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1. POSTURE
By; Dr. Sadia Saleem

2. VERTEBRAL COLUMN
33 vertebral bony segments divided into five regions.
• Cervical
• Thoracic
• Lumbar
• Sacral
• Coccygeal

3. Review
• Postural curve development
• Posture
• Good posture types
• Good and Bad posture
• Postural assessment views
• Correct and Faulty posture type
• Importance of posture

4. Posture Development
• Primary curves are retained from the
original fetal curvature, “C” curve
• Flexion of the spine.
• Concave anteriorly.
• Secondary curve is achieved by hyper
extension of the spine.
• Develop post-birth.
• Secondary curve concave posteriorly.

5. What is Posture?
• Posture refers to the position in which someone holds their body when
standing or sitting.
• It's the alignment and positioning of the body in relation to its limbs and
surroundings.
• Good posture ensures that the body’s muscles and ligaments are used
properly and efficiently, whereas bad posture can lead to various physical
complications.

6. Active Posture
 Static
 Dynamic
• A static posture occurs when we maintain one alignment for a prolonged
period of time.
• Standing, sitting, or kneeling.
• Dynamic postures refer to body alignments that occur when the body and/or
limbs are moving such as walking, jumping, or running.

7. POSTURE
 Correct Posture
• “Position in which minimum stress is each joint.” (Magee) Maintains the
natural curves.
 Faulty posture
• Any position that increases stress on joints Create muscle imbalances,
ligamentous tension, circulatory occlusion

8. What is the postural muscle?
• Core stability muscles or postural muscles, are the deep muscles in
abdomen, pelvis and back.
• Helps to maintain a good posture.
• Good posture can help prevent pain, pressure sores or reduced mobility.

10. • Muscles in this category include the abdominals
• Gluteals
• Deep neck flexors and the rhomboids
• These muscles seldom act alone but typically act in relation to postural
muscles.

11. BASE OF SUPPORT
• The area beneath a person that includes every point of contact that person
makes with the supporting surface.
• This means that when you are standing, your base of support is the area
between your two feet. The wider feet are positioned, the easier it is to
balance

13. CENTER OF GRAVITY
• In the vertebral column, the line of gravity typically falls just to the concave
side of the apex of each region’s curvature.
• Ideal posture allows gravity to produce a torque that helps maintain the
optimal shape of the spinal curvatures.
• The external torque attributed to gravity is the greatest at the apex of each
region: C4 and C5, T6, and L3.

14. Postural Reflex
• Definition. Postural reflexes are complex motor responses that provide
automatic control of posture, balance, and coordination. They are
characterized by a certain stereotyped posture of the trunk, head, and
extremities .
• Muscle
• Eyes
• Ears
• Joint Structure 
• Skin sensation also plays a part, eg.soles of the feet, when the body in
standing position. 
• Impulses from all these receptors are conveyed and coordinated in the
central nervous system.

15. Postural Control
• Postural control refers to the ability to maintain the stability of the body as a
whole and body segments “against gravity” or “movement of different body
segments” or “changes in the supporting surface”.
• Control depends on the integrity of nervous system, muculoskeletal system
and special senses.

16. CAUSES OF POOR POSTURE
•
Muscle
imbalances/contractures
Pleural effusion
Respiratory conditions
Appearance of increased
height (social stigma)
Structural factors
Congenital
anomalies
Developmental
problems
Trauma
Disease
Positional
factors/Habitual

17. Postural
Improvement
Muscle
Strengthening
Improved
Flexibility
Pain Relief
Prevention of
Degenerative
Changes

18. Bad Posture in Sitting
Characteristics
• Slouching:
 The spine is curved forward, leading the head to lean forward too.
• Crossed Legs:
 This can lead to an imbalance in the pelvic region.
• Leaning to One Side:
 Puts uneven pressure on the pelvis and lower back.
• Forward Neck:
 Protruding the head forward, straining the cervical vertebrae.
• Hunched Shoulders:
 Raises the tension in the neck and shoulders.

20. • Good posture the term good posture that puts the least strain on bones,
joints and their supporting structures. In practice, good posture should equate
with standing, sitting, lying or moving comfortably.

21. Ideal sitting posture
Static postural observation from the side
• In correct sitting posture the body weight is adjusted to balance over the
ischial tuberosities so that, together with the thighs, they provide a stable
base of support
• The knees are flexed approximately 90 degrees and the lower legs are
perpendicular, with the heels aligned with the backs of the knees.

23. POSTURAL EXAMINATION
• The assessment of posture is in standing position.
• The whole posture is asessed from head to toes in different views,
(a) Anterior views
(b)Lateral views
(c)Posterior views

24. Faulty Posture
• Disorders associated with the curvature of the spine include kyphosis —
excessive anterior concavity of the thoracic region;
• lordosis — excessive posterior concavity of the lumbar region
• scoliosis — an abnormal lateral curvature accompanied by twisting of the
spine.

25. mastoid process of
the temporal bone
anterior to the
second sacral
vertebra
Posterior to the hip
anterior to the knee
and ankle
Static postural observation from the side
In this position the imaginary plumb line represents the postural line of
gravity and facilitates the observation of relative symmetry in the sagittal
plane. Beginning with the spine, observe in relation to the plumb line the
positions of the head, tips of the shoulders, hip and knee joints, and
note unnecessary tension in associated muscles and soft tissue
ASSESSMENT

28. Kyphotic-Lordotic Posture
• Head- Forward
• Cervical Spine- Hyper-lordosis (hyper-extended)
• Thoracic Vertebrate- increased flexion
• Lumbar Vertebrate- Hyperlordosis; (hyperextended)
• Pelvis- Anterior tilt (forward and down)
• Knees- hyperextended
• Ankle joints- plantar flexed, legs are behind midline

29. Flat-Back Posture
• Head- Forward
• Cervical Spine- extended
• Thoracic Vertebrate- reduced curvature (extension)
• Lumbar Vertebrate – straight (flexion)
• Pelvis- posterior tilt (backward) and down)
• Hips- extended
• Knees- extended
• Ankle joints- slightly plantar flexed

30. Sway-Back Posture
• Head: Forward
• Cervical Spine -Hyper extended
• Thoracic Vertebrate- slight flexion
• Lumbar Vertebrate –slight extension
• Pelvis-posterior tilt and anterior to midline
• Hips- Hyper extended
• Knees- Hyper extended
• Ankle- slightly planter-flexed

31. Scoliosis
• Shoulders not level
• Prominent or uneven scapulas
• Uneven gap between arm and body
• Elevated or uneven hip
• Head not centered over pelvis
• Bending test reveals uneven portions of back

33. Physical therapy
• Stretching excercises
• Massage therapy
• To reduce pain and promote pain free range of
motion.
• Surgery
• Orthotics belts
Medication
• To reduce symptoms.