Understanding Posture: Assessment and Deviations

Abnormal Posture

Positioning that deviates from the midrange position of function.

Good Posture

The optimal alignment of the patient's body that allows the neuromuscular system to perform actions requiring the least amount of energy to achieve the desired effect.

Ideal Posture (Saggital)

Postural alignment where the LOG passes through specific anatomical points from ear lobe to anterior to the lateral malleolus, resulting in minimal stress on joints and muscle activity.

Reliability

Consistency between yourself and others in postural assessment.

Validity

Testing what you say you are testing in postural assessment.

Asymmetry of Alignment

Should be documented in postural assessment, challenging when unsure of the abnormal position.

Sagittal Plane Deviations - Ankle

Dorsiflexed/plantarflexed deviations.

Sagittal Plane Deviations - Knee

Flexion/extension deviations.

Sagittal Plane Deviations - Pelvis

Posterior pelvic tilt/anterior pelvic tilt deviations.

Sagittal Plane Deviations - Lumbar Spine

Excessive lordosis/flatback posture deviations.

Sagittal Plane Deviations - Thoracic Spine

Excessive kyphosis/flatback posture deviations.

Sagittal Plane Deviations - Cervical Spine

Flexion/extension deviations, including forward head posture.

Frontal Plane Deviations Posterior View - Ankle

Rearfoot varus/rearfoot valgus and forefoot abduction deviations.

Frontal Plane Deviations Posterior View - Femur

Medial rotation/lateral rotation and abducted/adducted deviations.

Frontal Plane Deviations Posterior View - Pelvis

PSIS or iliac crest not level deviations.

Frontal Plane Deviations Posterior View - Lumbar Spine

Sidebent or rotated deviations.

Frontal Plane Deviations Posterior View - Thoracic Spine

Sidebent or rotated deviations.

Frontal Plane Deviations Posterior View - Cervical Spine

Sidebent or rotated deviations.

Frontal Plane Deviations Posterior View - Shoulder

Scapular position, arm position, and head deviations.

Frontal Plane Deviations Anterior View - Ankle

Pronated/supinated midfoot and forefoot abduction deviations.

Frontal Plane Deviations Anterior View - Femur

Medial rotation/lateral rotation and abducted/adducted deviations.

Frontal Plane Deviations Anterior View - Pelvis

PSIS or iliac crest not level deviations.

Frontal Plane Deviations Anterior View - Lumbar Spine

Sidebent or rotated deviations.

Frontal Plane Deviations Anterior View - Thoracic Spine

Sidebent or rotated deviations.

Frontal Plane Deviations Anterior View - Cervical Spine

Sidebent or rotated deviations.

Frontal Plane Deviations Anterior View - Shoulders

Upper trap and muscular appearance, clavicular position, and head deviations.

Clinical Reasoning

Abnormal postures lead to abnormal stresses on the musculoskeletal system, guiding testing of muscle groups for potential issues.