Postural abnormalities (e.g. scoliosis)
A postural abnormality is defined as a deviant, non-physiological position of one or more joints. This posture deviation can be appropriate for a certain age (e.g. flat feet in young children, O-position or X-position of the knees, reinforced lordosis or hollow lower back in toddlers[SB1]) and is therefore usually temporary. Postural abnormalities of the back can occur during growth and only become visible later in life. We see an increase in postural abnormalities in schoolchildren during the use of (game) computers, mobile phones and i-pads. It is therefore important to keep an eye on your child's posture and if necessary raise the alarm. The most common postural abnormalities of the back are:
Scoliosis
Scoliosis is a visible curvature of the back, particularly in the lateral direction, with possibly also a rotation of the vertebrae, which can cause a so-called "hump". A distinction is made between structural (real) scoliosis and non-structural scoliosis (due to a posture deviation or compensation for a difference in leg length).
Structural scoliosis in young children can be caused by congenital abnormalities in the vertebrae or by an imbalance in muscle tension (such as in spasticity, muscular disorders or spina bifida). In schoolchildren, the most common form of structural scoliosis is the "idiopathic" scoliosis, which means that the cause of this scoliosis is unknown. This scoliosis often develops when the child starts to grow faster, usually at the beginning of puberty. One distinguishes an S-shaped scoliosis (with two bends) and a C-shaped scoliosis (with one bend). These curves are easy to see when your child bends his/her back forward with stretched legs. Sometimes you can see that the ribs on one side are higher than on the other side, this is called a gibbus.
In a non-structural scoliosis, a postural deviation can give an apparent curvature that disappears when the child bends forward. Leg length discrepancy can lead to a misalignment of the pelvis and the lower back, so that the rest of the back compensates with a counter-curve (as if to keep the head straight above it). When sitting, the curve in the back disappears. A small difference in leg length is common and does not have to have any consequences for the back, not even in the long run.
Kyphosis
A kyphosis is a curvature of the spine, whereby the upper back becomes round. Usually, this occurs as a result of adopting a passive posture, that is, sitting or standing in a slumped position. However, there can also be a growth disorder of the vertebrae, such as Scheuermann's disease.
Examination and treatment
By means of an interview, observation and examination we will determine the cause and severity of the postural abnormality or scoliosis and draw up a treatment plan. If necessary, we will refer you for additional examination (such as an X-ray) and a check-up by a specialist (paediatrician or orthopaedist). The treatment consists of providing information, active exercise therapy to strengthen the torso muscles and improve core stability, to make the child aware of his/her posture and to correct it (e.g. by means of side-shift exercises). In addition, children with scoliosis can be treated at our clinic through the Schroth Best Practice program.
Children with scoliosis can be treated at our clinic using the Schroth Best Practice program. SBP is an approach to scoliosis in which exercises are given that are easy to apply in the patient's daily life.
The scoliosis patient is assigned to a Schroth classification, after which a specific exercise program tailored to the individual patient is taught. The goal of Schroth exercises is to prevent/reduce the progression of the scoliosis. The Schroth Best Practice program is a continuation of the original Schroth program, which was primarily designed for large curves. The Schroth Best Practice approach to Scoliosis is also suitable for smaller curves.