What is posture?

- the position of the body at a given HI JHULIA

point I time (starkey) HEHEHEHEHEHEHEHEHEHEHEHEHEHEE
- a set of muscle contractions that place HHEH
the body in the necessary location from which a E0w BHOsZx jhUsm1Nh3
movement is performed (Enoka)
- The situation or disposition of the “stand as comfortably as you can”
several parts of the body with respect to each - mid fingers on top of each acromion
other for a particular purpose - iliac crest kung pantay
- shoulder kung pantay
> Birth
Entire spine concave forward (flexed) EXAMPLE : TOTAL SPINAL
“Primary curves” POSTURE
Thoracic spine > IDEAL
Sacrum 1. Head sits straight on shoulders
- nose in line c/ manubrium, xhiphoid,
> Developmental (usually around 3 umbilicus
mos) - earlobes in line with acromion process
Secondary curves 2. Shoulders and clavicles level are
Cervical spine equal
Lumbar spine 3. Normal appearance of shoulders
>Primary- kyphosis 4. Arms equidistant from trunk
>Secondary: Lordosis 5. Normal spinal curves
6. Illiac crest
INTRODUCTION 7. ASIS sit lower than PSIS
- Curves in the spine 8. Gluteal folds and knee joints are even
> primary - kyphosis 9. Patellae point forward
> secondary - lordosis 10. No Genu conditions note
old age? 11. Heads of fibula and all malleoli
level
-Center of gravity 12. Achilles tendons and heels appear to
be straight
> adult – slightly anterior to s2 and
child – t12 13. Evident arches

PHYSIOLOGIC EVOLUTION OF CAUSES OF POOR POSTURE

LOWER LIMB ALIGNMENT >Postural factors
-Genu varum – di siya pike (palabas - poor postural habit
yung tuhod) - muscle imbalance
> knees are pointed towards the lateral - pain
side or outside - respiratory conditions
Genu valgum – the knees are pointed at - general weakness
each other - excess weight
> legs straighten - loose/loss/ ANU 2 JHAS HAHAHAH
> 2-6 months? Ewan q of proprioception
- muscle spasm
FACTORS AFFECTING POSTURE
-Bony contours Structural Factors
-Laxity of ligamentous -Leg and length discrepancy
-Pelvic angle -Hemivertebra
-Muscle tone -Bony deformities

>pelvic angle – 30 deg BAD POSTURE

knees should not be hyper extended
 “Any position that deviates from good TYPES:
posture” 1. Round back – long rounded curve
- Static: standing, sitting sleeping with decreased pelvic invlination and
- Dynamic : Running, throwing,etc thoracolumbar kyphosis, trunk flexed forward
and a dereased lumbar curve
CAUSES OF POOR POSTURE 2. Gibbus- humpback that has a
> positional factors localized sharp posterior angulation of the
- appearance of increased height (social thoracic spine
stigma) 3. Flat back – decreased pelvic
- muscle imbalance inclination to 20 degrees and a mobile lumbar
- pain spine
- respiratory 4. Dowager’s hump – hump that you
see in older women, largely due to osteoporosis.
>structural factors
- trauma Causes:
- disease - Tuberculosis sa spine (pats disease?)
- developmental problems - Tumors
- “not typically easily manage” - Ankylosing spondylitis
- Scheuermann’s disease
COMMON SPINAL DEVIATIONS - Vertebral compression fracture

1. foot and ankle SCOLIOSIS

- hyperpronation - lateral deviation of the spine for more
- supination than 10 degrees
2. knee 1. nonstructural scoliosis – no bony
- gene recurvatum deformity and is not progressive, scoliotic curve
- genu valgum will disappear on forward flexion.
- genu varum 2. structural scoliosis – patient lacks
normal flexibility and side bending becomes
COMMON SPINAL DEFORMITIES asymmetric, may be progressive.

1. Lordosis levo (check spelling) scoliosis – left

- excessive anterior cervical spine dextro (check spelling) scoliosis – right
Causes: (Dextro thoraco (check din hehe), levo
- Postural deformity lumbar scoliosis) – mas mataas yung right
shoulder
- Lax muscles (esp. abs)
(Levo thoraco check spelling hehe),
- Heavy abdomen
dextro lumbar scoliosis) – mas mataas yung left
- Compensatory mechanisms
shoulder
- Hip flexion contracture
- Spondylolisthesis
KYPHOSIS
- Congential problems
- lordosis posture
- Fashion (high heels)
> Head - forward
> Lordosis - greater than 30 deg of pelvic angle
Cervical spine - hyperextended
Scapulae - abducted
2. Kyphosis
Thoracic spine - increased flexion
- excessive posterior curvature of the
Lumbar spine increased
spine that usually happens in your - - thoracic
vertebra Pelvis - anterior tilt
- round back Hip joints - flexed
- humback Knee joints - slightly extended
- flatback Ankle joints -slight plantar flexion
- dowager’s hump
> Sway back posture
 Cervical spine - slightly extended 2. Result of long term seated posture
Thoracic spine - increased flexion with 3. Rolled in and forward shoulders
posterior displacement of upper trunk 4. Increased thoracic kyphosis
Lumbar spine - flattening of lumbar 5. Forward head posture
area 6. Loss of cervical lordosis
Pelvis posterior- tilt
Hip joints - hyperexi, anterior disp of POSTURAL SIGNS OF UPPER
pelvis CROSSED
Knee joints - hyperextended Postural finding
Rounded shoulders
> Military type posture Forward drawn head
Head neutral position C0-c1 hyperextension
Cervical spine normal curve - slightly Winging of scapula
anterioir Elevation of shoulders
Thoracic spine normal curve - slightly Dysfunction
posterior Shortened pectorals
Lumbar spine - hyperextended Kypphotic t-spine
Pelvis Short subocciptals
Weak serratus anterior
> Flat back Shortened upper trap, levator, scapulae,
Head - forward weak lower and middle trap
Cervical spine - slightly extended Tight pectorals
thoracic spine upper part increased
flexion MUSCLE IMBALANCES OF UPPER
lumbar - flex CROSSED
pelvis posterioir - tilt Tight short muscles
Hip joints - extended Suboccipitals
knee joints - extended Pectorals
ankle joint - slight plantar flexion Anterior shoulder

COMMONLY SEEN POSTURAL LOWER CROSSED SYNDROME

DEVIATIONS Affects the lumbar spine and pelvis
> Shoulder/scapula Anterior pelvis and increased lumbar
Winging (open book winging) seratous lordosis
anterior weakness Tightness in the psoas and lumbar
erector spinae
> Head and C-Spine Long erm sitting contributes to this
Weakness of rhomboids and middle syndrome as well
trapezius
IMBALANCES IN THE
SIDE VIEW: FOLLOWING PAIRS OF MUSCLES
- Earlobe should be in line with the - Weak gluteus maximus and short hip
acromion flexors
- Note each curve on spine - Weak abdominals and short lumbar
Chest: erector spinae
>pectus carinatum
>pectus excavatum LAYERED SYNDROME
- pelvic angle is normal 30 degrees Combination of the muscle imbalances
- knees should be straight and not flex, seen in both upper and lower crossed syndrome
no recurvatum Develops with chronic cases.

Upper crossed syndrome: HIPS means:

1. Affects the head, neck and shoulders History, Inspection, palpation, special?
 Relevant History
Identifies factors that influence posture
- Overuse
- Neurological problems
- Pain
- Lack of awareness

INSPECTION
Use of lumb line

Body type
- Ectomorph
- Mesomorph
- Endomorph

Functional Tests
- Slump test
- Romberg
- Tandem walking

MUSCLE PALAPTION
- Palpation hypertonic (overused)
muscles.
- palpate for weak /inhibited muscles

POSTURAL AND PHASIC

MUSCLES (PICTURE)
KYPHOSIS (WITH FORWARD
HEAD AND ROUNDED SHOULDERS
(PICTURE)
LORDOSIS TABLE (PICTURE)
FLAT BACK (PICTURE)
SWAY BACK (PICTURE)