial forms of scoliosis.
Physical exercises that increase the flexibility of the spine and lead to overstretching are contraindicated.
The complex of remedies for exercise therapy used in the conservative treatment of scoliosis includes:
· Medical gymnastics;
· Exercise in water;
· massage;
· Position correction;
· Elements of sports.
Correction of scoliosis during exercise is achieved by changing the position of the shoulder, pelvic girdle and the patient's torso.
Exercises of therapeutic gymnastics should serve to strengthen the main muscle groups that support the spine - muscles that straighten the spine, oblique abdominal muscles, square muscles of the lower back, iliopsoas muscles, etc. increased visual control, etc.
One of the good remedies for exercise therapy is the use of elements of sport:
swimming style "BRASS" after a preliminary course of study. Volleyball elements are shown for children with a compensated course of scoliosis.
Prevention of scoliosis involves maintaining correct posture.When sitting for a long time, the following rules must be observed:
sit still for no longer than 20 minutes;
try to get up as often as possible. The minimum duration of such a "break" is 10 seconds while sitting, change the position of your legs as often as possible: feet forward, backward, put them side by side, then, on the contrary, spread apart, etc.
try to sit "correctly": sit on the edge of the chair so that your knees are bent at exactly right angles, ideally straighten your back and, if possible, take some of the load off the spine by putting your straight elbows on the armrests;
periodically do special compensatory exercises:
hang and pull your knees to your chest. Do the exercise as many times as possible.
take a stand on your knees and outstretched arms on the floor. Try to bend your back up as much as possible, and then bend it down as much as possible.
Morning gymnastics, health-improving workouts, active rest - the minimum motor necessary for every person and it consists of walking, running, gymnastics and swimming.
In addition to general strengthening, health-improving exercises, there are many special ones, for example, to strengthen the muscles of the abdominal press, chest, improve posture ... These exercises allow to some extent correct figure flaws, allow you to better control your body.
Success will depend on the length and frequency of the sessions.
Correct posture makes us not only more attractive, but also contributes to the normal functioning of all organs and systems of the body, is the prevention of scoliosis.
The following exercises will significantly strengthen your back muscles and keep your body in the correct position:
I. p. - standing, hands behind the head. With force, move your arms to the sides and, raising your arms up, bend. Freeze for 2-4 seconds and return to I.P. Repeat 6-10 times. Breathing is arbitrary.
I. p. - standing and holding a gymnastic stick behind his back (the upper end is pressed to the head, the lower end to the pelvis). Sit down, return to SP. Lean forward, return to SP. and finally, lean to the right, then to the left. Perform each movement 8-12 times.
I. p. - lying on your stomach. Leaning on your hands and without lifting your hips from the floor, bend. Freeze in this position for 3-5 seconds, then return to I.P.
I. p. - standing one step from the wall. Touching the wall with your hands, bend back, raising your arms up, and return to SP. Repeat 5-8 times. Standing against the wall, press against it with the back of your head, shoulder blades, buttocks and heels. Then move away from the wall and try to hold this body position as long as possible. If you work while sitting, periodically "press your back and lower back into the back of the chair, and if there is a high headrest, press your head against it with effort.
Here, if the cause of scoliosis is different leg lengths, a thicker insole is placed under the short leg, with the help of this the hip joint takes the desired (horizontal) shape, which straightens the spine.
Surgical treatment is prescribed for significant and rapidly progressing scoliosis and consists in the installation of various kinds of mechanical endocorrectors that correct the curvature of the spine.
Usually, it is possible to completely correct the curvature in childhood only with grade 1-2 scoliosis, when there are no pronounced irreversible (dysplastic) changes in the spine. With scoliosis of 3-4 degrees, it is possible to achieve only stopping the progression of the disease.
5. The basic complex of physiotherapy exercises for scoliosis and other curvature of the spine
Scoliosis, like any disease, can occur in various forms and treatment (including physiotherapy exercises) should be carried out individually.
Depending on the type and localization of the arch of the spine (S-shaped, thoracic, lumbar) and concomitant pathology, the orthopedist or exercise therapy methodologist selects a certain corrective position in which physiotherapy exercises should be performed, which should help compensate for the curvature and development of muscles in the desired direction. Therefore, after much thought about the advisability of publishing exercises, which, on the one hand, are known to every orthopedist or exercise therapy instructor, but on the other hand, can only conditionally be recommended "for everyone and for everyone", I decided to post an initial, basic set of simple symmetrical classical exercises, recommended for posture disorders and initial degrees of various curvatures of the spine and osteochondrosis.
This complex was compiled on the basis of the author's own experience of classes in the physical culture dispensary in Lyubertsy and in the children's orthopedic sanatorium "Bekasovo". Of course, I cannot give an exhaustive list of indications and contraindications to it, but you should be especially careful or not start classes at all without first consulting a doctor if you have:
Significant (3-4 degrees) or rapidly progressive scoliosis
Various kinds of sharp pain in the back, aggravated during exercise
Serious disorders of cardiac or pulmonary function, cerebral circulation
Now let's get started. Exercise should be done in a spacious, ventilated area with a large wall mirror and an exercise mat when lying down. The complex consists of several parts: warm-ups (exercise 1), exercises lying on your back, lying on your stomach, and standing. Rest between exercises is carried out in the starting position (ie if the exercise is lying on your back, we also rest in this position, there is no need to get up or sit down :) 1. Unloading the spine. All exercise therapy exercises begin with exercises to unload the spine. The classic exercise is walking on all fours. Duration of execution is 2-3 minutes.
We lie down on the mat on our back. Back exercises are designed primarily to strengthen your abdominal muscles.
2. "Stretching" of the spine. Lying on your back, stretch your heels "down", with the top of your head - "up". We carry out 3-4 "stretches" for 10-15 seconds.
3. Bicycle. Lying on our back, hands behind the head or along the body, with our legs we imitate movements, riding a bicycle. Important: most of the range of motion of the legs should be "below" the body, there is no need to dangle the legs above the stomach, it is necessary that the straightened leg alternately pass close to the floor. The pace of execution is medium. We perform 2-3 sets of 30-40 seconds.
4. Scissors. Lying on our back, hands behind the head or along the body, we perform cross horizontal and vertical leg swings. Important: it is advisable to make horizontal swings closer to the floor. The pace of execution is medium. We perform 2-3 sets of 30-40 seconds.
Now we roll over onto our stomach. Abdominal exercises are designed primarily to strengthen the various muscles in the back.
5. Stretching. It is performed similarly to exercise 2, only on the stomach. 6. Swimming. The initial position is lying on the stomach, legs are straight, the head rests on the back of the palms. We bend in the lower back (head, upper body, arms and legs raised, fulcrum is the abdomen). Holding this position, we perform movements imitating breaststroke swimming: - arms forward, legs spread apart
Hands to the sides, legs to connect
Hands to shoulders, legs still together, etc.
We perform 2-3 sets of 10-15 repetitions with a short rest between sets (5-10 seconds)
7. Scissors. Lying on your stomach, legs are straight, the head rests on the back of the palms. Raise your legs and perform cross horizontal and vertical leg swings. Important: when performing this exercise, the thighs must be lifted off the floor. The pace of execution is medium. We perform 2-3 approaches for 30-40 seconds.
8. Retention. Lying on your stomach, legs are straight, the head rests on the back of the palms. Raise the legs and upper body, bending at the lower back (head, upper body, arms and legs are raised, fulcrum is the stomach). Legs together, arms to the sides, palms turned up. We freeze statically in this position for 10-15 seconds. Important: it is advisable not to hold your breath; when performing this exercise, the hips must be torn off the floor. Perform 3-4 reps with a short rest between reps (5-10 seconds). Now we get up. 9. Hand rotation. Exercise for scapula retainers. Standing in front of a mirror (controlling posture), elbows to the side, fingers to the shoulders. We carry out the rotation of the hands backward (clockwise). Important: this exercise does not need a large amplitude of movement, on the contrary, the elbows should make a small circle during rotation. The pace of execution is slow. We perform 2-3 sets of 20-30 seconds each with a short rest between sets.
10. Squats. Posture exercise. Standing in front of a mirror (controlling posture), arms to the side, palms turned up. In this position, maintaining a beautiful posture, we stand on the toes, then squat down, again on the toes and back to the starting position. We perform 5-10 of these squats with short rest. The pace of the exercise is slow.
First of all, the beauty of the spine depends on ourselves. Wherever we are, we must always remember to think about our spine, control our posture. Nowadays, the predisposition to diseases of the spine is very high, because we live in the era of a, sitting in front of a computer most of all affects our spine. Therefore, if we remember that we need to sit up straight and control our posture, then this will help us avoid such a disease as, for example, scoliosis.
In extreme cases, for the prevention of diseases of the spine, there is such a thing as physiotherapy exercises, which helps to improve posture. There is a set of exercises that can be performed at home, but if you need more, then you need to contact the specialists in physiotherapy exercises, the implementation of these exercises will give only a tenth of what regular exercises can give under the guidance of a competent, professionally engaged in scoliosis, instructor.
List of used literature
1. Forget about back pain / Jenny Sutcliffe / Per. from English Boris Shevrygin - M .: ZAO Company "Makhaon", 2002. - 112 p .: ill.N.A.
2. Scoliosis and osteochondrosis: prevention and treatment / Medvedev BA / Series "Medicine for you" - Rostov n / a: Phoenix, 2004. - 192 p.
3. Biomechanics of posture / V. A. Kashuba - Kiev: Olympic literature, 2003
4. Popular medical encyclopedia. / Ch. ed. B. V. Petrovsky In the 1st volume. Abortion - Foot and mouth disease. - M .: "Soviet encyclopedia", 1987 - 704 p. with illustrations, 30 p. ill.
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