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30 Cards in this Set
- Front
- Back
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what is posture? |
Posture: relative arrangements of parts of the body Good Posture: State of muscular and skeletal balance that protects support the body against injury and progressive deformity irrespective of posture (e.g. lying, erect, squatting) in which these structures are working or resting. Bad Posture: faulty relationship of the various body position parts of the body, which increase strain on the supporting structures and in which there is less efficient balance of the over its base of support |
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what causes postural or movement impairments? |
Cumulative Micro-traumas Overuse Repetitive , submaximal stress that exceeds the tissues ability to adapt and repair Can occur over short or long period of time Repetitive Movements Movement repeated through ADL’s Faulty biomechanics or alignment |
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treatment |
Treatment should focus on: The correction of factors predisposing or contributing to the sustained faulty posture or movements When correction is not possible modification is indicated |
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Factors influencing Posture and Movement Impairments
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Physiological Impairments: Muscle and fascia length / extensibility Joint mobility Muscle strength and endurance Patterns of recruitment Timing and activation of muscles-Balance strategies-Pain Anatomical Impairments; Structural scoliosis Hip Anteversion Structural Limb Discrepancy Anthropometric Characteristics Psychological Impairments Development impairments i.e. age Environment inf luences Disease or Pathology |
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Why do a Postural Ax |
Acquire Information Save Time Establish Base Line Treat Holistically |
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Evaluating and Treating |
Need good understanding of basic principles related to alignment, joints and muscles Ax of joint positions indicates which muscles are elongated & which are shortened. Directed towards restoration & preservation of good body mechanics |
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what should our muscles be?
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Generally two types: Postural & Phasic want them to be strong and long |
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A good balanced balance between all postural and phasic muscles. |
Plumb Line through: Mid ear shoulder hips knees and finish A N T. To L AT. Malleolus |
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Military posture |
Shoulders pulled up and back Tight Lordosed Thoraco-lumbar spine Both postural and phasic muscles appear taut and tight Tight and shortened H/S and calves-Often tight hip f lexors |
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Flat back |
POST. Tilted pelvis-Abds variable sometimes tight sometimes weak-Wasted Buttocks Tight, short and usually weak h/s-Knees flexed due to tight H/S Tight calves-Weak Hip Flexors |
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sway back |
POST. Tilted pelvis but entire pelvis is ANT. Displaced Forward head lean-Long Kyphosis Lumbar spine may lack lordosis but does not Hip Hyperextended-Knees hyperextended |
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lordotic posture |
Pelvis ANT. Tilt-Weak Lower abds and EXT. obliques Tight back muscles (Extensors), tight H/F, Ilipsoas, quads and hip ABD-tight and weak H/S |
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kyphotic posture |
Forward head -Neck hyperextended-Inwardly curved chest -Increase Thoracic curve |
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lordotic-kyphotic posture |
Forward head lean-Cervical spine Lordosis -Thoracic Vertebra increased Flexion-Lumbar hyperextended -ANT. Tilt -Knees hyper EXT |
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Ideal Alignment anterior |
Centre of chin, nose and forehead Xiphiod Process Centre of umbilicus Centre of symphysis pubis Equal Distance between medial femoral condyles Equal distance between Medial Malleoli |
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ideal alignment posterior |
Centre of the head Centre of the Spineous process Cleff between buttocks Equal distance between medial aspect of aspects Equal distance medial malleoli |
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common postural abnormalities |
S and C shaped lumbar spine shoulders: Protract vs Retracted Elevation Vs Depression Scapular winging leg length discrepancy: True from ASIS to medial Malleolus -Apparent umbilicus to medial malleolus bow legged or knock knees patella baja (to far down) or patella alta (to far up) |
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foot variations |
can have high arch or flat arch achilles and ankles can roll out (pes valgus) or roll in (pes varas) |
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Variations of Foot presentation |
Claw toes (all toes) Hyperextension of MTP joints; flexion of PIP & DIPjoints Callus formation under heads of metatarsals Restrictive shoes, pes cavus, mm imbalances, age-related deficiencies Hammer toes (one/two toes) Hyperextension of MTP joint; flexion of PIP joint & hyperextension of DIP joint Calluses on superior surfaces of PIP jts & tips of distal phalanges |
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Scoliosis |
When a scoliosis develops the spine bends sideways and rotates along its vertical axis. These changes have cosmetic and physiological effects with long-term consequences which may result in significant health problems with severe curves. |
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Causes of scoliosis |
Congenital scoliosis. Caused by a bone abnormality present at birth. Neuromuscular scoliosis. A result of abnormal muscles or nerves. Frequently seen in people with Spina Bifida or cerebral palsy or in those with various conditions that are accompanied by, or result in, paralysis. Degenerative scoliosis.This may result from traumatic (from an injury or illness) bone collapse, previous major back surgery or osteoporosis. Idiopathic scoliosis. The most common type of scoliosis, idiopathic scoliosis, has no specific identifiable cause. There are many theories, but none have been found to be conclusive. There is, however, strong evidence that idiopathic scoliosis is inherited. |
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Treatment of Scoliosis |
Surgery for those who have curves beyond 40 -50° Braces for young children Electrical simulations Exercises Manipulations |
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how does posture affect muscle length? |
Prolonged posture alterations can result in muscle length changes. The time the muscles spends in the shortened range and the amount a muscle is contracted in the shortened range determines whether it becomes shortened. The stimulus for lengthening a muscle is the amount of tension placed on the muscle over a prolonged period of time. |
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Essential Muscle Length Tests |
LOWER QUADRANT medial & Lateral Hamstrings Gastroc & Soelous Te s t discriminate btwn TFL, RectFem & Illiopsoas *Thomas Test Medial and Lateral Rotators H/s Calf muscles TFL & Illliotibal band hip flexers hip rotaters |
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essential upper quadrant test |
UPPER QUADRANT Teres Major & Latissium dorsi Rhombiod Major, minor and Levator Scapular Pec Major and minor Shoulder Rotators – medial and lateral rotators |
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essential trunk test |
Abdominal muscles-RA- Internal and External Obliques- If possible TA |
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how is muscular strength affected ? |
it is the relationship btwn muscle strength & length that contribute to postural deviations. Stretch weakness Length – tension properties Strength in the shortened range |
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Other considerations |
MUSCLE ENDURANCE – fatigue affects movement, but endurance is often not a factor in perpetuating optimal resting alignment Length of muscles & peri-articualar structures support optimal alignment Little muscle activity is required to maintain a relaxed standing position JOINT MOBILITY normal limitations of joint motion in certain directions has postural significance to stability of the body particularly in standing. |
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General Treatment Strategies for postural dysfunctions |
Determine postural habits / Postural Dysfunctions Analyse common sporting / work place / repetitive postures Determine Shortened / Strong Structures Determine Weak / Lengthened structures Balance L vs R Balance Anterior vs Posterior |
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Impairments in joint mobility rarely happen in isolation |
AROM is usually affected by a combination of factors such as muscle length, muscle performance and joint mobility. In some case quality of movement is affected. |
