Common Postural Deformities - Class 7 Flashcards
many people have
less ideal posture
not all posture deviations
cause pathology
what must clinicians be able to identify
normal posture
asymptomatic deviations
postural deviations possibly causing soft tissue dysfxn and pain
what must we keep in mind when evaluating posture
any potential muscle imbalances can either cause the poor posture or be a result of the poor posture
postural deviations could also be the result of
skeletal malalignment
anomalies
combination
common postural deformities
foot and ankle
knee
spinal column
scoliosis
shoulder and scapula
head and cervical spine
foot and ankle
pronated foot
supinated foot
pronated foot
characteristic of excessively pronated subtalar and midtarsal joints
a pronated foot is characterized by
ADD and PF of the talus
eversion of the calcaneus
when WBing
supinated foot is characterized by
ABD and DF of the talus
inversion of calcaneus
what else is seen with a supinated foot
higher medial longitudinal arch
the knee
genu recurvatum
genu valgum
genu varum
genu recurvatum
person has greater than 5 degrees of knee hyperextension
how does one with genu recurvatum often stand
with knees locked in an extreme extended position
genu recurvatum could be caused by
congenital
pathology (combined tear of ACL & PCL)
genu valgum
excessive median angulating of the knee
someone with genu valgum’s knees are
visibly closer together
how could we determine if someone has excessive genu valgum
objectively measuring a person’s Q angle
why does genu valgus occur
b/c of structural abnormalities at the hip
contributing weakness at the hip
secondary to hyperpronation of the feet
genu varum
lateral angulation at the knees
knees are further apart
why does genu varum occur
b/c of structural anomalies at the hip
excessive supination of the foot
spinal column
hyperlordotic curve
kypholordotic posture
swayback posture
flatback posture
hyperlordotic curve
increase in the lumbar lordosis
w/o compensation in the thoracic or cervical spines
what may be acquired w/ hyperlordotic curve
increased lordosis secondary to adaptive shortening of hip flexors
adaptive shortening of hip flexors
rotating the ilia anteriorly
pulling the lumbar spine anteriorly
what may be present in a hyperlordotic curve
large anterior abdominal mass
large anterior abdominal mass –> including
pregnancy
obesity
poor posture awareness
ligamentous laxity
muscle weakness
these may increase lumbar lordosis as well
kypholordotic posture
pt has increased lumbar lordosis
there is also a compensatory increase in thoracic kyphosis
cervical lordosis increases
compensatory increase in thoracic kyphosis –> kypholordotic
attempt to maintain the spine in a position of equilibrium
cervical lordosis increases –> kypholordotic
forward head posture
to compensate for other areas
with kypholordotic posture
adaptive changes in muscle length can be observed throughout the trunk
swayback posture
increased lumbar lordosis and thoracic kyphosis
causes hips to extend
what does swayback position create
position of instability
position of instability –> swayback
b/c spinal column relies on ligaments rather than muscles for support
what is swayback posture associated w/
ectomorph
lax ligamentous mesomorph body types
in swayback position
joints are usually at the ends of their ranges
–> placing excessive strain on the surrounding ligamentous structures
flatback posture
loss of the normal “S” shaped curve of the spine in the sagittal plane
what happens to the spine in flatback posture
thoracic and lumbar curves are decreased
spine is relatively straight
what is flatback posture associated w/
forward head
posterior pelvic tilt
forward head –> flatback
occurs to counteract the posterior displacement of the thoracic and lumbar spines
scoliosis
another deck
shoulder and scapula
forward shoulder posture
scapula winging
forward shoulder posture
protraction and elevation of the scap
forward rounded posture of the shoulders
what may forward shoulder posture involve
scapular winging
internal humeral rotation
what does forward shoulder posture occur w/
forward head posture
common causes of forward shoulder posture
poor postural sense
adaptively shortened anterior chest muscles (esp pec minor)
associated elongation of the posterior interscapular muscles
abnormal cervical and thoracic spine sagittal plane curvatures
abnormal cervical and thoracic spine sagittal plane curvatures –> forward shoulder
alter position of the scap
scapular winging
medial border projects posteriorly
how can scapular winging occur
b/c of weakness of the periscapular muscles
secondary to trauma to the long thoracic nerve
weakness of the periscapular muscles –> scap winging
serratus anterior
middle and lower traps
when is scap winging most apparent
overhead movements
head and cervical spine
forward head posture
forward head posture
anterior displacement of the head relative to the thorax
forward head posture is a
very common postural deviation
what is forward head posture characterized by
external auditory meatus aligning anterior to the acromion process
forward head posture results in
flexion of the lower c-spine
flattening or flexion of the mid cervical spine
extension of the upper cervical spine
