Posture Flashcards
The plumb line test should:
(6 points)
- bisect the ear
- bisect the shoulder joint
- runs down the bodies of the lumbar vertebrae
- bisects the greater trochanter of the femur
- runs just behind the centre of the knee
- runs just in front of the centre of the ankle
The point of reference is at the base, hence aligned to a point just anterior to the lateral malleoluls
Ideal plumb alignment of upper back
Side: slight curve
Back: equidistant of scapulae from the vertebral column
Ideal plumb alignment of shoulder
Side: midway through the shoulder
Back: scapulae flat against upper back, approx T2 to T7 level
Ideal plumb alignment of pelvis & lower back
Side: Pelvis in neutral position, normal low back curvature; midway of trunk
Back: bilateral; PSIS are level
Ideal plumb alignment of hips & knees
Side: Slight posterior to hip joint (through greater trochanter) & slight anterior to knee joint.
Back: level gluteal folds
Ideal plumb alignment of ankles & feet
Side: slight anterior too lateral malleolus & apex of arch (calcaneocuboid joint)
Back: heels equidistant apart
What are the factors affecting posture (9 points)?
- Structural/anatomical
- Age
- Physiological
- Pathological
- Occupational
- Recreational
- Environmental
- Social & Culture
- Emotional
What are some examples of how structural/anatomical factors affect posture?
- Scoliosis
- Discrepancy in long bones length (upper/lower limbs)
- extra ribs
- extra vertebrae
- increased elastin in tissues (decrease rigidity of ligaments)
How does pathological factors affect posture?
- Illnesses/disease (e.g. osteomalacia may show up as genu varum)
- Pain
- Mal-alignment in healing of fractures
- conditions that inc/dec muscle tone
How does recreational, environmental, social & cultural factors affect posture?
Recreational:
difference b/w someone who plays regular racket sports vs committed cyclist
Environmental:
E.g. when people cold, develop diff postures
Social & cultural:
E.g. growing up sitting cross legged diff postures
What is the ‘ideal’ segmental alignment?
Head:
Cervical:
Scapulae:
Thoracic spine:
Lumbar spine:
Pelvis:
Hip joints:
Knee joints:
Ankle joints:
Head: Neutral position, X tilted forward/back
Cervical: Normal curve, slightly convex anteriorly
Scapulae: Flat against upper back
Thoracic spine: Normal curve, slightly convex posteriorly (cervical thoracic lordosis)
Lumbar spine: Normal curve, slightly convex anteriorly (lumbar spine lordosis)
Pelvis: Neutral position, ASISes in the same vertical plane as symphysis pubis
Hip joints: Neutral position, neither flexed nor extended
Knee joints: Neutral position, neither flexed nor hyper extended
Ankle joints: Neutral position (plantigrade), leg vertical & at right angle to sole of foot
What is kyphotic-lordotic posture? (Side view)
Head:
Cervical:
Scapulae:
Thoracic spine:
Lumbar spine:
Pelvis:
Hip joints:
Knee joints:
Ankle joints:
Head: Forward
Cervical: Hyperextended (inc. in cervical lordosis)
Scapulae: Abducted
Thoracic spine: Kyphotic (concave - inc. flexion)
Lumbar spine: Lordosis (hyperextended)
Pelvis: Anteriorly tilted
Hip joints: Flexed
Knee joints: Slightly hyperextended
Ankle joints: Slight plantarflexion (bc. of backward inclination of the leg - if knee hyperextend, usually plantarflexion
Which muscles are weak in kyphotic-lordotic posture?
Abs
Hamstring
Glutes
These are all being stretched
Which muscles are tight in kyphotic-lordotic posture?
Quads
Lowerback
What is lordotic posture? (Side view)
Head:
Cervical:
Scapulae:
Thoracic spine:
Lumbar spine:
Pelvis:
Hip joints:
Knee joints:
Ankle joints:
Head: Neutral position
Cervical: Normal curve (slight anterior)
Scapulae:
Thoracic spine: Normal curve (slight posterior)
Lumbar spine: Lordosis (hyperextended)
Pelvis: Anteriorly tilted
Hip joints: Flexed
Knee joints: Slightly hyperextended
Ankle joints: Slight plantarflexion
Which muscles tend to be weak in lordotic posture?
Abs
Hamstrings
Glutes?
Which muscles tend to be tight in lordotic posture?
Quads
Lower back
What is flat-back posture? (Side view)
Head:
Cervical:
Scapulae:
Thoracic spine:
Lumbar spine:
Pelvis:
Hip joints:
Knee joints:
Ankle joints:
Head: Forward
Cervical: Slightly extended
Scapulae:
Thoracic spine: Upper part - increased flexion; Lower part - straight
Lumbar spine: Flexion (straight)
Pelvis: Posteriorly tilted
Hip joints: Extended
Knee joints: Extended
Ankle joints: Slight platarflexion
Which muscles tend to be weak in flat-back posture?
Lower back (lumbar region)
Hip flexors
Which muscles tend to be tight in flat-back posture?
Abs (maybe)
Hamstring
What is sway-back posture? (Side view)
Head:
Cervical:
Scapulae:
Thoracic spine:
Lumbar spine:
Pelvis:
Hip joints:
Knee joints:
Ankle joints:
Head: Forward
Cervical: Slightly extended
Scapulae:
Thoracic spine: Increased flexion (long kyphosis) with posterior displacement of the upper trunk
Lumbar spine: Flexion (flattening) of the lower lumbar area
Pelvis: Posteriorly tilted (compensate the flexion of lumbar spine)
Hip joints: Hyperextended with anterior displacement of the pelvis
Knee joints: Hyperextended
Ankle joints: Neutral
Which muscles tend to be weak in sway-back posture?
Abs
Quads
Which muscles tend to be tight in sway-back posture?
Hamstrings
How to tell if someone has an anterior pelvic tilt?
PSIS is higher than ASIS
PSIS: posterior superior iliac spine
ASIS: Anterior superior iliac spine
