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Spinal Exam
 
 

Assessing Posture

 
 
 
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Overview

  • How to Assess

  • Inspect the patient's posture while they are standing, sitting and squatting. Inspect from laterally, anteriorly and posteriorly.
  • Look For

    The relationship between the positions of the head, trunk, upper and lower limbs.
  • Head & neck - tilt and rotation
  • Shoulders - level of shoulders, scapular prominence
  • Chest - deformities
  • Spine - kyphosis, lordosis and scoliosis
  • Pelvis - pelvic tilt
  • Legs - angle between thigh and leg (genu valgum / varum)
  • Feet - position, pronation
  • Causes of Poor Posture

  • Structural - deformities of the spine, foot and ankle
  • Leg Length discrepancy
  • Poor foot posture
  • Muscular imbalance - habitual poor body position

Centre of Gravity

  • Look For

  • The line that falls from the earlobe down through the chest, abdomen, pelvis and lower limb (line of gravity).
  • Significance

  • Optimal posture involves the balanced distribution of body mass around the centre of gravity, with minimal muscular energy use. Any deviation from this results in instability, weakness and pain.

Extra Credit

  • Shoulder Cross Syndrome

  • Elevation of shoulders - tight upper shoulder girdle fixators / weak lower shoulder girdle fixators
  • Protraction of shoulders -  tight shoulder girdle protractors / weak shoulder girdle retractors
  • Head forward + cervical lordosis - tight neck extensors / weak deep neck flexors
  • Pelvic Cross Syndrome

  • Increased lumbar lordosis - tight hip flexors / weak hip extensors
  • Protuberant abdomen - tight lumbar extensors / weak lumbar flexors
  • AP pelvic tilt - tight tensor fascia lata / weak hip abductors
  • Lateral pelvic tilt - tight quadratus lumborum
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