Postural Assessment. Postural Assessments . Why do we do it? Is it all that important? Can it be changed? . Why do we do it?. Injury prevention? Pain reduction? Aesthetics? Performance? . Posture .
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Points of reference consisting of the lobe of the ear, the seventh cervical vertebra, the acromial process, the greater trochanter, just anterior to midline of the knee, and slightly anterior to the lateral malleolous which form a theoretical line around which the body is balanced in perfect skeletal alignment, yielding equal weight distribution and maximum joint stability .
Unbalanced biomechanical joint stresses that result from muscle imbalance may lead to joint damage, setting up a vicious cycle of pain and inflammation. The structural inflammation then affects the neuromuscular system of the joint, creating further dysfunction. Eventually the body adapts the motor program for movement to compensate for the dysfunction
Postural Structural Biomechanical Model Conclusions
Misalignments can “impose excessive stress on the spine leading to degeneration/damage or dysfunction and eventually to painful back conditions
In this model, the imbalances and symmetries increase the abnormal mechanical/physical stresses imposed on the musculoskeletal system. This may lead recurrent injury or the development chronic conditions through a gradual process of wear-and-tear
120 asymptomatic participants the experimenters found that “ Out of the 65 male subjects tested 55 (85%) presented with an anterior tilt, 4 with a posterior tilt and 6 presented as neutral. Across the sample of female subjects 41 presented with an anterior tilt (75%), 4 with a posterior tilt and 10 presented as neutral.” (9).
“A number of individuals with normal posture were found to have significant pain, whereas some individuals with more severe postural deviations in the thoracocervical- shoulder region were found to have minimal pain.” (5)
Does an increase in muscular strength allow a better posture to be held? If this were the case it would not be unreasonable to expect that individuals with poor posture had weak muscles; however this is not the general finding.
“In the context of postural-structural-biomechanical (PSB) factors, it is expected that tremendous forces, well above the daily physical stresses, would be required to reposition/adjust/correct any structural misalignments. These would have to be applied on a daily basis over several months or even years. A termination of treatment is likely to result in rapid reversal of PSB gains, unless the individual is able to self maintain them by specific exercise. The winner in the competition-in-adaptation, is ultimately the one most practiced, that is, the default PSB state/behavior of the individual”
Incidence of pain increased in subjects with more severe postural abnormalities
However, posture is individual: a number of individuals with normal posture were found to have significant pain, whereas some individuals with more severe postural deviations in the TCS region were found to have minimal pain. Causality cannot be determined.