Postural Assessment (Mia)
Postural Assessment (Mia)
Postural Assessment (Mia)
Dysfunction Syndrome
Ideal static postural alignment (posterior view)
Shortened soft tissue have reduced elasticity
o Shoulders level, head in midline Pain at end-range when shortened tissues are
Sprengel’s deformity (scapula tensed
did not descend) Pain is never felt on movement and is not
Scapular winging referred
Derangement Syndrome Base of Support (BOS)
Misalignment of IV disc materials/bony Area on which an object rests and that provides
alignment support for the object
Symptoms are affected by movement BOS = stability
May be referred and often are constant
Development of Posture
Importance of Good posture
o Primary curve
Protects the joints and other structures from
Spine concave anteriorly at birth
injury
Persists throughout life, but only in
Promotes good muscle balance and flexibility
specific areas (thoracic and sacral spine)
Kyphosis Allows greater precision and endurance in
o Secondary Curve performing a task
Present at 3 months (when child learns Allows for adequate respiration
to lift his head) Improves general appearance and uplifts
Cervical spine convexity emotional well-being of a person
Lordosis
Dangers of Poor Posture
Important so that the
child may observe his Predisposes the soft tissues and the spinal
surroundings structures and even the organ system to injury
6-8 months (when child learns to sit and May block food and air
walk; keeping trunk upright)
Lumbar spine convexity
Lordosis
Principles of Proper Posture
This frees the hand of the child
for manipulation Stand with your body erect so your shoulders
o Old age and Spinal Curvatures and hips are level; avoid slouch or “round back”
As one ages, the curvatures go back to positions
the ones in an infant (returns to C Sit with knees and hips flexed to 90° with your
curved shape or kyphosis) feet flat with the floor/stool. Your knees should
Due to disc degeneration, ligamentous be same levels as your hips with pelvis rolled
calcification, vertebral wedging, forward
osteoporosis Arms should be supported; either relaxed on
the thigh or at arm rests
Use a lumbar roll during prolonged sitting
Avoid standing/sitting in one position for a
Center of Gravity (COG) prolonged period of time
Stand with your ankles, knees, hips and
Imaginary point in the body where all the force shoulders aligned; keep your head over your
acting upon it are balanced body
Changes as the body moves (inside or outside
the body)
Adults: 1 inch anterior to S2
Infants: Xiphoid processes
Walking Lower Crossed Syndrome
Always stand erect
Face the direction of movement
always
Use a heel to toe gait pattern
(absorbing excessive force)
Walk with your normal stride
Conditions/Clinical notes
Step deformity
dislocation of Acromioclavicular joint;
sticking out of clavicle
Sulcus sign
anglulation o the end of shoulder, excessive
pull of gravity (common in patients with
stroke)
Carrying angle
Cubitus Varus – elbow near body Extension Abdominals Erector spinae
Cubitus Valgus – elbow out
Squinting Patellae
Both patella are directed to each other
Grasshopper eye
Both patella are directed outside flexionHip flexors (Iliopsoas) Glutes, Hamstrings
Patella Alta
Patella that rides higher than the other *when one is tight, the other one is weak
Patella Baja
Patella that rides lower than the other
Genu Varum Upper Crossed Syndrome
*ask patient to have their feet together
Present with space in between knees
(<2 fingers is significant)
Genu Valgum
*ask patient to have their feet together
Knees stick together before the feet do
In-toeing (Pigeon’s toe)
Caused by rotation of tibia; squinting of
patella (cause of hip probs) will cause
this
Flatfoot (Pes Cavus)
Flexible – upon lifting foot, an arch will
appear
Rigid – upon lifting foot, there is no arch
Malalignments viewed Anteriorly
8-15°
Lateral Pelvic Tilt (pelvic drop – Right hip adduction Right lumbar lateral flexion
right leg stance) Weak right abductors (positive Tight left adductors
Trendelenburg’s)
Lateral pelvic tilt (pelvic hitch – Right hip abduction Left lumbar lateral flexion
right leg stance) Weak left adductors Tight right abductors
Forward rotation of 1 ilium on Right hip medial rotation Left lumbar rotation
sacrum (right leg stance) Medial-facing patella Scoliosis – concavity to left
In toeing Knee flexion
Pronation of foot
Long leg
Anterior Pelvic tilt Hip flexion (tight hip flexors) Lumbar extension (increased Lordosis)
Hyperextended knees
Poking chin (cervical extension)
Rounded shoulders (protracted scapula)
Thoracic kyphosis
Ankles plantar flexed
Posterior pelvic tilt Hip extension Lumbar flexion (flat back)
Hips extended
Knees extended
Forward head posture
Backward rotation of one ilium Right hip lateral rotation Right lumbar rotation
on sacrum (right leg stance) Lateral facing patella Scoliosis – concavitiy to right
Out-toeing Knee extension
Supination of foot
Short leg
Genu Recurvatum Ankle plantar flexion Posterior pelvic tilt
Excessive anterior pelvic tilt Flexed trunk posture
Excessive thoracic kyphosis
MCT2017