posture Flashcards
what is posture?
-position or alignment of body parts
what is a bipedal stance?
locomotion by which a person moves on their 2 legs
what are the 2 types of posture?
-static
-dynamic
describe static posture
-how you hold yourself when you are not moving eg sitting, standing or sleeping
-the body segments are aligned and maintained in fixed positions
where is the COG in a static posture?
-COG is within the base of support
describe dynamic posture
-how you hold yourself when you are moving eg walking, running , throwing , lifting etc
what is the spine like in a newborn?
-spine is flexed, forming a long C curve posteriorly
what develops in the spine of a child when head control and standing is achieved?
-head control causes the counter curve cervical spine
-‘secondary curvatures’
-standing - second counter curve in the lumbar spine
what are the curves of the spine?
-cervical - convex forward - ‘lordosis’
-thoracic - convex posteriorly - ‘kyphosis’
- lumbar - convex forward - ‘lordosis’
-sacral - convex posteriorly
what is the good / ideal posture?
-body’s alignment is balanced so that stress applied to the body segments is minimal
-shouldn’t take much energy / effort at all
-posture should be painless
what is poor posture?
bodys alignment is out of balance causing exaggerated stress to various body segments
describe a balanced upright posture in terms of muscle activity in the head and trunk
-head - anterior atlanto - occipital joint - a little bit of flexion, so the posterior cervical muscles contract to hold it
-trunk - curves are balanced
describe balanced posture in an upright position in the hip
-hip -posterior movement
-iliposoas will contract to bring forward a bit
-iliofemoral ligaments provide stability
-if there is anterior movement - the hip extensors contract
describe the movements of the knee joint in balanced upright posture
– knee in extension
-stability from ACL
-no muscle support required
what muscle provides stability to the ankle joint in a balanced upright posture?
the soleus muscle
what would analysis of posture in a standing position involve?
-subject must be barefoot
-looking at three dimensions - anterior, posterior and lateral
-compare alignment of body parts with an imaginary vertical line
-using the posterior check lkist
what are you looking at in an anterior view / assessment of posture?
-head alignment
-shoulders
-pelvis
-ASIS
-feet
-patellae
-2 sides of the body must be symmetrical
-little or no muscle activity is required
what would you be looking at in a postural assessment of a patient from a lateral view?
-head alignment
-shoulders
-thoracic spine
-lumbar spine
-pelvis
-hip position
-knee position
what should you be looking for during a postural assessment of a patient from a posterior view?
-head alignment
-acromion processes
-looking at the thoracic spine
-looking at the lumbar spine
-looking at the iliac crests
-looking at the sacro-iliac joint - dimples
-looking at the knee creases
-feet - pronation ? etc
what is the ideal sitting position?
-feet flat on ground
-hips & knees 90 degrees flexed
-arms should be able to rest on arm rest / table etc
-sitting on ischial tuberosities
why would you need to assess someone lying down?
-if someones sleep is affected - seeing how they lie down
-neurological patients
-people who are bed bound
-someone post surgery
what would you be looking out for during analysis of posture in a lying position?
- -comfort & relaxation
-neutral alignment of head and spine
-does the body adapt to the surface ie do they relax on it?
what factors can affect posture?
- genetic / hereditary - gender, body type, congenital defects etc
- environmental -the matters, bed , chair , footwear, occupation etc
- physiological - age , growth, pregnancy, auditory / visual function
- disease - eg MSK, neurological , vestibular diseases
at what age do arches in the feet develop?
until approx 6 years of age
what is a swayback posture?
-forward head
-increase in posterior tilt of the pelvis & the trunk (thoracic kyphosis)
-hamstrings are shortened and tight and iliopsoas are lengthened
what is a kypholordotic posture?
-rounded part of upper back
-increase in lumbar lordosis
-increase in thoracic kyphosis
-knees hyperextended
what is a flatback posture?
-lumbar spine is flat
-decrease in thoracic kyphosis
-flat upper back
what is scoliosis?
lateral curvature of the spine
what are the 2 types if scoliosis?
-idiopathic - 80%- cannot be straightened on bending forwards
-postural - disappears on bending forwards
how are scoliosis curves named?
named by the direction of the convexity and in location
what can be seen in posture with relation to the knees?
-genu valgum
-genu varum
what does valgus mean?
-lateral deviation in the frontal plane - eversion or abduction
- angling knees of knees towards each other
what does varum mean?
-medial deviation in the frontal place - inversion or adduction
-bowling of the knees outwards
what is pes planus?
-referred to as ‘flat feet’
-loss of the medial longitudinal arch of the foot
-weight bearing on navicular bone
what is pes cavus?
-a foot with abnormally high plantar longitudinal arch
-people who have this condition may place too much weight on the ball or heel of the foot when walking
what is hammer toe?
-curled due to a bend in the middle joint of the toe.
-may be caused by shoes that dont fit the foot well
what are the implications of poor posture?
-changes in 1 segment will cause changes in others
-changes in normal alignment - increase force per unit area
-muscles could be in an elongated , shortened , weakened
-ligaments - elongated, more lax etc
what are the effects of incorrect posture?
-increased tension of soft tissue which may lead to pain
-prolonged low grade stretch
-compression
-increased chance of injury
what are the general management guidelines of managing posture for physios?
-making the patient aware of their incorrect posture in a gentle way
-relief of pain
-stretching programme for weak structures
-increase ROM
-education
-increased strength and muscle balance
