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Combined posture disorders
Medical expert of the article
Last reviewed: 04.07.2025
The round-concave back is the most common type and is characterized by increased anteroposterior curvature of the spine. The magnitude of the lumbar lordosis depends on the degree of forward tilt of the pelvis. The more the pelvis is tilted forward, the more pronounced the lordosis in the lumbar region will be. Deepened lumbar lordosis is in turn compensated by increased curvature of the thoracic spine, and the latter is balanced by increased cervical lordosis. With this posture defect, the abdomen and buttocks sometimes protrude quite significantly, while the chest seems flattened. This depends on the large slope of the ribs, associated with increased curvature of the upper part of the thoracic spine. Due to the significant slope of the ribs and increased lumbar lordosis, the waist is somewhat shortened and thickened. It should be noted that with this posture disorder, lateral curvatures of the spine are less common;
A flat-concave back is most common in women and is characterized by an increased forward tilt of the pelvis. Externally, this looks like an accentuated posterior protrusion of the pelvis, an increase in lumbar lordosis, and a flattening of the thoracic and cervical curves.
In case of posture disorders, attention should be paid to the constantly observed flattening of the muscles on one side of the neck and shoulder girdles, which is especially noticeable during palpation. One shoulder girdle is located lower than the other. The shoulder girdle is shifted forward, the spinous processes form a small arc (the so-called inconstant scoliotic arc), the shoulder blades are located asymmetrically, the muscles are flabby. In the active posture position, this position is corrected, the lateral curvature of the spine disappears, and the mutual perpendicularity of the three main planes of the body is restored.
So, speaking about pathological posture, we should distinguish between its two forms:
- when the deformation develops in the sagittal plane;
- when the curvature develops in the frontal plane.
But such a strict geometric division of deformations is not always possible. Mixed forms of spinal curvature disorders are more often observed.
The most significant difference between them and true scoliosis is that in various forms of postural disorders there are no signs of torsion at the site of curvature and there are no other organic or structural changes in the vertebral bodies that cause clinically detectable paravertebral asymmetry. In postural disorders, functional impairment of muscle coordination and self-control predominates.
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