Promotion of Good Posture

Examination of Posture

Who examines the posture of a child? Marked deviations from normal do not need much of a trained eye. Parents observe deviations and may comment upon them to a teacher. Elementary teachers, indeed all teachers, can readily observe the marked kyphosis or scoliosis beneath a blouse, shirt, or sweater. Physical education teachers notice undressed students in the dressing rooms and showers. They should also make it a project to examine carefully the posture of each student. This is too often a neglected part of class procedure because the importance of good posture is not appreciated.

Posture is evaluated by inspecting a child from the front, rear, and side views. The levels of the shoulders, the heights of the hips, and the possibility of pelvic tilt are observed. Alterations in curvature from front to back are detected easily.

To detect early scoliosis, the examiner observes the child, undressed, from the rear, marks the spinous processes of the vertebrae with a pencil and observes the alignment. If any side-to-side deviation (scoliosis) is noticed in a student, consultation with an orthopedic surgeon is indicated. Early recognition of scoliosis is important. It becomes more prominent and increases in severity during the period of rapid growth of the vertebrae. Some cases of scoliosis are explained on a postural basis; others result from structural defects. The orthopedist makes the differentiation. Therefore, a student with scoliosis should be placed under medical supervision so that a diagnosis can be made. With progression of a structural to understand the importance of this problem.

Kyphosis also is important. Although much of it is on a postural basis, a certain number of children have a disturbance of the epiphyses in the vertebrae. The condition is called Scheuermann’s disease. The result is pain. A teacher or parent will complain: “He won’t stand up straight. He’s round-shouldered. He looks hunchbacked.” It hurts to straighten up. In contrast to a child with a postural problem, the one with vertebral disease cannot straighten up. As time goes on, the pain becomes worse. As compensation for the kyphosis in order to maintain balance, he develops a lordosis. The result eventually is pain in both upper and lower back. Kyphosis is not normal. It is not outgrown. If there is pain with the attempt to assume a good posture, there will most likely be an accompanying bony deformity of vertebrae. A child deserves most urgently an orthopedic consultation.

As a part of a postural fitness program, in the spring of 1968 the Medical Services Branch of the Denver Public Schools conducted individual posture inspections on 3327 seventh grade girls, enrolled in 17 junior high schools. Fifty-two girls needed further orthopedic evaluation. Seventy-eight girls were given specific individual posture instructions, to be followed outside the physical education classes. Their postural deviations were not serious enough for medical referral. School nurses and women physical education teachers assisted in the project.

Causes of Poor Posture

Good posture cannot be forced upon a child. Any factors, either of health or environment, which weaken muscular strength or encourage exaggerations of spinal curves, will produce poor posture. Children need more exercise to counteract sedentary habits. Good health and strength are reflected in bearing. Chronic fatigue, malnutrition, illness, and psychological feelings which motivate an attempt at self-effacement affect posture. Other causes may be poor adjustment of seats and desks, poor lighting, poor vision, impaired hearing, careless habits of sitting, walking, and standing, and poorly fitted shoes and clothes. Postural fads which develop in high school, such as throwing the trunk back on the pelvis, produce poor posture. A postural alteration of vertebral alignment during the growth period could become permanent in time. Tall students tend to throw the bead too far forward and develop “round shoulders.” Congenital anomalies or diseases of the vertebrae, involvement of their cartilaginous surfaces as in rheumatoid arthritis, spasm of supporting muscles to the spine caused by a slopped disc, or weakness of the supporting muscles themselves all have produced poor posture.

Children do complain of backaches. This pain is not exclusively the privilege of adults. The pain from disease of the epiphyses of the vertebrae, mentioned in the description of scoliosis, may occur as early as nine or ten years of age. Adolescents can suffer injuries of the back. Rheumatoid arthritis can cause variable amounts of disabilities in joints, including those in the back. Recurrent or persistent backache must be diagnosed. Teachers should listen to the complaints.

Promotion of Good Posture

How can a teacher promote good posture? Attention must be paid to environment. The classroom must be correctly lighted so that children do not stoop forward in an attempt to see better, or so that they will not need to twist the body in order to avoid glare. A good adjustment of seating equipment for each young person, regardless of age level, should encourage him to a good sitting position.

Not only is a comfortably adjustment made, but a child should be taught how to sit properly. He needs changes of activities so that he will not sit for too long periods. He should use playground equipment to make his activities and exercises pleasurable. He should be made posture-conscious, without being nagged. Teaching methods should be used which will motivate a youngster at each age level to adopt good postural practices. Good practices of sitting, standing, and walking develop good posture in the growing child.

A teacher should be alert to a child’s health problems and to environmental situations which cause fatigue and slumping. An elementary teacher inspects the posture of her pupils. She should not expect adult posture but should be familiar with the desirable body alignment at various ages.

Every teacher in a junior or senior high school should be concerned about posture. One can hardly fail to observe the tall adolescent who slumps down and sticks out his feet, or who bends forward so that his eyes are a few inches above the paper as he writes. Good posture is particularly emphasized in such classes as physical education, speech, music, art, health education, sewing, typing, and accounting, or wherever good grooming and good carriage are essential for comfort and appearance.

One way to promote good posture is to cause interest and pride in maintaining a good posture. Los Angeles city schools sponsor a Posture Contest annually. The year 1996-97 found 165,000 pupils in the contest from 72 junior and 42 senior high schools. The physical education departments were directly involved. Trophies were awarded. In addition, the Health Services Branch of the Los Angeles City Districts is closely associated with the Corrective Physical Education and Posture Education programs for all grade levels and arranges for orthopedic consultations.

Parents need to be educated so that they can provide an environment at home which enables a child to sit and study properly. Above all, they need to know what constitutes normal posture in a young child.   

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Category: School Health Practice