Body Posture & Muscles Functions: (Part 2)

In this post, I want to discuss further about muscles functions in the body, particularly the neck muscles. This topic may seem to be quite 'dry and anatomical' for some of you readers out there, but I can guarantee you that it is an important topic for physical and overall health. For me, this is a rare yet cool knowledge anyone can possess, and to know your body better, comes a beneficial advantage to yourself.

Now, let's get to know our neck much better. The cervical spine and the muscles of the neck form a remarkable structure that provides for movement of the head in all directions, and for stability in various positions. The neck supports the weight of the head in the upright position. For the gymnast who performs a headstand, the neck supports the weight of the body momentarily! The neck is in a position of slight anterior curve, and the upper back is in a position of slight posterior curve.

In typical faulty posture, the alignment of the head does not change, but the alignment of the neck changes in response to altered upper back positions. If the upper back is straight, the neck will be straight. If the upper back curves posteriorly into a kyphotic position, the neck extension increases correspondingly to the extent that a marked kyphosis may result in a position of full neck extension with the head maintaining a level position. Please have a look at the photos below.

kyphotic posture

Now, we tend to notice a huge number of people (especially desk jockeys) who suffer from kyphosis @ hunchback posture. A lot of hours in poor sitting position during working hours, driving and also at home watching TV, usage of computers, etc. What about most people in the gym (especially guys) who are obsessed doing bench press and also chronic push up routines? I have met huge amount of guys who would do easily 50-100 reps of push ups every single day. Without correcting the already kyphotic posture, these chronic pushing movements will further aggravate problem, leading to muscular imbalances and even poorer biomechanics. Over developed chest muscle group will lead to tight pectoral major and minor as well, if proper myofascial release is not integrated regularly, and missing out on proper functional pulling movements is critical to avoid muscles imbalances and increased risk of injury.

Bear in mind, chronic problems of the neck may result from faulty posture of the upper back. Along with many attributes, the neck is also vulnerable to stress and serious injury. Occupational or recreational activities may demand positions of the head that result in alignment and muscle imbalance problems. 

Emotional stress may cause an acute onset of pain with spasm of the neck muscles. The problem may be only temporary or the stress may be long-standing and result in chronic problems. The appropriate use of massage in the early stages can be an important part of treatment.

A common cause of whiplash injury to the neck is one in which a stopped or very slow-moving vehicle is hit from the rear by a fast-moving vehicle. By the impact, the head is suddenly thrust backward resulting in hyperextension of the neck, followed immediately by a sudden thrust forward resulting in hyperflexion of the neck. Trauma caused by a whiplash may result in temporary and relatively mild symptoms, or may cause severe and long-term problems.

This post presents basic evaluation and treatment procedures in relation to faulty and painful neck conditions. The normal anterior curve of the spine in the cervical region forms a slightly extended position. Cervical spine

extension is movement in the direction of increasing the normal forward curve. It may occur by tilting the head back, bringing the occiput toward the seventh cervical vertebra. It also may occur in sitting or standing by slumping into a round-upper-back, forward-head position, bringing the seventh cervical vertebra toward the occiput.

Cervical spine flexion is movement of the spine in a posterior direction, decreasing the normal anterior curve.

Movement may continue to the point of straightening the cervical spine (e.g the end range of normal flexion), and in some instances, movement may progress to the point that the spine curves convexly backward (e.g a position of mild kyphosis).

It is important to maintain good neck range of motion. We are constantly challenged by the need to turn the head to look sideways or tilt it to look downward to avoid colliding with or tripping over something. Hence, it is advisable to establish and justify a means by which measurements can be taken to determine the range of

motion of the neck in relation to established standards. Various methods have been employed to measure the

range of motion of the cervical spine, such as radiographs, goniometers, electrogoniometers, inclinometers, tape measures, Cervical ROM devices as well as ultrasound. If the upper back is rigid in a position of kyphosis, treatment of the tight neck extensors with massage and gentle stretching may acceptable but still worthwhile. 

If the posture of the upper back is habitually faulty but the person is able to assume a normal alignment, efforts should be directed toward maintaining good alignment. Temporary use of a support to help correct faulty posture of the shoulder and upper back may be beneficial as well. 

Faulty Head and Neck Positions:

 

Cervical Spine, Good and Faulty Positions: For the radiograph on the left, the subject sat erect, with the head and upper trunk in good alignment. For the radiograph on the right, the same subject sat in a typically slumped position, with a round upper back and a forward head. As illustrated, the cervical spine is in extension.

Now, let's discuss about neck muscles testing. There will be several variations to test the neck flexors primarily anterior, posterior and anterolateral. 

Anterior Neck Flexor

Patient: Supine, with the elbows bent and the hands overhead, resting on the table.

Fixation: Anterior abdominal muscles must be strong enough to give anterior fixation from the thorax to the pelvis before the head can be raised by the neck flexors. If the abdominal muscles are weak, the examiner can provide fixation by exerting firm, downward pressure on the thorax. Children approximately 5 years of age and younger should have fixation of the thorax provided by the examiner.

Test: Flexion of the cervical spine by lifting the head from the table, with the chin depressed and approximated toward the sternum.

Pressure: Against the forehead in a posterior direction.

Weakness: Hyperextension of the cervical spine, resulting in a forward-head position.

Anterolateral Neck Flexor

Patient: Supine, with elbows bent and hands beside the head, resting on table.

Fixation: If the anterior abdominal muscles are weak, the examiner can provide fixation by exerting firm, downward pressure on the thorax.

Test: Anterolateral neck flexion.

Pressure: Against the temporal region of the head in an obliquely posterior direction.

Weakness: A contracture of the right sternocleidomastoid produces a right torticollis. The face is turned toward the left, and the head is tilted toward the right. Thus, a right torticollis produces a cervical scoliosis that is convex toward the left with the left sternocleidomastoid elongated and weak. In a patient with habitually faulty posture and forward head, the sternocleidomastoid muscles remain shortened position and tend to develop shortness.

Posterolateral Neck Extensors

Patient: Prone, with elbows bent and hands overhead, resting on the table.

Fixation: None necessary.

Test: Posterolateral neck extension, with the face turned toward the side being tested.

Pressure: Against the posterolateral aspect of the head in an anterolateral direction.

Shortness: The right splenius capitis and left upper trapezius are usually short, along with the sternocleidomastoid, in a left torticollis. The opposite muscles are short in a right torticollis.

Muscle problems associated with pain in the posterior neck are essentially of two types, one associated with
muscle tightness and the other with muscle strain. Symptoms and indications for treatment differ according to
the underlying fault. Both types are quite prevalent. The one associated with muscle tightness usually has a gradual onset of symptoms, whereas the one associated with muscle strain usually has an acute onset.

Neck pain and headaches associated with tightness in the posterior neck muscles are most often found in patients with a forward head and a round upper back. Headaches associated with this muscle tightness are essentially of two types: occipital headache and tension headache.

In a tension headache, in addition to the faulty postural position of the head and neck and the tightness of the posterior neck muscles, an element of stress is also involved. This makes the condition tend to fluctuate with times of increased or decreased stress. In any event, the tight muscles usually respond to treatment that helps these muscles to relax.

Active treatment consists of heat, massage and stretching. The massage should be gentle and relaxing at first, then progress to deeper kneading. Stretching of the tight muscles must be very gradual, using both active and assisted movements. The patient should actively try to stretch the posterior neck muscles by efforts to flatten the cervical spine.

Because the faulty head position is usually compensatory to a thoracic kyphosis, which in turn may result from postural deviations of the low back or pelvis, treatment frequently must begin with correction of the associated faults. Treatment for the neck may need to begin with exercises to strengthen the lower abdominal
muscles and with use of a good abdominal support that permits the patient to assume a better upper back and chest position.

In the next post, I will discuss about work place ergonomics, massages which will help the neck muscles, as well as exercises on how to stretch relevant muscles. Stay tuned.

Body Posture & Muscles Functions: (Part 1)

I've decided to start off with a new discussion, a topic which not many people talk alot about it. A topic about body posture and muscles functions. How both are associated to enable or disable proper biomechanics of human body. Whenever you go, either in the gyms, bootcamps or any sporting event, you may heard alot about fat loss, muscle building, cardiovascular fitness, yoga, powerlifting, crossfit training, etc. But, how often do you hear fitness professionals or enthusiasts talk about the importance of body posture/biomechanics? Rare, and it is not a popular topic amongst most of us including athletes and fitness folks.  

This topic will be important for whoever suffer from postural problems such as back pain, TMJ, hyper lordosis, thoracic kyphosis, scoliasis, 'pink panther syndrome' and much more. Could it be that specific joint or muscle which is causing the problem? Or is it something else? Would visiting orthopaedic surgeon help fix the problem? Can you improve if not eliminate the condition without involving surgery? Let's get into the fundamentals of our biomechanics and analyse in details some of our postures and muscles association.

In this post, I will mainly discuss about facial muscles in the face. As some of you would have known, good posture is a good habit that contributes to the wellbeing of the individual. The structure and function of the body provide the potential for attaining and maintaining good posture. Conversely, bad posture is a bad habit and, unfortunately, is all too common. Postural faults have their origin in the misuse of the capacities provided by the body, not in the structure and function of the normal body. If faulty posture were merely an aesthetic problem, the concerns about it might be limited to those regarding appearance. However, postural faults that persist can give rise to discomfort, pain, or disability. The range of effects, from discomfort to incapacitating disability, is often related to the severity and persistence of the faults.

Discussion of the importance of good posture springs from a recognition of the prevalence of postural problems, associated painful conditions and wasted human resources. This text attempts to define the concepts of good posture, to analyze postural faults, to present treatments, and to discuss some of the developmental factors and environmental influences that affect posture. The objective is to help decrease the incidence of postural faults resulting in painful conditions. Cultural patterns of modern civilization add to the stresses on the basic structures of the human body by imposing increasingly specialized activities. It is necessary to provide compensatory influences to achieve optimum function under our mode of life.

The high incidence of postural faults in adults is related to this tendency toward a highly specialized or repetitive pattern of activity. Correction of the existing conditions depends on understanding the underlying influences and implementing a program of positive and preventive educational measures. Both require an understanding of the mechanics of the body and its response to the stresses and strains imposed on it. Inherent in the concept of good body mechanics are the inseparable qualities of alignment and muscle balance. Examination and treatment procedures are directed toward restoration and preservation of good body mechanics in posture and movement. Therapeutic exercises to strengthen weak muscles and to stretch tight muscles are the chief means by which muscle balance is restored. Good body mechanics requires that range of joint motion be adequate but not excessive. Normal flexibility is an attribute; excessive flexibility is not. A basic principle regarding joint movements can be summarized as follows: the more flexibility, the less stability; the more stability, the less flexibility. A problem arises, however, because skilled performance in a variety of sport, dance, and acrobatic activities requires excessive flexibility and muscle length.

Posture is usually defined as the relative arrangement of the parts of the body. Good posture is that state of muscular and skeletal balance which protects die supporting structures of the body against injury or progressive deformity, irrespective of the attitude (erect, lying, squatting, or stooping) in which these structures are working or resting. Under such conditions the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs. Poor posture is a faulty relationship of the various parts of the body which produces increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support.

Painful conditions associated with faulty body mechanics are so common that most adults have some firsthand knowledge of these problems. Painful low backs have been the most frequent complaints, although cases of neck, shoulder, and arm pain have become increasingly prevalent. With the current emphasis on running, foot and knee problems are common. When discussing pain in relation to postural faults, questions are often asked about why many cases of faulty posture exist without symptoms of pain, and why seemingly mild postural defects give rise to symptoms of mechanical and muscular strain. The answer to both depends on the constancy of the fault. A posture may appear to be very faulty, yet the individual may be flexible and the position of the body may change readily. Alternatively, a posture may appear to be good, but stiffness or muscle tightness may so limit mobility that the position of the body cannot change readily. The lack of mobility, which is not apparent as an alignment fault but which is detected in tests for flexibility and muscle length, may be the more significant factor. Basic to an understanding of pain in relation to faulty posture is the concept that the cumulative effects of constant or repeated small stresses over a long period

of time can give rise to the same kind of difficulties that occur with a sudden, severe stress.

Important differences exist between treatment of an acutely painful condition and that of a chronic one. A given procedure may be recognized and accepted as therapeutic if it is applied at the proper time. Applied at

the wrong time, this same procedure may be ineffective or even harmful. Just like an injured neck, shoulder, or ankle, an injured back may need support. Nature's way of providing protection is by "protective muscle spasm," or "muscle guarding," in which the back muscles hold the back rigid to prevent painful movements. Muscles can become secondarily involved, however, when they are overburdened by the work of protecting the back. Use of an appropriate support to immobilize the back temporarily relieves the muscles of this function and permits healing of the underlying injury. When a support is applied, protective muscle spasm tends to subside rapidly, and pain diminishes.

PRINCIPLES OF ALIGNMENT, JOINTS AND MUSCLES

Evaluating and treating postural problems requires an understanding of the basic principles relating to alignment, joints and muscles:

•  Faulty alignment results in undue stress and strain on bones, joints, ligaments and muscles.
•  Joint positions indicate which muscles appear to be elongated and which appear to be shortened.
•  A relationship exists between alignment and muscle test findings if posture is habitual.
•  Muscle shortness holds the origin and insertion of the muscle closer together.
•  Adaptive shortening can develop in muscles that remain in a shortened condition.
•  Muscle weakness allows separation of the origin and insertion of the muscle.
•  Stretch weakness can occur in one-joint muscles that remain in an elongated condition.

Now, let's look at muscles located in the face. Facial muscles are called the muscles of expression. The facial nerve, through its many branches, innervates most of the facial muscles. Numerous muscles may act together to create movement (e.g., as in a grimace), or movement may occur in a single area (e.g., as in raising an eyebrow). Loss of function of the facial muscles interferes with the ability to communicate feelings through facial expressions and with the ability to speak clearly. A smile, a frown, a look of surprise expressions such as these are created by the actions of muscles that insert directly into the skin. Because of the unique insertions of facial muscles, tests of these muscles differ from other manual muscle tests that require test position and fixation for the subject and pressure or resistance by the examiner. Instead, the subject is asked to imitate facial expressions while looking at photographs of a person performing the test movements or while watching the examiner perform them.

Let's talk abit about TMJ. Movements of the temporomandibular joint (TMJ) include depression of the mandible (e.g opening the mouth), protrusion of the mandible (e.g movement in a forward direction) retrusion of the mandible (e.g movement in a posterior direction) and lateral motion of the mandible (e.g side-to-side movements). Retrusion is very limited compared to protrusion. There are two primary movements of the TMJ, which includes rotation about a mediolateral axis and translation along the anteroposterior and superoinferior axes.

1. Rotation occurs first, and then translation, as the mandibular condyle moves anteriorly and inferiorly on

the temporal bone. Closing of the mouth is initiated with posterior translation of the mandible to the maximal opening. The combined translatory and rotatory movements that occur during opening of the mouth are reversed for closing to the resting position.

2. In normal jaw opening and closing, the movements of each TMJ are synchronous so that the jaw does not deviate toward either side. Asymmetrical lateral shift involves sliding the mandible to one side.

3. Disorders of the TMJ can lead to headache, facial pain and limitations of jaw opening. The muscles 

usually involved in such disorders are the pterygoids, masseters and temporalis.

4. Conservative physical therapy treatment may be sufficient to relieve pain. Various dental devices may be used to help realign or exercise these muscles.

Cranial nerves and deep facial muscles

Cranial nerves & deep superficial facial and neck muscles