Today what I’m going to discuss is something called flexion dysfunction (Posture Dysfunction).
For those of you who have never heard of the term, flexion dysfunction occurs when you’ve been so immaculate about keeping your back in extension or its safe alignment that when you do go into flexion, it causes discomfort.
So we call it a flexion dysfunction because you get tight going into flexion.
If you are a client, you might want to seek guidance from a therapist.
Essentially, We’re not advocating that you incorporate the movements that we have identified as unsafe, where there’s the weight of your head and the weight of the shoulders and all of the activities of daily living that are demonstrated.
But we are advocating that you do some flexion in unweighted positions, be it in the water, lying on your side, where you’re allowing your spine to get into its full range of flexion and extension.
The extension you’ve probably incorporated in your life, but it’s the full range of flexion so that you don’t get tight into flexion and don’t develop a flexion dysfunction.
Postural Abnormalities
the masses of the trunk influence the spine’s position, and when these muscles change from their optimal length, fit creates posh abnormalities, or people move into poor postural positions.
People’s posture can be affected by poor habits such as sitting at a desk hunched over too much computer work, unbalanced training at a gym, repetitive sporting habits, excessive weight and not enough strength.
A postural change can be considered structural, meaning that the bones have changed and cannot be fixed.
For example, bony Spurs at a joint or a leg length difference judo broken leg or it could be considered functional, which means that is temporary and can be changed such as scoliosis created by wearing a bag across the shoulder or rounded shoulders do too much chest training. These types of postural changes place excessive stresses on associated joints, the muscles and the ligaments and, therefore, can lead to pain, degeneration, lack of function and lack of performance. Since we know that certain muscles are more prone to shortening and some are more prone to lengthening, we often see similar types of postural abnormalities. And as such, you, the fitness professional, must be aware of these and know what to do to help them. Let’s look at some of the postures you are likely to encounter.
Forward Head
posture, too much retraction of the neck.
Kyphosis
excessive curvature of the thoracic spine.
Rounded Shoulders
with a scapular become protracted; this is often associated with kyphosis and a Ford head posture.
lordosis
An excessive curvature and the lumbar spine.
Flat Back
where their curvature in the lumbar spine is removed.
Scoliosis
a lateral deviation of the spine.
While we will explore these in more detail in the future is important that you start developing your assessing skills now. Do some people watch and observe how they stand and move.
What observations can you make about their head, spine and pelvis?
The more you do this, the better you will become at assessing posture.
eliminate pain from injuries and chronic conditions
Observation and Posture Analysis
In this article, we’re going to discuss observation and posture analysis. Observation is the first step of your physical assessment.
During observation, you’re trying to see if you can find any structural abnormalities that you can link to your patient’s complaints.
To conduct a good observation, I have to be able to see certain landmarks on the body; therefore, I’m going to ask my patient to take off their shirt, wear shorts, and take off their shoes.
Now that the patient is properly exposed, we can start with the observation.
I advise the patient to stand upright, look straight ahead, relax the shoulders and let the arms hang naturally beside the body.
In the frontal plane, one of the first things I could look at is the line from the tip of the nose running through the middle of the chin to the manubrium of the sternum.
The head could also be rotated or leaning to one side.
Next, I could compare the level of the shoulders, assess the angle of both clavicles and see if the nipples are at the same height.
The latter should be disregarded with female patients.
Moving downwards, I can compare both iliac crests and use the anterior superior iliac spine as another landmark.
The space in-between the trunk and arms can also be compared.
Furthermore, arm length differences can be examined when comparing the level of the fingertips of both hands.
Looking at the knees, I check if the apex of both patellas is levelled and whether they have an outward, so-called varus position or an inward, so-called valgus position.
At last, I check the level of both medial malleoli.
In the sagittal plane, one of the first things to assess should be the lateral plumb line, the so-called line of Appleton, which is the line running from the earlobe through the humeral head.
Check if the head is excessively positioned anteriorly or posteriorly.
The shoulders might also be pro- or retracted.
When looking at the patient from the side, it’s wise to examine the spine for abnormalities in the lordosis and kyphosis.
At the pelvic level, you can check the angle between the anterior superior iliac spine and the posterior superior iliac spine, which is usually around 15°.
Lastly, check if the knees are hyperextended.
Look at the patient from the back.
Again, check if the head is rotating or leaning to one side.
When examining the spine, you look for lateral shifts that could indicate scoliosis.
Posterior reference points include both acromial, the scapular spines, and the scapula’s inferior angles.
Also, check how far away the medial borders of the shoulder blade area are from the spine.
Compare both iliac crests and check the posterior superior iliac spine.
The gluteal fold could also be used as a reference point.
You could identify valgus or varus positioning on knee level, just like in the frontal plane.
Lastly, compare both medial malleoli and depending on the number of toes you see next to the Achilles tendon, one leg could be rotated more than the other.
Be aware, though, that not everything that you consider abnormal is also pathological.
The Benefits of Good Posture
Has anyone ever told you, “Stand up straight!”
or scolded you for slouching at a family dinner?
Comments like that might be annoying, but they’re not wrong.
Your posture, the way you hold your body when you’re sitting or standing, is the foundation for every movement your body makes and can determine how well your body adapts to its stresses.
These stresses can be things like carrying weight or sitting in an awkward position. And the big one we all experience all day, every day: gravity.
If your posture isn’t optimal, your muscles have to work harder to keep you upright and balanced. Some muscles will become tight and inflexible. Others will be inhibited. Over time, these dysfunctional adaptations impair your body’s ability to deal with the forces on it.
Poor posture inflicts extra wear and tear on your joints and ligaments, increases the likelihood of accidents, and makes some organs, like your lungs, less efficient.
Researchers have linked poor posture to scoliosis, tension headaches, and back pain, though it isn’t the exclusive cause.
Posture can even influence your emotional state and your pain sensitivity. So there are a lot of reasons to aim for good posture.
But it’s getting harder these days.
Sitting in an awkward position for a long time can promote poor posture, and so can using computers or mobile devices, which encourage you to look downward.
Many studies suggest that, on average, posture is getting worse.
What Does Good Posture Look Like?
When you look at the spine from the front or the back, all 33 vertebrae should appear stacked in a straight line.
From the side, the spine should have three curves:
one at your neck, one at your shoulders, and one at the small of your back.
You aren’t born with this s-shaped spine.
Babies’ spines just have one curve like a “c.”
The other curves usually develop by 12-18 months as the muscles strengthen. These curves help us stay upright and absorb some stress from activities like walking and jumping.
If they are aligned properly, when you’re standing up, you should be able to draw a straight line from a point just in front of your shoulders, to behind your hip, to the front of your knee, to a few inches in front of your ankle.
This keeps your center of gravity directly over your support base, which allows you to move efficiently with the least amount of fatigue and muscle strain.
Your neck should be vertical, not tilted forward if you’re sitting.
Your shoulders should be relaxed with your arms close to your trunk.
Your knees should be at a right angle, with your feet flat on the floor.
What If Your Posture Isn’t Great?
Try redesigning your environment.
Adjust your screen so it’s at or slightly below eye level.
Make sure all parts of your body, like your elbows and wrists, are supported, using ergonomic aids if you need to.
Try sleeping on your side with your neck supported and a pillow between your legs.
Wear shoes with low heels and good arch support, and use a headset for phone calls.
It’s also not enough to just have good posture.
Keeping your muscles and joints moving is extremely important.
Being stationary for long periods with good posture can be worse than regular movement with bad posture.
When you do move, move smartly.
Keep anything you’re carrying close to your body.
Backpacks should be in contact with your back carried symmetrically.
If you sit a lot, get up and move around on occasion, and be sure to exercise.
Using your muscles will keep them strong enough to support you effectively, besides all the other benefits to your joints, bones, brain and heart. And if you’re worried, check with a physical therapist because you should stand up straight.
