Does sitting slouched and slanted cause scoliosis?
July 20, 2010
Question: My daughter sits with a slouch, and sometimes sits with her body slanted to one side, will that cause scoliosis?
No. Sitting with a slouch or in any other bad posture does not lead to scoliosis. When we discuss about scoliosis, we typically mean idiopathic scoliosis, a form of scoliosis caused by genetic factors which lead to uneven growth of the spine. Curvature of the spine from bad posture is known as postural scoliosis and is reversible.
Posture and scoliosis
Human skeletons are mainly supported by muscles and ligaments. The center of gravity of the skeleton varies when its alignment changes, which in turn affects how much the muscles have to work to maintain its stability. Therefore, “bad postures” refer to postures in which the body structures need to work harder in order to maintain a particular position, and “good postures” refer to postures in which the muscles work the least.
- In an upright posture, the ideal posture is one that if looked from the side, the ear is right above the shoulder, and the shoulder right above the hip. Any posture that deviates from which would be requiring more effort from the muscles. So, sitting slouched or slanted to one side would require more muscle work on one side of the body, which may lead to overuse and tightness of those muscles.
- In the case that one stays in a faulty posture for long and causes muscle imbalance, the spine may be slightly curved due to uneven muscle tension. This type of curve is called postural scoliosis, which is not the same with scoliosis that is caused by bone deformities. If taking a spine X-ray in lying, this type of scoliosis will disappear on the X-ray film.
So, bad posture may cause postural scoliosis, but it will not cause bone deformity. The good news is that postural scoliosis is completely reversible by exercises and posture re-training.
Handbag Ergonomics – Part I
January 31, 2010
Musculoskeletal Consumer Review recently caught up with Cheryl Ng, an Associate Principal Physiotherapist at Core Concepts. We were curious about the term, 'handbag syndrome'. that Cheryl mentioned during her recent interviewed by Lian He Wan Bao on pains from carrying big handbags. Cheryl is also Head of Etonia, Core Concepts division for Women's Health.
MCR: Are heavy bags a potential cause of shoulder and neck aches? Why?
Flickr: chelsea steve
A heavy handbag, shoulder bag, or purse can injure the neck, back and shoulders. The neck has a natural curve that evenly distributes forces on the spine. Hence, when a person carries a heavy bag on one side over a long period of time, this natural curve starts to get distorted which can lead to chronic neck and shoulder pains, back pain, and even headaches. Left untreated, it can lead to more serious injuries such as herniated discs and accelerated degeneration of the cervical spine.
MCR: What weight (of bags) is considered to be too heavy to be carried on the shoulder, and for what duration?
Cheryl: Typically, it is advised that the weight of the handbags/ shoulder bags/ laptop bags should not weigh more than 10-15 percent of your body weight. Also, check by feeling the bag on our shoulder. When you sling the bag on your shoulder, and it feels uncomfortable, especially when the weight pulling shoulder down, it is time to downsize or reduce the contents in your bag. However, I recommend lighter bags (contents included), not more than 2-3 kg as we tend to carry such bags frequently and over a extended period of time (travelling to work and back home, shopping) which can change the biomechanics of the neck , back and shoulders and lead to pain and dysfunction.
MCR: What serious problems can be caused if bags are too heavy? And what physiotherapy can be done to alleviate the aches?
Cheryl: A common problem is that one shoulder becomes slightly higher than the other. Some scenarios such as talking on mobile while carrying the heavy handbag, will worsens the problem, because in addition to balancing too much weight on one side, she is lifting the shoulder at the same time, straining the neck and shoulder ligaments and muscles.
Typically, handbag syndrome brings about neck, shoulder muscles and ligaments strain/ injuries, causing poor neck and shoulder postures. Left untreated, these can lead to more serious injuries such as herniated discs, accelerated degeneration of the spine and less commonly, traction injury of the brachial plexus, which symptoms are weakness and sensation changes (i.e. numbness over the shoulder and arm).
Physiotherapy can help resolve these pains by analyzing the structure of the your body, such as how does your head sits on your shoulders or how your posture could have brought about the biomechanical changes in your neck and shoulders causing pains. To reduce the stiffness, pain and discomfort brought about by these changes, physiotherapists apply various strategies in the restoration of spinal and shoulder girdle mobility and stability that results in a reduction in the patient’s pain and spasm. Strategies include manual techniques, such as joint mobilization and manipulation, deep tissue massage, muscle energy technique and neck and shoulder girdle stabilization exercises. However, treatment is always more effective if the problem is detected and treated early as chronic problems (more than 3 months) have poorer treatment results. Therefore, if the pain does not resolve within 3 days and seems to get worse, it is time to make an appointment with your physiotherapist.
Some tips in choosing a handbag that is ergonomical.
- Choose a handbag that is proportionate to your body size and not larger than what is needed. Your handbag should not weigh more than 10 percent or less of your body weight.
- Select a bag made of lightweight material such as vinyl or canvas instead of leather.
- The shoulder straps should be wide, adjustable, and padded if possible. Poorly designed shoulder straps can dig deep into muscles causing strain and pinched nerves. If possible, select a strap that is long enough to sling across to the opposite side of the body to help distribute weight of the bag more evenly.
- Do consider a backpack. It distributes the weight between both shoulders.
- Choose a handbag that has several individual pockets instead of one large compartment. This will help to distribute the weight evenly and keep contents of the bag from shifting.
- Do not wait to seek treatment for pain. You can avoid serious injury and surgery by addressing the problem early.
Carrying a handbag.
- Use both hands to check the weight of the handbag.
- Instead of always carrying your handbag on the same shoulder, switch sides often.
- Retract your shoulders while carrying the bag.
The interview continues in Heel Ergonomics – Part II
What not to do? The Question Less Asked.
January 18, 2010
Recently, a client asked me "Ok. So what shouldn't I do now?" And it struck me how infrequently we get such questions. As professionals we are often asked them by our clients, "What should I do?" in the belief that something 'more' is the solution to their problems; that they are missing out on something that they should be doing. This is true for most fields and healthcare is no exception.
Photo: Flickr albertopveiga
In the case of musculoskeletal conditions, a small minority of conditions have their roots in the person's genetic code; meaning that they were born with it. Most have external causes – lifestyle, diet, occupational conditions or movement habits. For example low back pain from poor posture, wrist repetitive strain injury from poor ergonomic workplace setup and sports injury from overtraining.
When faced with such musculoskeletal injuries, humans don't seem to be geared up to accept simple answers. We prefer complex solutions (read machines with lots of blinking lights) over simpler ones (read manual therapy or exercises using body weight). We see this across many different situations.
The most common situation is, 'what sort of machine test will you do?' We have learnt to equate the more expensive and more complex the machine scanning us to better results. We wrote about this about a year ago, "Diagnose First, Scan Second" where a recent study found that the routine use of radiography (X-ray), MRI, or CT scans in patients with low-back pain but no indication of a serious underlying condition does not improve clinical outcomes. Combine this no-improvement outcome with the more recent reports on radiation overdoses from CT scan and it is worrying.
Another situation is the use of impressive looking machines for treatments. Will a more expensive looking exercise machine work better for me than a simple home-based type device? In the fitness industry, there is a growing trend of people moving away from machine-based exercises towards simpler functional movement-based devices like the TRX Suspension Training. Not only is it several hundred dollars cheaper if not thousands, it can be more versatile and challenging.
Surprisingly, sometimes even when it comes to treating a specific condition, the best answer may be to do nothing. In the case of whiplash, one of the recommended treatment protocols during the early stage of whiplash is to "Act As Usual". It can be quite unsettling when visiting a doctor for whiplash treatment and to be told to act normally, to do nothing different.
Of course it does not mean that the most appropriate treatment is always to do nothing or to do something less. However, it does mean that not every appropriate treatment must do something or to do something more.
Perhaps a simple rule of thumb to help you learn to do less to achieve more with your health, for every 'what can I do?' question, ask 'what shouldn't I do?".
Waking up with neck pain? Try this.
December 25, 2009
How often do we wake up in the morning with stiffness and pain in the neck? You are not alone. This is one of the most common complain of most people but most people just think it’s just a sign of ageing and that they have to live with it. However, this is not true. You need not have to wake up every morning with this pain and stiffness.
Carpal Tunnel Syndrome
December 8, 2009
You’re going about doing your everyday work when you notice yourself shaking your hand to get rid of the tingling in it. It’s starting to really bother you because you’ve had the tingling at night too. You’re probably wondering if it’ll go away on its own. Does this sound like you? You might have Carpal Tunnel Syndrome. Read more
Office Ergonomics or the lack of it.
November 9, 2009
A large number of people who seek medical help for their musculoskeletal problems usually present with neck, shoulder and back pains. These clients are often deskbound at work and with the increase use of computers, it is no wonder the incidence of spinal pains is on the rise.
The repetitive stress associated with our work environment can be minimized with an understanding of the flaws of mass produced furniture, combine with a little effort and common sense in altering and re-organizing our work station. Below are some of the complaints most office workers express. Read more
Areas of Physiotherapy
November 6, 2009
Physiotherapy is an extremely wide field of study. It can be classified into different areas of focus, patient age groups, gender and type of activities (or sub-specialties). As a result, people often get confused about what it is, who it is for and what it does. Most often one gets to learn about physiotherapy you come into contact with it for your own health matters or know someone close who is undergoing treatment. We will look at some of the basic classifications to help clear some of the confusion around this wide and complex field.
Main Areas of Physiotherapy
Source: Flickr jasonvance
- Musculoskeletal – This is the area that deals with injuries related to the muscles, bones and joints of the human muscle and skeletal system. Conditions such as back pain, tennis elbows and ankle sprains fall into this category. Private clinics outside of the hospital setting typically focus on this area. This area is sometimes referred to as Orthopaedics.
- Cardio-Respiratory – This area deals with conditions related to the lung and circulatory system (e.g. heart). Conditions such as fall into this category are bronchial asthma, chronic obstructive lungs disease and pneumothorax. Generally, this is an in-patient area. Meaning patient are still warded in the hospital such as after cardiac surgery. Out-patient care such as chest percussion treatment is sometimes called upon for patient who suffers from attacks of chest congestion and find it difficult to breath.
- Neurology – This area deals with rehabilitation of patients recovering from neurological condition such as stroke, cerebral palsy. Stroke depending on its severity often lead to partial paralysis of some part of the body. Neuro-physiotherapy helps the patient to recover some of the mobility and control of these body parts. This is often confused with the Musculoskeletal area of physiotherapy as it includes improving muscle strength and control. The key difference here is the source of the muscular dysfunction.
Patient Demographics
Each of these areas can be further broken down into three broad age classification – pediatrics, adult and geriatrics.
Pediatrics deals with young infants and children. Teenagers typically are classified as adult though these age group do have specific needs that needs to be managed separately such growth spurts in the bone structures.
Adults are the largest group of patients for physiotherapy as they represent the bulk of the population. However, with a rapidly aging population, geriatric physiotherapy for older adults is increasingly playing a larger role in the community.
Gender Classification
Men and women sometimes have different requirements when treating certain conditions dues to the difference to their physiology. Some are clearly visible such as the bone structure. One example is women having wider hips than men. This difference plays an importance role in the treatment of knee pains.
Other differences are not as visible such as hormonal difference such estrogen and its impact on bone density as women age.
Activities and Sub-specialties
With each area, there are further sub-specialties such as sports physiotherapy. Sports physiotherapy is a sub-specialty of the Musculoskeletal area. It can be further classified to the various patient demographics. Treating young children and teenagers the same as adult with sports physiotherapy can led to irreparable damage to their growth and subsequently adult musculoskeletal frame.
Another example of sub-specialty is women health and in particularly pregnant women and post-natal women.
So the next time, if you get confused with an explanation of what is physiotherapy, remember that the other person is most likely talking about another area of this wide field and that you are both most probably right!
Sway Back No More
May 20, 2009
Do you stand or walk like a limbo rocker? If yes, you may have sway back. Apart from slouching, sway back is another common bad posture that leads to back pain. Like most posture problems, it is easily correctable by treating and preventing its contributing factors.
Understanding How Back and Neck Pains Are Diagnosed
April 19, 2009
One of the most popular questions we get is, “How do we treat back pain?” Understandably, if you are suffering any sort of pain, anyone would want to know how to get rid of it. But it is not the best first question. A better first question is, “How do we figure what’s causing the pain?
How to grow your own fresh air by Kamal Meattle
March 23, 2009
This is a slight departure from our usual articles on musculoskeletal health. But the state of health of your joints, muscles and the ergonomic soundness of your surrounding workplace doesn’t add up to much without access to good fresh air. Watch and listen to Kamal Meattle at TED on 3 simple home & office plants common in Singapore to improve the quality of air in your home and office.
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See the Therapist
For an appointment to consult with one of our physiotherapist for treatment, kindly call us at : +65 6226-3632 (4 Lines)
or SMS us at +65 9232 2661 or email us at enquiry@coreconcepts.com.
Find out more about our various divisions at group.coreconcepts.com.sg/divisions.
Ask the Specialists
"Hi MCR, I keep hearing about ultrasound therapy but I get confused with the seemingly different answers I get about them. There appears to be one for healing... Read more »
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Lenia Teo, B.HSc(physio)
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