sway back

[charlize29]

Hi,

Sway back is also called relaxed or slouched posture. The amount of pelvic tilting is variable, but usually there is a shifting of the entire pelvic segment anteriorly, resulting in hip extension, and shifting of the thoracic segment posteriorly, resulting in the flexion of the thorax on the upper lumbar spine. This results in an increased lumbar lordosis in the lower lumbar region, an increased kyphosis in the lower thoracic region and usually a forward head. The position of the mid- and upper lumbar spine depends on the amount of the displacement if the thorax. When standing for prolonged periods, the person usually assumes an asymmetric stance in which most of the weight is borne on one lower extremity, with periodic shifting of the weight to the opposite extremity.

Potential Sources of pain:
1. Stress to the iliofemoral ligaments, the anterior longitudinal ligament of the lower lumbar spine, and the posterior longitudinal ligament of the upper lumbar and thoracic spine. With asymmetric postures, there is also stress to the iliotibial band on the side of the elvated hip.
2. Narrowinf of the intervertebral foramina inthe lower lumbar spinethat may compress the blood vessels, dura the nerve roots esp. with arthiritic conditions.
3. Appriximation of the atricular facets in the lower lumbar spine.

Muscle Imbalances observed:
1. tight upper abdominal muscles ( upper segments of the rectus abdominis and obliques) internal intercostal, hip extensor and lower lumbar extensor muscles and related fascia.
2. Stretched and weak lower abdominal muscles ( lower segments of the rectus abdominis and obliques)extensor muscles of the lower thoracic region and hip flexor muscles.

Common Causes:
As the name inplies, this is the relaxed posture inwhich the muscles are not used to provide support. The person fully yields to the effects of gravity and only th epassive structures at the end of each joint range( such as ligmanets, joint capsules and bony approximation)provide stability. Casues can be attitudinal( the eprson feels comfortable when slouching) from fatigue( seen when required to stand for extended periods) from muscle weakness ( the wekaness may be the cause or effect of the posture) or form a poorly designed exercise program (one that emphasizes thoracic flexion)

References: Therapeutic Exercises Foundations and Techniques, Third Edition by: Carolyn Kisner & Lynn Allen colby

[Hessa]

thank you alot to alophysio & charlize for their replies

Hessa

[JeffK]

Hi.
I've been looking into sway-back posture recently & I found some quite useful info in the book "Muscles, Testing and Functions with Posture and Pain" (5th ed), by Kendall, et al (ISBN: 0781747805).

You can look at & search in the book online by going to google books & searching for it there. (I haven’t posted here enough to be allowed to insert URLs).

Also, there will be links there to other, related books e.g. "Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods" by Kessler & Hertling (ISBN: 0781736269)

I hope this helps,

Jeff