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Anatomy of Back Muscles

  The muscles of the back can be divided into three groups – superficial, intermediate and deep: Superficial  – associated with movements of the shoulder. Intermediate  – associated with movements of the thoracic cage. Deep  – associated with movements of the vertebral column. The deep muscles develop embryologically in the back, and are thus described as  intrinsic  muscles. The superficial and intermediate muscles do not develop in the back, and are classified as  extrinsic  muscles. This article is about the anatomy of the superficial back muscles – their attachments, innervations and functions. The superficial back muscles are situated underneath the skin and superficial fascia. They originate from the vertebral column and attach to the bones of the shoulder – the clavicle, scapula and humerus. All these muscles are therefore associated with movements of the upper limb. The muscles in this group are the trapezius, latissimus dorsi, levator scapulae and the rhomboids. The trapezius
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Klapp exercises

 Introduction:

Klapp’s method also known as Kriechmethode ( crawling method) was developed in Germany in the beginning of the 20 century as a method for treating idiopathic scoliosis. This concept was created by orthopedist Bernhard Klapp and soon after if was developed by his son Rudolf Klapp. It was a nonsurgical method established with the aim of correcting the spinal curvature by stretching and strenghthening the back muscles.

It was noticed that during crawling on all fours, at a certain moment the spine gets exposed to a mobilizing, exercising and corrective influence so he established and exercise programme where children with idiopathis scoliosis were treated on all fours position. The therapy of the idiopathic scoliosis with help of complex exercise on all fours became not only the most used therapy in Germany for treating scoliosis. but also as a prevention of wrong body posture by children in the school age and is slowly gaining momentum all over the world.

Klapp stated that the spine is responsible for protecting and maintaining the static and dynamic functions, the nerves and blood vessels. He emphasized that wrong posture leads to a muscle imbalance in the body leading to negative effects on the spine and leading to impairments of the same.

Clinical Relevance:

Klapp divided the back impairments roughly into 8 general categories:

  • Inborn scoliosis (often connected with “spina bifida”, inborn wrong leg joint position, dislocation of the hip, chest anomalies)
  • Scoliosis as result of disease (tuberculosis, osteomyelitis, rickets…)
  • Static scoliosis (different length of the legs, amputation)
  • General scoliosis (from school, wrong body posture)
  • Scoliosis after paralysis
  • Post traumatic scoliosis (burn…)
  • Antalgic scoliosis (scoliosis caused by pain)
  • Idiopathic scoliosis (over 90%)

KLAPP’S CRAWLING

It is a unique method, which uses crawling on all fours to correct body posture by reducing pressure on the spine and optimizing use of back extensors.

The principle is in spreading your weight on the four supporting points while crawling which causes a rotation in the spine and simultaneous stretch - thus functionally strengthening of the “muscle corset”.

The movement has to always start in exact default position, locomotion has to be slow, smooth, along with your limbs pressing against the ground and keeping your spine straight. Even though idiopathic scoliosis has not been cured by the Klapp’s method, it is very effective in optimizing the muscle tension in the back area thus helping in realign the posture non surgically.

Indications:

  • Scoliosis
  • Wrong body posture
  • Strengthening the muscle “corset”
  • Trunkal muscle imbalance

Exercises:

Exercises are defined in such a way so as to start from the default positions of the spine from the ground up to the straight erect spine working on each affecting the centre of mass of each segment of spine to realign them.

Some of the exercises are:

  1. Walking on knees
  • Walking on knees with lengthened trunk
  • Kyphotic walking on the knees with swimming motion in the arms
  • Kyphotic walking on the knees with circling movement in the arms

2. Crawling on all fours:

  • Crawling on one side at a time
  • crawling alternate sides at a time
  • Pushing

3. Creeping

With Klapp's method it is possible to execute and integrate more challenging and complex exercises slowly and gradually progress towards correct posture and realignment of the spine and improve muscle balance in the trunk.

 Drawback :

  • The exercises advocated by Klapp have a major drawback of affecting the children's knees due to continuous crawling and as a result are not used rampantly today.
  • Exercises that overemphasized flexibility created problems by making the spine more vulnerable to collapse.
  • When treating patients with S- curves, it was difficult to plan an exercise programme accordingly

References


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