PostureMentoring Conference Call

DPTI 2014

Why?

• Structure governs function

• Most often the things that we do on a daily basis are what ends of being the cause of pain.

• Structural changes occur

• Postural Adaptation exist with length and strength

Examples: Upper and Lower Crossed Syndromes

Treat Cause Not just the Source of the Symptoms

• Source: Anatomical Structure

• Cause: contributing factors

Examples:

Rotator Cuff Tendonitis

Source: Impingement RTC Tendon

Cause: Tight Pectoralis, deceased scapular stability, flat t/s

Patellafemoral Pain

Source: Fat Pad Irritation

Cause: Hyperextension, inhibited quads, decreased gluteal strength

Posture tells you a story…

• The big picture…

• Helps guide your objective testing.

• Usually what sticks out the most is your biggest contributing factor.

• Example: HUGE paraspinals: compression on the spine

• Paraspinal tone needs to be addressed

• Step two: why are they so tonic? Abs weak? Hip flexors tight?

Static Posture Assessment

• Guide Your Objective Testing

• Objective Testing will Confirm Observations made in standing (or sitting)

Getting Started

• Use dominate eye in midline

• Compare symmetry and shadows

• Hypertrophy= rounded and convex

• Hypotrophy= flat, hollow and concave

• Standing vs. sitting

• Primary complaints

• Body region

• Occupation

• Shoes off

• Body region exposed

Dynamic Postural Assessment

• Subcortical function CNS

• Reactive muscle firing

• SLB

• Squat SL Squat

• OH Reach

Pelvic Position

Buttocks

Gluteal toneAtrophyGluteal Fold

Hamstring tone/ Adductor Buldge

Single Leg Balance

• Dynamic Assessment

Knee Position

• Hyperextension

• Femoral Rotation

• Popliteal Crease

• Medial Hamstring

Soleus Muscle Belly/ Foot Position

• Heel Shape

• Quadratic

• Pointed

• Foot

• Pronated

• Cavus Toes

Re-supination test

• Dynamic Assessment

ThoracoLumbar Paraspinals

Scapular Position/ Thoracic Spine

Scapula

• Protracted/ Retract

• Elevated/ Depressed

• Upward/ Downward

Rotated

• Winging

• Tilted

Thoracic Spine

• Kyphosis/ Flattened

Scapular Position/ Thoracic Spine

Scapula

• Protracted/ Retract

• Elevated/ Depressed

• Upward/ Downward

Rotated

• Winging

• Tilted

Thoracic Spine

• Kyphosis/ Flattened

Upper Trap/ Levator Notch

Deltoid/ Supraspinatus Atrophy

• Shadows

• Asymmetry

• Concave/ flat

Glenohumeral hypermobility

• Dynamic Assessment

Abdominals

• Lateral Line

• Pseudohernia

• Hollowing

Quad Dominance

• Dynamic assessment

Tibialis Anterior Symmetry

• ??Early L5 NR Lesion

Pectoralis

• Muscle Bulk

• Anterior Humerus

• IR of Humerus

• sideview

Rib Cage Position

• Rib Angle

• Rib Flare

Head/ Neck Position

• SCM

• Chin- Neck Angle

• Forward Head