2 Posture Posture is how the body balances. Muscles, bones, and ligaments all work together to exert postural control.The nervous system innervates these structures to regulate growth and function.Muscles and their nerves…A) provide stability to the trunk.B) produce movement during physiologic activity.
3 Postural AnalysisThe motor system consists of bones, muscles, and ligaments.The nervous system controls the motor system.Postural analysis is an assessment of the function of the motor system as well as the nervous system.
5 Neutral PostureThe brain and nervous system utilize information from three sources to balance the body in space.Sources of balance…Eyes – level.Ears – vestibular apparatus.Muscles and joints – proprioceptive pathways.
6 Righting ReflexA postural reaction that turns a falling animal's body in space so that its paws or feet are pointed at the ground.Returns the animal to sternal recumbency after being placed on its back or side.A normal reaction is dependent on normal vestibular, visual and proprioceptive functions.
7 Causality Postural changes can be the cause of a clinical problem. Postural changes can be the effect of a clinical problem.Orthopedic problems can cause a postural change, which can worsen the orthopedic problem.Asymptomatic postural problems can produce mechanical stress, which can predispose an individual to injury.
8 Ideal Posture There is no “normal” posture. Ideal posture serves as a reference point.Ideal posture…Distributes gravitational stress for balanced muscle function.Allows joints to move in their mid range to minimize stress on ligaments and articular surfaces.Effective for the individual’s activities of daily living.Allows the individual to avoid injury.
10 Effect of Habits on Posture Good habits contribute to a strong and stable posture.Bad habits contribute to poor posture and instability.
11 Examples of Poor Postural Habits Excessive sitting.Carrying a heavy backpack.Slumping.Poor sleeping positions.One-sided activities…Carrying a heavy purse.Sitting on a wallet.Sitting in a twisted position.
17 Muscle Palpation Palpate for hypertonic (overused) muscles. Palpate for weak / inhibited muscles.A muscle is weak because it is unstressed and should be strengthened with exercise.An inhibited muscle is not being used because it’s antagonistic muscle is being overused.
18 Reciprocal Inhibition Reciprocal inhibition describes muscles on one side of a joint relaxing to accommodate contraction of muscles on the other side of a joint.
26 Posterior View Evaluation Occipital protruberance.Cervical, thoracic, and lumbar spinous processes.Coccyx.Gluteal folds.Arms should hang equally with palms slightly visible.
27 Posterior View Evaluation The space between the arms and sides of the body should be equal.Legs should be equally abducted.The backs of the knees should be the same.Ankles and feet aligned b/l (no pronation or supination).
28 Posterior View Evaluation Structures that should be level and equal.Tips of mastoid processes.Acromia.Scapula.Lower margins of 12th ribs.Iliac crests.Posterior superior iliac spines (PSIS).Ischial tuberosities.
38 Lateral View Evaluate from both sides. Landmarks. External auditory canal.Acromion process of shoulder.Axillary line.Mid-point of iliac crest.Greater trochanter of hip.Lateral condyles of femur.Tibia slightly anterior to lateral malleolus.
46 Anteroposterior / Front View Balanced posture should appear equal from left to right.Landmarks.Bridge of nose.Center of chin.Episternal notch.Xiphoid process.Umbilicus.Pubes.
47 Anteroposterior / Front View Arms should hang similarly with palms at the side of the thighsShoulder girdle symmetryHands should show similar rotation and placement on the bodyLegs should appear equally abducted from the center line
48 Anteroposterior / Front View Feet aligned b/lNo pronation / supinationNo inversion of eversionKnees forward and symmetric b/l
49 Anteroposterior / Front View Structures that should be equal b/l and levelEyesClaviclesLower margins of the ribcageAnterior superior iliac spines (ASIS)Femoral trochantersKneesAnkles
50 Internal Rotation of Shoulders / Rounded Shoulders
53 Upper Crossed Syndrome Affects the head, neck and shoulders.Result of long-term seated postures.Rolled-in and forward shoulders.Increased thoracic kyphosis.Forward head posture.Loss of cervical lordosis.
55 Postural Signs of Upper Crossed Syndrome Postural findingRounded shouldersForward-drawn headC0-C1 hyperextensionWinging of scapulaeElevation of shouldersDysfunctionShortened pectoralsKyphotic t-spineShort suboccipitalsWeak serratus anterior, weak rhomboidsShortened upper trap, shortened levator scapulae, weak lower and middle trap
56 Muscle Imbalances in Upper Crossed Syndrome Tight-short musclesSuboccipitalsPectoralsAnterior shoulderUpper trapeziusWeak-long musclesMid to lower trapeziusSerratus anteriorRhomboids
57 Lower Crossed Syndrome Affects the lumbar spine and pelvis.Anterior pelvis and increased lumbar lordosis.Tightness in the psoas and lumbar erector spinae.Long-term sitting contributes to this syndrome as well.