What are the 2 main muscular concepts related to faulty posture?
1.
Muscle length-tension relationship
- active and passive insufficiency
2.
the concept of opposing muscles
- the balance between agonists and antagonists
What are 4 types of muscle imbalances that can lead to faulty posture?
give an example of each.
1.
Excessively shortened muscles:
- tight iliopsoas causing an anterior pelvic tilt.
2.
Excessively lengthened muscles:
- weak lower trap causing scapular protraction
3.
Excessive muscle activation:
increased sub occipital tone causing head extension
4.
l
1. Postural (tonic) muscle
2. Phasic muscle
3. Stretch weakness
4. adaptive shortening
a. allowing/ permitting
b. creating
(use each answer 2x)
1. b
2. a
3. a
4. b
give imbalances resulting from each of the following causes:
- Nerve injury (3)
- pain (2)
- joint effusion (1)
Nerve injury:
- paralysis
- muscle weakness
- spindle inhibition
Pain:
- inhibition of muscle activity
- over activation of muscle activity
Joint effusion:
- reflexive inhibition of muscle activity
give imbalances resulting from each of the following causes:
- poor posture (1)
- repetitive activity (2)
Poor posture:
alteration in muscle-length tension relationship
Repetitive activity:
- adaptive shortening
- increased recruitment
Why do postural muscles
create
imbalances?
why do phasic muscle
allow
them?
Postural:
- they become over activated and shorten due to pain and excessive stress
Phasic:
- they become inhibited and weak due to pain
List off as many POSTURAL muscles as you can..1..2..3..GO! (12)
SCM
Pectoralis Major
Upper Trapezius
Quadratus Lumborum
Iliopsoas
TFL
Rectus Femoris
Piriformis
Hamstrings Group
Short Hip Adductors
Gastrocnemius,Soleus
Erector Spinae
List off as many PHASIC muscles as you can..1..2..3..GO! (9)
Scalenes
Lower Trapezius
Levator Scapulae
Rhomboids
Serratus Anterior
Rectus Abdominis
External and Internal Obliques
Gluteus Maximus, Medius, Minimus
Vastus Lateralis, Medialis
What 4 moments should you have your patient perform to get them in the proper
orthoposition
?
1. march in place 10x
2. roll shoulders forward & backward 3x
3. nod head forward & backward 5x
4. inhale and exhale deeply
note: this is used to assess static posture.
Describe how you should set each body part for a proper assessment and what will offset each:
- ankle (3)
- feet (2)
Feet:
- heels 3-4 inch apart
- toe out 7-10deg.
ankle:
- LOG anterior
- DORSIflex moment
offset: soleus and gastroc will counter the dorsi
Describe how you should set each body part for a proper assessment and what will offset each:
- Knee (4)
- Hip (3)
Knee:
- LOG anterior to axis
- EXTENSION moment
Offset: posterior capsule and ligaments
- hamstring activity on EMG
Hip:
- LOG Posterior to axis- through great trochanter
- EXTENSION moment (post pelvic tilt)
Offset: ligaments will offset, muscle not need
Describe how you should set each body part for a proper assessment and what will offset each:
- SI joint (3)
- Lumbosacral joint (3)
- Pelvis (3)
SI joint:
- LOG depends on angle (30deg. best)
- LOG passes ANTERIOR to SI jt.(flexion/anterior moment)
offset: sacrotub post. and iliosacral ant.
Lumbosacral joint:
- depends on angle
- LOG passes THROUGH body of L5 (slight extension moment)
offset: ant.
Describe how you should set each body part for a proper assessment and what will offset each:
- Vertebrae (break down by region) (4)
- Head (3)
- shoulder joint (2)
Vertebrae:
- Lumbar: LOG through
- Thoracic: LOG anterior (flexion moment)
- Cervical- LOG through
- intermittent back and cervical extensors on EMG
head:
- LOG through external auditory meatus and odontoid process (flexion moment)
- good alignment depend
Tell whether the LOG is ANTERIOR (A), POSTERIOR (P) of THROUGH (T)..
- head
- cervical
- thoracic
- shoulder
- lumbar
- SI joint
- hip
- knee
- ankle
- head- external auditory meatus
- cervical- T
- thoracic- A
- shoulder- T
- lumbar- T
- SI joint- A
- hip- P
- knee- A
- ankle- A
Define the following:
- postural fault
- postural pain syndrom
- postural dysfunction
Postural fault
: malalignment WITHOUT structural limitation
Postural pain syndrome
: malalignment with PAIN due to mechanical stress. NO strength or flexibility deficits
Postural dysfunction
: malalignment with PAIN, adaptive shortening and weakness. Vuln
Name 6 common postural deviation patterns`
1. hyperlordotic
2. kypholordotic
3. sway back
4. flat back
5. forward shoulder
6. forward head
HYPERLORDOTIC POSTURE:
- malalignment (3)
- involved joints (3)
- shortened muscles (2)
- muscles elongated and weak (2)
- mechanical stress (3)
malalignment:
- increased lumbar lordosis
- ant. pelvic tilt
- flexed hips
involved joints:
- lumbar spine
- pelvis
- hips
shortened muscles:
- low back extensors
- hip flexors
muscles elongated and weak:
- abs
- hamstrings (not weak tho)
mechanical stres
KYPHOLORDOTIC POSTURE
- malalignment (4)
- involved joints (3)
- shortened muscles (4)
- muscles elongated and weak (3)
- mechanical stress (3)
malalignment:
- increased lumbar lordosis
- ant. pelvic tilt
- flexed hips
- increased thoracic kyphosis
involved joints:
- pelvis
- hip
- All spinal regions (except sacrum)
shortened muscles:
- ant. chest muscles
- neck extensors
- low back extensors
- h
SWAY BACK POSTURE
- malalignment (6)
- shortened muscles (3)
- muscles elongated and weak (4)
- mechanical stress (5)
malalignment:
- genu recurvatum
- hip joint extension
- posterior pelvic tilt
- ant. shift of pelvis
- increased lower thoracic kyphosis
- forward head& shoulders
shortened muscles:
- hamstrings
- upper internal obliques
- low back/cervical extensors
musc
FLAT BACK POSTURE
- malalignment (7)
- shortened muscles (5)
- muscles elongated and weak (2)
- mechanical stress (4)
malalignment:
- ext. hip joint
- post. pelvic tilt
- flexed lumbar spine
- decreased thoracic kyphosis
- flexed middle/lower C spine
- forward head
- ext. upper C spine
shortened muscles:
- hamstrings
- glute max
- abdominals
- thoracic extensors
- upper
FORWARD HEAD
- malalignment (2)
- shortened muscles (4)
- muscles elongated and weak
- mechanical stress
- joints involved
malalignment:
- flexion of lower C spine
- extension of upper C spine
shortened muscles:
- sub occipitals
- SCM
- upper traps
- Levator scapulae
muscles elongated and weak:
- ant. cervical flexors
- scapular depressors
mechanical stress:
- upper cervical
ROUNDED SHOULDERS
- malalignment (2)
- shortened muscles (4)
- muscles elongated and weak (4)
- mechanical stress (4)
malalignment:
- humeral head displaced anteriorly
- scapula aBducted
shortened muscles:
- pec major
- pec minor
- subscap
- serratus anterior
muscles elongated and weak:
- GHJ
- ER
- mid/lower traps
- rhomboids
mechanical stress:
- ant GHJ capsule
- scapu
Choose the correct option for a
RIGHT
hand dominance pattern:
R shoulder-
high/low
R iliac crest-
high/low
spinal shift-
L/R
Pelvis shift-
R/L
R hip-
abd/add
L hip-
Abd/add
Foot pronation-
L/R
R shoulder-
low
R iliac crest-
high
spinal shift-
L
Pelvis shift-
R
R hip-
add (weak glute med)
L hip-
Abd
Foot pronation-
L
Choose the correct option for a
LEFT
hand dominance pattern:
L shoulder-
high/low
L iliac crest-
high/low
spinal shift-
L/R
Pelvis shift-
R/L
R hip-
abd/add
L hip-
Abd/add
Foot pronation-
L/R
L shoulder-
low
L iliac crest-
high
spinal shift-
R
Pelvis shift-
L
R hip-
abd
L hip-
add
Foot pronation-
R
IR of hips and ER of hips:
which one causes VARUS?
VALGUS?
IR- VARUS
ER- VALGUS
Describe the different between:
Function scoliosis
and
Structural scoliosis
also, what happens with each type when the person bends over?
Functional-
this is the body trying to keep the head level through compensating a muscular imbalance, muscle guarding, pelvic obliquity, or leg limb discrepancy.
bend over- DISAPPEARS
Structural-
an actual congenital bony anomaly of the vertebra.
bend ove
With scoliosis, trunk muscles on the __________ will be _________:
1. Convex side
2. concave side
a. weak and elongated
b. adaptive shortening
1. a
2. b