Posture

POSTURE      

• Note spinal curvatures, muscle bulk, extremity positioning, deformity.

• View postures from anterior, lateral and posterior aspects.

• Comment on sitting and standing postures.

• Note whether the client has the ability to correct on cuing.

• Ensure appropriate disrobing.

Technique      

The client should be barefoot and standing in a relaxed position/posture. There should be sufficient distance between the client and the assessing physiotherapist to adequately view their posture. The various components of the postural assessment is viewed anteriorly, posteriorly and from the side as well.

Examples of the various components that can be included in the postural assessment are:

Head:

• Forward head positioning

Shoulder:

• Symmetry - are the shoulders level from anterior and posterior view

• Roundedness - assessed anteriorly and from the side.

• Are the shoulders in internal rotation?

• Is there anterior translation of the humeral head?

Thoracic spine:

• Assessment from the side - Is an increased or decreased thoracickyphosis present?

General spinal curvature:

• Assessed posteriorly - Is there a spinal scoliosis present?

Lumbar spine:

• Assessed from the side - Is there an increased lumbar lordosis or a flattened lumbar spine? Are they in axial extension (upright posture) 

• Assessed from the back - Any visible muscle spasm? Hinging at the thoracolumbar junction?

Pelvis:

• Assessed from the front, rear and side.

• Assess levels of ASIS and PSIS.

• Assess levels of iliac crests.

• Is pelvis in anterior or posterior tilt?

Hips:

• Symmetry - are hips level.

• Are hips in internal or external rotation?

• Is there a visible gluteal bulk?

• Are the hips in extension or flexion - viewed from the side?

Knees:

• Are the knees in hyperextension or flexion when viewed from the side?

• Is muscle bulk symmetrical 

Ankle / Feet:

• Are the arches flattened or raised?