Patient Positioning
- The patient should stand facing examiner with feet shoulder width apart. Directions - Have patient stand close to the plumb line without touching the yarn. - Assure that the plumb line evenly bisects the patients face. - Capture an Image of the patient in this position to use for the analysis. Rules of Analysis - This portion of the postural analysis should be completed starting at the feet of the patient. Key Points of the Analysis - Feet - Examine to determine whether or not the space between the feet is evenly bisected by plumb line. - Patellas - Examine to determine if the patellas are in the center of the knee, present medially or present laterally. May need to take multiple shots to determine patella positioning depending on shorts length. - Anterior Superior Illiac Spine - Examine level of the ASIS bilaterally to determine if even levels are present. - Pectoral Muscles - Examine to determine if pectoral muscles are even and bisected by the plumb line. - Shoulders - Examine to determine if shoulder levels are even bilaterally. - Trapezius Muscles - Examine to determine if trapezius muscles appear even bilaterally. |
Implications and Rehabilitation Direction
- Feet - Uneven spacing between the feet when the face is evenly bisected by the plumb line indicates postural problems are present in the patient.
- Patellas - Patella positioning can be classifed into three classes.
1. Patella Nuetral - Normal finding and requires no attention in rehabilitation program.
2. Squinting Patellas - Patellas present medially on the knee. A condition commonly referred to as knock knees that indicates weakness of the hip abductors. The rehabilitation program for an individual who presents with this condition should include exercises aimed at strengthening the hip abductors. The primary hip abductors are the tensor fascia latae, sartorius, gluteus maximus and medius, vastus lateralis and rectus femoris. The muscles are shown on the image below (right side).
- Feet - Uneven spacing between the feet when the face is evenly bisected by the plumb line indicates postural problems are present in the patient.
- Patellas - Patella positioning can be classifed into three classes.
1. Patella Nuetral - Normal finding and requires no attention in rehabilitation program.
2. Squinting Patellas - Patellas present medially on the knee. A condition commonly referred to as knock knees that indicates weakness of the hip abductors. The rehabilitation program for an individual who presents with this condition should include exercises aimed at strengthening the hip abductors. The primary hip abductors are the tensor fascia latae, sartorius, gluteus maximus and medius, vastus lateralis and rectus femoris. The muscles are shown on the image below (right side).
3. Frog Eyed Patella - Patellas present laterally on the knee. A condition commonly referred to as bow legged that indicates weakness of the hip adductors. The rehabilitation program for an individual who presents with this condition should include exercises aimed at strengthening the hip adductors. The primary hip abductors are the adductor longus, adductor brevis, adductor magnus, gracillis and pectineus. The muscles are shown on the image below (right side).
- Anterior Superior Illiac Spine - Observe the levels of the anterior superior illiac spine bilaterally. Uneven ASIS level indicates pelvic misalignment and can be treated with orthopedic manipulative treatment. Patient may need several treatments to permanently change the alignment of their pelvis. This treatment should be administered by certified osteopathic doctors only.
- Shoulders - Observe shoulder levels and make a note of any difference in shoulder level bilaterally. If patient presents with uneven shoulder levels move to next step to determine reason for postural misalignment.
- Trapezius Muscles - Observe trapezius muscles bilaterally for size difference and level difference. A size discrepancy between the right and left trapezius muscle indicates unilateral weakness of the trapezius muscles on one side of the body. A rehabilitation program for an individual with this postural defect should include unilateral strength exercises of the affected trapezius muscles, levator scapulae and rhomboid muscles. These muscles are displayed in the image below and are primarily responsible for scapular retraction and scapular elevation.
- Shoulders - Observe shoulder levels and make a note of any difference in shoulder level bilaterally. If patient presents with uneven shoulder levels move to next step to determine reason for postural misalignment.
- Trapezius Muscles - Observe trapezius muscles bilaterally for size difference and level difference. A size discrepancy between the right and left trapezius muscle indicates unilateral weakness of the trapezius muscles on one side of the body. A rehabilitation program for an individual with this postural defect should include unilateral strength exercises of the affected trapezius muscles, levator scapulae and rhomboid muscles. These muscles are displayed in the image below and are primarily responsible for scapular retraction and scapular elevation.