Postural Assessment
Written by Michael lloyd
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Postural AssessmentWhen a patient presents at the clinic, as well as Orthopaedic, Range of Motion and other specific tests relating to their condition, another thing I would be looking at is their general structure or posture. If you were able to look at a medical drawing of the Skeletal System you would notice a plumb line running top to bottom through each drawing. This plumb line helps to show how structure looks in its neutral position. When in this position muscles, ligaments and tendons are much less antagonistic and will allow for greater range of motion and more fluid movements helping to create a pain free environment. When viewed from the side this plumb line passes through the back of the knee joint, middle of the hip joint, front of the elbow, middle of the shoulder and through the earlobe. Looking from behind it passes through the middle of the skull, each of the spinal vertebrae and the middle of the pelvis. In my clinic the plumb line is replaced by a laser, this shines on the skin giving a very precise picture of structure. Looking from the side it becomes easy to see if a joint is in front of or behind the line and to look for any torsion to the spine or pelvis. From behind whether there is excessive curvature of the spine as in scoliosis and whether they are weight bearing equally through both feet. |
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The pictures provided show a swayback posture, one of the more common to see in clinic. Notice the knees and more so the hips push forward of the line, this creates hyper lordosis or too much curve in the lower back, also see the forward shift of the head as an aid to help balance. This particular structure will place constant stress on the low back, making it difficult to stand still for any length of time before pain made you move, also that morning feeling of not being able straighten fully for the first 10 minutes. The position of the head will create an amount of neck tension, restriction to movement and possible chronic headaches. Looking from behind the laser is slightly to the right indicating more weight going through the left leg but with no lateral curvature. Following treatment you can see how the knees, pelvis and head have all started to return to their neutral position. From behind, the laser passes on a more central line indicating better weight bearing. Kim is one of the countries top marathon runners and has kindly allowed me to print these pictures to show how posture changes following treatment. A side effect of Kim’s structure was chronic headaches on a near daily basis; these are no longer a problem following treatment. Michael Lloyd |
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