Now, more than ever, children and teenagers spend large amounts of time sitting - either at school or in front of a computer or television. This is ultimately the cause of poor posture and back problems, experts say, and later in life it may come back to haunt them. Chronic back and spinal pain, 'hunchback of Notre Dame' roundness and a tendency to suffer injuries in later life can ensue if long-term poor posture is not addressed. And considering an infant sits up ram-rod straight quite comfortably - only to have his or her spine round into a C-shape once they hit the school years - it stands to reason that too much sitting isn't good. Fanny Leung Pui Sheung, a physiotherapy manager at the Matilda Hospital, says the amount of postural problems associated with children and teenagers in Hong Kong has grown much worse, with children as young as nine and 10 suffering from neck and back pain. She says it means their bodies can't take a knock later in life, when injuries can occur more easily - during sport, for instance. She says the health of their spines is worrisome, with some suffering from scoliosis-type spines (curvature of the spine), resulting from poor posture and muscle weakness or imbalance. Scoliosis is a condition we may be born with, and children undergo routine tests for it. But more are now suffering from spine curvature due to their alignment and lack of muscle strength, Leung says. 'We encourage them to be more active and also offer Pilates exercises [at the hospital] to let them know which postural muscles they are using when they move their bodies,' Leung says. In 2007, the problem of poor posture encouraged the Hong Kong Chiropractors' Association (HKCA) to join the World Health Organisation and the US Bone and Joint Decade to launch the Straighten Up Hong Kong! campaign. It says the initiative - originally from the US and now global - aims to raise awareness of the increased level of spine discomfort and disability due to the technological age and its effect on posture. 'Many people work and play in cramped, awkward, slouched postures. The resulting back pain compromises the quality of our lives. Every year, back pain results in tremendous costs related to health-care fees and diminished individual income and productivity,' the HKCA says. 'Recent studies indicate that training school children in beneficial posture habits and exercises can be helpful in facilitating postural improvement.' Straighten Up America is a programme designed to promote spinal health and has spinal exercise modules that the HKCA has adopted. They are simple, three-minute exercises for all ages, designed to help strengthen the spine and improve posture (watch it at www.chiropractic-uk.co.uk/straightenup/default.aspx ). HKCA spokesman and chiropractor Jeffrey Shurr says the higher incidence of back pain among children in Hong Kong and around the world is cause for concern. Shurr says chiropractors did not see a high incidence of children's back pain a decade or so ago. 'Back pain is certainly the most prevalent new condition we're seeing in kids,' Shurr says. 'It was considered to be a pathological problem [in people under 20] until ruled out. Now it's quite common.' Shurr says it's mostly due to a lack of physical activity and more time spent in front of computers and video games. 'There's a lack of emphasis on physical education in schools these days, and look at what they're carrying - reference books in their backpacks and instruments and laptops.' Shurr says being active and reminding children to straighten up by offering the HKCA-adopted exercises are a start. Choosing furniture of the right height for your child can help - seats that are not too high for the table or desk, for instance. 'The idea is that we spend three minutes a day brushing our teeth and we've all experienced a huge improvement in dental hygiene ... so we can get used to exercising our spines. 'If we get used to it the same way we care for our teeth, then we are on our way,' he says. Adults with rounded backs, Shurr says, could have prevented their problems if it had been dealt with earlier in life, making the argument for childhood postural awareness even greater. For Pure Yoga instructor Samantha Chan Suk-ling, getting children active by doing yoga classes is a great way to improve posture. 'It's really about getting them to do more exercise,' Chan says. 'Yoga is a whole-body exercise and it gets them stretching and really lengthening their backs, and at the same time strengthening their core,' she says. 'It can help children's posture a lot. It reminds them to sit straight as it's about awareness [of the body].' Chris Watts, head active isolated stretching specialist at Stretch Asia, says the classroom needn't be just about sitting still. He advises going to any children's playground during break or recess and watching how children run, skip, jump, twist and bounce. 'Then go and watch them in their classrooms on those hard chairs and low tables see how they all slump and slouch and yawn and generally feel and look very de-energised,' Watts says. 'Staying active in the classroom by getting up every 30 minutes to stretch and to move is very important, as is teachers and parents recognising and identifying slouching and poor postural habits as being detrimental to children's health. 'Believe me, when your nervous system gets used to rounded shoulders or heads poking forward or pigeon toes, it will become a part of who you are, and it gets harder and harder to change. If it becomes a habit, it simply does not get better.' Watts says children's spines are not fully developed until they are 20 or 21. 'Their bones are soft and will mould very easily to the function of their daily lives. Another important thing to remember, he says, is that when children are going through their growth spurts, their bones will grow much faster than their muscles and connective tissue. 'This is where, as parents, we should be monitoring our children's spines and their ankle position, as well as their foot arches and general posture, as this will adversely affect normal growth patterns and create asymmetrical postural patterns where one side of their body will dominate the other.' The problem for many parents is that merely barking orders at kids won't stop them from slouching. Local fitness trainer and myotherapist Liam Fitzpatrick, who offers postural screening at Clinic Equip, points to an article by David Newbound of the Children's Seating Centre in Britain, in which Newbound discusses how to avoid simply harassing your child and instead give them a lifetime of good posture. 'We are kidding ourselves if we think commands like 'sit up straight', 'stop slumping' or 'walk properly' will be effective. They are crude in comparison with the complexity of natural movement that was once dominant [the ape-like walk],' says Newbound in the article. 'Instead of triggering the natural reflexes, the command appears to interfere with them. The result can be over-control of muscles and a tenseness that persists throughout their lives. We are simply adding one more habit on top of those that are masking the reflexes.' Newbound offers tips such as practising sitting stretches, movement classes such as gymnastics, ice skating, swimming and dance, not staying seated in a chair too long and adjusting the angle of computer screens. In the meantime, set a good example and straighten up.