=Round Shoulders= are a defective posture with which everyone is
familiar. How many children have escaped the parents’ criticism to
sit, stand, and walk erect? And not a few of the afflicted have not
succeeded after persistently doing their best.
Round shoulders or stoop shoulders are commonly attributed to
indifference. Probably a few cases are due simply to laziness and
indifference, and others may be carelessness, and usually when they
arrive at an age where pride of their physical demeanor and powers
enters as a life factor, the child soon overcomes the postural
weakness. With still others the correct, persistent physical training,
as exemplified in military schools, will readjust the defect. But there
is a class, and by far the largest, where round shoulders are a very
real and active weakness of the physical body. And the weakness is not
primarily in the shoulders as nearly everyone thinks. The stoop is a
result. The origin is in the lower dorsal spinal column. Here will be
found a posterior curvature that involves nearly the entire dorsal and
lumbar areas. This is the real, the original cause of the larger number
of round shoulders.
This backward curve of the spinal column, instead of the forward curve
as it should normally be at the waist, obliterates the brace or truss
of the spinal column that is so essential in maintaining an erect
posture of the shoulders. It allows the individual to “fall into his
stomach,” to drop the shoulders, and as a consequence the chest cavity
is depressed. The spine is one continuous backward bow, and when he
does try to sit straight, and it is always with a constant effort, the
normal, the physiological curves of the spine are not apparent.
First, then, there is a spinal weakness in the region of the
innervation to the digestive organs. Indigestion of various forms
is a common accompaniment. Second, there is lessened lung and heart
capacity. The ribs are depressed, interfering with perfect aeration and
elimination on the part of the lungs and with normal activity and tone
of the heart muscles. Phthisis is predisposed. Is it any wonder the
child’s blood is impoverished and anemia results from the insufficient
aeration and poor digestion and assimilation? Costogenic anemia may
also be a result. And, third, the shoulders are “round” from the spinal
weakness and flattened chest, really an effect; but while the most
noticeable, it is the least serious.
It is evident from careful observation and study of these cases that
the treatment resolves itself into the treatment of a posterior spinal
curvature. Shoulder braces, steel braces and jackets, and casts have
very little place, if any, although there may be diseased bone of such
character and severity that a cast will be necessary; this, however,
would refer to treatment of Pott’s disease and similar conditions.
Hence, the =treatment= is, first to replace and readjust the malaligned
vertebræ. There must be an actual physical manipulation in order to
correct the vertebræ at fault. This is the essential, and by far the
primal, treatment for the key to the truss or brace that holds and
retains the body in an erect position is then replaced.
Second, raising the depressed ribs. Remember the depressed ribs are
dependent upon the spinal condition. The thorax should be treated as a
comprehensive whole, not the spinal column alone.
Third, exercises are a valuable aid. The individual’s part is as
necessary, in a way, as the physician’s, for in order to accomplish
the maximum there should be consistent and appreciative work on the
part of the patient. Holding the shoulders back, the head erect and
the chin in, drawing the abdomen in and up, all with deep breathing
by the use of the chest muscles, the patient will be able to retain
the correction obtained during treatments. “Setting up” exercises are
helpful. Developing the muscles of forced expiration is excellent. Thus
the patient must be conscious of the work required of him and act in
concert with the physician. Minute instruction on the requirements of
each case is demanded.
Good food, pure water, and fresh air are necessary, particularly in the
anemic. Right living and correct environment are always in order.