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POSTURAL ANALYSIS

POSTURAL ANALYSIS. DIVERSIFIED I Janine M. Ludwinski, D.C. ORDER OF EXAMINATION PRIOR TO POSTURAL ANALYSIS. Observe patient (unaware) Obtain thorough history Examine area of complaint. VERTICAL LINE FROM THE POSTERIOR EOP C7 T12 S2 GLUTEAL CLEFT MEDIAL FEMORAL CONDYLES MEDIAL MALLEOLI.

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POSTURAL ANALYSIS

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  1. POSTURAL ANALYSIS DIVERSIFIED I Janine M. Ludwinski, D.C.

  2. ORDER OF EXAMINATION PRIOR TO POSTURAL ANALYSIS • Observe patient (unaware) • Obtain thorough history • Examine area of complaint

  3. VERTICAL LINE FROM THE POSTERIOREOPC7T12S2GLUTEAL CLEFTMEDIAL FEMORAL CONDYLESMEDIAL MALLEOLI

  4. EXAMINE FROM BELOW UPWARD • LONGITUDINAL ARCH • PRONATION • SUPINATION • MEDIAL MALLEOLI LEVELS • ACHILLES TENDON POSITION • SIGNS OF LIGAMENTOUS LAXITY

  5. REASONS BEHIND TOE-IN & TOE-OUT • TOE-IN • INTERNAL TIBIAL ROTATION • TIBIA VARUM • INCREASE INTERNAL ROTATION of FEMUR —often due to muscular contraction/imbalance • TOE-OUT • BILATERAL- SACRAL ANTERIORITY • UNILATERAL- PELVIC ANTERIORITY • INCREASED EXTERNAL ROTATION of FEMUR—often due to muscular contraction/imbalance

  6. KNEES • FLEXED • LEWIN’S-Hamstring spasm • Quad weakness • Acute low back pain • HYPEREXTENDED • Ligamentous • Anterior compression fracture

  7. Imbalance of Hip Rotators • Leg length discrepancies and foot pronation may lead to: • Iliotibial band syndrome • Piriformis syndrome • Recurrent muscle strains (hamstring and groin pulls) can be an indicator of asymmetry in structural alignment.

  8. HIP MUSCLES… • Transfer ground-reaction forces from legs to trunk during gait • Supply coordinated propulsion • Provide balanced stability for the pelvis and spine • Through repetitive use patterns and after injuries, hip muscles may become shortened and/or weak [1] Kim D. Christensen, DC, CCSP, DACRB

  9. THIGH AND PELVIS • BULK OF HAMSTRINGS • GREATER TROCHANTERS • PELVIC TILT, SWAY (antalgia), TORTION- AS or PI • ILIAC CREST LEVELS • PSIS LEVELS • SACRAL ROTATION (S2—PSIS distance) • GLUTEAL MUSCLES- Deeper Dimpling—sacral anteriority, or hypertonicity

  10. VERTICAL PLANE of LUMBAR SPINE • GROSS OR SECTIONAL TOWERING OR CURVATURE PARASPINAL MUSCLE TONICITY • SPINOUS ALIGNMENT • LORDOSIS • GROSS LATERAL FLEXION • SKIN DISCOLORATION

  11. THORACIC OBSERVATIONS • GROSS OR SECTIONAL TOWERING OR SCOLIOSIS/CONVEXITY • RIB HUMP, + ADAM’S SIGN • SCAPULAR WINGING (myopathies, shoulder instability, scoliosis, mm or ligamentous laxity) • POSTERIOR SCAPULA • HIGH SHOULDER/TRAP • INTERNAL ROTATION HUMEROUS • KYPHOSIS • SPINOUS ALIGNMENT

  12. NECK and HEAD OBSERVATIONS • MASTOID PROCESS LEVELS • HEAD TILT OR ROTATION • ANTERIOR HEAD CARRIAGE • LORDOSIS • C2 SPINOUS ALIGNS WITH S2 TUBERCLE? • MUSCLE TONE • SPINOUS ROTATION

  13. NOTE DIFFERENCES • WHEN PATIENT AMBULATES • WHILE PATIENT IS PRONE • WHILE PATIENT IS SUPINE

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