analyse of posture Flashcards
posture
refers to the bodys alignment with respect to the force of gravity. gravity exerts a downwards force no matter of position- affecting equilibrium. normal posture is a position of minimal stress
physics
gravity- an invisible force pulling on object towards earth centre. COG- a hypothetical point around which the force of gravity acts. BOS= the area that bears weight. line of gravity- an imaginable vertical line from the COG to the supporting service- changes in relation to position of body parts
COG and balance
COG moves when a person moves. in women COG lower in pelvic
normal alignment
good alignment in any position of body entails distributing the force of gravity so no structures are under undue stress
why do you want good alignment
muscles have normal tone, balance between opposing muscle groups, normal spinal curves, normal girdle position, no strain to support body- comfort and efficiency
the line of gravity
just behind the coronal suture, through odontoid process of axis, through ear lobe, through shoulder joint, through bodies of lumbar vertebra, through GT, just anterior to knee midline, just anterior to lateral malleolus
muscle activity in maintaining balance in standing
posterior cervical muscles contract to jeep head from falling forwards. global and core muscles maintain the balance of spinal curves. in relaxed standing the illiofemoral lig provides stability at hip. stability at knee, from ACL and tension in gastric and hamstrings, knee fully extended- no muscle action, soleus keeps the tibia from rotating forward
postural stability of spine
muscles of the neck and trunk are important stabilisers of the spine. global- effect more than 1 vertebra. core- sit deeper than global, act oversell areas, 1/2 motion segments at a time, contract to compress to provide stability
global muscles- lumbar
rectus abdominius, external and internal oblique, quadratus lumborum, erector spine, illiopsoas
global muscles- cervical
sternocleidomastoid, scalene, levator scapulae, upper trap, erector spinae
core muscles- lumbar and cervical
lumbar- transverse abdominius, multifidus, QL, deep rotators, cervical- rectus capitis anterior and laterals, longus coli.
maintenance of posture
anatomical approximation e.g. closed pack joint position, general muscle tone maintains position, when postures are dynamic/ or COG is moving then some muscle activity will increase- tension to task, there is always a balance between passive systems (anatomy), active systems (muscle) and the neural control needed
pelvic alignment- neural position
the ASIS are in same transverse plane, ASIS and pubic symphysis is in the same vertical plane, when the ASIS is lower than PSIS- anterior tilt, opposite- posterior tilt
faulty postures
sway back, lumbar lordosis, thoracic kyphosis, forward head
swayback posture
increased lordosis in lower lumbar reigion, increased kyphosis in thoracic reigion a protracted head. caused by gravity, fatigue or muscle weakness. lack of flexibility in upper abdominal , hip extensor or lower lumbar extensor muscles. weak lower abdominal, lower thoracic extensors and hip flexors muscles
swayback position
head- forward, neck- slightly extended, scapula- winged, chest/thorax- kyphotic (increased flex), lower back- flattened, pelvis- posterior tilt, hip- extended knee hyper extended
lengthened and weak- hip flexors, external oblique, upper back extensors, neck flexors
short and tight- hamstrings, internal oblique, low back muscles (ES and QL)
lordotic posture
in lumbar reigion- increase in lumbosacral angle, increase in lumbar lordosis, increase in anterior pelvic tilt and hip flexion. caused by weak abdominal muscles/ pregnancy/ obesity, lack of flexibility in hip flexor and lumbar extensor, weak hip extensors
lordotic posture position
head- forward, neck- increased curve, scapula- retracted, thoracic- increased kyphotic, lower back- hyperextended (lordosis), hips- flexed, pelvis- hyperextended, feet- slight PF
short and tight- neck extensors, hip flexors, lower back
lengthened and weak- neck flexors, upper back, ES, hamstrings, possibly abs
flat low back posture (flat back)
decreased lumbar lordosis, hip extension, posterior pelvic tilt, caused by slouching flexing in sitting postures, lack of flexibility in trunk flexors and hip extensors, weak lumbar extensors and hip flexors
flat low back position
head- forward position, neck- slightly extended, chest- flattened, pelvic- posterior pelvic tilt, hips- positioned forward and extended, knees- hyper extended,
lengthened and weak- ilipsoas, ES, QL
short and tight- hamstrings, abdominal
round back with forward head (kyph-lordotic)
in thoracic and cervical reigion- increased thoracic kyophosis, protracted scapulae and head, caused by gravity, poor occupation or functional prolonged postures, lack of flexibility in muscle cervical spine and head that attach to scapula and upper thorax, sub occipital muscles,
round back with forward head position
head- forward, neck- increased curve, scapula- abducted, thorax- increased kyphosis, lower back- hyperextended (lordosis), hips- flexed, pelvis forward (anterior pelvic tilt), knee- slightly hyperextended, feet- slight PF
short and tight- neck extensors, hip flexors, lower back
lengthened and weak- neck flexors, upper back, ES, hamstrings, possibly abdominals
military posture
flat upper back and neck, decrease in thoracic curve, depressed shoulder girdle, decreases cervical lordosis, retracted head, lordotic posture lumbar reigion ant pelvic tilt, caused by exaggeration of military posture. lack of flexibility in anterior neck/ thoracic extensors and scapula retractor muscles and hip flexors/ lumbar extensors, weak scapular protractor muscles- weak abs and hip extensors
military posture position
head- neutral position, neck- normal curve/ slightly forward, scapula- forward tilt, chest/thorax- normal curve/ slightly back, lower back- lordosis/ increased curve, pelvis- ant tilt, knee- slightly hyperextended, feet- slightly turned out
lengthened and weak- abdominals and hamstrings
short and tight- low back and hip flexors
spinal abdominals
normal, lordosis, kyphosis, scoliosis
scoliosis
thoracic and lumbar reigion only. S or C curve. asymmetry in pelvic and lower extremities. structural and non- structural (reversible). caused by neuromuscular disorder or disease (structural), leg length difference, muscle spasm (non-structural), lack of flexibility of muscles on concave side, weakness and stretch of muscle on convex side
effect of pelvic tilt on lumbar posture
pelvis tilts forward and pulls lumbar spine into lordosis (anterior pelvic tilt), pelvis tilt backward and pulls lumbar spine flat (posterior pelvic tilt)
forward shifted pelvis (swayback)- hip joint extended and pelvis shifts forward and is also tilted backward. knee hyperextended
familiar sitting postures- relaxed position
head balanced with COG just in front of A/O joint, weight supported upon ischial tuberosity, lumbar curve depends on angulation of the ilia and sacrum. COG behind ischia, flattened lumbar curve (Slouched). COG in front of ischia lumbar lordosis, more weight through feet
pelvic positioning in sitting
pressure in the IV discs increases in sitting C.F. standing and with the flattening of the lumbar curve.
ideal seated work posture
balanced seating- spine carries body weight most comfortably, back thigh angle 135° means lumbar curve retained and muscle relaxed. a seat the tilts forwards encourages the natural postures.
postural problems- clinical
wheelchair assessment to ensure optimal postures are maintained. could be padding, cushions, heights of feet rest. middle pic- windswept deformity- deformity in hips and knees, far right- developing scoliosis due to sitting posture
postures in lying
position of little energy use, normal alignment of the body still important as it limits stress on structures. consider sleeping positions of patients and positions of support for exercise and activity
postures in lying- supine
good postural alignment requires the normal cervical and lumbar lordosis be maintained. pillows of approbate sickness are essential. consider the surface on which the person is lying when evaluating curves
postures in lying- side lying
good posture requires that head, spine and pelvis be in normal alignment. pillows at head should not create side flexion of neck or thoracic spine. hips should be slightly flexed, and pelvis should not rotate lumbar spine or hip overly adduct. harder surface or too soft- affects alignment
postures in lying- prone lying
normally not a good posture. normal alignment of the cercial spine is impossible if head turned. pillows to prevent flattening of lumbar curve and stretch tibias anterior. supporting the neck in normal alignment for treatment purposes is challenging
