Pemeriksaan Posture untuk Remaja Posture is how the body balances. Muscles, bones, and ligaments all work together to exert postural control. The nervous system innervates these structures to regulate growth and function. Muscles and their nerves… A) provide stability to the trunk. B) produce movement during physiologic activity. The motor system consists of bones, muscles, and ligaments. The nervous system controls the motor system. Postural analysis is an assessment of the function of the motor system as well as the nervous system.

1. Postural
Assessment

2. Posture
• Posture is how the body balances.
• Muscles, bones, and ligaments all work together to exert
postural control.
• The nervous system innervates these structures to regulate
growth and function.
• Muscles and their nerves…
• A) provide stability to the trunk.
• B) produce movement during physiologic activity.

3. Postural Analysis
• The motor system consists of bones, muscles, and
ligaments.
• The nervous system controls the motor system.
• Postural analysis is an assessment of the function
of the motor system as well as the nervous system.

4. Pain Cycle

5. Neutral Posture
• The brain and nervous system utilize information from
three sources to balance the body in space.
• Sources of balance…
• Eyes – level.
• Ears – vestibular apparatus.
• Muscles and joints – proprioceptive pathways.

6. Righting Reflex
• A postural reaction that turns a falling animal's body in space so that its paws or
feet are pointed at the ground.
• Returns the animal to sternal recumbency after being placed on its back or side.
• A normal reaction is dependent on normal vestibular, visual and proprioceptive
functions.

7. Causality
• Postural changes can be the cause of a clinical problem.
• Postural changes can be the effect of a clinical problem.
• Orthopedic problems can cause a postural change, which
can worsen the orthopedic problem.
• Asymptomatic postural problems can produce
mechanical stress, which can predispose an individual to
injury.

8. Ideal Posture
• There is no “normal” posture.
• Ideal posture serves as a reference point.
• Ideal posture…
• Distributes gravitational stress for balanced muscle function.
• Allows joints to move in their mid range to minimize stress on ligaments and
articular surfaces.
• Effective for the individual’s activities of daily living.
• Allows the individual to avoid injury.

9. Land Mark

10. Land Mark

11. Land Mark

12. Postural Changes With Age

13. Postural Changes
With Age

14. Balanced Posture

15. Effect of Habits on Posture
• Good habits contribute to a strong and stable posture.
• Bad habits contribute to poor posture and instability.

16. Examples of Poor Postural Habits
• Excessive sitting.
• Carrying a heavy backpack.
• Slumping.
• Poor sleeping positions.
• One-sided activities…
• Carrying a heavy purse.
• Sitting on a wallet.
• Sitting in a twisted position.

17. Postural Changes

18. Effects of Poor Posture on Muscles
•Overstressed muscles tighten.
•Favored muscles weaken.
•This imbalance perpetuates the poor
posture.

19. Spinal Distortions
• Anterior to posterior.
• Lateral.
• Helical.
• Foundational distortions create changes above.

20. Spinal Column Views

21. Helical Spinal
Distortion

22. Type Of Faulty

23. Muscle Palpation
• Palpate for hypertonic (overused) muscles.
• Palpate for weak / inhibited muscles.
• A muscle is weak because it is unstressed and should be
strengthened with exercise.
• An inhibited muscle is not being used because it’s
antagonistic muscle is being overused.

24. Reciprocal Inhibition
Reciprocal inhibition describes
muscles on one side of a joint
relaxing to accommodate
contraction of muscles on the
other side of a joint.

25. Postural and Phasic Muscles
• Postural (tend to hyperactivity)
• Triceps surae
• Hamstrings
• Adductors
• Rectus femoris
• Tensor fascia latae (TFL)
• Psoas
• Erector spinae
• Phasic (tend to hypoactivity)
• Tibialis anterior
• Gluteus maximus
• Gluteus medius
• Rectus abdominus
• Lower / middle trapezius
• Longus capitus and colli
• Deltoids
• Digastrics

26. Postural and Phasic Muscles
• Postural (tend to hyperactivity)
• Quadratus lumborum (QL)
• Pectoralis
• Upper Trapezius
• Sternocleidomastoid
• Suboccipital
• Masticatories

27. Posture Blocks

28. Prior To Postural Evaluation
• Obtain pertinent history.
• Description of symptoms.
• Fractures.
• Injuries.
• Congenital anomalies.
• Dominant hand.
• Note gross structural asymmetries such as
scoliosis.

29. Postural Views

30. Posture Types

31. Posterior View Evaluation
• Occipital protruberance.
• Cervical, thoracic, and lumbar spinous processes.
• Coccyx.
• Gluteal folds.
• Arms should hand equally with palms slightly visible.

32. Posterior View Evaluation
• The space between the arms and sides of the body should be equal.
• Legs should be equally abducted.
• The backs of the knees should be the same.
• Ankles and feet aligned b/l (no pronation or supination).

33. Posterior View Evaluation
• Structures that should be level and equal.
• Tips of mastoid processes.
• Acromia.
• Scapula.
• Lower margins of 12th ribs.
• Iliac crests.
• Posterior superior iliac spines (PSIS).
• Ischial tuberosities.

34. Ideal Posterior
Alignment

35. Scoliosis

36. Pelvic Unleveling

37. Gothic Shoulder

38. Scapular Winging

39. Scapular Winging
and Abduction

40. Tight Levator Scapula

41. High Left Shoulder

42. Right Head Tilt and Rotation

43. Lateral View
• Evaluate from both sides.
• Landmarks.
• External auditory canal.
• Acromion process of shoulder.
• Axillary line.
• Mid-point of iliac crest.
• Greater trochanter of hip.
• Lateral condyles of femur.
• Tibia slightly anterior to lateral malleolus.

44. Ideal Lateral Alignment

45. Head Alignment Lateral View

46. Forward Head Posture

47. Head and Neck Weight Distribution

48. Forward Head Tilt

49. Abdominal Protrusion

50. Pelvic Tilt (Anterior and Posterior)

51. Anteroposterior / Front View
• Balanced posture should appear equal from left to right.
• Landmarks.
• Bridge of nose.
• Center of chin.
• Episternal notch.
• Xiphoid process.
• Umbilicus.
• Pubes.

52. Anteroposterior / Front View
• Arms should hang similarly with palms at the side of the thighs
• Shoulder girdle symmetry
• Hands should show similar rotation and placement on the body
• Legs should appear equally abducted from the center line

53. Anteroposterior / Front View
• Feet aligned b/l
• No pronation / supination
• No inversion of eversion
• Knees forward and symmetric b/l

54. Anteroposterior / Front View
• Structures that should be equal b/l and level
• Eyes
• Clavicles
• Lower margins of the ribcage
• Anterior superior iliac spines (ASIS)
• Femoral trochanters
• Knees
• Ankles

55. Internal Rotation of Shoulders / Rounded
Shoulders

56. Genu Valga (Knock-knees)

57. Genu Vara (Bowlegs)

58. Upper Crossed Syndrome
• Affects the head, neck and shoulders.
• Result of long-term seated postures.
• Rolled-in and forward shoulders.
• Increased thoracic kyphosis.
• Forward head posture.
• Loss of cervical lordosis.

59. Upper Crossed
Syndrome

60. Postural Signs of Upper Crossed Syndrome
• Postural finding
• Rounded shoulders
• Forward-drawn head
• C0-C1 hyperextension
• Winging of scapulae
• Elevation of shoulders
• Dysfunction
• Shortened pectorals
• Kyphotic t-spine
• Short suboccipitals
• Weak serratus anterior
• Shortened upper trap, shortened
levator scapulae, weak lower and
middle trap

61. Muscle Imbalances in Upper Crossed Syndrome
• Tight-short muscles
• Suboccipitals
• Pectorals
• Anterior shoulder
• Upper trapezius
• Weak-long muscles
• Mid to lower trapezius
• Serratus anterior

62. Lower Crossed Syndrome
• Affects the lumbar spine and pelvis.
• Anterior pelvis and increased lumbar lordosis.
• Tightness in the psoas and lumbar erector spinae.
• Long-term sitting contributes to this syndrome as
well.

63. Lower Crossed
Syndrome

64. Imbalances in the Following Pairs of Muscles:
• Weak gluteus maximus and short hip flexors.
• Weak abdominals and short lumbar erector
spinae.
• Weak gluteus medius and short TFL and QL.

65. Postural Signs of Lower Crossed Syndrome
• Postural finding
• Lumbar hyperlordosis
• Anterior pelvic tilt
• Protruding abdomen
• Foot turned out
• Hypertrophy of thoracolumbar
junction
• Groove in iliotibial band
• Dysfunction
• Shortened erector spinae
• Weak gluteus maximus
• Weak abdominals
• Shortened piriformis
• Hypermobile lumbosacral junction
• Shortened tensor fascia latae

66. Upper and Lower
Crossed Syndrome

67. Layered Syndrome
•Layered syndrome is a combination of the
muscle imbalances seen in both upper and
lower crossed syndrome.
•It develops with chronic cases.

68. Layered
Syndrome

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