Postural Assessment Posture Posture is how the body
![Postural Assessment Postural Assessment](https://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-1.jpg)
Postural Assessment
![Posture ● Posture is how the body balances. ● Muscles, bones, and ligaments all Posture ● Posture is how the body balances. ● Muscles, bones, and ligaments all](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-2.jpg)
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.
![Postural Analysis ● The motor system consists of bones, muscles, and ligaments. ● The Postural Analysis ● The motor system consists of bones, muscles, and ligaments. ● The](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-3.jpg)
Postural Analysis ● The 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.
![Pain Cycle Pain Cycle](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-4.jpg)
Pain Cycle
![Neutral Posture ● The brain and nervous system utilize information from three sources to Neutral Posture ● The brain and nervous system utilize information from three sources to](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-5.jpg)
Neutral Posture ● The 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.
![Righting Reflex ● A postural reaction that turns a falling animal's body in space Righting Reflex ● A postural reaction that turns a falling animal's body in space](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-6.jpg)
Righting Reflex ● A 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.
![Causality ● Postural changes can be the cause of a clinical problem. ● Postural Causality ● Postural changes can be the cause of a clinical problem. ● Postural](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-7.jpg)
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.
![Ideal Posture ● There is no “normal” posture. ● Ideal posture serves as a Ideal Posture ● There is no “normal” posture. ● Ideal posture serves as a](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-8.jpg)
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.
![Balanced Posture Balanced Posture](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-9.jpg)
Balanced Posture
![Effect of Habits on Posture ● Good habits contribute to a strong and stable Effect of Habits on Posture ● Good habits contribute to a strong and stable](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-10.jpg)
Effect of Habits on Posture ● Good habits contribute to a strong and stable posture. ● Bad habits contribute to poor posture and instability.
![Examples of Poor Postural Habits ● Excessive sitting. ● Carrying a heavy backpack. ● Examples of Poor Postural Habits ● Excessive sitting. ● Carrying a heavy backpack. ●](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-11.jpg)
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.
![Postural Changes Postural Changes](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-12.jpg)
Postural Changes
![Effects of Poor Posture on Muscles ● Overstressed muscles tighten. ● Favored muscles weaken. Effects of Poor Posture on Muscles ● Overstressed muscles tighten. ● Favored muscles weaken.](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-13.jpg)
Effects of Poor Posture on Muscles ● Overstressed muscles tighten. ● Favored muscles weaken. ● This imbalance perpetuates the poor posture.
![Spinal Distortions ● Anterior to posterior. ● Lateral. ● Helical. ● Foundational distortions create Spinal Distortions ● Anterior to posterior. ● Lateral. ● Helical. ● Foundational distortions create](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-14.jpg)
Spinal Distortions ● Anterior to posterior. ● Lateral. ● Helical. ● Foundational distortions create changes above.
![Spinal Column Views Spinal Column Views](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-15.jpg)
Spinal Column Views
![Helical Spinal Distortion Helical Spinal Distortion](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-16.jpg)
Helical Spinal Distortion
![Muscle Palpation ● Palpate for hypertonic (overused) muscles. ● Palpate for weak / inhibited Muscle Palpation ● Palpate for hypertonic (overused) muscles. ● Palpate for weak / inhibited](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-17.jpg)
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.
![Reciprocal Inhibition ● Reciprocal inhibition describes muscles on one side of a joint relaxing Reciprocal Inhibition ● Reciprocal inhibition describes muscles on one side of a joint relaxing](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-18.jpg)
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.
![Reciprocal Inhibition Reciprocal Inhibition](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-19.jpg)
Reciprocal Inhibition
![Postural and Phasic Muscles ● Postural (tend to hyperactivity) ● Phasic (tend to hypoactivity) Postural and Phasic Muscles ● Postural (tend to hyperactivity) ● Phasic (tend to hypoactivity)](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-20.jpg)
Postural and Phasic Muscles ● Postural (tend to hyperactivity) ● Phasic (tend to hypoactivity) ● Triceps surae ● Tibialis anterior ● Hamstrings ● Gluteus maximus ● Adductors ● Gluteus medius ● Rectus femoris ● Rectus abdominus ● Tensor fascia latae (TFL) ● Psoas ● Erector spinae ● Lower / middle trapezius ● Longus capitus and colli ● Deltoids ● Digastrics
![Postural and Phasic Muscles ● Postural (tend to hyperactivity) ● Quadratus lumborum (QL) ● Postural and Phasic Muscles ● Postural (tend to hyperactivity) ● Quadratus lumborum (QL) ●](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-21.jpg)
Postural and Phasic Muscles ● Postural (tend to hyperactivity) ● Quadratus lumborum (QL) ● Pectoralis ● Upper Trapezius ● Sternocleidomastoid ● Suboccipital ● Masticatories
![Posture Blocks Posture Blocks](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-22.jpg)
Posture Blocks
![Prior To Postural Evaluation ● Obtain pertinent history. ● ● ● Description of symptoms. Prior To Postural Evaluation ● Obtain pertinent history. ● ● ● Description of symptoms.](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-23.jpg)
Prior To Postural Evaluation ● Obtain pertinent history. ● ● ● Description of symptoms. Fractures. Injuries. Congenital anomalies. Dominant hand. ● Note gross structural asymmetries such as scoliosis.
![Postural Views Postural Views](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-24.jpg)
Postural Views
![Posture Types Posture Types](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-25.jpg)
Posture Types
![Posterior View Evaluation ● Occipital protruberance. ● Cervical, thoracic, and lumbar spinous processes. ● Posterior View Evaluation ● Occipital protruberance. ● Cervical, thoracic, and lumbar spinous processes. ●](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-26.jpg)
Posterior View Evaluation ● Occipital protruberance. ● Cervical, thoracic, and lumbar spinous processes. ● Coccyx. ● Gluteal folds. ● Arms should hand equally with palms slightly visible.
![Posterior View Evaluation ● The space between the arms and sides of the body Posterior View Evaluation ● The space between the arms and sides of the body](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-27.jpg)
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).
![Posterior View Evaluation ● Structures that should be level and equal. ● ● ● Posterior View Evaluation ● Structures that should be level and equal. ● ● ●](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-28.jpg)
Posterior View Evaluation ● Structures that should be level and equal. ● ● ● ● Tips of mastoid processes. Acromia. Scapula. Lower margins of 12 th ribs. Iliac crests. Posterior superior iliac spines (PSIS). Ischial tuberosities.
![Ideal Posterior Alignment Ideal Posterior Alignment](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-29.jpg)
Ideal Posterior Alignment
![Scoliosis Scoliosis](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-30.jpg)
Scoliosis
![Pelvic Unleveling Pelvic Unleveling](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-31.jpg)
Pelvic Unleveling
![Gothic Shoulder Gothic Shoulder](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-32.jpg)
Gothic Shoulder
![Scapular Winging Scapular Winging](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-33.jpg)
Scapular Winging
![Scapular Winging and Abduction Scapular Winging and Abduction](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-34.jpg)
Scapular Winging and Abduction
![Tight Levator Scapula Tight Levator Scapula](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-35.jpg)
Tight Levator Scapula
![High Left Shoulder High Left Shoulder](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-36.jpg)
High Left Shoulder
![Right Head Tilt and Rotation Right Head Tilt and Rotation](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-37.jpg)
Right Head Tilt and Rotation
![Lateral View ● Evaluate from both sides. ● Landmarks. ● ● ● ● External Lateral View ● Evaluate from both sides. ● Landmarks. ● ● ● ● External](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-38.jpg)
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.
![Ideal Lateral Alignment Ideal Lateral Alignment](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-39.jpg)
Ideal Lateral Alignment
![Head Alignment Lateral View Head Alignment Lateral View](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-40.jpg)
Head Alignment Lateral View
![Forward Head Posture Forward Head Posture](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-41.jpg)
Forward Head Posture
![Head and Neck Weight Distribution Head and Neck Weight Distribution](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-42.jpg)
Head and Neck Weight Distribution
![Forward Head Tilt Forward Head Tilt](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-43.jpg)
Forward Head Tilt
![Abdominal Protrusion Abdominal Protrusion](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-44.jpg)
Abdominal Protrusion
![Pelvic Tilt (Anterior and Posterior) Pelvic Tilt (Anterior and Posterior)](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-45.jpg)
Pelvic Tilt (Anterior and Posterior)
![Anteroposterior / Front View ● Balanced posture should appear equal from left to right. Anteroposterior / Front View ● Balanced posture should appear equal from left to right.](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-46.jpg)
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.
![Anteroposterior / Front View ● Arms should hang similarly with palms at the side Anteroposterior / Front View ● Arms should hang similarly with palms at the side](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-47.jpg)
Anteroposterior / Front View ● Arms should hang similarly with palms at the side of the thighs ● Shoulder girdle symmetry ● Hands should show similar rotation and placement on the body ● Legs should appear equally abducted from the center line
![Anteroposterior / Front View ● Feet aligned b/l ● No pronation / supination ● Anteroposterior / Front View ● Feet aligned b/l ● No pronation / supination ●](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-48.jpg)
Anteroposterior / Front View ● Feet aligned b/l ● No pronation / supination ● No inversion of eversion ● Knees forward and symmetric b/l
![Anteroposterior / Front View ● Structures that should be equal b/l and level ● Anteroposterior / Front View ● Structures that should be equal b/l and level ●](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-49.jpg)
Anteroposterior / Front View ● Structures that should be equal b/l and level ● ● ● ● Eyes Clavicles Lower margins of the ribcage Anterior superior iliac spines (ASIS) Femoral trochanters Knees Ankles
![Internal Rotation of Shoulders / Rounded Shoulders Internal Rotation of Shoulders / Rounded Shoulders](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-50.jpg)
Internal Rotation of Shoulders / Rounded Shoulders
![Genu Valga (Knock-knees) Genu Valga (Knock-knees)](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-51.jpg)
Genu Valga (Knock-knees)
![Genu Vara (Bowlegs) Genu Vara (Bowlegs)](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-52.jpg)
Genu Vara (Bowlegs)
![Upper Crossed Syndrome ● Affects the head, neck and shoulders. ● Result of long-term Upper Crossed Syndrome ● Affects the head, neck and shoulders. ● Result of long-term](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-53.jpg)
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.
![Upper Crossed Syndrome Upper Crossed Syndrome](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-54.jpg)
Upper Crossed Syndrome
![Postural Signs of Upper Crossed Syndrome ● Postural finding ● Dysfunction ● Rounded shoulders Postural Signs of Upper Crossed Syndrome ● Postural finding ● Dysfunction ● Rounded shoulders](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-55.jpg)
Postural Signs of Upper Crossed Syndrome ● Postural finding ● Dysfunction ● Rounded shoulders ● Shortened pectorals ● Forward-drawn head ● Kyphotic t-spine ● C 0 -C 1 hyperextension ● Short suboccipitals ● Winging of scapulae ● Elevation of shoulders ● Weak serratus anterior ● Shortened upper trap, shortened levator scapulae, weak lower and middle trap
![Muscle Imbalances in Upper Crossed Syndrome ● Tight-short muscles ● Weak-long muscles ● Suboccipitals Muscle Imbalances in Upper Crossed Syndrome ● Tight-short muscles ● Weak-long muscles ● Suboccipitals](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-56.jpg)
Muscle Imbalances in Upper Crossed Syndrome ● Tight-short muscles ● Weak-long muscles ● Suboccipitals ● Mid to lower trapezius ● Pectorals ● Serratus anterior ● Anterior shoulder ● Upper trapezius
![Lower Crossed Syndrome ● Affects the lumbar spine and pelvis. ● Anterior pelvis and Lower Crossed Syndrome ● Affects the lumbar spine and pelvis. ● Anterior pelvis and](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-57.jpg)
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.
![Lower Crossed Syndrome Lower Crossed Syndrome](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-58.jpg)
Lower Crossed Syndrome
![Imbalances in the Following Pairs of Muscles: ● Weak gluteus maximus and short hip Imbalances in the Following Pairs of Muscles: ● Weak gluteus maximus and short hip](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-59.jpg)
Imbalances in the Following Pairs of Muscles: ● Weak gluteus maximus and short hip flexors. ● Weak abdominals and short lumbar erector spinae. ● Weak gluteus medius and short TFL and QL.
![Postural Signs of Lower Crossed Syndrome ● Postural finding ● Dysfunction ● Lumbar hyperlordosis Postural Signs of Lower Crossed Syndrome ● Postural finding ● Dysfunction ● Lumbar hyperlordosis](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-60.jpg)
Postural Signs of Lower Crossed Syndrome ● Postural finding ● Dysfunction ● Lumbar hyperlordosis ● Shortened erector spinae ● Anterior pelvic tilt ● Weak gluteus maximus ● Protruding abdomen ● Weak abdominals ● Foot turned out ● Shortened piriformis ● Hypertrophy of ● Hypermobile thoracolumbar junction ● Groove in iliotibial band lumbosacral junction ● Shortened tensor fascia latae
![Upper and Lower Crossed Syndrome Upper and Lower Crossed Syndrome](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-61.jpg)
Upper and Lower Crossed Syndrome
![Layered Syndrome ● Layered syndrome is a combination of the muscle imbalances seen in Layered Syndrome ● Layered syndrome is a combination of the muscle imbalances seen in](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-62.jpg)
Layered Syndrome ● Layered syndrome is a combination of the muscle imbalances seen in both upper and lower crossed syndrome. ● It develops with chronic cases.
![Layered Syndrome Layered Syndrome](http://slidetodoc.com/presentation_image_h/d1fc247d14ac978234e6e232e1f6b54c/image-63.jpg)
Layered Syndrome
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