Purpose[edit | edit source]The body posture of sportsmen is an area of interest for many researchers seeking to determine potential relations between body asymmetry and unilateral load accumulation, as well as specific injuries.[1] In athletes postural assessment is important, because of the inter-relationship between the trunk and core musculature and the lower quarter and upper quarter.[2] Postural assessment as part of the screening process is relevant as there is evidence of correlations between injury and posture.[3] Abnormal postures can influence muscle function.[2] Show Studies of various sports find load accumulation and uneven muscle tone can cause postural faults. 
Technique[edit | edit source]The athlete is barefoot and stands in a relaxed position/posture. There should be sufficient distance between the athlete and the assessing physiotherapist to adequately view the athlete's posture. The various components of the postural assessment is viewed anteriorly, posteriorly and from the side as well. Examples of the various components that can be included in the postural assessment are:
Where possible, identify the overall postural type (e.g. Flat back, Sway back, Normal, Lordosis, Lordosis/Kyphosis) as this can provide clues to what structures are at risk. Practical Implications[edit | edit source]Analysis of body posture parameters is important to evaluate postural changes in players and to prevent injuries. Optical measurement systems (including 3D photogrammetric systems) can be useful, especially due to their ability to reveal errors in body posture, as well as individual compensation patterns.[1] Body asymmetries may be caused by e.g. one-sided training loads. The implementation of exercises to reduce myofascial imbalances in the musculoskeletal system and core stability is vital when these imbalances result in altered posture.[1] Evidence[edit | edit source]Reliability:[edit | edit source]A basic musculoskeletal postural assessment is sufficiently reliable when performed by trained clinicians. Posture, mobility and movement can be assessed with adequate reliabililty.[3] Singla and Veqar (2014) reviewed postural assessment methods[4] (visual observation, plumbline, goniometry, photographic, radiographic, photogrammetric, flexiruler, electromagnetic tracking device) and found that postural evaluation studies based on the photogrammetric method were the most reliable. This method evolved from the photographic and digitization method. In this method, photographs of the subjects are taken in the frontal or sagittal planes with a camera which is mounted on a leveled tripod stand, which is placed at some distance from the subjects. The photographs obtained are transferred to a computer system. They are used to calculate postural angles. Angles are then drawn between the markers by drawing horizontal and/or vertical lines. With the use of this method, quantifiable and reliable data can be obtained. It is used in measuring e.g. head posture, shoulder posture, cervical lordosis, thoracic kyphosis, lumbar lordosis, lower limb posture and pelvic tilt. Resources[edit | edit source]References[edit | edit source]
Postural assessments can provide information that guides exercise programming. As an exercise professional, understanding how to identify and potentially improve postural deviations may help individuals prevent injury, improve balance, and increase strength. Proper posture helps us stand, walk, sit, and lie in positions that do not strain supporting muscles and ligaments and allows muscles to function optimally. Keeping joints in correct alignment reduces the stress on the ligaments and minimizes the likelihood of injury, while allowing muscles to work more efficiently. Deviations from a neutral spine are caused by many factors, including repetitive movements, awkward positions (such as a habitual slouched posture), side dominance, fatigue, or a lack of joint stability and/or mobility—all of which are correctable factors. Non-correctable factors include congenital conditions, some pathologies, structural deviations, or traumas (e.g., surgery, injury, or amputation). Any deviation can lead to pain, compensations, and/or dysfunctional movement patterns. For healthy joint mechanics, it is important to reduce tightness or overactive muscles and work toward adequate flexibility, muscle strength and endurance, and balance (i.e., balance on each side of the joint and from right to left sides of the body). Below are some examples of typical postural deviations, as well as possible exercises for promoting improved posture. Lordosis: An increased anterior lumbar curve with an associated tilting of the pelvis. This typically leads to tension on the spine, which could result in low-back pain. Exercise Considerations: Focus on strengthening abdominal and hip extensor (hamstrings) muscles, while stretching the hip flexors and spine extensors (erector spinae). Supine Hollowing Cat-Cow Hip-flexor Stretch Kyphosis: An increased posterior thoracic curve with associated rounded shoulders, depressed chest, and forward-head posture with neck hyperextension. Exercise Considerations: Rounded-shoulders posture may be caused by weakness or lengthening of the muscles that control scapular movement—the rhomboids and trapezius. Excessive tightness or shortening of the chest muscles can also contribute to rounded-shoulder posture. Chest Stretches Cobra Prone Scapular Stabilization Flat Back: A decreased anterior lumbar curve or a reduced normal inward curve of the lower back with the pelvis tilted posteriorly and head exhibiting a forward position. Exercise Considerations: The rectus abdominis and upper-back extensors may be shortened while the hip-flexors and lumbar extensors may be lengthened. Focus on strengthening the erector spinae and multifidus while promoting lumbar stability and thoracic mobility. Bird-dog Hamstring Stretch Contralateral Limb Raises Sway Back: A decreased anterior lumbar curve and increased posterior thoracic curve. Sway back is often seen with rounded shoulders, a depressed chest and a forward-tilted head. The femur and head are farther forward than what is seen in a kyphosis deviation. Exercise Considerations: Hamstrings and lumbar extensors may be shortened while the hip flexors and upper-back extensors may be lengthened. Focus on strengthening the muscles in the upper back while stretching the chest and promoting lumbar stability and thoracic mobility. Chest Stretches Strengthening Obliques Prone Scapular Stabilization Scoliosis: An excessive lateral spinal curvature often accompanied by vertebral rotation. While scoliosis is a congenital or non-correctable condition, exercises can be implemented to help manage the deviation. Exercise Considerations: Implement exercises aimed at improving strength and range of motion of the muscles on both sides of the vertebral column. Exercises for Scoliosis Regularly performing exercises that create balance between opposing muscles along the trunk and spine are helpful for promoting optimal posture. The key focus is on stability and mobility. PLEASE NOTE: If your client cannot actively assume a neutral spine during your assessment, it is recommended to refer him or her to a physician. Exercise professionals do not diagnose medical issues, but instead refer clients to medical professionals if clients are experiencing severe pain or a possible injury. Additional Reading: 5 Lower Back Bodyweight Exercises to Ward Off Low Back Pain Low-back Rehab Exercises |
What are three postural distortion patterns to look for in static postural assessments?
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