Skeletal Abnormalities

Authors:  Anna Norton, Ella Bonner, and Livi Kovach

The spine generally has four different curvatures to the spine to provide support to the body and keep it stable. The first at the top of the spine is the cervical lordosis curve from your neck to shoulder blades. Below that is the thoracic kyphosis which falls behind your chest. This curve helps with balance and standing. The lumbar lordosis is below this one and is part of the lower back helping with your hips and belly. The lower-most curve is the sacral kyphosis near the pelvis. To have good posture means that each of the curvatures are bent enough to support one another without increasing them too far. The following degrees are the normal degrees for each of the sections respectively: 20-40 degrees, 20-40 degrees, 40-60 degrees, and 20-45 degrees. If outside of these ranges, a person’s posture is no longer considered good potentially leading to health issues and back pain. 

Not only does proper posture affect the feeling in your back, but it also can affect how your heart is able to respond to stimuli. First, good posture allows blood to flow throughout the body as efficiently as possible. Blood vessels can become compressed if you are slouching. Not only does it affect the flow throughout the body, but blood pressure and heart strain can increase if the spine is not in alignment. Along with the blood flow, proper alignment allows for oxygen intake to be as efficient as possible. All together, proper alignment allows for the most efficient pumping of the heart and blood. 

Scoliosis is side to side curvature of your back instead of the normal front to back. Someone who has family members with scoliosis are most at risk or if they have acquired an injury impacting their spine or back muscles, they may also be at risk. Most physical therapists would begin with working on core strengthening and back flexibility to minimize pain felt from scoliosis. A back brace may also be worn to stabilize the spine as well. 

Excessive kyphosis and excessive lordosis happen when the normal curves of the spine become too exaggerated. Excessive kyphosis affects the upper back and causes a rounded or hunched posture. This is often seen in older adults due to aging, osteoporosis, and compression of the vertebrae over time. Gravity also plays a role, gradually pulling the upper body forward. Excessive lordosis affects the lower back and causes an exaggerated inward curve, sometimes described as a swayback posture. This is more common in people with weak core muscles, poor posture habits, obesity, or during pregnancy. 

Physical therapy can help manage both conditions by focusing on posture, strength, and flexibility. For kyphosis, therapists over work on strengthening the upper back muscles and improving posture awareness. For lordosis, therapy usually focuses on strengthening the core and stretching tight hip muscles. PT can help reduce pain, improve posture, and prevent the condition from getting worse by addressing the muscle imbalances that affect spinal alignment.

Hip antiversion and retroversion describe how the thigh bone sits in the hip socket. Hip anteversion occurs when the femur is rotated forward, which often causes the knees and feet to turn inward. Hip retroversion occurs when the femur is rotated backwards, leading to an outward turning of the feet. These conditions can affect how a person walks, stands, and moves during daily activities, and they may place extra stress on the hips, knees, and lower back. 

Although physical therapy cannot change the shape of the bones, it can help improve how the body functions. PT can strengthen the muscles around the hips and core, improve flexibility, and correct movement patterns. This helps reduce strain on the jois and can improve balance, posture, and overall movement. Physical therapy is especially helpful in preventing pain and long-term issues related to poor alignment. 

Other abnormalities of the body’s structure can occur in a person’s legs. Genu Valgum, also known as Knock-Knees, occurs when a person’s knees tilt towards each other while his or her ankles remain apart. It can be observed through a waddling or other unusual gait, outward rotation of feet, inward angles of both legs, or ankles remaining separated when knees are touching. Genu Varum, also known as Bowlegs, occurs when a person’s knees remain apart when standing with his or her feet together. It can be observed through unsteady walking with frequent tripping, inward rotation of feet, outward curvature of knees when ankles are touching, or a gap between knees when standing. PT rehab can be very beneficial in improving these conditions and addressing discomfort or pain. Strengthening exercises for targeted muscles allows for better support of joints and proper alignment, and stretching exercises reduce muscle tightness that may be causing strain on the knees and legs. Postural exercises encourage patients to become more aware of their alignment and body mechanics. Overall, PT treatment can prevent later issues and discomfort as well as teach and encourage healthy and safe movement.

Structural abnormalities can also occur in a person’s feet and toes. Hallux Valgus, also known as Bunions, occurs when a person’s big toe is pushed towards the other four toes and out of its normal alignment. It is typically a visible bony bump on the big toe and leads to pain, swelling, and decreased range of motion.  Hallux Varus occurs when a person’s big toe is pushed out of its normal alignment and away from the other four toes. It can be identified through excessive space between the big toe and the second toe and can lead to pain, limited function, and other concerns. PT rehab can help treat these conditions by offering targeted strength exercises for a patient’s foot. These exercises or stretches can strengthen the muscles that will encourage the toes to stay in the proper alignment.

Overall, the human body and its supporting skeleton are a very complex system that involves many different bones and muscles coming together. Each person’s body is unique and different and has its own shape and position. This means that there is not one universal good position for the human body. However, sitting in any one position for a prolonged time is not beneficial for the body and can have negative effects on a person’s posture and skeleton. This shows how important it is to get up and moving and allow your body to work through many different positions to stay active.

Resources: 

https://www.nyspine.com/blog/what-are-the-four-normal-curves-of-the-spine/ 

https://progressionpt.com/the-connection-between-posture-and-heart-health/ 

https://my.clevelandclinic.org/health/diseases/15837-scoliosis#symptoms-and-causes 

https://www.connecticutchildrens.org/specialties-conditions/orthopedics/conditions/genu-varum-bowlegs-and-genu-valgum-knock-knees

https://www.profysionj.com/about-us/blog/2025/may/how-physical-therapy-helps-children-with-knock-k/#:~:text=1.,a%20safe%20and%20supportive%20way.

https://my.clevelandclinic.org/health/diseases/14386-bunions-hallux-valgus

https://www.ncbi.nlm.nih.gov/books/NBK470261/

Neumann, D. A. (2017). Kinesiology of the musculoskeletal system: Foundations for rehabilitation (3rd ed.). Elsevier.

Kendall, F. P., McCreary, E. K., Provance, P. G., Rodgers, M. M., & Romani, W. A. (2005). Muscles: Testing and function with posture and pain (5th ed.). Lippincott Williams & Wilkins.