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Posture Assessment

Posture Assessment. Chapter 3. Issues in the Lower Leg. Forefoot/rearfoot varus Excessive pronation @ STJ Flat-footed Excessive wear on outside of shoe Forefoot/rearfoot valgus Excessive supination @ STJ Refer to pg. 109. Factors Influencing Posture. Neurologic issues Muscle weakness

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Posture Assessment

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  1. Posture Assessment Chapter 3

  2. Issues in the Lower Leg • Forefoot/rearfoot varus • Excessive pronation @ STJ • Flat-footed • Excessive wear on outside of shoe • Forefoot/rearfoot valgus • Excessive supination @ STJ • Refer to pg. 109

  3. Factors Influencing Posture • Neurologic issues • Muscle weakness • Hypermobile joints • Hypomobile joints • Bony abnormalities • Leg length • Spinal column

  4. Clinical Evaluation of Posture • Where to Start? • Draw a plumb line down vertical axis • History • Inspection/observation • Anatomical assessment • Functional tests

  5. History • Mechanism of pain • What are the symptoms? • What type of activity/job involved in? • Previous issues • Surgery • Pregnancy

  6. Inspection • Get into a pattern: superior→inferior inferior→superior • Position yourself LEVEL to the region you are assessing • Determine body type • Ectomorph • Endomorph • Mesomorph

  7. Views to Evaluate • Lateral • Deviations in the A/P aspect • See table 3.9 pg. 63 • Anterior/posterior • Deviations in the saggital plane • See table 3.10, 3-11 pg 66,67

  8. Leg Length • True • Anatomical

  9. Palpation Assessment • Lateral Aspect • ASIS and PSIS • Goniometer assessment • ASIS should be 8 - 10° inferior to PSIS • Anterior Aspect • Illiac crests • Malleoli heights – bilaterally • Patella position • Shoulder heights

  10. Palpation Assessment • Posterior Aspect • Position of PSIS • Spinal alignment • Scapular position – box 3-5, pg 73 • Protraction • Retraction • Winging

  11. The Knee • Genu Recurvatum – hyperextension • Genu Valgum – knock-kneed • Excessive Q-angle • Genu Varum – bow legged

  12. The Spine • Lordosis – extension • Kyphosis – flexion • Scoliosis – lateral curvature

  13. The Spine • Hyperlordotic • Lumbar lordosis with normal thoracic and cervical spines • Excessive anterior tilt • Kypholordotic • Lumbar lordosis with increased thoracic kyphosis • Excessive anterior tilt

  14. The Spine • Swayback • Hypermobility of joints • Genu recurvatum • Posterior pelvic tilt • Thoracic kyphosis • Flat Back • Posterior pelvic tilt • Decreased lumbar lordosis • Decreased thoracic kyphosis • Extended upper cervical spine

  15. The Spine • Scoliosis - Lateral curves • Functional Scoliosis • Muscular imbalance • Leg length discrepency • Structural Scoliosis • Defect or congenital bony anomaly in vertebral column

  16. Upper Extremity • Forward Shoulder • Rounded shoulders (excessive protraction) • Tight anterior shoulder musculature • Excessive curvature in cervical/thoracic • Forward Head • Flexion of lower/mid cervical spine • Extension of upper cervical spine

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