Lecture 16 Flashcards
Posture
alignment of the body parts whether upright, sitting, or lying down
described by the position of the joints/body segments
should be examined in all positions
Good posture
protects the supporting structures of the body against injury. muscle function at their most efficient level
Poor posture
faulty relationship of the various parts of the body
produces increased strain on the supporting structures
less efficient balance of body over BOS
mechanical stress
may be a primary cause of pain
may contribute to recurrences of a painful condition
may be associated w/failure of condition to heal
pain syndromes related to impaired posture
repetitive posture deviation
pain from mechanical stress when faulty posture is maintained for prolonged posture
adaptive shortening of soft tissues and muscle weakness
Structural deformity
present even at rest
ex: fracture
Functional deformity
result of a particular posture and disappears when posture is changed
ex: scoliosis due to short leg
Dynamic deformity
caused by muscle action
ex: valgus movement at knee b/c of weak hip abduction
Line of gravity passes through these anatomic structures
external auditory meatus
bodies of lumbar vertebrae
slightly posterior to center of hip joint
sacral promontory
slightly anterior to center of knee joint
calcaneocuboid joint
Surface landmarks of line of gravity
ear lobe
midway btwn the front and the back of chest
midway thru back and abdomen
through greater trochanter
slightly anterior to midline through knee
slightly anterior to lateral malleolus
Inferior angle scapular dysfunction
inferior medial border is prominent at rest
results from anterior tipping of scapula in sagittal plane
rotator cuff impingement
medial border scapular dysfunction
entire medial border is posteriorly displaced from thoracic wall
occurs from internal rotation of scapula in transverse plane
GHJ instability
Spine curvatures
Cervical = lordosis
Thoracic = kyphosis
Lumbar = lordosis
Sacral = kyphosis
Anterior tilt of pelvis
increased lordosis
Posterior tilt of pelvis
decreased lordosis
Lumbar Lordotic Curve
more weight anteriorly
pulls wall forward
exaggerated lumbar curve
Valgus deformity
normal angle between tibia and femur in frontal plane is 170-175
<165 = genu valgum. knock knee
Varus deformity
normal angle between tibia and femur in frontal plane is 170-175
>180 = genu varum, bow legged
Genu recurvatum
more common in athletes
normal tibia to femur angle in sagittal plane is 180
>180 = recurvatum
Pes Planus
ankle swoops outwards
Pes Cavus
ankle swoops inwards
Lordotic Posture
increases in lumbosacral angle, lumbar lordosis, anterior pelvic tilt
usually have increased thoracic kyphosis and forward head
Slouched posture
entire pelvic segment is shifted forward
throacic segment is posterior resulting in flexion of thorax on lumbar spine
increased LOWER lumbar lordosis
head forward
hanging on Y ligaments
Flat low back posture
decreased lumbosacral angle
decreased lumbar lordosis
posterior tilt of pelvis
head forward
UPPER thoracic spine flexed
Contributions to deviations in posture
ROM
muscle length
joint integrity
muscle performance
environmental factors
pain
psychological factors
neurological factors
motor control
Lateral view landmarks
<1/3 head of humerus protrudes ant to acromion
prox/distal humerus in line vertically
inferior angle of scapula is flat against thorax
scapula is 30° ant to frontal plane
Ant/posterior view landmarks
antecubital crease faces ant, olecranon faces post
palms faces body
vertebral border of scapula is parallel to spine, 3in from spine
spine of scap at T3
vertebral border of scap is against thorax
Adam’s forward bend test
shoulders asymmetrical
prominent shoulder blade
visible curve
hips asymmetrical
waist asymmetrical
upper or lower back hump
Suboccipital release
decrease muscle tension in preparation for training of the deep neck flexors
forearms at rest
posterior skull rests on thenar eminences
finger tips at C2 level
gentle distraction
hold position for 3-4 minutes
Deep neck flexor activation
activate and control muscles that control cervical retraction/axial extension
requires capital flexion, slight flattening of cervical lordosis
nodding YES motion
chin to throat
use towel under occiput for forward head posture to avoid extension
minimize sternocleidomastoid contraction
Posture correction Cues C-Spine/Thoracic
Shoulder rolls
Head retraction
Head retraction
draw chin and ears backwards to bring head over neck
keep jaw level, don’t tip head backwards
Shoulder rolls
with arms relaxed, lift shoulders up/back/down
put shoulder blades in back pockets
Lumbar spine correction, sitting
don’t have back on chair
slump onto tailbone, rock forward
find midpoints between extremes
proprioceptive feedback
Lumbar spine correction, standing
stand with back against wall, heals close to wall
find a midpoint between back touching wall/and low back at a curve
haptic input
