Postural Deviations

Lecture X
Dr. Amaal Hassan Mohammed Ebrahim

Definition of Poor posture

Poor posture is a faulty relationship
of the various parts of the body which
produce increased strain on the
supporting structures and in which
there is less efficient balance of the
body over its base of support

What is postural deviation?

It means you are not using proper
body mechanics. it means that your
posture is poor.
Can happen with either an increase
or decrease of the normal body
curves, leading to:
1. Uneven pressure within joint
surface
2. Ligament strain
3. Increase muscle work
4. May cause pain

Poor body mechanics may cause:

Serious injury to back/neck
Postural deviations
Chronic neck/low back pain
Increased wear on joint tissues

Factors Influencing Posture

Neurologic issues
Muscle weakness
Hypermobile joints
Hypomobile joints
Bony abnormalities
Leg length
Spinal column

Poor Posture
Poor posture may result in:
Headaches
neck/back pain
Forward head

Poor Posture
Poor posture may result in:

sunken chest
Protruding abdomen
Strain on muscles in the
neck, back, abdomen, and
legs

Poor Posture
Poor posture may result
in:
Protruding abdomen
Strain on muscles in the
neck, back, abdomen,
and legs

Clinical Evaluation of Posture

Where to Start?
Draw a plumb line down vertical axis
History
Inspection/observation
Anatomical assessment
Functional tests

Views to Evaluate
Lateral
Deviations in the A/P aspect

Anterior/posterior
Deviations in the saggital plane

Foot Deviations
Pes planus
(flat feet) causes
increased
abduction of the
forefoot and
valgus deviation of
the hind-foot,
thereby increasing
tension on the
tibial nerve

Pes planus
(Flat feet)

Hallux Valgus
Hallux Valgus is
a common
deformity that
can affect
anyone. It is
the deviation of
the big toe
towards the 2nd
toe.

Bunion deformity
what are bunions?
Outwardly, is the painful
bony "bump" that
"grows" out of the foot
at the base of the big
toe. In addition, the
deformities associated
with bunions is
deviation of the big toe
towards the 2nd

Hammer toe
A hammer toe is a
deformity of the
proximal
interphalangeal
joint of the second,
third, or fourth toe
causing it to be
permanently bent,
resembling a
hammer.

The Knee
Genu Recurvatum hyperextension
Genu Valgum knock-kneed
Excessive Q-angle

Genu Varum bow legged

Genu Recurvatum

Poor Posture, 10 Year Old Child

Genu Valgum knock-kneed

Genu valgum,
commonly called
"knock-knees", is a
condition where the
knees angle in and
touch one another
when the legs are
straightened.

Genu Varum bow legged

Genu varum (also called
bow-leggedness or
bandiness), is a
deformity marked by
medial angulation of
the leg in relation to the
thigh, an outward
bowing of the legs,
giving the appearance
of a bow.

The Spine
Lordosis extension
Kyphosis flexion
Scoliosis lateral curvature

Kyphosis
Kyphosis is usually
associated with an
increase curve of the
thoracic spine. Along
with this, a slightly
posterior pelvic tilt is
seen along with a
reduced lumber curve
and a forward head
position. The client will
show a hunched over
posture with a
depressed chest.

Lordosis
We speak of Lordosis
when there is an
increased curve in the
lumbar spine of lower
back. Often there is also
an increased pelvic tilt.
The client will show a
posture in which the
stomach and head are
pushed forward.

Military type
Although this posture
is not one of the four
main types of postural
alignment, the Military
type posture can
occasionally be
observed.
It is characterised by
an increased curve in
the lumbar spine of
lower back and an
anterior pelvic tilt.
The client shows a
posture in which the
chest is pushed
forward.

The Spine
Hyperlordotic
Lumbar lordosis with normal thoracic and
cervical spines
Excessive anterior tilt

Kypholordotic
Lumbar lordosis with increased thoracic kyphosis
Excessive anterior tilt

Scoliosis
Scoliosis a condition in
which the spine is
curved from side to
side, shaped like an "s"
and may also be
rotated.
The spine curves away
from the middle or
sideways.

Diagnosis?

The Spine
Swayback

Hypermobility of joints
Genu recurvatum
Posterior pelvic tilt
Thoracic kyphosis

Flat Back

Posterior pelvic tilt

Decreased lumbar lordosis
Decreased thoracic kyphosis
Extended upper cervical spine

The Spine
Scoliosis - Lateral curves
Functional Scoliosis
Muscular imbalance
Leg length discrepency

Structural Scoliosis
Defect or congenital bony anomaly in vertebral
column

Upper Extremity
Forward Shoulder
Rounded shoulders
(excessive
protraction)
Tight anterior
shoulder
musculature
Excessive curvature
in cervical/thoracic

Upper Extremity
Forward Head
Flexion of lower/mid cervical spine
Extension of upper cervical spine

The Role of Physical Therapy

Early detection of postural errors.
Education of good posture and bad
posture.
Reduce of abnormal tension and pain
Increase strength and mobility
Enhance of neuromuscular control
Increase self motivation and confidence.
Reduce fatigue.