05-11: Posture

Question 1

Why assess posture?

Answer 1

Postural faults can provide information about muscle balance with regard to muscle length and muscle strength

Question 2

Purpose of curves of the spine

Answer 2

• Decreases risk of injury

- Absorbs shock

Question 3

Neutral Pelvis Alignment

Answer 3

ASIS 8-10˚ higher than PSIS in transverse plane

Question 4

Posterior Pelvic Tilt Alignment

Answer 4

ASIS higher than PSIS

Question 5

Anterior Pelvic Tilt Alignment

Answer 5

ASIS lower than PSIS

Question 6

Static posture

Answer 6

• Not moving

- Standing, sitting, lying down

Question 7

Dynamic posture

Answer 7

• Moving

- Postural Sway

Question 8

Tools to assess posture (2)

Answer 8

• Plumb line

- Postural grid

Question 9

Anterior Assessment: Normal

Answer 9

• Head: Level and neutral
• Shoulders: Even, no elevation/depression
• Sternum: Plumb line through center
• Hips: ASIS even
• Legs: Normal BOS, feet shoulder width apart
• Knees: No genu valgum (knock knee) genu varus (bow leg)
• Ankles: Arches are normal
• Feet: Toeing out

Question 10

Anterior Assessment: Abnormal

Answer 10

• Head: Tilting, rotation, uneven mandibles
• Shoulders: Elevation/depression
• Pelvis: Uneven ASIS, uneven iliac crests
• Hips: IR/ER, uneven greater trochanters
• Knees: Ext/Int tibial torsion, malaligned patella
• Ankles: Pes Planus (flat feet), Pes Cavus (high arch)
• Toes: Hallux valgus (great toe adducts), claw toe, hammer toe (flex of PIP), mallet toes (flex of DIP)

Question 11

Posterior Assessment: Normal

Answer 11

• Head: Level and neutral
• Shoulders: Even, no elevation/depression
• SPs: Centered down the middle
• Hips: PSIS even
• Legs: Normal BOS, feet shoulder width apart
• Knees: No genu valgum or genu varus
• Ankles: Straight calcanei

Question 12

Posterior Assessment: Abnormal

Answer 12

• Head: Tilt, rotation
• Shoulders: Elevation/depression
• Scapula: Protraction/ABD, Retraction/ADD, winging
• Thoracic: Scoliosis
• Lumbar: Lateral curvature
• Knees: genu valgum or genu varus
• Ankles: Pes planus, pes cavus

Question 13

Lateral Assessment: Normal

Answer 13

• Head: Center of ear lobe (EAM)
• Shoulders: Acromion process
• Thoracic: Slightly anterior to vertebral bodies
• Lumbar: Bisect vertebral bodies
• Pelvis: Middle of iliac crest
• Hips: Through greater trochanter
• Knees: slightly posterior to patella of extended knee (anterior to midline of knee)
• Ankles: Slightly anterior to lateral malleolus

Question 14

Lateral Assessment: Abnormal

Answer 14

• Head: FHP
• Cervical: Decreased/flattened curve; increased curve
• Shoulders: Rounded
• Thoracic: Kyphosis
• Lumbar: Decreased (posterior tilt) or increased curve (anterior tilt)
• Pelvis: Anterior tilt, posterior tilt
• Knees: flexed, genu recurvatum (excessive extension)
• Ankles: Longitudinal arch flattened/exaggerated

Question 15

Kyphosis-Lordosis Posture

Answer 15

• Thoracic kyphosis, lumbar lordosis
• Scapula protracted
• Increase in lumbar lordosis, anterior pelvic tilt
• Hip flexion, knee hyperextension, plantar flexion
• Shortened: One-jt hip flexors, neck extensors, low back muscles
• Typical with vertebral compression fx

Question 16

Sway back

Answer 16

• Forward head, exaggerated upper cervical ext/lower cervical flex
• Elongated thoracic spine, posterior displaced from plumb line
• Lumbar spine has increased lordosis, anterior pelvic tilt
• Elongation/weakness: Hamstrings, cervical flexors, upper back ext, ext oblique, one-jt hip flexors
• Shortened/strong: internal obliques, low back extensors

Question 17

MIlitary posture

Answer 17

• Decrease in cervical lordosis
• Chest out, shoulders pulled back, decreased thoracic spine curve
• Increased lumbar lordosis, anterior pelvic tilt, hips glex, knee ext exaggeration (lock)
• Elongated/weak: Chest
• Shortened/strong: Upper back

Question 18

Scoliosis

Answer 18

• Lateral curvature
• “C” curve (not compensated) or “S”curve (compensated, curves twice to correct vertical slant)
• Caused by: muscle shortening on one side, compression fx on one side, leg length descrepancy, structural changes in ribs