Poor posture & a Rounded upper back

The poor posture of a rounded upper back is technically called a “Thoracic Hyperkyphosis.”

Causes of back pain

The thoracic spine is the upper part of the back, “hyper” means increased and kyphosis is the forward curve of the spine. This is a common development associated with ageing, especially in women.  The underlying reasons may be osteoporosis (which needs to be treated), vertebral degeneration, dehydration of the intervertebral discs and a weakening of muscles, particularly in the upper back.

Hyperkyphosis (this rounding) can lead to a significant deterioration in general health status and has been associated with  increased mortality and low well-being scores in older adults.  Very often people with this problem have altered postural alignment and difficulties in using normal strategies for balance and control during daily activities, which puts them at a greater risk for falls.

The good news is that something can be done.  Recently there has been a lot of research on this problem and guidelines on how to manage and improve it.  Efficacy has ben shown for bracing (in severe cases), taping, manual therapy and therapeutic exercises, all of which your Physiotherapist can assist with.

The focus of rehabilitation is to facilitate functional improvements in dysfunctional muscles, and to improve muscle strength, endurance, flexibility, and co-ordination, in addition to improved alignment of the spine.

A recent study found an improvement in posture (the amount the upper back was rounded and the amount the head was too far forward), in addition to balance and quality of life in older women suffering from this condition.

Exercises in this study included those for breathing, thoracic expansion, thoracic mobility and awareness of thoracic alignment.  There was a focus on thoracic rotation and extension (the backward movement), rib cage expansion, shoulder blade retraction (pulling together) and arm elevation.  Exercises were performed for one hour, twice per week.  There was greater improvement in those that attended in person rehabilitation (over those that performed home exercises only).

Posture can be changed, the risk of falls reduced and balance of quality of life improved.

Juli-Ann Riley, Riley Physiotherapists

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