Posture Introduced By You Friend: Amal Abd-Almunem
What is static posture? Static posture is the posture where the body and its segments are aligned and maintained in a certain position (standing, lying, sitting)
When do we have static posture? When all body segments, muscles and ligaments are in equilibrium.
What is dynamic posture? Static posture is the posture where the body and its segments are moving. (walking, running, jumping, throwing and lifting)
What are the things that affect the posture? (postural control depends on the integrity of which systems?) • Central Nervous System (CNS) • Musculoskeletal system • Visual system • Vestibular system • Input from the receptors in and around the joints
What are the forces acting on the body? • Gravity • Inertia ( in dynamic posture) • Ground Force Reaction (GFR)
What happens when the line of gravity pass anterior to the segment (e.g. femur + tibia)? It will create a moment, and pull the proximal part (femur) toward it, because it is a force and therefore the femur will go anteriorly
What happens when the line of gravity passes anterior to the ankle joint? The proximal tibia will move anteriorly causing dorsi-flexion
What makes the foot in neutral position? Due to the activity of planter flexion to bring the tibia to the normal position.
How does the line of gravity pass in the knee joint normally? It normally passes anterior to the joint and posterior to the patella
What will happen in the previous case? The proximal segment (femur) will move anteriorly, this will cause the knee joint to protect the knee from hyper extension
Where is the line of gravity in the hip joint? It passes slightly posterior to the axis of rotation of the hip joint.
How can we bring the pelvis from posterior? The hip flexor (ilopsoas) will flex hip and bring it again anteriorly
What will happen if the lumbosacral angle is more than 30 degree? This will cause lordosis, because the line of gravity passes anteriorly to the sacroiliac joint, so it will pull the sacrum forward and downward, the brain sends signals to pull muscles into proper position.
What is the case in the vertebral column? It passes posterior to the cervical and lumber and anterior to the thorax
Where does the line of gravity pass in the head, and what does it do? It passes posterior to the coronal suture through the ear, anterior to the axis of rotation of flexion and extension. It will pull the head anteriorly causing flexion
What happens if the line of gravity passes posterior to the knee joint? This will cause flexion of the knee and this is not normal
What will happen if one leg is longer than the other? The back leans toward the shorter, the spine is in scoliosis, and the concave side is toward the shorter leg.
What happens when a person tries to touch the ground? He will flex his hip 90 degree, and the extra movement will come from the spine
What happens to the pelvis when a person tries to do hip flexion? Anterior tilt
How can a patient do more than 45 degree hip abduction The extra degrees come from the lateral tilt.
Notice! Normally iliac crests are on one level. Anterior superior iliac spine & posterior superior iliac spine are on one horizontal level. If the patient has anterior tilt, ASIS moves anteriorly & inferiorly, the pubis will move superior & posterior.
What will happen to the hip joint and lumber spine if we have anterior tilt of the pelvis? Flexion will happen in the hip joint, and we’ll have to bind the back in backward (excessive extension) so that we can look forward, this called lordosis.
What will happen in the case of posterior tilt of the pelvis The hip will be extended, so we’ll have to bring the body in a straight position, this will decrease the lordosis of the spine. This is known as flatting of the spine.
What happens if the person stands on the left leg and the right hip is hiking? The axis of rotation will be in the left hip joint, the supported side (left hip) will be abducted.
What happens if a person stands on the left leg and drops the right hip? The left leg will be adducted
What happens if the right pelvis is rotating forward and the left side is the supporting side? The left hip will be internally rotated and the opposite is true.
How can we know if the foot is in the normal shape or not? We palpate the medial malleolus and then palpate the navecular bone and the head of the first metatarsal, then we draw a line, if the are in a straight line, then the foot is normal. That line is called FEISS LINE
How can we know if the person has a flat foot? First we draw Feiss line, then we palpate the navicular bone, if the navicular bone is below the fesis line then this person has flat foot. In this case, the calcaneous is pushed backward and there is more stress in the metatarsals.
What is Pes Cavus? It is when the patient has hyper arch, and the navicular bone will be above the line.
What is hallux valgus? It is when the patient has lateral deviation of the big toe at the metatarsophalangeal joint, so there will be pressure on the medial side which is in contact with the shoe.
What is hammer toe? It is when the patient has hyperextension in the metatarsophalangeal joint and the distal interphalangeal joint + flexion in the proximal interphalangeal joint. Friction in the shoe will happen and will cause a problem.
What is claw toe? It is when the patient has flexion in the distal and proximal interphalangeal joints + hyperextension in the metatarsophalangeal joint.