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
What is the ideal alignment for posture? (Posterior view, aka back view)
Head:
Cervical:
Scapulae:
Thoracic spine:
Lumbar spine:
Pelvis:
Hip joints:
Knee joints:
Ankle joints:
Head: Neutral, X tilted/rotated
Cervical: Slight lateral flexion
Shoulders: level, X elevated/depressed
Scapulae: Neutral, medial borders parallel
Thoracic spine: Straight
Lumbar spine: Straight
Pelvis: Level, both PSISes in same horizontal plane
Hip joints: Neutral, X abducted/adducted
Lower extremities: Straight; X bowed/knocked
Feet: Parallel; X pronated/supinated
Look at posterior view - Faulty alignment 1 & 2
Posture Slides, slide 30
Have you looked at it???
What will be weak and what will be tight in posteriorly tilted pelvis?
Weak quads
Weak anterior hip flexors
Weak erector spinae
Tight hamstrings
Tight abs (maybe)
What will be weak and what will be tight in anteriorly tilted pelvis?
Weak hamstrings
Weak abs
Tight Quads
Tight erector spinae
Tight anterior hip flexors
