Posture

by:
IMRAN AHMED MEMON
 POSTURE
• Posture is the attitude assumed by the
body either with support during muscular
inactivity, or by means of co-ordinated
action of many muscles working to
maintain stability.
• Posture changes with the
positions and
movements of the body
throughout the day and
throughout life.

• Every movement begins

and ends in a posture.
 What is posture?
• Defined:
– “The position of the body at a given point in
time.” (Starkey)
– “A set of muscle contractions that place the
body in the necessary location from which
a movement is performed.” (Enoka)
– “The situation or disposition of the several
parts of the body with respect to each other
for a particular purpose.” (Webster)
– Characteristic manner of bearing one’s
body
 The concept of human posture has
different meanings to different persons:

• To the orthopedic surgeon, it may be an indication of the

soundness of the musculoskeletal system.

• To the Kinesiologist, it is a measure of mechanical efficiency of

muscles, balance and of neuromuscular coordination.

• It is the attitude which is assumed by body parts to maintain

stability and balance with minimum effort and least strain during
supportive and non supportive positions.
 Static
Active
Types of
Dynamic
Posture
Inactive
1) Inactive posture

Definition:
When all the essential muscular activity
required to maintain life, is reduced to
Minimum i.e minimal demand upon
cardiopulmonary musculature.

Examples:
• When a person is sleeping or resting.
• Postures for training general relaxation.
 2) Active posture:
Definition:
When integrated action of many muscles is required
to maintain posture.

Examples:
1. Standing
2. Sitting,
3. lifting,
4. lying,
5. walking.
 a) Static posture
Definition:
Posture at rest or without
anticipated muscle action.
OR
a constant pattern of posture is
maintained by the interaction of groups
of muscles which work more or less
statically
Examples:
sitting, standing, lying, kneeling.
• Static posture is maintained by
muscles, which work statically and
preserve the state of equilibrum.
 b) Dynamic posture
Definition:
Posture in action or in anticipation of
action. OR
The alignment of body during movement.
• Dynamic posture is constantly modified and
adjust to meet the changing circumstances
during movement.
 Examples:
• running
• walking
• writing
• dancing.
 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.
 THE POSTURAL MECHENISM
Definition:
An adoption
of posture by the
help of muscle and
nervous system.
THE POSTURAL MECHENISM
The muscles:
• the intensity and distribution of muscle
work which is required for both static and
dynamic postures varies considerably with
the pattern of posture,and physical
characteristic of the individual.
• The group of muscle most frequently
employed are anti-gravity muscles
 Skeletal muscle
• The structural unit of
skeletal muscle is muscle
fiber .

• Muscle fiber could be of

two types:
1. Static or Postural (often
called ‘slow twitch’ red )
2. Phasic (often called ‘fast
twitch’ white).
1) Static or Postural ('slow twitch’ red ):
• They help to maintain posture without too
much effort and contribute to balance.
• Contraction is slow but sustained for long
time without fatigue.
• e.g: anti-gravity or postural such as
soleus.
2) Phasic ('fast twitch’ white):
• They are used for movement and activity.
• Rapidly contracted in response to the
stimulus but easily fatigued.
• e.g: gestronemious.
• Static or postural fibers burn energy
slowly and can keep working for a long
time without tiring. However, phasic fibers
quickly run out of steam.

• Poor posture causes muscle fatigue

because it calls on the phasic fibers
instead of static fibers to maintain the
body’s position.
A majority of long distance endurance
athletes are born with an exceptional
amount of Slow-Twitch Red Fibers.

 In contrast, strength athletes such as

wrestlers and bodybuilders usually have
a higher amount of Fast-Twitch White
Fibers.
• Nervous control: postures are maintained
are adopted as a result of neuromuscular
coordination, the appropriate muscles
being innervated by means of a very
complex reflex mechanism.

• Reflex: An efferent response to an afferent

stimulus.
 Postural Reflex

• Efferent response is the motor response, antigravity

muscles being principal effector organs. (maintain the
erect position of body by counteracting the effect of
gravity)
• Afferent stimuli arise from various sources most
important are:
1. Muscles
2. The eyes
3. Ears
4. Joint structures/ skin
• 1. Muscles:
• The proprioceptive receptors are located in muscles,
tendons and joints and they give information about the
position of the limbs and the body. Proprioceptors
include muscle spindles, Golgi tendon organs and joint
receptors
• Muscle spindles are found throughout the muscle belly,
parallel to extrafusal fibers (typical muscle fibers).
These receptors are sensitive to the changes in muscle
length as the muscle relaxes (dynamic stretch), and
they can also be activated by passively stretching the
muscle.(stretch reflex)
2. The eyes: visual sensation records any alteration
in the position of the body with regard to the
surroundings.
Visual sensation records any alteration in the
position of the body with regard to its surroundings,
and the eyes form one of the receptors for the
righting reflexes
 3. The ears:
stimulation of the receptors of the vestibular nerve
results from the movement of fluid contained in the
semicircular canals of the internal ear.
Any movement of the head disturbs the fluid they
contain, and thus knowledge of movement an direction
are recorded
4. Joint structures/ skin:
• in the weight bearing position approximation of bones
stimulates receptors in joint structures and elicits reflex
reactions
The proprioceptive receptors are located in joints.

•Exteroceptive receptors perceive stimulation arising

from the external environment and are located in the
cutaneous ,subcutaneous tissues and on the foot sole
(pressoreceptors).
 Pattern of posture
Static and dynamic posture gragdualll
build up by the integration of the many
reflex. They combine togather and make
the postural reflex
Some are:
• in born
Some are:
•conditioned
 Good posture
•posture is said to be good when it fulfils the
purpose for which it is used with maximum
efficiency and minimum effort.
•Posture in which the body segments are
balanced in the position of least strain and
maximum support.
Correct posture can:
improve performance
 decrese abnormal stress
 reduce the development of pathological
conditions
 Definition of a “ Good Posture”:
A good posture is the state of muscular and skeletal
balance which protects the supporting structures of the
body against injury and progressive deformities,
irrespective of the attitude in which these structures are
working or resting.
• Under these conditions, the muscles will function most
efficiently and the optimum positions are afforded for the
thoracic and abdominal organs.
• There is no single best posture for all individuals. Each
person must take the body he / she has and make the
best of it. The “ good Posture” is the one that suits one’s
own condition and the condition of the environment.
• e.g. during attention. The normal posture will be erect,
while in extreme fatigue, the normal posture will be that
conserves energy.
.
 Development of good posture
• the chief factors which predispose to the
health and development of the muscles
and the postural reflex are-
• 1. A stable psychological background.
• 2. Good hygienic conditions.
• 3. Opportunity for plenty of natural free
movement
 Poor posture
• Any position that deviates from “good posture”
• : posture is poor when it is inefficient, that is,
when it fails to servethe purpose for which it was
designed, or if unnecessary amount of muscular
effort is used to maintain it.
• Faulty posture:
– Deviates from ideal posture
– Requires an increased amount of muscular
activity
– increased amount of stress on the joints and
surrounding tissues
– Decrease endurance
• Restrictions in normal movement patterns
may cause compensatory postures
– Overtime can result in muscle imbalances and
soft tissue dysfunction
 Development of poor posture
Factors which predispose to poor
posture:
• General causes: mental attitude, poor
hygienic conditions, prolonged fatigue etc.
• Local factors: localized pain, muscular
weakness, occupational stresses etc.
Commonly Seen Postural
Deviations
 Commonly Seen Postural
Deviations

NORMAL VARUS VALGUS

 HIPS

• History
• Inspection
• Palpation
• Special (Functional)
Tests
 Relevant History
• Identify factors that – Hypermobile Jts
influence posture – Hypomobile Jt
– Bony Abnormality
– Overuse – Leg Length
– Neurological
Problems
– Pain
– Ms weakness/
Imbalance
 Inspection
Anatomical reference
– 3 views
• Lateral (sagittal plane
movements)
• Anterior (frontal/
transverse plane
movements)
• Posterior (frontal/
transverse plane
movements)
 Lateral View
• Look for:
– @ ankle?
– @ knee?
– @ hip?
– @ shoulder?
– @ neck?
– @ head?
 Anterior view

• Anterior view – Malleoli level

– Head straight on – Arches
shoulders – Foot rotation
– Shoulders level – Bowing of bones\
– Clavicles/AC joints
– Sternum & ribs
– Waist angles & arm
positions
– Iliac crests
– ASIS
– Knees
 Posterior View
• Look for:
– @ heel?
– @ pelvis?
– @ lumbar spine?
– @ scapulae?
– @ neck?
– @ head?
 Palpation
• In assessment position (i.e., standing),
palpate:
– Laterally
• ASIS vs. PSIS Posteriorly
PSIS positions
– Anteriorly
Spinal alignment
• Patellae
Scapular positions
• Iliac Crests
• ASIS heights
• Lateral Malleolar heights
• Shoulder heights
Functional Tests

 Rule out bony

restrictions
 Rule out soft tissue
restrictions
 Assess muscular
length
 ROM
 Resting muscle
length
 Principles of re-education
• Mental attitude and poor hygienic
conditions
• Postural defects
• Pain and muscle weakness
• Occupational strains
 Technique of re-education
1. Relaxation>> the muscles are free from
tension are said to be relax
Type:
 Total body relaxation
 Mental relaxation
 Local relaxation
2. Mobility:
by
• general free
exercises
• range
movement of
all joints
• Muscle power
• if there is any
muscular weakness
it can be controlled
by muscular
development and
helps to maintain
their muscle tone
and efficiency.