Importance of Postural Analysis in Physiotherapy

By P. Senthil, MPT, CPS, (PhD),Professor,Mohamad Sathak A J College of Physiotherapy,Chennai.

Does Posture Correction Matter?

• How much?

• Why?

• How do we change it?

What is Posture?

Posture is not a position, but a dynamic pattern ofreflexes, habits, and adaptive responses to anythingthat resists you being more or less upright andfunctional, such as:• Gravity, of course!• Awkward working conditions, which may be

unavoidable.• Abnormal anatomy.• Athletic challenges.

• If you start to tip over, or lose the stability you need for a task, postural reflexes kick in and engage muscles to pull you into a more or less upright and/or functional position again.

• The biological systems and tricks that keep us upright are neat — and surprisingly poorly understood.

• Posture is also more than the sum of those parts, more than “just” a collection of righting and stabilizing reflexes — it is the way we live, the shape of our flexible “container,” the physical manifestation of our comfort zone.

• We habitually hold ourselves and move in ways that serve social and emotional needs, or avoid clashing with them: posture can be submissive or dominant, happy or sad, brave or fearful, apathetic or uptight.

• The challenges and rewards of trying to change posture are not just musculoskeletal, and it can be a personally profound process. Patterns and behaviours that lead to trouble are usually strong.

Posture is the embodiment of our comfort zone.

At worst, it can be like a Cage.

What is “Poor Posture”?

• More precisely stated now: Poor Posture is an unnecessary and problematic pattern of physical responses to Postural challenges.

• Sitting for hours with your knees tucked sharply under your chair is a classic example, and it’s a real hazard to kneecaps— avoidable and entirely caused by a lack of awareness of how knees work.

• What about Postural laziness? That’s what most people picture when they think of poor posture.

• The avoidance of Postural challenges leads over time to Poor Postural fitness.

• If you avoid postural challenges enough, eventually you’ll have trouble coping with them when you have to … and so we’re back to the first definition (POOR POSTURE).

Factors leading to Poor Posture:• Genetics & Hereditary• Current/past injuries• Job – Related• Aging process• Stature – height• Psychological aspect – emotional-confidence, joy, depression,

fear, mood.• Anatomy of women• Pregnancy• Culture• Fatigue posture

Poor Posture Related Injuries• Ligaments can permanently stretch• Cartilages can be damaged due to abnormal friction• Disc injuries• Neurological problems like headaches, numbness, tingling • Arthritic changes in weight-bearing joints• Decreased ROM, Strength, and Joint dysfunction.• Continuous and long-term pain• Work-related musculoskeletal disorders• Cumulative Trauma cycle

The Evolution of Posture:

Why Implement A Posture Assessment Program?

• Critical to assesses body alignment and design exercise prescription.

• Improve Our Professional skill level.• Re-evaluation and measure outcome of

patient.• Visual feedback mechanism to Patients.• For Research proposal and Documentation.• Referral source will be increased.

Does Posture matter?

POSTURAL STRAIN

POSTURAL LAZINESS

POOR POSTURE

Does Posture matter?

POOR POSTURAL

FITNESS

POSTURAL STRAIN

POSTURAL LAZINESS

POOR POSTURE

How to Assess Posture?

• Visual Observation method.• Goniometric method.• Plumb line method.• Photographic and Digitization method.• Radiographic method.• Photogrammetric method.• Posture Grid charts.• Posture analysis software.• 2D & 3D Video-Motion analysis.

Can you Change posture?

• Much of what we perceive as “Poor Posture” is the result of biological adaption over decades and is unlikely to change without a truly heroic effort — and perhaps not even then.

• In principle, humans can adapt to almost anything — in fact, it’s the law.

• However, the same principle dictates that change is slow and difficult.

Address Major systemic barriers to success

CONCLUSION:

• Posture is almost certainly associated with some pain problems.

• Much of so-called “Poor Posture” is actually just postural strain and bad ergonomics.

• Poor Posture are probably the result of long-term biological adaptation that is either extremely difficult or impossible to change.

• Posture can affect mood, emotion and probably pain sensitivity.

• EARLIER EVALUATION AND CORRECTION OF POSTURAL ADAPTATION HELPS TO MAINTAIN POSTURAL FITNESS AND PHYSICAL CAPABILITY OF INDIVIDUALS.

Thank you