1. Lesson 1 Unit 1 Postural Types & Deviations
Conducting Subjective/Objective Assessments
Postural Types & Deviations

2. Aims of the Session
This session will introduce candidates to the issues related to posture.

3. Learning Outcomes
By the end of the lesson the candidate will be able to
State the determinants of an individuals posture
Know how to see good posture
Identify 5 postural characteristics and there effects
Complete Unit 1 worksheet – Postural types and deviations

4. Posture
What is POSTURE?
Posture can be defined as;

5. What determines an individuals posture
The arrangement of body parts or segments, used to allow a person to stand!
Student Task
What determines an individuals posture

6. Determinants of an individuals Posture
Posture is linked to;
Structure and size of bones,
The position of the bony landmarks,
Injury and Disease,
Static and dynamic living patterns,
Psychological state.

7. Posture What is good posture?
Whether we consider good or poor posture, the same applies,
The bones should represent a series of links connected by joints being held together by ligaments and muscles.

8. Good Posture
Good posture therefore is a state of muscular and skeletal balance,

9. Good Posture
Good posture therefore is a state of muscular and skeletal balance,
If these links are arranged in a vertical plane,
The line of gravity should pass from the anterior of the ear and through the centre of each joint,
This means the least amount of stress is placed on the muscles and ligaments.

10. Good Posture Lateral
Look to see, if you draw an imaginary line from the anterior of the ear, which then should pass through their shoulder, hip, knee and ankle joint

11. Good Posture Anterior/Posterior

12. Good Posture Task Check someone you know for good posture
Naturally stand as you would
Look to see, if you draw an imaginary line from the anterior of the ear, which then should pass through their shoulder, hip, knee and ankle joint

13. Postural Defects
Postural defects are either via genetics, or occur due to environmental issues
i.e.
Injury,
Disease,
Skeletal imbalance,
Habitual,

14. Postural Defects Injury
When a bone, ligament or muscle injury occurs, it may weaken the support,
This support is normally provided to the total framework,
Injuries usually cause the body to adapt thus other structures become dominant.

15. Postural Defects Disease
Disease usually weakens bones and muscles or cause loss of joint stability, thus upsetting posture,
Examples are arthritis, osteoporosis, eating disorders etc.

16. Postural Defects Skeletal Imbalance
The most familiar skeletal imbalance is seen in the lower body,
This can cause an anterior/posterior or unilateral tilt of the pelvis causing Kyphosis Lordosis, or Scoliosis.

17. Postural Defects Habit
Probably the biggest cause of postural defect is peoples habits,
By repeating the same body alignment on many occasions, i.e. leaning over a computer or lounging in a chair,
And maintaining that position for extended periods of time, the surrounding musculature rests in a lengthened or shortened position.

18. Postural Defects Habit
This gives rise to adaptive shortening or stretch weakness
Habitual postures associated to an individuals mental attitude and the wearing of high heeled shoes for prolonged periods of time will shift the centre of gravity forward.

19. Lower Cross Syndrome

20. Lower Cross Syndrome Characteristics
An anterior pelvic tilt producing hyper-lordosis,
Lower back pain with no obvious cause,
ASIS is more than 2cm lower than PSIS.

21. Lower Cross Syndrome Effects
Adaptive shortening/dominant muscles include,
Iliopsoas, Erector Spinea, and Rectus Femoris,
the lordosis is deep and short, so imbalance is predominantly in the anterior muscles creating an anterior tilt
combined with lengthening/ weakness in, the Gluteus Maximus, Medius & Minimus, Rectus Abdominis and the Hamstring group.

22. Lower Cross Syndrome Effects
However, if adaptive shortening/dominant muscles create a shallow lordotic curve which extends into the thoracic area, creating a posterior tilt so imbalance alternates the other way,
Gluteus Maximus, Medius & Minimus, Rectus Abdominis and the Hamstring group become adaptively shortened/dominant muscles and Iliopsoas, Erector Spinea, and Rectus Femoris,
become lengthened/weakened muscles.

23. Lower Cross Syndrome Treatment
Anterior Tilting Pelvis
lordosis is deep and short
Stretch Iliopsoas, Erector Spinea, and Rectus Femoris,
Strengthen Gluteus Maximus, Medius & Minimus, Rectus Abdominis and the Hamstring group.

24. Lower Cross Syndrome Treatment Posterior Tilting pelvis
Shallow lordotic curve which extends into the thoracic area,
Stretch Gluteus Maximus, Medius & Minimus, Rectus Abdominis and the Hamstring group
Strengthen Iliopsoas, Erector Spinae, and Rectus Femoris.

25. Upper Cross Syndrome

26. Upper Cross Syndrome Characteristics Protraction of the shoulders,
Medial rotation of the humerus,
Kyphotic posture,
Hyper-lordotic cervical vertebrae,
Chin poke.

27. Upper Cross Syndrome Effects
Adaptive shortening/dominant in the upper Trapezius and Levator Scapula, Pectoralis Major and Minor, combined with adaptive lengthening/weakness deep cervical flexors, middle and lower trapezius, Serratus Anterior,
Specific postural changes are seen in UCS, including forward head posture, increased cervical lordosis and thoracic kyphosis, elevated and protracted shoulders, and rotation or abduction and winging of the scapulae.

28. Upper Cross Syndrome Treatment
Stretch upper Trapezius and Levator Scapula, Pectoralis Major and Minor,
Strengthen deep cervical flexors, middle and lower trapezius, Serratus Anterior,

29. Scoliosis

30. Scoliosis Characteristics A lateral deviation of the spinal vertebrae,
Lower back pain,
Uneven musculature on one side of the spine
A rib prominence or a prominent shoulder blade, caused by rotation of the ribcage in thoracic scoliosis,
Uneven hips, arms or leg lengths,
Slow nerve action (in some cases).

31. Scoliosis Effects Localised pain in affected area’s,
Muscle imbalance, short/dominant on the side which is laterally flexed, (as picture, Left QL, Right ES longissimus) long/weak on the side which is laterally extended (as picture, Right QL, Left ES longissimus) .

32. Scoliosis Treatment Stretch Left QL, Right ES longissimus) long/weak
Strengthen Right QL, Left ES longissimus).

33. Sway Back

34. Sway Back Characteristics A Posterior tilting pelvis,
Extension of the hips,
Flexion of the lumbar and thoracic regions,
Extension of the cervical region,
Hips will shift forward anteriorly of a plumb line,
Knee’s may be hyper-extended.

35. Sway Back Effects Low, mid and/or upper back pain,
Weak/lengthened abdominals, Hip flexors, External Oblique's, and Neck flexors,
Short/dominant Hamstrings, Internal Oblique's and Erector Spinae,
Stiff spine and/or pelvis,
Ligaments laxity or overstretching of
your back and pelvis.

36. Sway Back Treatment Effects
Strengthen abdominals, Hip flexors, External Oblique's, and Neck flexors,
Stretch Hamstrings, Internal Oblique's and Erector Spinae,

37. Dowager’s Hump

38. Dowager’s Hump Characteristics Protraction of the shoulders,
Medial rotation of the humerus,
Kyphotic posture,
Hyper-lordotic cervical vertebrae,
Chin poke.
A hump on the upper back

39. Dowager’s Hump Effects
Caused by osteoporotic changes in the upper spine,
They may be mechanical blocks, pain & discomfort,
Short/dominant Pectoral’s & upper Trapezius,
Long/weakened lower Trapezius & Rhomboids.

40. Dowager’s Hump Treatment
Stretch Short/dominant Pectoral’s & upper Trapezius,
Strengthen Long/weakened lower Trapezius & Rhomboids.

41. Learning Outcomes Can you now
State the determinants of an individuals posture
Know how to see good posture
Identify 5 postural characteristics and there effects
Complete Unit 1 worksheet – Postural types and deviations