Non-structural Misalignments of Body Posture in the Sagittal Plane

Overview

Journal Scoliosis Spinal Disord

Date 2018 Mar 9

PMID 29516039

Citations 40

Authors

Dariusz Czaprowski

Lukasz Stolinski

Marcin Tyrakowski

Mateusz Kozinoga

Tomasz Kotwicki

Affiliations

Soon will be listed here.

Abstract

Background: The physiological sagittal spinal curvature represents a typical feature of good body posture in the sagittal plane. The cervical and the lumbar spine are curved anteriorly (lordosis), while the thoracic segment is curved posteriorly (kyphosis). The pelvis is inclined anteriorly, and the lower limbs' joints remain in a neutral position. However, there are many deviations from the optimal body alignment.The aim of this paper is to present the most common types of non-structural misalignments of the body posture in the sagittal plane.

Main Body Of The Abstract: The most common types of non-structural misalignments of body posture in the sagittal plane are as follows: (1) lordotic, (2) kyphotic, (3) flat-back, and (4) sway-back postures. Each one may influence both the skeletal and the muscular system leading to the functional disturbance and an increased strain of the supporting structures. Usually, the disturbances localized within the muscles are analyzed in respect to their shortening or lengthening. However, according to suggestions presented in the literature, when the muscles responsible for maintaining good body posture (the so-called stabilizers) are not being stimulated to resist against gravity for an extended period of time, e.g., during prolonged sitting, their stabilizing function is disturbed by the hypoactivity reaction resulting in muscular weakness. The deficit of the locomotor system stability triggers a compensatory mechanism-the stabilizing function is overtaken by the so-called mobilizing muscles. However, as a side effect, such compensation leads to the increased activity of mobilizers (hyperactivity) and decreased flexibility, which may finally lead to the pathological chain of reaction within the musculoskeletal system.

Conclusions: There exist four principal types of non-structural body posture misalignments in the sagittal plane: lordotic posture, kyphotic posture, flat-back posture, and sway-back posture. Each of them can disturb the physiological loading of the musculoskeletal system in a specific way, which may lead to a functional disorder.When planning postural corrective exercises, not only the analysis of muscles in respect to their shortening and lengthening but also their hypoactivity and hyperactivity should be considered.

Citing Articles

Postural Differences in Speaking Versus Non-Speaking Children with Autism Spectrum Disorder.

Bedziechowska-Czyzewska M, Malak R, Romanowski M, Andrusiewicz M, Samborski W, Baum E Children (Basel). 2025; 12(2).

PMID: 40003247 PMC: 11853906. DOI: 10.3390/children12020145.

Own Typology of Body Posture Based on Research Using the Diers Formetric III 4D System.

Wilczynski J J Clin Med. 2025; 14(2).

PMID: 39860507 PMC: 11765972. DOI: 10.3390/jcm14020501.

A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 1: an analysis by classical training components.

Robles-Palazon F, Blazquez-Rincon D, Lopez-Valenciano A, Comfort P, Lopez-Lopez J, Ayala F Ann Med. 2024; 56(1):2408457.

PMID: 39351708 PMC: 11445890. DOI: 10.1080/07853890.2024.2408457.

A Randomized Controlled Trial of Active Stretching of the Hamstrings and Core Control for Low Back Pain and Musculoskeletal Discomfort during Prolonged Sitting among Young People.

Plandowska M, Labecka M, Truszczynska-Baszak A, Rajabi R, Plaszewski M J Clin Med. 2024; 13(17).

PMID: 39274261 PMC: 11396236. DOI: 10.3390/jcm13175048.

An Eight-Week Randomized Controlled Trial of Active Mobilization of the Hamstrings for Non-Specific Low Back Pain and Musculoskeletal Discomfort during Prolonged Sitting among Young People: Study Protocol.

Labecka M, Plandowska M, Truszczynska-Baszak A, Rajabi R, Plaszewski M, Rozanska D J Clin Med. 2024; 13(14).

PMID: 39064200 PMC: 11278042. DOI: 10.3390/jcm13144161.

References

Hides J, Lambrecht G, Richardson C, Stanton W, Armbrecht G, Pruett C . The effects of rehabilitation on the muscles of the trunk following prolonged bed rest. Eur Spine J. 2010; 20(5):808-18. PMC: 3082685. DOI: 10.1007/s00586-010-1491-x. View

Bergmark A . Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand Suppl. 1989; 230:1-54. DOI: 10.3109/17453678909154177. View

Reeve A, Dilley A . Effects of posture on the thickness of transversus abdominis in pain-free subjects. Man Ther. 2009; 14(6):679-84. DOI: 10.1016/j.math.2009.02.008. View

Sahrmann S, Azevedo D, Van Dillen L . Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017; 21(6):391-399. PMC: 5693453. DOI: 10.1016/j.bjpt.2017.08.001. View

Appell H . Muscular atrophy following immobilisation. A review. Sports Med. 1990; 10(1):42-58. DOI: 10.2165/00007256-199010010-00005. View

Hides J, Stokes M, Saide M, Jull G, Cooper D . Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine (Phila Pa 1976). 1994; 19(2):165-72. DOI: 10.1097/00007632-199401001-00009. View

Richardson C, Bullock M . Changes in muscle activity during fast, alternating flexion-extension movements of the knee. Scand J Rehabil Med. 1986; 18(2):51-8. View

Janssen M, Kouwenhoven J, Schlosser T, Viergever M, Bartels L, Castelein R . Analysis of preexistent vertebral rotation in the normal infantile, juvenile, and adolescent spine. Spine (Phila Pa 1976). 2011; 36(7):E486-91. DOI: 10.1097/BRS.0b013e3181f468cc. View

Hides J, Lambrecht G, Stanton W, Damann V . Changes in multifidus and abdominal muscle size in response to microgravity: possible implications for low back pain research. Eur Spine J. 2015; 25 Suppl 1:175-82. DOI: 10.1007/s00586-015-4311-5. View

10.

Hides J, Belavy D, Cassar L, Williams M, Wilson S, Richardson C . Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain. Eur Spine J. 2008; 18(3):410-8. PMC: 2899422. DOI: 10.1007/s00586-008-0827-2. View

11.

Hides J, Belavy D, Stanton W, Wilson S, Rittweger J, Felsenberg D . Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest. Spine (Phila Pa 1976). 2007; 32(15):1687-92. DOI: 10.1097/BRS.0b013e318074c386. View

12.

Belavy D, Richardson C, Wilson S, Rittweger J, Felsenberg D . Superficial lumbopelvic muscle overactivity and decreased cocontraction after 8 weeks of bed rest. Spine (Phila Pa 1976). 2007; 32(1):E23-9. DOI: 10.1097/01.brs.0000250170.53746.27. View

13.

Fujitani R, Jiromaru T, Kida N, Nomura T . Effect of standing postural deviations on trunk and hip muscle activity. J Phys Ther Sci. 2017; 29(7):1212-1215. PMC: 5509594. DOI: 10.1589/jpts.29.1212. View

14.

Mendis M, Hides J, Wilson S, Grimaldi A, Belavy D, Stanton W . Effect of prolonged bed rest on the anterior hip muscles. Gait Posture. 2009; 30(4):533-7. DOI: 10.1016/j.gaitpost.2009.08.002. View

15.

Gajdosik R, Albert C, Mitman J . Influence of hamstring length on the standing position and flexion range of motion of the pelvic angle, lumbar angle, and thoracic angle. J Orthop Sports Phys Ther. 1994; 20(4):213-9. DOI: 10.2519/jospt.1994.20.4.213. View

16.

OSullivan P, Grahamslaw K, Kendell M, Lapenskie S, Moller N, Richards K . The effect of different standing and sitting postures on trunk muscle activity in a pain-free population. Spine (Phila Pa 1976). 2002; 27(11):1238-44. DOI: 10.1097/00007632-200206010-00019. View

17.

Claus A, Hides J, Moseley G, Hodges P . Different ways to balance the spine: subtle changes in sagittal spinal curves affect regional muscle activity. Spine (Phila Pa 1976). 2009; 34(6):E208-14. DOI: 10.1097/BRS.0b013e3181908ead. View