L2: Intro to Posrure and Principles of Movement Flashcards
why do we assess posture
- part of the objective examination
- begin to build a picture what structures and changes may be contributing to symptoms
- it affects stability and balance
- it affects movement and function
- it can cause pain and injury
why does everyone not have the same ‘normal posture’
- no 2 individuals have the same body type
- variations in leg, trunk, arm dimensions, distribution of fat, muscle bulk influence posture
- people adapt and use their bodies differently in various environments or prefessions
frontal (coronal) plane
splits body into front and back
sagittal plane
splits body left and right
transverse (horizontal) plane
splits body top to bottom
what is the importance of good posture and alignment
- prevents postural deformities
- prevents muskuloskeletal pain syndromes
- reduces stress on joint surfaces
- maintains joint integrity
- contribute to optimal joint patterns
suggested framework for the postural assessment
- start at the top
- work methodically in one direction
- look at key bony landmakrs
- consider symmetry of the posture
- consider weight bearing (base of support)
- look at muscle bulk
- look at skin creases
- anterior, lateral and posterior aspects
how is ideal posture measured
using the ‘plumb line’ as a reference point for assessing posture
- intersection of sagittal and coronal planes
- body is in equilibrium and there should be a balanced distribution of weight and a stable position of each joint
anatomical/ surface pointsof plumb line of reference for lateral posture
Slightly anterior to:
- lateral malleolus
- axis on the knee joint
Slightly posterior to:
- axis of the hip joint
Passess through:
- bodies if lumbar vertebrea
- bodies of most cervical vertebrae
- ear and should joint
Spinal curves - gentle ‘S’ shape
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
anatomical/ surface pointsof plumb line of reference for posterior posture
- head - neither tilted or rotated
- cervical spine - straight
- shoulders - level, not elevated or depressed
- scapulae - neutral position (medial borders parallel, 3-4 inches apart)
- Tx and Lx straight
- hip joints - neutral, neither abducted or adducted
- lower extremities - neither knocked knees (valves) or bowed (varus)
- feet - parallel of slight toeing out
curve of cervical spine
lordosis (inward curve)
curve of thoracic spine
kyphosis (outward curve)
curve of lumbar spine
lordosis (inward curve)
shoulder and scapular anatomical landmarks need ot be aware of
medial border
lateral border
spine
inferior angle
postition of scapula for normal posture
lie flat against thorax approx 15-30 degrees forward of coronal plane
- foraward/ protected scapula more than 30 degrees foraward. Retracted scapula less than 15 degrees forward
- no angle or border is prominent (no winging where medial border is prominent, no tipping where inferior anfle of scapula is prominent)
- medial edge of the spine of the scapula should be level with T3
- inferior angle should be level with T7
- the medial border or the scapula should be approximately 2-2.5 inches from the spine
positon of shoulders for normal posture
- should be level
- observe for muscle activity - if they are forwards/ one higher than the other
position of clavicles for normal posture
should be symmetrical
bony landmarks you shoud look/ feel for on pelvis
- anterior superior iliac spine
- posterior superior iliac spine
some factors that may contribute to abnormal posture
- pain
- fatigue
- pathology
- weakness
- msucle tone
common altered neck positions
posterior neck tilt, anterior head tilt, forward head posture
what is this altered neck position
posterior head tilt
what is this altered neck position
anterior head tilt
what is this altered neck position
forward head posture
what abnormal postural alignment is this
kypho-lordosis
