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what is ideal posture?
ideal alignment, balance between length and strengt
energy efficient
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where does the line of gravity pass thru and what type of rotation does it cause?
head
passes thru external auditory meatus
produces flexion
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where does the line of gravity pass thru and what type of rotation does it cause?
neck
passes thru the cervical bodies
produces flexion
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where does the line of gravity pass thru and what type of rotation does it cause?
shoulder
bissects tip of acromion
no rotational influence
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where does the line of gravity pass thru and what type of rotation does it cause?
trunk
midway thru trunk
causes flexion (thoracic)
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where does the line of gravity pass thru and what type of rotation does it cause?
hip
thru greater trochanter
causes extension
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where does the line of gravity pass thru and what type of rotation does it cause?
knee
slightly anterior to midline of patella
hyperextend
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where does the line of gravity pass thru and what type of rotation does it cause?
ankle/foot
slightly anterior to lateral malleolus
causes dorsiflexion
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what are the normal curves of the spine?
cervical, thoracic, lumbar
cervical (lordosis)
thoracic (kyphosis)
lumbar (lordosis)
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what is ideal pelvic alignment?
iliac crests even
ASIS horizontal line within 15d lower than PSIS
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ASIS in relation to PSIS
more than 15d =
less than 15d =
more than 15d anterior pelvic tilt (hip flex)
less than 15d posterior pelvic tilt (hip ext)
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what does bad or faulty posture do to the body?
creates increased stress on joints
can lead to pain or disability
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what are some possible causes of faulty posture?
repeated movements (ADLs, work recreation)
sustained postures (prolonged sitting, biking long distances)
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what is genu varum?
MR of femur
hyperextension of knees
pronation of foot
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what is genu valgum?
LR of femurs
hyperextension of knees
supination of foot
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how does R handed posture present?
Right shoulder lower
Right hip higher
Left foot more pronated
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in Right handed posture which muscles are short/strong?
- R lateral trunk muscle
- L hip abductors
- R hip adductors
- L fib longus/brevis
- R tib posterior
- R flexor hallucis longus
- R flexor digitorum longus
- L TFL
- R inverters
- L everters
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in Right handed posture which muscles are long/weak?
- L lateral trunk muscles
- R hip abductors
- L hip adductors
- R fib longus/brevis
- L tib posterior
- L flexor hallucis longus
- L flexor digitorum longus
- R everters
- L inverters
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how does kyphosis/lordosis posture present?
forward head
kyphosis/lordosis
anterior pelvic tilt
hips flexed
knees hyperext
ankle PF
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what muscles are long in kyphosis/lordosis posture? short?
long- neck flex, upper back erector spinae, external oblique, hamstrings (long but not weak)
short-neck extensors, hip flexors, lower erector spinae strong
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how does lordosis posture present?
anterior pelvic tilt
high and marked lordosis
anterior deviation from plumb line
anterior pelvic tilt/lordosis
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what muscles are short in lordosis posture? long?
short-low back extensors, hip flexors
long-anterior abs, hamstrings (may not be weak)
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how does sway back posture present?
forward head
long kyphosis
flat lumbar
posterior pelvic tilt
hip hyperext
knee hyperext
ankle neutral secondary to anterior deviation of pelvis/thighs
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what muscles are long in sway back posture? short?
long-1 jt hip flexors, external oblique, upper back extensors, neck flexors
short-internal oblique, hamstrings, low back muscles are strong
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how does flat back posture present?
forward head
flexion of thoracic region
posterior pelvic tilt
hip extension
knee hyperext
ankle slight PF
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what muscles are long in flat back posture? short?
long-1 jt hip flexors
short-hamstrings, abs
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patient presents with weak middle and lower trap and short pec and lat during exam.
what postural deviation might you see?
forward shoulders
possible thoracic kyphosis
scapula may be winged or abducted
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patient presents with weak neck flexors and short upper traps and neck extensors on exam
what postural deviation might you see?
forward head with cervical hyperextension
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patient presents with weak external obliques and iliopsoas and short upper abs and hamstrings on exam
what postural deviation might you see?
posterior pelvic tilt
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what are common muscle group that develop stretch weakness?
- neck flexors
- middle and lower traps
- upper erector spinae
- lower abs
- post glute med
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what type of postural deviation is seen with weak abs, short ilipsoas, and short back extensors?
lordosis
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what type of postural deviation is seen with weak glute med on the left and weak hip adductors on the right? short lateral trunk flexors on the L and short hip adductors on the L?
L hip high, pelvic tilt
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what type of postural deviation do you see when:
weak on right: fib longus/brevis, extensor hallucis longus, extensor digitorum longus
strong on right: tibialis posterior, flexor hallucis longus, flexor digitorum longus
supinated foot on right
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describe muscle imbalances you may see with postural genu varus
weak: LR of hip, popliteus, tib post, flexor digitorum longus, flexor hallucis longus
short: MR of hip, quads, fib longus/brevis
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what muscle imbalances might you see with right thoracic, left lumbar scoliotic curve?
weak: right upper erector, left lower erector
short: left upper erector, right lower erector
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what muscle imbalances might you see with structural genu valgus
long: medial knee joint structures (adductors, sartorius)
short: lateral knee joint structures (TFL-ITB, glute max)
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what muscle imbalances might you see with forward shoulders with thoracic kyphosis with scapular winging of the inferior angle of the scapula?
weak: middle and lower trap, upper erector spinae
strong: pec major/minor, lats possibly the serratus
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