Postural Assessment

What's the purpose for postural assessment?

The following is an explanation of the effect of poor posture on the muscles attached to the spine:

 

It is well documented in physiology that a muscle stretched beyond the physiological resting position tends to weaken. This is called Stretch Weakness. On the flip side, muscles kept in a shortened position tend to lose elasticity. They may test strong in the shortened position, but become weak as they are lengthened. This is called Tight Weakness.

Some of the short-term effects of this profile are pain from stress to the shortened structures, and a predisposition to injury or overuse syndromes, due to strength and flexibility imbalances.

These postural imbalances cause the forward head and round shoulder posture profile, which in turn:

  • Decreases the load-bearing capabilities of the spine
  • Increases the loading on its supportive musculature
  • Decreases the flexibility and strength of the supporting musculature.

It is possible that this overall instability in the cervical spine can lead to subluxations or misalignments.

All three of these effects are important to the body worker when considering a treatment plan. It is rare that initial treatment alone can correct this type of deficient posture profile. Direct intervention is needed to correct the muscle imbalances first.

For every one inch the head moves forward of neutral (ear lined up with center of shoulder), an additional 15-30 pounds of tension is placed on the supporting neck muscles. Most adults will present with two or more inches of additional forward displacement. Its estimated that 90% of the general UK population carries this type of posture profile. That doesn't mean its normal, just prevalent.

A secondary result of this posture profile is an increased curve in the lumbar spine. Many think that the head posture is a result of the increased low back curve, but it is actually the opposite. In an attempt to balance the body, in light of the 10-12 lb head being forward of the normal centre of gravity, the body bends backward. This increases the low back curve and tilts the pelvis forward.

Joints Affected

  • Atlanto-Occipital
  • Cervical Spine
  • TMJ (tempomanidibuar joint)
  • Scapulothoracic
  • Glenhumeral

Direct and associated pain and dysfunction in the above joints can be directly attributed to the effects of Forward Head posture.

When the muscles are placed under additional stress, the vertebral joints and disks are placed under additional physiological loads. This can lead to pain and/or weakness.