If you have not yet signed up for the NASM CES certification, receive a big discount here.
Get your copy of the NASM CES exam cheat sheet. It helps immensely for studying for the exam.
My PTP students report cutting their NASM CES study time and effort in half with Trainer Academy.
Benefit from the Exam Pass Guarantee and Retake Fee Guarantee. Plus, take advantage of my current discount code PTPDECEMBER for 50% off the MVP Program (Ends December 14th, 2024).
Try it out for free here to see if it’s right for you, or read my detailed review for further insights.
Chapter Goals:
- Know the function of a static postural alignment.
- Know the relationship that is found between postural alignment, neuromuscular function, and performance.
- Explain the dynamic between lifestyle factors and postural alignment.
- Find the steps for performing static postural assessments.
- Be able to classify the common postural conditions based on the static postural assessment.
- Relate the common posture assessment condition to muscular imbalances.
Introduction
The analysis of posture is part of the corrective exercise assessment process.
Posture is an observable assessment of how the client puts their body in various positions.
Posture is observed both statically and dynamically.
Static posture and its assessments are going to be covered throughout this chapter.
This is the second process in the CES assessment flow roadmap.
Importance of Posture as it Relates to Injury
Static posture assessments are the first step in finding muscle imbalances, also known as alterations in length-tension relationships.
They may not find the root cause, but it will give insight into which muscles are being held chronically in shortened or lengthened positions and shed light on related impairments in other body parts contributing to dysfunctions.
One common example is a strong relationship between a rounded shoulder posture and the degree of a person’s forward head posture.
This would lead to identifying Jandaโs upper crossed syndrome, inevitably leading to a musculoskeletal injury.
Muscle Imbalance
There may be various factors causing changes in the alignment of joints, the mobility of myofascial tissues, and the function of muscles.
Whatever the reason, the body will adapt continuously to produce the functional outcome requested by the CNS.
Pattern overload is often a reason for these soft tissue problems.
A desk worker may have a forward head posture for a significant time during work, which could cause neck pain and lead to damage past dysfunction and into, tissue damage, and pathology.
The muscles adapt to the chronic positioning that we expose them to. We end up with less efficient cervical stabilizer muscles.
Exclusive PTP CPT Offers |
||
---|---|---|
Gold Standard Cert | Most Popular Cert | Best Study Materials |
A Good Option | A Good Option | Best CPT for you? |
Ensure not to use the common overactive and underactive muscles we see.
Factors Relating to Postural Imbalances
Altered Movement Patterns from Chronic Suboptimal Postures
Many people have developed their own poor posture habits and didnโt even realize it.
This is very true for the office workers constantly sitting at their desks.
Altered Movement Patterns from Habitual Repetitive Movement
Reps of the same movement may lead to overuse and injury at some point, leading to changes in the mobility of the myofascial tissues.
Poor postures and lacking daily movements are considered to be contributing factors.
This is true for athletes and the average people and their everyday life.
A construction worker that hammers all day with the same hand would be an example of a specific person affected.
A postural imbalance may happen in the gym when people only focus on certain muscle groups and miss others.
Altered Movement Patterns from Acute Injury
This may result in chronic muscle imbalances.
It may be as part of healing from an injury; we see adaptive postures for the attempts to avoid pain.
And this causes alterations throughout the kinetic chain or shows in other compensating body parts.
Altered Movement Patterns After Surgery
The body repairs itself with scar tissue after surgery.
These scars can lead to dysfunction and result in compensations of movement patterns and posture changes.
Systematic Approach to Assess Static Posture
Static posture assessments need strong skills in visual observation from the practitioner.
This is found with time and practice.
These assessments generally begin at the feet and travel all the way up to the head.
Alterations found lower down will affect things higher up.
Kinetic Chain Checkpoints
The major joints and regions of the body that make up the five kinetic checkpoints are the foot and ankle, the knee, LPHC, shoulders and thoracic spine, and the head and cervical spine.
In the Anterior View
The foot and ankle, from this view, should be straight and parallel, not flat, and also not externally rotated.
The knee should be in line with the second and the third toes.
The LPHC should have the pelvis level to the horizon.
Exclusive PTP CPT Offers |
||
---|---|---|
Gold Standard Cert | Most Popular Cert | Best Study Materials |
A Good Option | A Good Option | Best CPT for you? |
The shoulders and the thoracic spine should be level, not elevated or rounded.
The head and the cervical spine should be in a neutral and non-tilted or rotated position.
From the Lateral View
The foot and the ankle should be in a neutral position, with the leg vertical at a right angle to the sole of the foot.
The knee should stay neutral and shouldnโt be flexed or hyperextended.
The LPHC should have the pelvis in a neutral position and not rotated posteriorly or anteriorly.
The shoulders and the thoracic spine should align with the hips and the ears.
The head and the cervical spine should be in a neutral position and not in cervical extension.
From Posterior View
The foot and ankle should have the heel straight, parallel, and not overly flattened.
The knee should be neutral and not adducted or abducted.
The LPHC should have the pelvis level to the horizon.
The shoulders and spine should be level, not elevated or rounded forward.
The head and the cervical spine should be in a neutral position and not tilted or rotated.
Common Patterns of Postural Distortion
Everything in the body is regionally interdependent, so the impairments found are usually present in multiple forms.
Because of this, we have grouped them into patterns based on their relation.
The most popular classifications are Jandaโs syndromes, which describe three distortion patterns.
Kendallโs postures describe four distortion patterns, and this is the second most popular.
Jandaโs Syndromes
Lower Crossed Syndrome
People that have spent a lot of time sitting will often have this due to the chronic positioning of their hips.
This is a combination of excessive lumbar lordosis and an anterior tilt of the pelvis.
There is also a show of lumbar shift laterally, the knees flexed or hyperextended, and the feet plantar flexed.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Upper Crossed Syndrome
People with this may have a forward head posture, a hyperextended cervical spine, and rounded shoulders.
They can have excessive thoracic kyphosis, shoulder elevation, rotation or abduction of shoulders, and scapula winging.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Layered Crossed Syndrome
This may have components of both the upper and lower crossed syndromes.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Kendallโs Posture Types
Lordotic Posture
People with lordotic postures may have excessive lumbar lordosis and an anterior pelvic tilt.
People may assume other compensations like a lateral lumbar shift, lateral leg rotation, and a knee that slightly flexes or is hyperextended.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Flat Back
This may show both upper and lower posture issues.
All of the main problems discussed throughout jandaโs syndromes may be present.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Sway Back
A possible extended cervical spine sees this in the upper body and kyphosis.
For the lower body, we see a flattening of the lumbar spine, tilted pelvis, and extended hips.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Kyphosis Lordosis
Forward head, excessive kyphosis, and elevated and rounded shoulders.
In the lower body, we see excessive lumbar lordosis, lateral lumbar shift, anterior pelvic tilt, flexed hips, hyperextension of the knee, and plantarflexed ankles.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Pes Planus Distortion Syndrome
This is similar to the impairments in the lower cross syndrome we discussed.
It is focused on the lower body with slight changes.
Make sure to read over the muscle activity to know the overactive and the underactive muscles that are caused by this condition.
Tyler Read
PTPioneer Editorial Integrity
All content published on PTPioneer is checked and reviewed extensively by our staff of experienced personal trainers, nutrition coaches, and other Fitness Experts. This is to make sure that the content you are reading is fact-checked for accuracy, contains up-to-date information, and is relevant. We only add trustworthy citations that you can find at the bottom of each article. You can read more about our editorial integrity here.