POSTURAL ROUND BACK
The most common cause for kyphosis is purely postural.
WHO GETS POSTURAL ROUND BACK AND WHY?
Children stand in a hunched over position for a variety of non-physical reasons: it is easier, they may be lazy, they may have low self-esteem, or, in adolescent girls, they may slouch to hide developing breasts. Such poor posture is usually noted to worsen during the adolescent growth spurt, when a child may assume a more pronounced round back. Poor posture of this form, in which no underlying deformity or disease exists, is known as postural round back and is a completely correctable situation.
DIAGNOSING POSTURAL ROUND BACK
The diagnosis of postural round back can be made in two ways. First, during examination the roundness corrects with hyperextension (bending backwards) or improvement of posture by the patient. When the child bends forward, a smooth gentle curve is seen, as opposed to what is seen in Scheuermann’s disease. The second way to diagnosis postural round back is to rule out other causes of kyphosis through radiographs, which will be normal in postural round back.
TREATMENT OF POSTURAL ROUND BACK
The treatment for postural round back is education in proper sitting and standing. For children who continue to stand in a slouched position, an exercise program is the second line of treatment. Exercises can strengthen the scapular muscles and spine extensor muscles. Typically, a physical therapist teaches an exercise regimen to the child and sets up a home program for the patient. The therapist should periodically see the child, to assure that the exercises continue to be done properly.