Hyperkyphosis

Question 1

What is the condition Hyperkyphosis?

Answer 1

This is an increase in the normal Thoracic Kyphotic Curve, With protracted Scapulae and Head forward posture.

Question 2

How can you change a clients Functional / Postural Curves that have been voluntarily altered or reserved by positional changes?

Answer 2

You can correct these changes through passive soft tissue stretching, Joint mobilization & Strengthening exercises.

Question 3

With hyperkyphosis a pattern of muscles responding to stress by shortening & adaptively weakening appears where?

Answer 3

In the Shoulders & Neck Region.

Question 4

What muscles are shortened in the “Shoulder Crossed” Syndrome?

Answer 4

The shortened shoulder protractors and Neck Extensors inhibit the posterior thoracic muscles.
Anterior neck Flexors, Suprahyoids & infrahyoids.
Producing an increase in the Thoracic curve and compensatory increase in the Cervical lordotic Curve.

Question 5

What are implications that come along with an increase in the thoracic curve for the Upper body?

Answer 5

Breathing Issues found with restricted T-Spine mobility and Rib motion, This can lead to Respiratory conditions.
Protraction of the Scapula displaces the GH Joint.

Question 6

What occurs to the SITS muscles with Protraction of the Scapula?

Answer 6

With the Protraction of the Scapula the GH joint’s position is altered turning it inferiorly.
This forces the rotator cuff muscles to contract to maintain the humeral head in the proper position.
And a increase in stress of the Joint capsule may increase the risk of Frozen Shoulder.

Question 7

What are implications of increased cervical curve as seen with the Head forward posture?

Answer 7

The implications for the head and neck include:
The increased pressure on the Facet joints of the upper C-Spine leading to Wear on the Discs.
The mandible is moved posteriorly by the Stretched Anterior throat muscles, Leading to Stress on the TMJ.

Question 8

What muscles are Short with Hyperkyphosis & Shoulder Protraction?

Answer 8

Pec major & Minor, Subclavius, Serratus anterior And Anterior intercostals.

Question 9

What are some Causes for Hyperkyphosis?

Answer 9

Sustained Poor Posture, Occupational Sources, Overuse of Pectoral Muscles and Flexion Strengthening Exercises.
And Pathologies such as Spondylitis and Ankylosing.

Question 10

What are Some pathologies that can lead to Hyperkyphosis?

Answer 10

Osteoporosis, Ankylosing Spondylitis, Pott’s Disease, Scheuermann’s Disease.

Question 11

What muscle would be tight with Depressed Shoulders?

Answer 11

Latissimus Dorsi.

Question 12

What Muscles would be tight / Shortened with Head forward Posture?

Answer 12

Lev Scapula, SCM, Upper trap, Scalenes and the Sub-Occipitals.

Question 13

What Muscles would be tight / Shortened with Head forward Posture?

Answer 13

Lev Scapula, SCM, Upper trap, Scalenes and the Sub-Occipitals.

Question 14

What Muscles would be Tight with Elevated Upper Ribs?

Answer 14

Serratus Posterior Superior and there will be Abnormal Breathing patterns.

Question 15

What are Muscles that are Stretched, Weak and Taut with a client that has Head forward posture / Hyperkyphosis?

Answer 15

Rhomboids, Middle Traps.
These are Phasic muscles responding to stress by Fatiguing.
With head forward posture the Longus Cervicis and Capitus, The Suprahyoids and infrahyoids are stretched and weak.

Question 16

What muscles Adaptively Stretch when having Head forward posture?

Answer 16

Thoracic Erector Spinae & lower Cervical Erectors.

Question 17

What happens When Hyperkyphosis is combined with Hyperlordosis?

Answer 17

The Abdominals are stretched, Weak and Taut.

The Hip Flexors and Lumbar Erectors are Short and Tight.

Question 18

What are the Types of Hyperkyphosis?

Answer 18

There is Functional and Structural.

Question 19

What is the Symptom Picture for a Client with Functional Hyperkyphosis?

Answer 19

Pain may arise from a Stretched longitudinal ligament in the T spine and from Facet joint irritation in the upper C spine.
Pain may also arise from Ischemic tight tissue, Overstretched and Trigger points.
Muscle imbalance is present, other postural conditions are present, secondary conditions may develop such as T spine outlet syndrome.

Question 20

What is the Symptom picture for a client with Structural Hyperkyphosis?

Answer 20

In addition to the Functional Hyperkyphosis.
there is associated vertebral wedding or fusion.
There is Posterior displacement of the nucleus pulpous.

Question 21

What are some observations you can make of a client with Hyperkyphosis in the lateral View?

Answer 21

Slight ankle planter flexion with possible knee hyperextension.

Question 22

What are things you can palpate on a client that presents with Hyperkyphosis?

Answer 22

The pectoral Muscles, SCM and Anterior and upper cervical extensors are tender and Hypertonic and contain trigger points.
With accompanying Hyperlordosis the Pelvis may be flexed.
The AC joint may be Anterior.
increased Thoracic Curve.
The EAM is anterior to the Plum line.
Increased Cervical lordotic curve.

Question 23

What are some ROM testing you can do for a client presenting with Hyperkyphosis?

Answer 23

AF ROM testing shows Decreased Extension of the of the Thoracic spine.
PR ROM of the Cervical Spine is reduced in the forward flexion and lateral Flexion with shoulder protraction, reduced external rotation of the GH joint.
Active resisted shows weakness in the middle traps and Rhomboids.