Scoliosis in children is a very common pathology, which occurs very often not only among school-age children, but also among preschoolers. We will consider the causes of the development of the disease, its signs, methods of diagnosis, treatment and prevention.

Scoliosis concept

In a healthy person, the spinal column has four natural curves in the sagittal plane: two anterior (cervical and lumbar lordosis) and two posterior (sacral and thoracic kyphosis). The vertical plane dividing the body into right and left halves is called sagittal. Perpendicular to it, the same vertical plane passing between the front and back parts of the body is called frontal.

Scoliosis is a pathological curvature of the spinal column to the left or right in the frontal plane, which subsequently leads to “twisting” of the vertebrae and an increase in physiological curves. The resulting compression of blood vessels and internal organs causes disruption of the cardiovascular, respiratory, urinary, nervous and other systems of the body.

It has been observed that girls suffer from scoliosis approximately 9 times more often than boys. According to medical statistics Almost 10% of children and adolescents have curvature of the spinal column. Therefore, pediatric orthopedists confidently place scoliosis in one of the first positions among all pathologies of the musculoskeletal system.

In childhood, there are two periods when a jump in body growth occurs: from 6 to 7 years and from 11 to 14 years. It is these age intervals that are considered periods of high risk of developing scoliosis.

Ask your child to stand up, turn his back to you, lower his arms along his body and not strain. If you notice that one shoulder is higher than the other, or one shoulder blade is higher than the other, or the distance from the arm to the body at the waist is greater on one side than on the other, ask your child to lean forward. In this position, you can see that not all the vertebrae lie on the same line. The presence of at least one of these signs is a reasonable reason to see a pediatric orthopedist to rule out scoliosis. The following principle applies to this disease: early treatment leads to a favorable outcome. The child’s body is not yet fully formed, it continues to grow, so it is much easier to resist the progression of scoliosis in a child than in an adult.

Classification of scoliosis

In orthopedics, various classifications of scoliosis are used depending on the reasons for their development, the severity of the pathological process, the time of manifestation of the disease, etc.

If scoliosis manifests itself between the first and second years of a child’s life, it is called infantile. If the disease manifests itself at the age of 4–6 years, it is referred to as juvenile scoliosis; at 10–14 years, it is referred to as adolescent scoliosis.

Two main types of scoliosis:

1. Congenital scoliosis, which is formed in the prenatal period due to improper development of osteochondral structures. The reasons may be:
   • developmental anomalies of the spine (hemivertebrae, wedge-shaped vertebrae);
   • sacrolumbar dysplasia;
   • accessory ribs or fusion of ribs.

In this case, the transitional parts of the spine (thoracolumbar, cervicothoracic, lumbosacral) are most often affected. But usually there is no large arc of curvature, since single vertebrae are involved in the process. Therefore, congenital scoliosis appears no earlier than 5–7 years.

1. Acquired scoliosis is formed in a child after birth under the influence of certain factors.

Depending on the origin and causes of the disease, there are 5 groups of scoliosis:

1. Scoliosis muscular origin. They are formed as a result of pathology of the muscles and ligaments, for example, with muscular dystrophy, muscular hypotonia, congenital hip dislocation, contracture of the hip or knee joint, congenital torticollis.
2. Scoliosis neurogenic origin. They develop as a result of injury spinal cord, Friedreich's ataxia, polio, cerebral palsy, syringomyelia and other pathologies nervous system.
3. Dysplastic Scoliosis is all congenital scoliosis.
4. Scoliosis, which is based on injuries and illnesses chest(spinal fractures, pleural empyema, extensive burns, thoracoplasty, etc.) and other pathological conditions(rickets, juvenile rheumatoid arthritis, Hunter syndrome, Marfan syndrome, juvenile osteochondrosis, tumors of the spinal cord and spine, etc.).
5. Idiopathic scoliosis, the causes of which have not been established. This group includes the majority of scoliosis that develops in childhood and adolescence.

Factors contributing to scoliotic curvature of the spinal column:

• physical inactivity;
• asthenic conditions;
• age-inappropriate loads on the spine;
• incorrect posture;
• the formation of the musculoskeletal system, which continues until the age of 18.

According to the shape of the curvature, scoliosis is as follows:

• C-shaped when the spine has one arch in the frontal plane;
• S-shaped– two arcs;
• Z-shaped- three arcs.

Based on the location of the apex of the lateral curvature of the spine, several types of scoliosis are distinguished:

• cervicothoracic (at the level of III–IV thoracic vertebrae);
• thoracic (at the level of VIII–IX thoracic vertebrae);
• thoracolumbar (at the level of the XI–XII thoracic vertebrae);
• lumbar (at the level of I–II lumbar vertebrae);
• lumbosacral (at the level of the V lumbar and I coccygeal vertebrae).

There are several different clinical and radiological classifications of scoliosis according to severity. Our doctors use classification of the outstanding domestic traumatologist-orthopedist V.D. Chaklin, compiled in 1973.

Idegree, in which the lateral curvature of the spine is noticeable in a vertical position of the body and disappears in a horizontal position. If the child is standing, asymmetry of the shoulder blades and shoulder lines or waist is visible, which depends on the location of the curvature. The angle of scoliosis on radiographs does not exceed 10°;

IIdegree, when the lateral deformity of the spine is more pronounced, and it does not disappear in the supine position. A costal hump begins to form, and a compensatory arch appears. On the side of the curvature, a muscle roll is identified along the spine. The angle of scoliosis on the x-ray is greater than 11°, but less than 30°;

IIIdegree, in which a significantly pronounced lateral curvature of the spinal column is combined with a formed compensatory arch. The rib hump reaches a large size, the chest is deformed. Unloading the spine does not give any result. The angle of scoliosis on the radiograph is 31°–60°;

IVdegree when the angle of scoliosis exceeds 60°. In addition to pronounced musculoskeletal deformations, there are disturbances in the functioning of internal organs (heart, lungs, etc.).

Depending on the nature of the course, scoliosis can be progressive or non-progressive.

Symptoms of childhood scoliosis

Children with grade I–II scoliosis do not have any complaints as such. But those around them always note that they have a lowered head, an asymmetry of the back, and pinched shoulders. With III–IV degrees of deformity, the child sometimes begins to complain of back pain, he may be bothered by shortness of breath, he notices transient painful sensations in the area of ​​the heart and rapid heartbeat. Stiffness in movements increases, the child becomes inattentive and quickly gets tired. Young children may have difficulty walking, stumble, or lose their balance.

Scoliosis is not only a physical, but also a cosmetic defect. Sick children may complain of Bad mood, become depressed. Their relationships with peers are disrupted and their self-esteem drops. Therefore, parents, first of all, as well as psychologists and doctors, must help the child overcome these problems.

Doctors of all specialties who work with children know how important it is early diagnosis scoliosis. Therefore, a pediatrician, local pediatrician, surgeon, pediatric neurologist, physiotherapist, dermatologist, etc. can suspect a deformity of the spinal column and refer the patient for further examination.

A child with scoliosis or suspected of having scoliosis is managed by a pediatric orthopedist, and in the absence of this doctor in the clinic, by a surgeon. To make a diagnosis, the doctor examines the child from behind and in front, from both sides, in standing positions straight and leaning forward, as well as sitting and lying down. If there are signs of scoliosis (back asymmetry, rib hump, etc.), he uses a scoliozometer to determine the degree of curvature of the spinal column in degrees. If the spine is deviated from the vertical axis by more than 5–7°, the doctor refers the patient to.

To identify pathology of the spinal column, radiography is performed in the vertical and horizontal positions of the patient in two projections. In conclusion, the radiologist indicates the degree of scoliosis, determining it using the Chaklin method. To obtain more detailed information and in the absence of contraindications, X-ray tomography, MRI or CT of the spinal column, and myelography are performed. During treatment, a non-radiation method of computer optical topography is used to monitor its effectiveness. Pediatric orthopedists often use a camera at all stages of patient observation and treatment. Comparing those made in different time and from different photographic angles, the doctor can indirectly judge the course of the disease.

If there are indications, a child with scoliosis is consulted by a gastroenterologist, cardiologist, pulmonologist, neurologist, who may prescribe additional examination (laboratory tests, ECG, ultrasound, etc.).

The orthopedic surgeon chooses treatment tactics for each child strictly individually. It is determined by the patient’s age, the severity of scoliosis, and the course of the disease (with or without progress). All treatment methods for this type of spinal column deformity are divided into conservative and surgical.

Conservative treatment includes orthopedic treatment, massage, physiotherapeutic procedures, physical therapy, manual therapy, and wearing a corset. The orthopedic regimen includes constant monitoring of correct posture, sleeping on a hard board, unloading the spine with a horizontal body position several times a day.

If a child has grade I-II scoliosis and the disease does not progress, all measures are taken to eliminate the causes that contribute to the curvature and organize proper motor activity patient and unloading the spine. The main thing is to prevent the progression of the pathological process. The child is prescribed an orthopedic regimen, massage of the entire back, therapeutic exercises, and swimming lessons.

If grade I–II scoliosis progresses, to the above-mentioned prescriptions, the orthopedist adds a special complex of physical therapy, manual therapy (soft techniques), physiotherapy (magnetic therapy, mud and hydrotherapy, SMT therapy, electromyostimulation, heat therapy, etc.), wearing an orthopedic corset , correcting the position of the spinal column.

If conservative treatment does not give the desired effect, and the disease progresses, if the angle of scoliosis exceeds 40°, and the child has impaired functions of the internal organs, surgical treatment of the disease is indicated. Doctors try to perform the operation after 10, but before 14 years, since this age period is considered optimal for its implementation.

Surgical treatment involves the implantation of special devices (distractors, endocorrectors, etc.) into the chest, fixing the spine in the maximum possible straightened state. Surgery is always preceded by traction of the spinal column. Other options for surgical treatment are osteoplastic (resection of the vertebrae), mobilizing (removal of the intervertebral disc, etc.) and cosmetic (resection of the hump, angle of the scapula, etc.) operations. After any surgical intervention, the child undergoes a long course of rehabilitation therapy.

Prognosis of childhood scoliosis

Scoliosis that manifests itself in a child at 10–12 years of age is less aggressive. The disease, which appears before the age of 6 years, usually has a progressive course, accompanied by early development spinal column deformities. It is impossible to completely cure the disease, but stopping the pathological process and reducing the severity of the curvature is quite possible.

Children with scoliosis are subject to long-term observation by an orthopedist and should receive specialized treatment at least twice a year. The prognosis for mobility and independence is determined by the degree of scoliosis. Sick children with mild forms of curvature move freely and participate in active games on a par with peers. If scoliosis is severe, independence may be limited due to body imbalance and the child will need a cane or walker. In this case, mobility is most often limited, especially bending of the body.

For girls with spinal deformity, the prognosis for pregnancy is quite favorable, since special sets of exercises have been developed to make bearing a child easier and prepare the woman for childbirth.

Young men of military age suffering from scoliosis are not subject to conscription into the RF Armed Forces or are subject to restrictions, which is determined by the severity of the deformity.

Disease prevention

Scoliosis, like many diseases, is easier to prevent than to treat. No one can cope better with measures to prevent the development of spinal deformity than the child’s parents. Only parents have the opportunity to constantly monitor their child.

• before the age of one year, do not rush the child to grow: do not put him on pillows if he cannot sit on his own, and do not use a walker if the baby is not yet standing on his own;
• Enroll your son or daughter in the pool as early as possible, since swimming is the most effective sport in terms of preventing scoliosis;
• always monitor the correct posture of the child, his physical activity and motor mode;
• by personal example, teach him to do morning exercises every day;
• buy an orthopedic mattress for your child to sleep on;
• organize it correctly for him workplace, buy a backpack for school.

Remember that in both treatment and prevention of scoliosis, only patience and perseverance combined with confidence and optimism will lead you to success.

Zaluzhanskaya Elena Aleksandrovna, pediatrician

Scoliosis in children or juvenile scoliosis is called so because it is most often diagnosed between the ages of 3 and 10 years and develops mainly during the period of active growth of the child. Currently, almost 80% of school-age children show symptoms of scoliosis of varying severity during a medical examination.

Parents should take this disease seriously. If a child shows signs of scoliosis, you should not postpone a visit to an orthopedist, since the disease can be completely cured while the spine is forming. In this period musculoskeletal The baby’s apparatus lends itself well to correction.

With the right approach and timely treatment, it is possible to quickly correct your posture and cope with the disease. Parents should know more about the causes of the disease and its manifestations in order to take preventive measures in time, or consult a doctor to select the optimal treatment tactics.

Scoliosis in children: what is it?

Spinal scoliosis in children is a common disease of the musculoskeletal system, leading to pathological changes in the spine and curvature of the spinal column. In the absence of timely treatment, the pathology leads to an asymmetrical arrangement of the shoulder girdles, shoulder blades, pelvic distortion, and deformation of the chest. But the greatest danger of scoliosis is not a cosmetic defect, but the fact that internal organs are compressed and displaced, which causes disruption of their functions and can lead to the development of serious diseases.

Most schoolchildren who lead a sedentary lifestyle are susceptible to childhood scoliosis, and girls suffer from spinal curvature much more often than boys. Any parent should know how to check their child's posture. To do this, you need to put him in front of you with his back, taking off his outer clothing. The baby should stand straight, with arms extended along the body and heels placed together.

In this position, you need to examine the spine. The position of a healthy spinal column is even and straight, the shoulder blades and shoulder girdles are at the same level. The shoulder blades should be equally convex, the clearance between the arms and hips on both sides should be the same. Any irregularities in posture will be visible to the naked eye. If a child has one shoulder higher than the other, noticeable asymmetry of the shoulder blades and curvature of the spine when bending forward, this will indicate that there are problems with the musculoskeletal system. In such cases, you should not delay contacting a specialist; the sooner treatment is started, the greater the chance of a complete recovery.

What contributes to the development of scoliosis?

Childhood scoliosis can be either congenital or acquired. Congenital curvature of the spine occurs due to anomalies of bone structures and weakness of the muscular system, which are inherent at the genetic level.

Acquired scoliosis is caused by the following reasons:

• Sedentary lifestyle;
• Incorrect posture;
• A number of diseases of the musculoskeletal system (rickets, rheumatism, polio);
• Inflammatory diseases (pleurisy, radiculitis, tuberculosis);
• Poor nutrition, lack essential vitamins and minerals;
• Violations of the daily routine;
• High loads on the spine in some sports;
• Presence of neoplasms (tumors).

Curvature of the spine in children can be caused by rickets, musculospinal atrophy, physical trauma, and improperly distributed physical activity. For example, schoolchildren often carry a heavy school bag or backpack on only one shoulder.

There is a widespread belief that scoliosis occurs only in schoolchildren; in fact, the first signs of the disease can appear in early childhood. Thus, scoliosis in a year-old child can manifest itself with symptoms that are rarely associated with damage to the spine. However, parents need to be especially careful and pay attention to the following signs indicating pathology of the spinal column in infants:

1. Asymmetrical gluteal folds;
2. Strabismus, torticollis, malocclusion;
3. The baby rolls over from back to stomach over the same side;
4. In sleep, turns head only to one side;
5. While crawling, raises the buttocks;
6. When a baby learns to sit, he often falls over on one side, tucking his leg under him.

These signs indicate the beginning of a pathological process that will progress as the child gets to his feet. The spinal discs will gradually begin to shift, which will lead to deformation of the vertebrae; as a result, during the intensification of growth (between 6 and 8 years), unfavorable changes will become obvious.

Degrees and types of scoliosis

Photo: Degrees and classification of scoliosis

Depending on the deformation of the spine and the severity of its curvature, there are 4 degrees of scoliosis:

• I degree - the angle of lateral deformation is from 1° to 10° (shoulders are brought together, there is a stoop);
• II degree - lateral deformation reaches an angle from 11° to 25° (the pelvis is skewed, the curvature of the back is noticeable);
• III degree - the angle of deformation ranges from 26° to 50° (a hump appears, the costal arches protrude noticeably);
• IV degree - severe deformation of the spine is noted, the angle of curvature is more than 50°.

According to the shape of the curvature, scoliosis can be:

1. Arc-shaped is the most common type of spinal curvature in children. The apex of the curvature is located on one or two vertebrae in the lumbar region, and most often there is a left-sided curvature of the spinal column. Visually, a left-sided arch is noticeable in the lumbar spine. There is an uneven distribution of muscle mass, when obvious muscle hypertrophy is visible on the left side, and their absence is noted on the right side.
2. The C-shape is distinguished by one arc of curvature.
3. The S-shape is already characterized by two arcs. Curvature of the spinal column occurs in two parts of the spine at once, in both directions (right and left). This form of scoliosis is characterized by rapid development. There have been cases where pathology formed in just 1 year, although before that there were no prerequisites for its development.
4. The Z-shape is considered the most difficult in terms of treatment, since scoliotic changes are associated with the presence of three arches.

Scoliosis can be thoracic or lumbar. Depending on the age of the patient, three periods of the disease are distinguished: infantile (up to 3 years), juvenile (10-14 years) and adolescent (15-17 years).

Main symptoms

At the initial stage of development, scoliosis can be asymptomatic; the child does not complain of pain or discomfort in the spine during this period. The first changes in the back area can be seen by an orthopedist, so you should regularly bring your child for a preventive examination to this specialist. Difficult gait, accompanied by frequent stumbling, and muscle spasms suggest the development of scoliosis in children.

• Scoliosis of the 1st degree in children can be suspected based on some characteristic features: stoop, constricted shoulders, constantly lowered head, asymmetry of the shoulder girdle and waist, sloping pelvis. In this case, when bending forward, an arc of curvature is highlighted, which disappears when the body straightens.
• Scoliosis of the 2nd degree in children, in addition to the above symptoms, is supplemented by displacement of the vertebrae, the presence of a muscle roll in the lumbar region and protrusion of muscles in the thoracic region from the side of the curvature. The curvature of the spine is noticeable in any position of the body.
• With grade 3 scoliosis, there is a pronounced rotation of the vertebrae, a well-defined rib hump, bulging arches, weakening of the abdominal muscles and rib contractures.
• With grade 4 scoliosis, a significant deformation of the spine is visible, with a pronounced rib hump and stretched paravertebral muscles, while the muscles and ribs in the concavity zone sink.

Children's scoliosis at stages 1 and 2 occurs without pronounced complaints. Later, as the disease progresses, symptoms such as pain in the back, shortness of breath, rapid heartbeat, heart pain, mood swings, fatigue, and stiffness are characteristic. Curvature of the spine in children is often combined with other pathologies of the musculoskeletal system (flat feet, kyphosis, hip dysplasia).

Consequences

Treatment of the spine should begin at the first unfavorable symptoms, otherwise the disease will progress and, in advanced cases, lead to dangerous and irreversible changes, including:

• Severe spinal deformity;
• Formation of a rib hump;
• Noticeable asymmetry of the pelvis;
• Chest deformity;
• Dysfunction of the cardiovascular and respiratory systems;
• Violation of the development of vital internal organs.

The consequence of untimely treatment of scoliosis may be the earlier development of osteochondrosis or spondylosis, the appearance of vegetative-vascular dystonia and other neurological disorders. Therefore, early detection of scoliosis and timely, adequate treatment is the most important task during clinical examinations of young children.

If scoliosis is suspected, the doctor will prescribe an X-ray examination. If there is a need to clarify the diagnosis, use more modern methods diagnostics (MRI or CT). If there are indications, the patient and his parents are consulted by other specialists (cardiologist, neurologist, pediatric surgeon and orthopedist). Based on the examination results, the specialist will draw up a complete picture of the disease and prescribe the appropriate course of treatment.

Treatment methods

Complex treatment is selected for each child individually, based on the patient’s age, form and severity of the disease. For grade 1 scoliosis, treatment measures are aimed at strengthening the body and developing the muscle corset. In the second degree of pathological changes, the goal of therapeutic measures is to prevent further progression of the disease.

This can be a specially designed complex of therapeutic exercises, physiotherapeutic treatment, manual therapy, wearing an orthopedic corset, back massage, swimming. Popular physiotherapeutic procedures include sessions of electrophoresis, electrical muscle stimulation, ozokerite and paraffin applications, and ultrasound treatment. Massage for scoliosis in children helps relieve tension from overloaded spinal muscles, increases their tone, and improves blood circulation in the spine.

An important point is adherence to an orthopedic regimen, which includes sleeping on a hard surface, monitoring correct posture, and unloading the spine in a horizontal position.

A special complex of therapeutic exercises (therapeutic gymnastics) is being developed, which the child must regularly perform under the supervision of instructors. Exercise therapy for scoliosis in children is the most effective treatment method.

With the help of physical exercises, you can correct your posture, strengthen weak back muscles and correctly distribute the load on the spine. It makes sense for parents to go to such classes with their child to support him and monitor the correct technique. As an example, here are a few health exercises:

• It is recommended to apply the gymnastic stick to your back, at shoulder level. The child should wrap his arms around it on both sides and walk in this position for about two hours;
• Daily squats with support on your hands (repetitions up to 20 times) are useful;
• From the “lying on your back” position, you need to hug your knee and touch it to your chin, raising your head (repeat 10 times).
• Surgical intervention is possible in the third and fourth degrees of scoliosis. As a rule, the operation is performed on a patient at a juvenile age (the spine is fixed, the costal hump is reduced). After surgical treatment, the child will need a long rehabilitation period.
• It is important to catch the disease at an early stage, then conservative treatment methods give good results: out of 100% of small patients, 90% recover completely.

Watch a video of exercises for scoliosis in children:

Traditional treatment

In addition to the main treatment, in consultation with your doctor, you can make compresses and take baths with decoctions of medicinal plants at home:

• Crushed aloe leaves are mixed with natural honey and 1/2 cup of vodka, a gauze cloth is soaked in this mixture and applied to the sore spot for 30 minutes.
• Dissolve regular or sea ​​salt V hot water, moisten a bandage in saline solution and apply it to the painful area for 2 hours.
• Crushed aspen bark is poured with hot water, boiled for 20 minutes, filtered and poured into the bath. Taking such a therapeutic bath will relieve muscle spasms and reduce pain.

Prevention

To prevent the development of scoliosis, take preventive measures in advance. Choose a comfortable pillow and an elastic, dense mattress for your child. Make sure your baby sleeps on his back, this will help relieve stress on the spine.

As a preventative measure, older children are recommended to lead an active and active lifestyle, go swimming, constantly monitor their posture, monitor their diet, and regularly exercise gymnastic exercises aimed at strengthening the muscle corset. An instructor will help you choose exercises, and you can do them at home.

The child needs to create good conditions for completing school assignments, choose the right furniture and lighting. Make sure that the load on the child's spine is distributed correctly. For a schoolchild, it is better to choose not a briefcase, but a comfortable satchel that can be worn on both shoulders.

Parental attention and compliance with all preventive measures will help prevent the disease. In the case when scoliosis has already been diagnosed, do not be alarmed, be patient, strictly follow the doctor’s instructions, set yourself up positively and the disease will recede. Remember that than older child, the more difficult it will be to cope with scoliosis. Don't waste time, treat spinal curvature on time.

The human spine is a kind of axis on which the entire body rests. It contains the spinal cord, a kind of control center for all functions of the body.

Curvature of the spine is scoliosis.

Basic preventive measures

Problems associated with the spine always negatively affect the body. Therefore, prevention of scoliosis is also prevention of many diseases. The main measures to prevent scoliosis in preschoolers come down to two rules:

• It is necessary to ensure that the child is physically active, during which movements are made to prevent curvature of the spine.
• During load - sleep, exercise - the spine should be in the most favorable physiological position.

Prevention of scoliosis should begin from an early age, since due to the relative softness of children's bones, children often develop spinal curvature. Any monotonous habitual position of the spine leads to the development of scoliosis:

When the child spends time in the crib a large number of time, does not know how to roll over, it is necessary to ensure that his head does not turn only in one direction.

• There is no need to try to get your baby to sit or stand ahead of time.
• There is no need to carry the baby on the same arm.
• When the child begins to roll over, you need to make sure that he does it in both directions.
• When a child begins to walk, you should try not to hold him by the same hand.
• The preferred sleeping position is on your back.

In the future, with the development of hand motor skills - when doing modeling, drawing, appliqué, as well as when preparing for school, the child spends a significant part of his time sitting at the table, which creates all the prerequisites for the spine to be in the wrong condition, therefore:

• A preschool child should sit still for no more than twenty minutes.
• We must try to get him to get up as often as possible.

When sitting motionless, it is necessary for the child to change the position of his legs:

• feet back, forward;
• put them side by side;
• dilute.

You need to sit on the edge of a chair, your back is straight, your knees should be bent at right angles, put your elbows on the armrest as often as possible, thereby removing part of the load from the spine.

During breaks, do special exercises:

hang by your hands, pull your knees to your chest, perform the exercise as many times as possible;

On the floor, take a kneeling position, stretch your arms forward, bend back as much as possible, and then forward.

A preschool child should be in motion for at least six hours a day. Morning exercises, leisure, running, walking, outdoor games - this is the motor minimum for a child. In addition to general strengthening and health-improving exercises, it is necessary to introduce special ones to strengthen the chest and muscles. abdominals, improving posture. You can do them:

• along with morning exercises;
• during any rest;
• while walking.

The furniture that is in a child’s everyday life is very important:

The child should sleep not on the sofa, but on a bed with a good, elastic, dense mattress, even an orthopedic one or on coconut shavings. It is advisable to teach him to sleep without a pillow.

The place where the child eats and studies must be equipped with spacious and comfortable furniture.

• When a preschooler begins to read, you need to make sure that he does not slouch.
• It is necessary to constantly adjust the height of the child’s furniture, taking into account his growth.
• The study area should have good lighting.

What else plays an important role in prevention?

An important role in the prevention of scoliosis in preschool children is played by:

• A balanced, nutritious diet; the child’s diet should contain foods rich in vitamins and calcium, that is, fruits, vegetables, milk, fish.
• Staying outdoors. Hardening with air must be combined with physical exercise, water - dousing, wiping; in summer - sun rays; bath, but very carefully so that the body does not overheat.
• Stable, comfortable shoes.

It is also necessary to take into account that when planning a pregnancy, a woman, preferably six months before it, needs to take a course of vitamins B12 and folic acid. When taking these drugs, the risk of developing congenital bone defects, which can lead to congenital scoliosis, is reduced.

All preventive measures taken on time will help maintain the health of the child. After all, beautiful and correct posture not only makes a person attractive, but also contributes to the normal functioning of the entire body.

Scoliosis (from the Greek “crooked”) is a fairly common disease today. Few people can boast of a perfectly straight spine and correct posture. Both adults and children suffer from spinal curvature to a greater or lesser extent. How dangerous is scoliosis? What could it lead to? And most importantly, how to prevent it?

Scoliosis is a condition characterized by curvature of the spine in all planes: right, left, forward, backward; as well as around all its axes. In this state, the spine looks like a twisted vine. Most often, scoliosis occurs in children; it is especially dangerous when such a diagnosis is given to children before school age, because scoliosis rapidly progresses in the period from 5 to 7 years. Scoliosis in a teenager is not so dangerous, because there is hope that the disease will not develop.

Rice. Scoliosis. A real preparation from 1894, located in the Berlin Medical Historical Museum at the Charite Clinic.

Doctors share two concepts: scoliosis and scoliotic disease. With scoliosis, changes are observed in the vertebrae themselves, the correct shape of which can no longer be returned. But with scoliotic disease there are no such changes, there is only muscle disharmony: on one side of the spine they are stronger, and on the other weaker. This muscle imbalance causes lateral curvature of the spine. Therefore, by strengthening the back muscles, you can get rid of postural defects. Untreated scoliotic posture can develop into scoliosis.

Causes of scoliosis:

- staying in one position for a long time;

- desks and desks that are inconvenient and incorrectly selected in accordance with the child’s height;

- lack of physical activity;

- carrying heavy objects (especially in one hand);

- visual impairment;

— diseases of internal organs;

- birth defects.

Precursors of scoliosis

Rice. Rachitic skeleton. A real preparation from 1900, located in the Berlin Medical Historical Museum at the Charite Clinic.

Rickets- a disease associated with a lack of vitamin D, which is formed under the influence of sunlight, so children born in winter and autumn are at risk. The ultraviolet spectrum of light, under the influence of which vitamin D is synthesized, does not penetrate through window glass, so walking with your child only on a glassed-in balcony/loggia is not enough. The child needs “living” sunlight. Due to a lack of vitamin D, bones become soft. The first signs of the disease are noticeable at 2-3 months of a child’s life: he becomes excitable, whiny, sleeps poorly, flinches at loud sounds, sweats a lot, and bald patches appear on his head.

In an untreated disease, after six months the symptoms become more pronounced: the back of the head flattens, the bones of the skull become pliable and soft. The breast is deformed, it becomes like a chicken breast or “shoemaker’s breast” (indentation in the middle), the pelvis and limbs are bent; the person becomes more irritable. The legs take an O-shape (varus deformity), and the frontal and parietal tubercles protrude strongly on the skull. Small children with rickets later begin to crawl, sit, stand, are delayed in development, and are more likely to develop malocclusion, caries, and poor posture. When children recover, they feel better, calm down, and cry less, but skeletal deformities can persist for a long time.

Vitamin D is used to treat rickets, but its dosage and duration of treatment is determined only by a doctor. Besides drug treatment It is important to properly organize the child’s day: hardening, gymnastics, massage. The diet should include a sufficient amount of foods rich in calcium, phosphorus, vitamins, and microelements.

Early and high-quality treatment in some children allows them to cope with the disease.

Another serious reason for stooping is flat feet. In people with flat feet, the center of gravity is shifted back, thus disrupting the balance of the entire body. The person involuntarily leans forward to avoid falling and begins to slouch. Most people have static flat feet, which develops due to congenital weakness of the ligaments, hereditary bone thinness, abnormal gait, excess weight. Poorly chosen shoes, perhaps main reason static flat feet. The mechanics of a normal step are disrupted and the foot is deformed if you always wear high-heeled shoes or a rigid platform. Professional activity(standing for long periods of time or carrying heavy objects) can also cause flat feet.

Treatment for flat feet is carried out by an orthopedist. The treatment is based on special daily gymnastics, which is supplemented by warm foot baths, massage of the feet and legs - to strengthen the muscular-ligamentous system.

Ideal shoes have a heel 2-3 cm high and a tight heel. It is useful to use insoles that lift the flattened arch of the foot and improve posture. For flat feet, walking barefoot in nature, hardening, swimming, and cycling provide a good healing effect. Advanced cases are treated promptly.

Very often, scoliosis is a manifestation of some other diseases and conditions, such as hip joint diseases, diffuse connective tissue diseases, different leg lengths, cerebral palsy. These diseases, due to their characteristics, change the load on the vertebrae, distributing it incorrectly, and cause their deformation, which entails curvature of the spine. Various intrauterine diseases lead to congenital scoliosis. The development of the disease can be provoked by birth trauma. Rickets suffered at an early age and various types of injuries are the causes incorrect posture(most often due to the resulting muscle weakness). At an older age, scoliosis appears in children whose workplace is organized incorrectly and forces them to sit hunched over. Curvature of the spine can also appear in adults as a result of prolonged asymmetrical loads on the back muscles.

5 main groups of scoliosis:

1. Scoliosis of muscular origin. Poorly developed muscles and ligaments cannot ensure normal development of the spine. For example, rachitic scoliosis occurs as a result of a degenerative process in neuromuscular tissue (along with those in the skeleton).
2. Scoliosis of neurogenic origin occurs with poliomyelitis, spastic paralysis, radiculitis. This also includes scoliosis caused by degenerative changes in the intervertebral discs.
3. Congenital scoliosis occurs as a result of impaired bone development.
4. Scoliosis caused by diseases of the chest: pleural empyema, extensive burns, plastic surgery.
5. Scoliosis, the causes of which have not yet been studied.

Depending on which part of the spine is curved, the following types of scoliosis are distinguished:

— “stooping”: increased thoracic curve in the upper sections with a straight lower back;

— “round back”: increased thoracic curve throughout the entire thoracic spine;

— “concave back”: increased bending in the lumbar region;

- “round-concave back”: an increase in the thoracic curve with an increase in the lumbar curve;

- “flat-concave back”: a decrease in the thoracic curve with a normal or slightly increased lumbar curve.

Severity of scoliosis

Scoliosis I degree: lateral deviation of the spine up to 10 degrees and slight twisting (visible on an x-ray).

Scoliosis II degree: curvature angle of 10-25 degrees, pronounced twisting of the spine (a hump can be detected), the presence of compensating bends (the spine bends in the other direction and becomes s-shaped). The X-ray image clearly shows the deformation of the vertebrae.

Scoliosis grade III: curvature angle of 25-40 degrees, severe deformation of the vertebrae, formation of a large hump. In places of greatest curvature, the vertebrae acquire a wedge-shaped shape.

IV degree scoliosis: curvature angle 40-90 degrees, figure disfigurement: posterior and anterior costal humps, deformation of the pelvis and chest, cinematic scoliosis of the thoracic region.

At-risk groups:

- children with a hereditary predisposition to scoliosis;

- children who play a lot of music (the violin and accordion especially contribute to the curvature of the spine);

- fast growing and thin;

- children from schools and kindergartens with increased workload.

How to check if you or your loved ones have scoliosis?

1. Stand with your back to a wall or door. If a person stands correctly, then his spine forms a concave curve in the neck and waist (lower back), and a convex curve in the chest and pelvis, touching the wall in these places. There are gaps between the spine and the wall in the neck and lower back that are equal to the thickness of the subject’s palm. If these distances are greater, then there are postural disorders.
2. Locate the protruding seventh cervical vertebra at the base of the neck. Take any weight on a string (plumb line) and, applying it to this protruding place, see: does the plumb line go straight along the spine and then between the buttocks? If yes, then everything is fine. If it doesn’t go away, then there is scoliosis.
3. Bend forward and see if one of your shoulder blades is sticking out. You can check yourself with a mirror: all changes in posture are clearly visible in it.

Scoliosis (especially grades III and IV) is dangerous because it disrupts the functioning of all organs and systems: the heart, lungs, blood circulation, abdominal organs, and nervous system suffer. People with scoliosis develop osteochondrosis earlier. In addition, scoliosis is a cosmetic defect that puts pressure on a person’s psyche and prevents them from living a full life.

Scoliosis can be accompanied by lordosis (a strong forward curve of the spine) or kyphosis (a backward curve), deformities of the shoulder blades, sternum and muscles. Kyphosis (hunchback) and lordosis are essentially different diseases, but they often accompany each other, because if kyphosis develops in one part of the spine, then compensatory lordosis occurs in the other, and vice versa.

A person has physiological lordosis and kyphosis: normally, a slight kyphosis is present in the upper part of the thoracic spine, in the area of ​​the sacrum and coccyx. Lordosis is normally present in the lower thoracic, lumbar and cervical spine. The depth of the physiological bends corresponds to the thickness of the human palm.

Scoliosis usually occurs at 6-7 years of age, which is associated with a sharply increasing load on the spine (starting school). The second stimulus for the development of scoliosis is observed at 12-13 years of age - with intensive growth. With age, the curvature of the spine only worsens, the deformation intensifies, the spine seems to twist around its axis. Deformities can only be corrected up to 14 years of age: the growth zones of the vertebrae have not yet closed. After this, scoliosis cannot be cured, but it is possible to stabilize a person’s condition and slow down the deformation of the vertebrae with the help of therapeutic exercises, massage, and physiotherapy. The purpose of these methods is to form a so-called muscle corset from the muscles of the abdomen, lower back, back, neck and shoulder muscles. The muscle corset supports the spine in the correct position, thus reducing severe curvature.

You cannot come up with a set of exercises on your own to strengthen the muscle corset, because some types of exercise for scoliosis are strictly prohibited (jumping, lifting weights, stretching and flexibility exercises). Stretching for scoliosis is not recommended, because a person stretches, first of all, healthy parts of the spine, which are already very mobile. Because of this, scoliosis develops faster, so if you have scoliosis, you don’t need to hang on horizontal bars or wall bars.

Properly selected therapeutic exercises should strengthen the muscles and not aggravate the course of scoliosis. All exercises are performed slowly and smoothly, with minimal amplitude, while the spine should be practically motionless. Manual therapy and massage help normalize muscle tone, increase joint mobility, and improve blood circulation. During their implementation, tissue nutrition is enhanced, and this in turn ensures strengthening and more intensive development of muscles.

With the help of a corset, you can forcefully give the spine the required form. The most important thing is that the corset is correctly selected and does not compress the internal organs. But there is no need to get carried away with corsets, since constant artificial maintenance of the spine in the desired position contributes to inactivity and weakening of one’s own muscles, which ultimately worsens scoliosis. Therefore, if you wear a corset, it won’t be for long, and it’s even better to create your own muscle corset. Manual therapy can help in the early stages of scoliosis, but only if done by an experienced professional.

Kyphosis (hunchback) at an early stage is treated with the help of special positions, in which the patient is placed for some time in the most correct position, unloading the spine.

The effectiveness of treatment largely depends on the degree of spinal deformity. In most cases, congenital pathologies are more difficult to correct. Older children and adult patients often have to undergo surgery. Surgical correction is performed for stages III and IV of scoliosis. During the operation, the spine is fixed with metal rods, after which the patient wears a plaster corset for several months. After surgery, lung volume does not increase, but blood oxygen saturation improves. In the future, the possibility of carrying out (and directly carrying out) overinflation of the lungs using devices that create positive and negative pressure during breathing is being considered.

Treatment of scoliosis will be effective only if you regularly perform the prescribed exercises, constantly monitor correct posture, massage your back, wisely alternate between classes and active recreation, and consult with an orthopedic doctor. In addition, consultations with a gastroenterologist, neurologist, otolaryngologist and dentist are needed.

The enemies of good posture

1. Sleeping area. It is beneficial to sleep on a hard bed, preferably on your stomach or back. The pillow should not be too big or soft. The ideal option is to use orthopedic mattresses and pillows.

1. Clothes and shoes. The development of scoliosis is facilitated by tight clothing (shirts), which interferes with the normal growth and development of the chest. It is harmful to wear shoes that are too big, tight or uncomfortable. Incorrect leg position leads to flat feet and long-term results - curvature of the spine. If a child is diagnosed with flat feet or club feet, these diseases should be treated immediately. For adults with scoliosis, it is not advisable to wear high-heeled or stiletto shoes.

1. Bags. The surest path to scoliosis is carrying a bag in one hand. For schoolchildren, it is preferable to choose backpacks with a hard back and wide straps. The backpack must be selected according to size. And for adults, backpacks are preferable to bags.

1. The workplace should be comfortable and well lit. It is not suitable for tall schoolchildren to sit on a low chair or at a low desk. If the child is short and does not reach the floor with his feet (sitting at the table), give him a stand so that the hip and knee joints are bent at a right angle. The same rules apply to sitting at the computer. It is very important that the furniture is suitable for the student’s height. Insufficient lighting and blurred vision have a bad effect on posture, because in this case the child sits hunched over and bends low over books and notebooks.

For office workers who spend 7-8 hours at work, it is important to properly organize their workplace, because sedentary work puts a huge strain on the spine. The height of the table should be 2-3 cm above the elbow of the seated arm, and the height of the chair should not exceed the height of the shin. When working at a desk, you need to lean on both elbows, both legs, your back should closely touch the back of the chair, maintaining a lumbar curve. A fist should be placed between the chest and the edge of the table.

1. The daily routine should be rational: sedentary work should be alternated with physical exercise. For schoolchildren, this could be physical education minutes. Children need to take breaks every 15-20 minutes when working at the computer. It will be useful to register your child for sports section. Office workers should take breaks for 5-10 minutes every 45 minutes, and at this time perform small exercises to stretch stiff muscles. Walking, hiking, and swimming are very useful for both children and adults.

How to lift weights correctly?

Try never to lift anything from an inclined position! Use a jack rather than a crane. Squat down and lift the load with a straight back, or even better, while maintaining the lumbar curve. In this case, the leg muscles should work, not the spine. If possible, press the load towards you so that the load is evenly distributed along the spine. The same rules must be followed when lowering the load. If the lifting of the load is carried out by the back muscles, their work can be facilitated by simultaneously bending the legs. It is very dangerous to lift loads in a state of physical fatigue, when the muscles do not provide the necessary protection to the spine.

Keep your back straight!

In the institutes for noble maidens, girls were forced to walk several times a day, holding a stick behind their back, to create a beautiful posture: their shoulders were straightened, a beautiful, proud posture was strengthened. The standard of correct posture: the head is slightly raised, the shoulders are turned, the shoulder blades do not protrude, the line of the abdomen does not extend beyond the line of the chest. This posture can be developed with special exercises that strengthen the muscles of the arms, legs, back, abdomen, and neck.

Exercises to strengthen your back muscles

1. Starting position (ip) - lying on your stomach. Raise your head and shoulders, clasp your hands at the back of your head, spread your elbows to the sides.
2. I.p. - the same, arms to the sides. Lift your straightened legs alternately and simultaneously without lifting your pelvis from the floor.

Exercises to strengthen the abdominal muscles

1. I.p. - lying on your back, arms along your body, lower back pressed to the floor. Raise your straightened legs alternately and simultaneously.
2. I.p. - the same. We make a smooth transition to a sitting position, while maintaining correct posture.

Exercises to strengthen the lateral muscles of the trunk

1. I.p. - lying on the right side, the right arm is extended, the left is located along the body. Raise and lower your left leg. Do the same exercise on your left side.
2. I.p. - the same, the right arm is extended, the left palm rests on the floor. Slowly raise and lower both straight legs. Do the same exercise on your left side. The movements should be smooth and rhythmic (one movement is performed in 2-3 seconds).

Exercises to develop correct posture

1. Lean tightly against the wall, with your back straight, your shoulders slightly apart, your chin raised (correct posture). Then take 2 steps forward, sit down, stand up. Take the correct body position again.
2. I.p. - lying on your back. The head, torso, legs are located on the same line, arms are pressed to the body. Raise your head and shoulders, fix your body position, and slowly return from the i.p.
3. Exercise with a weight on your head (a sandbag or a thick book): squat, walk with correct posture, and also step over obstacles.

Morning exercises

Exercises are best done on the floor or bed.

Lying on your back

1) Alternately pull your knees towards your chest, clasping your shins with your hands and at the same time pulling your toes towards you.

2) Perform the “bicycle” exercise for a minute. If it is difficult to work with both legs at the same time, work with them in turns. Pull the toe towards you.

3) I.p. - lying on your back, hands clasped at the back of your head, legs raised at an angle of 90 degrees. Raising your body as high as possible, try to touch your left knee with your right elbow and lower yourself. Then try to touch your left elbow to your right knee. Repeat the exercise 10 times on each side. During this exercise, the back muscles and oblique abdominal muscles are worked.

4) Lying on your back, bend your knees, resting on the back of your head and elbows, lift your pelvis, straining your buttocks. Stay in this position for a few seconds and lower yourself to the floor.

5) A variation of the same exercise: lift your pelvis, spread your knees as far apart as possible and bring them together with force. When you feel tired, lower your pelvis, rest and repeat the exercise.

On knees

1) Alternately pull one or the other knee to the opposite hand.

2) “Kitty”. Arch your back and stretch your spine up, then bend your lower back properly. Repeat several times.

3) Straighten and lift your left leg at the same time as your right arm. Return to the starting position. Then straighten and lift your right leg at the same time as your left arm. Repeat the exercise several times.

Constantly watch how you stand, walk, sit. Stand against a wall several times a day. When performing this exercise, try to straighten your shoulders as much as possible, touching the wall with your shoulder blades, buttocks and heels. The duration of the exercise is 3-4 minutes. Then walk around the room, but continue to control your posture. All exercises aimed at strengthening muscles should be performed symmetrically on both halves of the body, the loads should be distributed from top to bottom with a gradual increase.

If the ligamentous apparatus is weak, the following are prohibited: exercises on the horizontal bar, weight lifting, basketball, hockey, football. In other words, all “asymmetrical” sports, in which all physical activity occurs on one side of the body, are prohibited.

When sitting for a long time, for example on the sofa watching TV, change the position of your legs, head, move the pillow, do not freeze in one position.

To improve muscle function, it is useful to take natural vitamins and minerals, trace elements (B vitamins, calcium, silicon, zinc and others).