Posture

and Postural Assessment

Fitness & Lifestyle Assessment I

Guest Lecturer: Sarah Floyd RMT

Who Am I as a
Healthcare Provider?
Registered Massage Therapist (RMT) with the
College of Massage Therapists of Ontario (CMTO)
since October 2010.
Graduated from the Canadian College of Massage
and Hydrotherapy (CCMH) in June 2010.
RMT at Thornhill Rehabilitation and Chiropractic
Centre (TRCC)
http://thornhillrcc.com/
Reflexology Practitioner & Kinesio Tape
Practitioner

Who am I as a
student?
I attend the University of Guelph-Humber, fourth year Kinesiology
student
I opted for the research option in KIN3190 in Occupational Health,
and I am working as a research assistant for a biomechanics study at
Humber
I am the Co-Chair of the Guelph-Humber chapter for the CON-SNP
I played for UofGs womens Ultimate team

What is the first thing that comes to

mind when I say posture?

POSTURE

Postural Assessment Demo 1

Posture: Definition

Position of a body at any given time

A position of the body or of body

parts

Intentionally assumed position

Proper Posture:

Faulty Posture:

Any position that

____________ the
stress upon a joint

Any position that

_____________ the stress
upon a joint

True or False?
Posture simply refers to when a person is in a SEATED or STANDING
position?

FALSE!
!!
What ultimately needs to be considered when
observing posture?

POSITON
DEPENDENT

Positional Posture
Positions to consider :
Standing/sitting
Lying/Recumbent
(prone/supine)
Kneeling
Crouching
Ducking
Sleeping

Leaning
Resting
Recovery
Squatting
Working

(ergonomics)

Unusual Positions:
Standing on 1 leg
Headstand
Bridge
(gymnastics)
Head stand
Crab Position
Hanging
Upside Down

Factors that Affect Posture

Aging Process
Gravity
Genetics
Gender
Weight Distribution**
(pregnancy)
Pathology/Injury
Muscular Imbalance
Occupational
Recreational

Environmental (cold posture)

Balance
Proprioception
Emotional
Social
Muscular Weakness
Muscular Endurance
Muscular Strength/Power
Sociocultural
Technology **

Postural Assessment
Postural Analysis:
Detecting
deviations from
ideal posture
Static Posture: the
individual is not
moving while they
are being
assessed
ex. standing

Dynamic Posture:
the individual is
moving while they
are being assessed
ex. gait

Pre-Assessment
Questions to ask prior to the postural assessment:
1. Occupation
2. Describe manifestations of pathology (sign vs.
symptom)
3. Previous injuries
4. Congenital Abnormalities
5. Dominant hand
6. Activity history

Static Postural Analysis: Plumb Lines

Plumb Line: a plummet (weight) is attached to a string to assess the vertical reference of
an object

Used since Ancient Egyptian era

Performed by
viewing the bodys
plumb line from:
anterior, posterior
and lateral
perspectives

Remember,
As the persons position changes
the plumb lines remains the same.
The deviation about the plumb line
is relevant in postural analysis

Plumb Line Analysis: Posterior View

Considerations:
Bilateral
symmetry?
- left to right
- rotation
Head position
Scapula
- acromion, spine
of the scapula,
superior angle,
medial border,
inferior angle
Elbow (space)
Waist
PSIS
Gluteal fold
Greater trochanter
Popliteal Fossa
Calf muscle bulk
Achilles
Feet
- Too many toes?

Plumb Line Analysis Anterior

View
Considerations:
Bilateral
symmetry?
- left to right
- rotation
Head position
UFT bulk
Clavicle
Acromion
Waist
Elbows (space)
ASIS
Greater trochanter
Patella
Adductor Tubercle
Medial calf bulk
Knee alignment
(valgus/varus
stress)
Head of fibula
Ipsilateral lower

Plumb Line Analysis: Lateral View

Considerations:
Head position
Cervical spine
- anterior head
carriage
Acromion
- forward rounding
Thoracic spine
- kyphosis
Lumbar spine
- lordosis
PSIS vs. ASIS
-anterior pelvic tilt
-posterior pelvic tilt
Greater trochanter
Knee
- hyperextension
Ankle
Body position:
rotation
- visibility of

Clinical Application: Ankylosing

Spondylitis
-- Progressive inflammatory
condition whereby inflammation
becomes bone tissue
-- Fusion of the vertebral column
and peri-articular tissues in a
cephalad direction, starting with
the sacroiliac joints
- autoimmune
- affects men > female
- progression is case-dependent
- early symptomology: low back
pain

* progression may lead to deformitiesparticularly at the thoracic cage

Aside: What type of doctor would be required to treat

someone with AS?
http://

Clinical Application: Ankylosing

Spondylitis
How can a Kinesiologist help a patient that
has AS?
PREVENTIO
N

How could you help prevent this poor

resultant posture?

Importance of Posture Assessment in

Ankylosing Spondylitis: Preliminary
Study
n = 68 screened
from 95
3 Groups (preAS):
Kyphosis
Decreased chest
expansion

Scoliosis

Kyphoscoliosis

Lowest functional score

Decreased chest
expansion
Most Pain

**_______________ develops first and then an

_______________
Why might that
Study Conclusions: be?

Initial or on-going postural assessments will reveal tendencies toward

antalgic or inadequate posture
Rehabilitation to correct possible misalignment and prevent respiratory
complications
Rosu,

What complications could result from

poor posture?
Low Back
Pathology

Osteoarthr
itis

Potential
Complications
Thoracic
Outlet
Syndrom
e

Degenerati
ve Disc
Disease
Scoliosis

Supraspin
atus
Impingeme
nt

Clinical Application: Scoliosis

Scoliotic curves are named based on: 1) direction of the

______________
2) region within the spine
What muscular tightness might you expect to find?
Long and tight VS. Short and tight

Scoliosis: Etiology and Type

Causes:
- Posture
- Anatomical structure
- Muscle spasm
ex. leg length
discrepancy,
- Balance
wedge vertebra
- Vision
- Hearing
- Hormones
- Genetics
- Psychology
- Idiopathic

Functional /
Nonstructural

Typ
e

Asymmetri
c Loading

Structur
al
Hawes,

Scoliosis:
Assessment

Forward Bend
https://www.youtube.com/watch?
Test
v=1EPii3Pz6V0
Follow Up
1. What is the Forward Bend Test used to determine?
2. The hump on the ribcage represents the ____________ side of
the curve

Categories of Muscles
Categorize muscles based on their distinct functions
and properties

POSTURAL
- MUSCLES
Maintain upright
posture

PHASIC
- Propel the body
MUSCLES

during movement

Greater capacity to
do work

- Quick bursts of
energy

Slow to fatigue

- Fatigue Quickly

Tend to become
SCM
hyperactive and
Pectoralis
Major
short
Iliopsoas
Rectus Femoris
UFT
Erector Spinae
Soleus/gastrocmeni
us

- Tend to become
inhibited (weak) and
Deltoids
long
Triceps
LFT
Abdominals
Gluteals
Tibialis Anterior

Categories of Muscles Continued

ERRO
R

Is Asymmetrical
Loading Always Bad?
Asymmetrical loading is inherently detrimental to tissue
loading and can lead to dysfunction

Can you imagine a scenario where

asymmetrical loading would be
beneficial?
VS.

Ergonomics
OFFICE
ERGONOMICS

Ergon =
Work

(Greek Derivation)

Nomoi = Natural
Laws

AKA Human Factors (The International Ergonomics Association & Association of

Canadian Ergonomists)

Efficiency and comfort

Interactions of humans with other elements of a system (e.g.the tools,

equipment, products, tasks, organization, technology, and environment)

Massage Therapy Ergonomics

Point on the Wall:
encouraging neutral spine
Engage
core
Neutral
wrist

Shoulders relaxed and

retracted
Engage the LFT
Penny: encouraging
posterior pelvic tilt
Lunge Position: Wide Leg
Stance

Consider knee
alignment

I can use mild,

moderate or heavy
pressure as the
treatment indicates, but
how do I generate such

Massage Therapy Ergonomics

Continued

Practice
Come up with three tips you could provide a new client
regarding improving posture:
1)
2)
3)

Postural Assessment Demo 2

Postural Assessment Demo 3

Thank you!