WHAT IS IDEAL POSTURE AND WHAT IS FAULTY POSTURE
If a person has an ideal posture or correct posture it will produce minimum stress
on the joints so that means we can say any posture that increases stress on the
joints is faulty posture
for example if a person is sitting in a slouched position for
long period of time then his back will start aching because slouch Position will increase the
stress on joints so if the person will sustain this position for long period of time his back will
start aching so this is not at all an ideal posture ,if the muscles are weak or tight or joints are
stiff then that person cannot able to correct exposure and that's why it leads to pathologies
like lordosis kyphosis and scoliosis
In postural assessment we identify such pathologies and we treat them later
with the help of stretching exercises if muscles are tight or with strengthening
exercises if muscles are weak
we can assess posture in standing position with front, lateral and posterior views
The anterior view
• In this the midline divides the body
into two equal halves
the head should be straight on the
shoulders in the midline and you can
check this by looking at the tip of the nose
it should be always in the line
with the manubrium sternum note if there
is any kind of lateral flexion of neck or
rotation because it can be a sign of
tightness in sternocleidomastoid which is
present in torticollis
• The shoulders should be at equal
level but one thing that you need to
remember is it is normal to have the
dominant hand to be slightly lower than
the other note if there is any depression in
the Contour of the deltoid as it can be a
sign of subluxation of the glenohumeral
joint note if there is any abnormal
elevation of the shoulder joint or abnormal
depression of the shoulder joint from
anterior view you can also check if patient
has rounded shoulders if patient will have rounded shoulder then the humerus will
be internally rotated and that's why you can see more posterior or dorsals aspect of
the hand, in normal posture the Palms are facing towards the body but when a
person will have rounded shoulder then we see more dorsal surface of the hand
• The chest should be in midline note if there is any kind of lateral flexion or
rotation of the chest
• At elbow level you have to note the carrying angle the
normal carrying angle in males is 5 degree and in female it is 10 to 15
degrees note if there is any cubitis valgus in which this angle increases or
cubitus varus in which this angle decreases note hand and wrist if there
is any appearance of deformity which is present in rheumatoid arthritis
• For abdomen observe the umbilicus it should be in the midline along with the
sternum now for pelvis you have to palpate the Asis and they both should be
at the same level note if there is any lateral flexion or if there is any
rotation of the pelvis the knees should be straight observe if there is any genu
valgum or if there is any genu varum at the knee
• The patella should face forward if patella is laterally rotated it might be
there is lateral rotation of femur or tibia if patella is medially rotated it
might be there is medial rotation of femur or medial rotation of tibia both
medial malleolus will be at same level and both lateral malleolus will be at
same level note if there is any pes planus in which the medial Arch will touch the
floor and note if there is pes cavus in which the medial Arch will be more
than the normal note other deformities of foot like Hammer foot
THE LATERAL VIEW
• In lateral view first observe the head
position the earlobe should be in line with the
tip of the shoulder that is acromion process
in faulty posture note if there is any forward
head posture in forward head posture the ear
lobes will be not in the line with the
shoulder
• check the shoulders in normal posture
the shoulder will be in line with the ears but in
faulty postures check if there is any
protraction of the shoulders that will cause
internal rotation of the arm if there is
excessive retraction of shoulders then that is
also a faulty posture
• lateral view provides great
opportunity to check the curves of the spine
check the thoracic curve which is normal
kyphotic curve in faulty posture this curve can
be
increased seen in exaggerated kyphotic postures or this curve can be decreased in
flat backs
• In normal healthy person the abdomen should be flat note if there is
any protrusion in the abdomen lateral view provides a good opportunity to check
the lumbar lordosis in normal person the spine at lumbar level will have lordosis
but in faulty posture
this lumbar lordosis can be increased or decreased seen in flat backs
• check knees in normal posture the knees are either straight or zero to
five degrees flexed
• check if there is genu recurvatum in which there is hyper
extension of the knees or if the fixed flexion deformity
POSTURAL ASSESSMENT IN POSTERIOR VIEW
• In posterior view first is head position so it should be in the midline with the body
and you can ensure this by checking the earlobe level so the earlobe should be at the
same level and if there is any deviation in the head position then the ear lobes will
be not at same level and if there is any faulty rotation of the neck you can see one
side of the face more than the other
• The shoulders should be at the same level note if there is any abnormal elevation of
one side of the shoulder or abnormal depression
it is normal to have
a slightly depressed shoulder of dominant
handscapular level- the inferior angle of the
scapula should be at same level and you can
ensure this by palpating the inferior angle and if
it is hard to palpate then ask the patient to grab
their both hands and then it becomes prominent
and you can easily palpate the inferior angle of
scapula
• check thorax whether it is straight or if
there is any lateral deviation present because it
can be a sign of scoliosis and you can check it by
palpating the spinous process
• check the arms whether it is
equidistance from the body and note if there is
any rotation present in the limbs
• In normal posture both the PSIS should
be at same level you can palpate the dimples to
ensure that the PSIS are at the same level but in case in faulty posture if it is not at
the same level then it can indicate that person has
limb length discrepancy
• knees should be at same level in correct posture note if there is any genu valgum
or genuvarum present at the knees
• Both Achilles tendon should be straight in correct posture but if you see any
angle it can be a sign of pes planus
• In correct posture both the medial malleolus is superior and both the lateral
malleolus are inferior but if there is any variation in the position of the malleolus
then it can be a sign of pes palnus and pes cavus
