PT on the Net Research

Kyphosis


Question:

I have been training a female, 42 year old client for roughly two years now. She is in good health and her fitness level is outstanding. However, she is kyphotic. I have been designing her workouts with this in mind, but lately I'm finding myself more and more frustrated because we don't seem to be making changes. She gets massages once or twice a month, and even went so far as to order a special stretch fabric “brace” that goes across her upper back and loops over each arm. She has a hard time doing corrective exercises and foam rolling on her own. She knows she needs to do work on her own. I am aware of her strengths and weaknesses, and at times, I have a difficult time doing more exercises for her “weaknesses” because she simply doesn't like them. I have seemed to find a balance between what she likes and what she doesn't like (the stuff she NEEDS to do), which is good, but I feel I'm not doing enough. Furthermore, I've figured out she simply cannot effectively brace her abdominals, no matter how I try to explain it. I am assuming that her lack of deep core strength could be linked to her postural imbalances. She has a great deal of strength in her “big dumb” muscles. However, the level of strength in her core is sub-par. She loves hard exercises but gets bored and frustrated with core stabilization work because she simply cannot “feel” it. Also, she cannot catch on to proper breathing while maintaining effective bracing. I feel I may be worrying more than I should. Just how much reversal can be attained? Thank you in advance for your time and input!

Answer:

It sounds like you are doing the right things with your client. The core stabilization exercises are critical, and your client needs to understand this. You can explain that her core is like the trunk of a tree. If a tree has big strong branches but a weak trunk, the tree is eventually going to collapse. Similarly, if a person has big strong muscles but a weak core, the person will eventually get injured due to postural imbalances. Just because she cannot “feel” an exercise does not mean that it is not working. The body changes over a long period of time. She most likely did not develop kyphosis overnight, and the problem will not be corrected overnight. If she continues to do the exercises, she will eventually notice positive changes. It is hard to say how long it will take because people’s bodies react in different ways, but the exercises will eventually help. She needs to do the exercises on her own that you assign her since consistency is the key to success. If a student does not do assigned homework, he or she will not do well in class. Similarly, if your client does not do her assigned exercises, she will not make the desired changes. She needs to understand that you are the fitness professional and know what is best for her. Keep reiterating all the good that will come out of doing her core exercises and how much better she will feel if she sticks with it.

I have found a few cues to be helpful to have a client perform proper breathing while maintaining effective bracing. First, tell your client to picture a rope going through her belly button, with someone pulling that rope through the other side. This can give her the mental picture to brace her core muscles. When performing an exercise, you should always exhale on the hardest part of an exercise and inhale on the easiest part.

Depending on the severity and type of kyphosis, you may not be able to correct it with exercise alone. Exercises will help a great, deal but your client’s doctor is the only one that can determine if she can fully correct the problem. You should talk to him/her if possible. Keep up the good work with your client.