Exercise therapy for children with poor posture. Therapeutic exercise for postural disorders

Physical therapy exercises for children with poor posture are the most effective method of preventing and correcting spinal curvatures. Modern preschoolers and primary schoolchildren spend too much time in front of TV screens, in school lessons and doing homework. But not only the beauty and slimness of the figure, but also the health of many internal organs depends on general physical development.

How are physical education and human posture related?

With accelerated skeletal growth (at about 7 years of age), muscle mass increases slightly. Children at this age stretch out and appear taller and slimmer. But insufficient muscle development leads to the fact that the fragile spine, which does not have muscular support, becomes vulnerable to the formation of bends that are unusual for normal physiology.

It is customary to distinguish 2 types of violations:

• curvature of the spine in the sagittal region (natural curves are increased or decreased, stooping occurs, etc.);
• changes in the frontal plane - scoliosis.

As a result, the child’s volume of respiratory movements decreases, the functioning of the digestive tract and cardiovascular system is disrupted, and myopia often develops.

To prevent postural defects from occurring, the spine needs a powerful muscle corset. This is the name given to the muscles surrounding the spinal column: they support the flexible bone organ in an upright position, return the vertebrae to a physiological state after work (bending, lifting weights, etc.), and play a shock-absorbing role when moving, jumping, running. With undeveloped back muscles in an adult, many diseases associated with the displacement of the vertebrae occur.

To form strong muscles that will hold the spine in the correct position, they have been developed: they are available to children at the age of 5–7 years.

1. Take the stick so that your hands are in front and below. Raising your arms, move your leg back. Return to IP, repeat with the other leg. Perform 6–8 movements. The parent makes sure that the child bends backward at the waist.
2. Take the stick so that it is at the back. Hands down, feet together. Rising onto your toes, move your arms back as far as possible. Return to i.p. and repeat 4-6 times. The parent makes sure that the child does not bend his elbows or lean forward.
3. The stick is in front, below. Raise your arms, lower them to your chest, return to standing position. Do the exercise 4-5 times. Make sure your child maintains good posture.

At the end of the lesson, walk at a calm pace for 30 seconds. At the same time, posture must be maintained, to which the parent draws the child’s attention.

Exercise therapy complex for junior schoolchildren

In first-graders, disorders are most often first identified during a medical examination at school. They are a consequence of insufficient attention to the development of the child before school. But your posture can still be corrected by doing daily exercises at home. Daily morning exercises can also contain elements of exercise therapy.

It is already possible for children to take and maintain a control pose: go to the wall and lean on it with their heels, shins, buttocks, shoulder blades and the back of their head. Do not raise your shoulders. During the warm-up (walking, as indicated above), it is important to ensure compliance with the control pose.

After warming up, a first-grader can perform simple therapeutic physical exercises with or without a ball. He is not able to independently monitor the correct execution and posture, so the presence of an older family member is required who can control the student and correct his mistakes.

Physical therapy to correct posture may include the following exercises:

1. From i.p. standing, feet shoulder-width apart, lift the ball (or stick). When raising your hands, look at the object. Lower it onto your chest, return to IP. Do 5-6 repetitions.
2. Ball in 1 hand. Place it behind your back, transfer it to your other hand, and return to IP. Ensure compliance with the control pose. Perform 5-6 movements.
3. Raise your hands with a ball or stick above your head. Spread your elbows to the sides, connecting your shoulder blades. Make 4-6 tilts to the left and right.
4. Accept i.p. lying on your back. Raising your legs, spread them to the sides and then cross them. Perform 7–8 movements, return to IP.
5. The “Bicycle” exercise trains the abdominal wall well. Raise your legs and bend your knees. Imitate the movements of a cyclist for 20–30 seconds.
6. Use the movements of the Boxer and Swallow exercises. Options include chest lifts with your legs pressed to the floor or just your legs. You can use a stick, which should be held at shoulder level behind the neck. Repeat movements 4–6 times.

In addition to exercises aimed at developing the back muscles, primary schoolchildren should perform squats at least 10–15 times per lesson. They can be performed without a projectile by stretching your arms forward while bending your legs. If there is a stick, it is either held in front or placed behind the back at shoulder level. The latter option helps control posture on the part of the child himself.

Conclusion

In addition to performing exercise therapy complexes, it is necessary to provide the child with maximum physical activity. This could be hiking or cycling, skiing and skating, or outdoor games.

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To solve the assigned tasks, the entire arsenal of exercise therapy tools is used: physical exercises, including exercises of a general strengthening and special nature, applied sports, breathing, games, mechanotherapy. Natural factors of nature and massage are actively used.

The objectives of general strengthening exercises, appropriate to the age and physical fitness of those involved, are to improve the general physical condition of the patient, increase the level of his general endurance, strengthen the musculoskeletal system, including the creation of a “muscle corset,” the development of coordination and a sense of balance.

As the general strengthening tasks are solved, special exercises are introduced. The main ones in the treatment of postural defects include corrective exercises in which movements of the limbs and torso are aimed at correcting various deformities: changing the angle of the pelvis, normalizing the physiological curves of the spine, ensuring a symmetrical position of the shoulder and pelvic girdles, head, strengthening the muscles of the abdominal wall and back . When using these exercises, it is extremely important to select a starting position that determines their strictly localized effect, maximum unloading of the spine along the axis, exclusion of the pelvic tilt angle on muscle tone, and the optimal combination of isometric tension and stretching.

An effective general strengthening remedy for postural disorders is therapeutic swimming, which is recommended for all patients, regardless of the severity of the deformity, the course of the disease and the type of treatment. The use of a certain style (for example, butterfly with winged shoulder blades) turns swimming into an exercise with a special focus.

An important element of therapy is developing the skill of correct posture. After explanations from the instructor or physical therapy methodologist about the characteristics of normal posture, demonstration of it on the patient, to the creation of a new stereotype of muscle-joint sensations and spatial orientation. This can be helped by training in front of a mirror with visual self-control, mutual control of patients, and periodic monitoring of the position of the body against the wall.

Consolidation of the skill of correct posture also continues during the performance of various general developmental exercises for coordination and balance, in which the correct position of the pelvis, chest, head, and shoulder girdle is necessarily maintained. Games with rules that require good posture are widely used (games with continuous correct retention of the body, with the adoption of correct posture upon a signal or task).

Features of the exercise therapy technique for postural defects

In exercise therapy rooms, general developmental and corrective gymnastics classes are usually carried out in groups of 10-15 people. Duration of classes is about 1 hour. At the initial stages of treatment, physical exercises are performed mainly in the position of lying on the back, stomach, on the side, standing on all fours, which allows maintaining the correct position of all segments of the body during the lesson, later - in a standing position and when walking.

In the initial period of such classes (duration 1-1.5 months), individualized sets of special and general developmental exercises are selected, an idea of ​​​​correct posture, occupational and educational hygiene is developed. Basically, during the period (2 months), the entire complex of treatment problems is solved. At the final stage (1-1.5 months), the emphasis is on teaching patients to independently engage in physical exercises at home, which in case of postural defects must be performed almost all their lives, and self-massage.

In addition to solving problems common to all postural disorders, in each case it is necessary to perform exercises specific to correcting this particular defect.

Round back

An increase in the angle of the pelvis is ensured by strengthening a large group of muscles - the iliopsoas, rectus heads of the quadriceps femoris, pectinate, piriformis, lumbar back extensors and stretching shortened and tense muscles (biceps femoris, triceps surae).

Correction of kyphosis is ensured by bending the kyphosis, taking into account the apex of the curvature in the initial palm-knee position, hanging and lying (standing and sitting positions are excluded). As noted above, the position on all fours according to Clapp is one of the most convenient for the active redressal of kyphosis, since it combines unloading of the spine with lordosis and active work of the muscles, extensors of the neck and back. It is important that here it is possible to ensure unloading of the spine and, accordingly, increased mobility in its most rigid part - the thoracic part. In case of severe kyphotic deformity, in addition to physical exercises, additional correction is indicated by positioning it on a panel inclined under the chest.

Stretching the pectoral muscles is of particular importance in correcting kyphosis. : Pterygoid scapulae: strengthening the muscles that fix and bring the scapulae together (trapezius, rhomboid serratus anterior, etc.). To do this, perform exercises with dynamic and static loads: moving the arms back with various shock absorbers and weights (rubber bandages, expanders, dumbbells), push-ups from the floor, etc. Strengthening the occipital muscles and back extensors is of particular importance in correcting a round back, which is necessary for the correct and stable position of the spine.

Muscle contracture of the pectoralis major with anterior abduction and shoulder drooping: Stretching the pectoralis major muscles using passive stretching techniques and/or post-isometric relaxation techniques provides increased elasticity. Strength exercises to develop strength in the interscapular muscles also provide relaxation of the pectoral muscles based on the principle of reciprocal inhibition. This also contributes to the expansion of the chest, its better excursion, thereby increasing the cardio-respiratory capabilities of the body.

Abdominal protrusion is corrected by exercises for the abdominal muscles, mainly from the starting position lying on your back. Strengthening the abdominal muscles is necessary for all types of poor posture, as they stabilize the spine during physical exercise, providing the basis for strengthening the back muscles.

Round-concave back

Reducing the angle of the pelvis is the main task when correcting a round-concave back. It is provided by strengthening weakened and stretched muscles (extensors of the thoracic trunk and interscapular muscles - lower stabilizers of the scapulae, deep anterior cervical muscles, rectus and oblique abdominal muscles, large gluteal and posterior bundles of the gluteus medius muscles, biceps femoris) and stretching using passive stretching and PIR shortening and tense muscles (long back muscles - extensors of the trunk, lumbar and cervical regions, upper trapezius, pectoralis major, iliopsoas, rectus femoris, triceps surae).

Correction of kyphosis (solving problems related to the correction of kyphosis - see Round back).

Correction of associated deformities (solving problems related to the correction of associated deformities - see Round back). With this violation of posture, they are similar - winged shoulder blades, muscle contracture of the pectoralis major muscles, with anterior reduction and drooping of the shoulders, protrusion of the abdomen

Flat back

However, with this postural defect, she is in a tense state, which, in turn, does not allow her to effectively increase her power capabilities, providing the required level of traction to lower the anterior half-ring of the pelvis down. In addition to physical therapy classes, the active inclusion of sports and applied exercises in the exercise therapy room is recommended: skiing, swimming, rowing and other sports that require, in addition to general endurance, also strength endurance.

Increasing the pelvic tilt angle (solving problems associated with increasing the pelvic tilt angle - see Round back).

Improving spinal mobility - with a flat back, the task is less urgent than with kyphosis. Therefore, the movements performed here in all planes are aimed not so much at mobilizing the spine, but at strengthening its small muscles, as well as improving lymph and blood circulation in the ligamentous-articular apparatus of this area.

The use of exercises that cause lordosis in the thoracic spine is limited, i.e. extensional and using deep, semi-deep and horizontal crawling according to Clapp, especially in the first stages of correction.

Correction of associated deformities

Hyperlordosis of the cervical spine, accompanied by pushing the head forward. Here, strengthening the muscles of the neck, shoulder girdle and extensors of the upper thoracic back is essential in the correction, which ensures the correct and stable position of the head. Strength training is combined with stretching of the muscles, especially the trapezius, levator scapulae, and saphenous muscles of the neck.

Preference is given to static exercises with a small range of motion and moderate mouse tension.

Flat-concave back

Correction of associated deformities

Asymmetrical posture

Thus, by physiologically redistributing loads, symmetrical exercises effectively ensure equalization of the strength of the back muscles and elimination of asymmetry of muscle tone, thereby reducing the pathological curvature of the spine in the frontal plane. These exercises are simple and do not require taking into account the complex biomechanical conditions of the deformed musculoskeletal system, which reduces the risk of their erroneous use.

In the treatment of this postural defect, asymmetric exercises are also used that create muscle traction in the direction opposite to the curvature (the “Archery” exercise with weights with a rubber shock absorber ensures alignment of the spine in the thoracic region in the frontal plane).

Great importance in classes for the correction of postural defects is attached to regular (at least once a week) tests to assess the strength of muscle groups that ensure the correct position of the body in space. The positive dynamics of assessments when performing these tests will serve as one of the most important objective criteria for the methodological correctness of conducting classes for the correction of postural defects.

Assessment of static strength endurance of the back muscles is carried out based on the time of holding the weight of the upper half of the body in a prone position (normally 1-2 minutes), and for the abdominal muscles - the time of holding straight legs at an angle of 45" in a supine position (40 -60 s) Dynamic strength endurance for the abdominal muscles is assessed by the test - raising the body into a squat from a supine position with legs bent at the hip and knee joints (15-20 squats in 1 min).

A general test is the test of flexion and extension of the arms while lying down (15-20 push-ups from the floor in 1 minute). Although the test is usually used to assess the strength of the muscles of the arms and shoulder girdle, when carried out correctly, great demands are made on the muscles of the entire body, including the muscles that provide the “muscle corset”.

Exercise therapy for children with postural disorders plays a very important role. With regular exercise, results become noticeable within a few months. In addition, therapeutic physical culture has a strengthening effect on the entire body.

Normal posture implies symmetry of the whole body and correct position of the spine. However, more and more often children suffer from poor posture. The reasons for this phenomenon are that modern children spend a lot of time in front of televisions, game consoles, computers and move very little.

This condition cannot be called an illness in the full sense of the word. However, incorrect posture greatly increases the risk of developing various pathologies of the skeleton and more. Such a child is more likely to have diseases of the digestive tract, respiratory system, and a tendency to neuroses. This is due to the fact that the volume of the lungs decreases, all internal organs are somewhat displaced.

There are several types of this condition:

1. Kyphosis. A condition in which the physiological curves of the spine, directed outward, are increased, and those directed inward are smoothed.
2. Scoliosis. Asymmetrical posture, in which there is a displacement of the spinal column to one side. In this case, you can notice that the child’s shoulders are located asymmetrically (one higher than the other).
3. Flat back. With this pathology, all physiological curves of the spinal column are somewhat smoothed out.

Exercise therapy for poor posture is almost a panacea for such children. After all, a child’s body is just developing, it is malleable, and all shortcomings can be easily corrected. If this condition is neglected, then in adulthood a person cannot avoid serious problems with the spinal column.

In order to correctly correct your posture, it is important to choose the right exercises. This is best done by an orthopedist, who should definitely show the child. Indeed, in advanced cases, gymnastics alone will not do. The doctor may recommend wearing a special corset or other orthosis, or even surgical treatment.

If we talk directly about physical therapy exercises, then there are those that are suitable for everyone. These are, as a rule, general strengthening exercises, breathing exercises, and exercises to develop coordination.

For thoracic kyphosis, exercises are indicated to strengthen the muscles of the shoulder girdle, while stretching the chest muscles.

The exercise therapy complex for a flat back is aimed at uniformly strengthening the muscles of the legs, shoulder girdle, and lumbar region.

For asymmetrical posture (scoliosis), exercises are aimed at increasing the mobility of the spine, stretching it, and improving coordination of movements. At the same time, it is important to maintain the symmetry of body parts, so it is better to exercise in front of a mirror.

A very important point is the frequency of therapeutic exercise sessions. They need to be done daily until complete recovery. If you perform the exercises 1-2 times a week, there will be no effect.

Exercise therapy complex for preschoolers:

1. Varied walking - on toes, with high knees - 30s.
2. Mahi. I. p. - o.s. Swing your arms up through the sides, rise on your toes - inhale, take an i.p. - exhale.
3. Swing with a gymnastic stick. I.p. — o.s., stick below. Raise the gymnastic stick up, reach for it - inhale, lower it down - exhale.
4. Swing your legs. I.p. - lying on your stomach. Raise your legs, while your torso should not come off the floor.
5. "Martin". I.p. - the same. Raise your upper body without lifting your pelvis off the floor.
6. "Swimmer". I.p. — o.s. Half squat, bending your knees, move your arms back - inhale, take an i.p. - exhale. Make sure that the child's back is straight.
7. Alternately stand on one leg with your arms spread to the sides. Watch your posture.
8. Stand against the wall, with at least 2 points of contact between your back and the wall.

Exercise therapy complex for school-age children:

1. Raise and lower your hands with the ball. Elbows should be spread out to the sides.
2. Lower the ball behind your head and lift it above your head. The back is straight.
3. Place your hands behind your back - one on top, the other on bottom. Lock them together.
4. Bend to the sides with arms outstretched.
5. Lying on your back, arch your back in the lumbar region. The pelvis does not come off the floor.
6. Standing on your knees and palms, take turns bending and arching your back.
7. In the same position, simultaneously raise your right arm and leg, then your left.
8. Lying on your stomach, raise your shoulders and legs simultaneously. Hold this for a few seconds.
9. Simulate riding a bicycle while lying on your back.

It is very important to constantly monitor the correct position of the back of such children during physical therapy exercises. You definitely need to breathe properly and deeply. After performing exercise therapy, you should walk quietly and restore your breathing.

In addition, a sport such as swimming is great for correcting posture. It gives an even load on absolutely all muscles, and thereby develops them. Pull-ups, hanging on a horizontal bar, and simply walking while holding a gymnastic stick with your hands behind your back are also useful for such children.

It is important to remember that such a pathology is a completely correctable phenomenon. You just need to seek qualified help in time. The specialist will select the necessary exercise therapy complex for children with poor posture, and then your child will be healthy!

Posture - this is the usual body position of a casually standing person. Posture depends on the degree of development of the muscular system, the angle of the pelvis, the position and shape of the spine (physiological curves).

Posture disorders occur in children at an early age: in nursery – in 2.1%; at 4 years old - in 15-17% of children; at 7 years old - every third child. At school age, the percentage of children with poor posture continues to grow. So, according to D.A. Ivanova et al., 67% of schoolchildren have posture disorders.

There are four physiological curves of the spine in the sagittal plane: two are convex anteriorly - this cervical And lumbar lordosis; two are convexly facing backward - this is chest And sacrococcygeal kyphosis. Thanks to physiological curves, the spinal column performs spring and protective functions of the spinal cord, brain, internal organs, and increases the stability and mobility of the spine.

A newborn baby has only sacrococcygeal kyphosis, formed at the stage of intrauterine development. The beginning of the formation of physiological curves of the spine dates back to infancy.

By 3 months of life, the child develops cervical lordosis– under the influence of the work of the muscles of the back and neck while raising the head from a lying position on the stomach and maintaining this position.

By 6 months it begins to form thoracic kyphosis– with the development of the ability to independently move from a lying position to a sitting position and maintain a sitting position for a long time.

By 9-10 months it begins to form lumbar lordosis– under the action of the muscles that ensure the vertical position of the body during standing and walking.

The severity of the physiological curves of the spine also depends on the angle of the pelvis. As the angle of inclination increases, the spinal column, motionlessly articulated with the pelvis, tilts forward; At the same time, lumbar lordosis and thoracic kyphosis of the spine increase, which compensate for the violation of the vertical position of the body. As the angle of inclination of the pelvis decreases, the physiological curves of the spine are correspondingly flattened.

The child’s posture, from the standpoint of physiological patterns, is a dynamic stereotype and at an early age is unstable, easily changing under the influence of positive or negative factors. Heterochronic development of the bone, ligamentous, joint apparatus and muscular system at this age is the basis for postural instability. The unevenness of development decreases as the growth rate of the musculoskeletal system decreases and stabilizes towards the end of human growth.

Correct posture is characterized by: vertical position of the head and spinous processes; horizontal level of the shoulder girdles; symmetrical arrangement of the angles of the shoulder blades, mammary glands in girls and parapapillary circles in boys; flat stomach, retracted in relation to the chest; moderately expressed physiological curves of the spine; equal, symmetrical and well-defined waist triangles; symmetrical gluteal folds; equal length of the lower limbs and correct placement of the feet (legs are extended at the knee and hip joints; the axis of the body passes through the ear, shoulder and hip joint and the middle of the foot).

At different age periods, a child’s posture has its own characteristics. Thus, the most characteristic features of the posture of preschool children are the smooth transition of the line of the chest to the line of the abdomen, which protrudes by 1-2 cm, as well as weakly expressed physiological curves of the spine. The posture of schoolchildren is characterized by moderately pronounced physiological curves of the spine with a slight tilt of the head forward.

The pelvic tilt angle in girls is greater than in boys: in boys – 28°, in girls – 31°. The most stable posture is observed in children aged 10-12 years.

Poor posture is not a disease - it is a change in the functional state of the muscular-ligamentous and musculoskeletal systems, which (with timely started health measures) does not progress and is a reversible process.

At the same time, poor posture gradually leads to a decrease in the mobility of the chest, diaphragm, and a deterioration in the spring function of the spine, which, in turn, negatively affects the activity of the main systems of the body: the central nervous, cardiovascular and respiratory; accompanies the occurrence of many chronic diseases due to the manifestation of general functional weakness and imbalance in the condition of the child’s muscles and ligaments.

Reasons for the development of postural disorders:

Weakness of the child’s natural muscle corset;

Inconsistency of furniture with the child’s weight and height;

Incorrect body positions that the child takes during the day - when performing various types of activities and during sleep.

There are three degrees of poor posture.

I degree– characterized by slight changes in posture, which are eliminated by purposeful concentration of the child’s attention.

II degree– characterized by an increase in the number of symptoms of poor posture, which are eliminated when the spine is unloaded in a horizontal position or when suspended (by the armpits).

III degree– characterized by serious postural disorders that are not eliminated by unloading the spine.

For preschool children, grades I-II of postural impairment are most typical; for schoolchildren – II-III degrees.

Currently, seven types of postural disorders are distinguished in the sagittal and frontal planes (Fig. 28).

IN sagittal plane There are 5 types of postural disorders caused by an increase (3 types) or a decrease (2 types) of physiological bends (according to I.D. Loveiko, M.I. Fonarev, 1988).

At increasing physiological curves distinguish between stooping, round back and round-concave back.

Slouching characterized by an increase in thoracic kyphosis while simultaneously decreasing or smoothing lumbar lordosis. The head is tilted forward; the shoulders are brought forward, the shoulder blades protrude; buttocks are flattened.

Round back, or kyphotic posture is characterized by an increase in thoracic kyphosis, with an almost complete absence of lumbar lordosis. Hence the more capacious name - “total” kyphosis. The head is tilted forward; the shoulders are lowered and adducted, the shoulder blades are “wing-shaped”; legs bent at the knees. Recession of the chest and flattening of the buttocks are noted; trunk muscles are weakened. Adopting correct posture is only possible for a short time.

Round-concave back, or kypholordotic posture, characterized by an increase in all curves of the spine. Pelvic tilt angle [more than normal; the head and upper shoulder girdle are tilted forward; the stomach protrudes forward and hangs down. Due to underdevelopment of the abdominal muscles, prolapse of the internal organs (visceroptosis) may occur. The legs are maximally extended at the knee joints - often with hyperextension (recurvation). The hamstrings and gluteal muscles are stretched and worn out.

Against the background of cosmetic defects with these types of postural disorders, the excursion of the chest and diaphragm decreases, the vital capacity of the lungs and the physiological reserves of the respiratory and circulatory systems decrease. Rotational movements, lateral flexion and extension of the spine are sharply limited.

At reduction of physiological curves A distinction is made between flat and plano-concave backs.

Flat back characterized by smoothing of all physiological curves (to a greater extent - thoracic kyphosis). The chest is displaced anteriorly; “wing-shaped blades” appear. Pelvic tilt is reduced; the lower abdomen protrudes forward. Reduced tone of the trunk muscles.

Plano-concave back characterized by a decrease in thoracic kyphosis with normal or slightly increased lumbar lordosis. Observed with a combined change in physiological curves. The chest is narrow. The abdominal muscles are weakened, the angle of the pelvis is increased, while the buttocks lag behind; the stomach sags.

Cosmetic defects of the musculoskeletal system with these types of postural disorders are less pronounced: the spring function of the spine worsens, which, in turn, causes constant microtrauma to the brain when moving. Increased fatigue and headaches are noted. With a decrease in cervical and lumbar lordosis, bending of the body forward and backward (to a lesser extent), as well as lateral bending, is limited.

In frontal plane There are two types of postural disorders.

Asymmetrical, or scoliotic, posture characterized by a violation of the median location of body parts and deviation of the spinous processes from the vertical axis. The head is tilted to the right or left; the shoulder girdles and angles of the shoulder blades are located at different heights; Inequality of waist triangles and asymmetry of muscle tone are noted. Reduced general and strength muscle endurance. Unlike scoliosis, vertebral torsion does not occur, and when the spine is unloaded, all types of asymmetry are eliminated.

Sluggish posture characterized by general weakness of the muscular-ligamentous apparatus, the inability to hold the body in the correct position for a long time, and frequent changes in body position in space.

Prevention and treatment of postural disorders . Prevention of postural disorders is a long process that requires a conscious attitude and active participation from the child and parents. The child must be repeatedly explained (at an accessible level, taking into account his psychomotor development) and shown what correct posture is and what needs to be done to maintain it.

Prevention of postural disorders in organized preschoolers (attending preschool institutions) is carried out in physical education classes, swimming, music classes, etc.; for schoolchildren - in physical education lessons. Parents have a great influence on the formation of correct posture; from the first days of the child’s life, they perform massage and physical exercises (in accordance with age), and at an older age, they monitor the preservation of the skill of correct posture in everyday life, during various types of activities and during rest.

The basis for the treatment of postural disorders (especially the initial degree) is general training of the muscular corset of a weakened child, which should be carried out against the background of an optimally organized therapeutic-motor regimen, tailored to the type of postural disorders and the child’s age. Elimination of postural disorders is a necessary condition for primary and secondary prevention of orthopedic diseases and diseases of internal organs.

Objectives of exercise therapy for postural disorders:

Teaching the skill of correct posture and systematically reinforcing this skill;

Strengthening the muscles of the torso and limbs (evening out the muscle tone of the front and back surfaces of the torso, lower extremities, strengthening the abdominal muscles);

normalization of trophic processes in the muscles of the body;

Implementation of targeted correction of existing postural disorders.

Indications and contraindications for prescribing exercise therapy . Therapeutic gymnastics classes are recommended for all children with poor posture, since this is the only method that allows you to effectively strengthen and train the muscle corset, and even out the muscle tone of the front and back surfaces of the torso and thighs.

Initially, during exercise therapy classes you should temporarily not use: running, jumping, bouncing on a hard surface; performing exercises in the starting position while sitting; performing exercises with a large range of motion of the body. Clean hangs are not recommended for use in preschool and primary school age, since short-term traction of the spine (against the background of general weakness and disproportion of tone of the anterior and posterior surfaces of the muscles of the body) entails even stronger muscle contraction, which does more harm than good. In addition, traction used in medical practice should always be accompanied by long-term unloading of the spine in the i.p. lying down.

Exercise therapy technique . PH classes are held in clinics, medical and physical education clinics, health schools, preschool educational institutions (3-4 times a week). Reducing the number of classes to 2 times a week is ineffective.

A physical therapy course for preschoolers and schoolchildren lasts 1.5-2 months; the break between courses is at least a month. Over the course of a year, a child with poor posture must undergo 2-3 courses of exercise therapy, which allows them to develop a stable dynamic stereotype of correct posture.

There are preparatory, main and final parts of the exercise therapy course (lasting 1-2, 4-5, 1-2 weeks, respectively).

The preparatory part uses familiar exercises with low to medium repetitions. A visual perception of correct posture and its mental representation are created, and the level of general physical fitness of the child increases.

In the main part, the number of repetitions of each exercise increases. Special exercises are performed from unloading starting positions: lying on your back, on your stomach, standing on all fours and on your knees. Exercises are performed using the repeated or interval method, combined with passive rest. The main problems of correcting existing postural disorders are solved.

In the final part, the load is reduced. The number of repetitions of each exercise is 4-6 times. After 2-3 weeks of classes, 20-30% of exercises (mainly special ones) are updated. For preschoolers, 2-3 complexes are compiled, for schoolchildren - 3-4 LG complexes per one course of exercise therapy. The skills of correct posture are improved in more complex versions of the exercises.

Organizational and methodological requirements for conducting physical therapy classes for postural disorders

1. The presence of a smooth wall (without baseboard), preferably on the side opposite the mirror. This allows the child, standing against the wall, to take the correct posture, having 5 points of contact: the back of the head, shoulder blades, buttocks, calf muscles, heels; feel the correct position of your own body in space, developing a proprioceptive muscle feeling, which, with constant repetition, is transmitted and consolidated in the central nervous system - due to impulses coming from muscle receptors. Subsequently, the skill of correct posture is reinforced not only in the static (initial) position, but also when walking and doing exercises. Exercises to develop and consolidate the skill of correct posture (see Appendix 2).

2. There should be large mirrors in the classroom so that the child can see himself in full height, forming and consolidating a visual image of correct posture. Children of preparatory groups and primary school age give a description of correct posture based on images of fairy tale characters and animals, gradually moving on to describe their own posture and the posture of friends.

Exercise therapy products . The main means of exercise therapy for correcting posture are physical exercises, massage, hydrokinesitherapy; additional treatment is positioning.

Physical exercise. Selected according to the types of postural disorders.

General development exercises (GDE) are used for all types of postural disorders. Helps improve blood circulation and respiration, trophic processes. Performed from various starting positions, for all muscle groups - with and without objects, using simulators.

Corrective, or special, exercises. Provide correction of existing postural disorders. There are symmetrical and asymmetrical corrective exercises. For postural defects, mainly symmetrical exercises are used.

When performing these exercises, the median position of the spinous processes is maintained. If posture in the frontal plane is impaired, performing these exercises equalizes the tone of the muscles of the right and left half of the body, respectively stretching tense muscles and straining relaxed ones, which returns the spine to the correct position. For example: in i.p. lying on your back, hand behind your head - bend your knees and pull them towards your body; in i.p. lying on your stomach - raise your torso, imitating breaststroke swimming, do not lift your legs off the floor; in i.p. lying on your back, legs bent at the knees, arms along the body - lifting the body, moving the arms across the sides to touch the knees.

Special exercises for poor posture include: exercises to strengthen the muscles of the back and front surface of the thigh, exercises to stretch the muscles of the front surface of the thigh and the front surface of the body (with an increase in physiological bends).

Therapeutic gymnastics classes necessarily combine general developmental, breathing and special exercises, relaxation exercises and self-stretching. Exercises to strengthen the muscle corset (see Appendix 3).

Massage. In childhood, it is an effective means of preventing and treating postural disorders. The basic techniques are used: stroking, rubbing, kneading, vibration, as well as their varieties. All techniques are performed smoothly and painlessly. For children in the first year of life, as a rule, a general massage is performed. At an older age, the emphasis is on the muscles of the back, chest, and abdominals. Often massage precedes physical therapy sessions. Children of preschool age and older in PH classes can use self-massage techniques with auxiliary means (roller massager, massage paths, massage balls), which are performed in combination with physical exercises.

Hydrokinesitherapy. Exercises in water are a powerful positive emotional factor. Most children adapt to water from an early age. Hydrokinesitherapy allows you to solve two problems: 1) implementation of correction from the unloading position of the spine; 2) hardening effect (especially for weakened children). Long-term unloading of the spine in water (t not lower than 30°C) allows you to perform a variety of exercises at the side and on a foam board in combination with already mastered skills in various swimming methods. An approximate outline of a therapeutic swimming lesson for children 9-10 years old is as follows: introductory part (5 minutes) – exercises on land and at the side, general developmental exercises for all muscle groups; main part (25-30 min) – exercises in water; final part (5-7 min) – free swimming.

Treatment by position. In classes, LH is used during rest breaks and when performing special exercises. For this purpose, an elastic cushion (2-3 cm high) or a pillow is used (the older the child, the larger its size). If you have a round back, place a bolster under your shoulder blades – when performing exercises in i.p. lying on your back; with a flat-concave back, the roller is placed on the stomach - when performing exercises in the i.p. lying on your stomach or under your head - in and. n. lying on your back. Thus, the child’s spine takes the correct corrective position within 5-8 minutes.

Forms of exercise therapy . For children with postural disorders, various forms of exercise therapy are used: UGG, LH, independent exercise, dosed walking, health path, therapeutic swimming.

It is advisable for children (especially school age) to perform exercises on simulators. When reducing physiological curves, training on a rowing machine (rowing) is useful; when increasing physiological bends - on an exercise bike (training the cardiorespiratory system) with the handlebars raised high (arms parallel to the floor), as well as on the “Health” gymnastic complex. This type of training is also available to preschoolers, provided they have equipment that takes into account the weight and height characteristics of a given age.

For the prevention and treatment of postural disorders, large-sized multifunctional environment-forming objects are also effective - modules that help gradually consolidate the skills of correct posture, as well as enrich the child’s movements, improve the psycho-emotional state (large diameter balls, bright, multifunctional objects).

After a rehabilitation course of exercise therapy (with the doctor’s permission), the child may be recommended to engage in various sports.

Evaluation of the effectiveness of physical therapy exercises for postural disorders

The functional state of the torso extensor muscles and abdominal muscles, which are directly involved in creating the muscle corset and maintaining correct posture, is determined using special motor tests to determine their strength endurance (N.A. Gukasova, 1999). This includes the following tests.

Keep your legs at a 45° angle while lying on your back. The child lies on the couch, arms along the body. Then he freely raises his straight legs at an angle of 45° and, touching the researcher’s hand with his toes, holds them in this position. The holding time is determined using a stopwatch.

Keeping your torso suspended while lying on your stomach. The child lies on the couch in such a way that the upper part of the body (to the iliac crests) is suspended; hands on the belt, legs are fixed by the researcher. The time the body is held suspended is determined using a stopwatch.

The study of muscle strength endurance is carried out 2-3 times a year.

Poor posture poses the greatest danger during the period of rapid skeletal growth in children (7–16 years). But even preschool children are exposed to this risk, because parents rarely pay attention to how their child sits at the computer or TV.

Poor posture is one of the most pressing child health problems. The cause of this pathology is most often an irrational motor pattern, which subsequently causes disruption in the functioning of various organ systems.

Therapeutic gymnastics for poor posture in children

Back and joint health » Treatment

Isn’t it nice to look at a fit, slender person with correct posture: his head is raised high and his shoulders are straightened, and his gait is light and relaxed.

And a completely different impression is formed when you see a stooped passerby with shoulder blades sharply protruding back and a protruding “beer” belly.

However, an obscene appearance is only half the story. Poor posture carries much more serious problems.

In people who are faced with this problem, all internal organs are displaced to a certain extent, which leads to disruption of their normal functioning and the development of numerous diseases.

Such changes in the functioning of the body become especially noticeable at a later age, when changing the situation is already quite problematic.

Of course, doing exercises alone is not enough, and therefore exercise therapy must be accompanied by complex therapy, which can only be prescribed by a doctor.

Where to begin?

The first step is to understand what constitutes a natural and correct body position.

You can do this as follows: turn your back to the wall, then press your heels, buttocks, shoulder blades and the back of your head against it, keeping your head straight. Keeping this position, move away from the wall and try to remember it.

Perform this procedure several times a day, this way you will train your body to maintain correct posture.

Don't forget about your back when working in a sitting position. However, in this situation, everything depends not only on the person, but also on the furniture that surrounds him. Below are just some recommendations for choosing furniture for sitting work:

• The seat depth must be at least 36 cm;
• Observe the proportions: a person whose height is 170-180 cm needs a table with a height of at least 80 cm and a chair of 50 cm;
• The chair should be placed so that its seat extends approximately 4 cm under the edge of the working surface of the table.

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When working in a sitting position, it is necessary to perform posture exercises every hour, which will be discussed below.

AN APPROXIMATE SET OF EXERCISES FOR IMPAIRED POSTURE IN CHILDREN

Exercise No. 1 Formation, walking with arm movements, walking on toes.

Exercise No. 2 I. p. - basic position. Raising straight arms up - inhale, lowering - exhale (3-4 times). The pace is slow.

Exercise No. 3 I. p. - basic stance, hands on the belt. Bend the knee towards the stomach and return to i. p. (3-4 times with each leg).

Exercise No. 4. I. p. - basic stance, gymnastic stick in lowered hands. Raising the stick up - inhale, lowering - exhale (4-5 times).

Exercise No. 5 I. p. - basic stance, stick on the shoulder blades. Tilt the body forward with a straight back and return to i. p. (5 - 10 times). When tilting the body, exhale; when straightening, inhale.

Exercise No. 6. I. p. - basic stance, stick in lowered hands. Squat with arms stretched forward and return to i. n. Back straight (5 – 10 times).

Exercise No. 7. I. p. - basic stance, hands in front of the chest. Raising your arms to the sides with your palms up - inhale, return to i. p. - exhale (5 – 10 times).

Exercise No. 8. I. p. - basic stance, arms to the sides, palms up. Springy abduction of the arms back with return to the I.P. (5–10 times).

Exercise No. 9 I. p. - lying on your back, on an inclined plane, holding the rail of the gymnastic wall with your hands. Pulling bent legs to the stomach - exhale, straightening - inhale (4 - 5 times).

Exercise No. 10 I. p. - lying on your stomach, on an inclined plane, holding the edge (handles) with your hands. Alternate extension of the legs at the hip joints (4 – 8 times with each leg).

Exercise No. 11 I. p. - lying on your back, arms along the body, palms down, legs bent at the knee joints. Raising the pelvis with support on the palms, shoulders, feet - inhale, return to i. exhale (3-5 times).

Exercise No. 12. I. p. - lying on your back, arms along the body. Leg movements like on a bicycle (10–12 times).

Exercise No. 13 I. p. - lying on the mat, on the stomach; arms extended forward, resting on the floor. Stretch out, pulling your toes and stretching your arms forward as far as possible - inhale, relax your muscles - exhale (3-5 times).

Exercise No. 14 I. p. standing on all fours at the gymnastics wall, holding the 2nd or 3rd rail with your hands. Maximum deviation of the body back with straightening of the arms and subsequent return to i. p. (3-4 times).

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Exercise No. 15 I. p. - standing: hands on the belt, ball on the head (on a cotton-gauze bag). Half-squat with arms extended to the side (4–5 times).

Exercise No. 16 I. p. - standing; arms spread to the sides, a medicine ball (weighing 1 kg) or a volleyball on the head on a cotton-gauze bag. Walking on toes.

Exercise No. 17 I. p.

– standing against a wall without a plinth or against a gymnastics wall with correct posture (touching the wall with your shoulder blades, buttocks, heels, arms down along your body).

Fix the position, move away from the wall, walk around the room, maintaining correct posture for 3 - 5 minutes, return to i. P

check correct posture.

Exercise No. 18 I. p. - standing in a circle, holding hands. Stretch your arms: up while raising your toes (4-5 times).

Exercise No. 19 I. p. - standing in a circle, holding hands. Half squat with a straight back (3-4 times).

Exercise No. 20 I. p. - hands to shoulders, feet shoulder-width apart. Stretching your arms up - inhale, return to i. n. - exhale (3–4 times).

Exercise therapy for the younger age group

Correct posture should begin to be developed in a child before 6 years of age. The exercise therapy complex for poor posture includes the following exercises:

1. Walk for 15 seconds.
2. Walking on your toes or with your knees raised high, with your hands on your belt - 15 seconds.
3. Feet shoulder-width apart, straighten your arms. Raising them as you inhale, lowering them as you exhale, perform 4 approaches.
4. Standing straight, feet together, lift the gymnastic stick, placing it behind your back. Stretch your arms up, bending your lower back, return to the starting position, repeat at least 4 times.
5. Lie on your back (straighten your legs, extend your arms along your body). As you exhale, lift one leg, inhale, then the other. Perform 10 approaches.
6. Roll over onto your stomach. Raise all limbs and chest off the floor, holding the position for about 4 seconds. Repeat at least 4 times.
7. In the same starting position, tense your shoulders and lunge with your arms, imitating a boxer's punches. For each hand, do 8 repetitions.
8. Standing on your knees, close your feet and lower your arms. Moving each leg to the side in turn, spread your arms to the sides. Do at least 4 repetitions.

When performing each exercise, you need to keep your back straight, slightly arching it in the lower back, and also do not hold your breath.

An orthopedist will help you decide which exercises will be included in the exercise therapy complex, since everything is individual. In addition, doctors advise changing or complicating the exercises every 2-3 weeks so that the effectiveness of the exercise does not decrease and the muscles do not get used to the same type of load.