Head Position and Forward Posture

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Questions and Answers

What is the normal angle of the carrying angle in males?

5 degrees (correct)

15 degrees

20 degrees

10 degrees

What could be a reason for uneven contours of the clavicles?

Elevated shoulders

Mal-alignment of a fracture (correct)

Muscle imbalances

Normal posture

What is the normal position of the anterior superior iliac spines (ASIS) of the pelvis?

Uneven

Level (correct)

Higher on the right side

Lower on the left side

What is the result of a lateral tilt in the pelvis?

A lateral curve in the lumbar spine Signup and view all the answers

What is the normal angle of the carrying angle in females?

10 to 15 degrees Signup and view all the answers

What could be a result of an abnormal carrying angle?

Affect a person's ability to bear weight through the upper limb Signup and view all the answers

What could cause a shift of the thorax?

All of the above Signup and view all the answers

What should be observed in the clavicles?

Both the angle and contour Signup and view all the answers

What is the main effect of a forward head posture on the cervical extensor muscles?

They become lengthened and weak Signup and view all the answers

What is the result of an exaggerated lordotic curve in the cervical spine?

Increased compression on posterior cervical soft tissues Signup and view all the answers

What is associated with a kyphotic posture?

A diminished thoracic cavity Signup and view all the answers

What is a common feature of a slumped position?

Protracted shoulders Signup and view all the answers

What is associated with a retracted shoulder posture?

A military-style posture Signup and view all the answers

What can be a cause of a protracted shoulder on one side of the body?

Regularly wheeling a heavy luggage trolley behind on one side Signup and view all the answers

What is the effect of a forward head posture on the neck?

It increases the strain on posterior cervical soft tissues Signup and view all the answers

Which muscle groups may be lengthened in a person with a kyphotic posture?

Trapezius and rhomboids Signup and view all the answers

What is the effect of a kyphotic posture on the thoracic spine extensors and middle and lower fibers of the trapezius?

They become lengthened and weak Signup and view all the answers

What can be a natural consequence of pregnancy or a result of increased lumbar lordosis?

A protruding abdomen Signup and view all the answers

What is suggested by an internally rotated humerus?

Shortness in the muscles of medial rotation Signup and view all the answers

What can be compressed in the lumbar spine as a result of increased lordosis?

Zygapophyseal joints Signup and view all the answers

What can be a result of restrictions in the muscles and fascia of the chest?

A protruding abdomen Signup and view all the answers

What can be associated with shortened pectorals, tight intercostals, and shallow breathing?

A severely kyphotic posture Signup and view all the answers

What can be a characteristic of clients with increased flexibility or hypermobility syndromes?

A decreased kyphotic curve Signup and view all the answers

What can be a consequence of regularly performing an activity that involves external rotation on one side of the body?

A protracted shoulder on one side of the body Signup and view all the answers

What happens to the lumbar spine when the pelvis tilts anteriorly?

It becomes more curved Signup and view all the answers

What is a characteristic of a client with hyperextended knees?

Tight quadriceps Signup and view all the answers

What may prevent full extension of the knee joint?

A loose body within the joint Signup and view all the answers

What is a possible consequence of tight quadriceps in a client with hyperextended knees?

Anterior knee pain Signup and view all the answers

What happens to the pelvis when the lumbar lordosis is decreased?

It tilts posteriorly Signup and view all the answers

What is associated with a flexed knee position?

Tight hamstrings and weak quadriceps Signup and view all the answers

What is associated with an anteriorly tilted pelvis?

Lengthened hip flexors and shortened hip extensors Signup and view all the answers

What is the relationship between the pelvis and lumbar spine?

Changes in one affect the other Signup and view all the answers

What is the characteristic of genu valgum?

Increased pressure on the lateral side of the knee joint Signup and view all the answers

What happens to the muscles in genu valgum?

The muscles of the lateral thigh are shorter Signup and view all the answers

What is the characteristic of pes planus?

The medial side of the foot might even be touching the floor completely Signup and view all the answers

What is the possible cause of feet turned out in a ballet-type stance?

External rotation at the hip joint or lateral tibial torsion or both Signup and view all the answers

What is the characteristic of genu varum?

Increased pressure on the medial side of the knee joint Signup and view all the answers

What happens to the muscles in genu varum?

The muscles of the medial thigh are shorter Signup and view all the answers

What is the characteristic of pes cavus?

A greater-than-normal space between the floor and the medial side of the foot Signup and view all the answers

What is the possible cause of feet turned inwards?

Shortening of the internal rotators of the hip Signup and view all the answers

Study Notes

Head Position

A forward head posture affects the neck, chest, and arms, with the head positioned too far in advance of the body.
Cervical extensor muscles, such as the levator scapulae, are lengthened and weak, rather than shortened and tight.
This posture increases the strain on posterior cervical soft tissues, potentially leading to neck, shoulder, and upper back pain.

Cervical Spine

An exaggerated lordotic curve in the cervical spine often accompanies a kyphotic posture.
This increases compression on the posterior part of some cervical intervertebral discs and may compress the zygapophyseal joints.

Thoracic Spine

A kyphotic posture is associated with an exaggerated kyphosis in the thoracic spine, reducing the thoracic cavity.
This leads to shortened intercostals, pectoralis minor, adductors, and internal rotators of the shoulders.
Muscles often weak in a kyphotic posture include the thoracic spine extensors and the middle and lower fibers of the trapezius.

Shoulder Position

Protraction of the shoulders (slumped position) is associated with lengthened and weak rhomboids, tight pectorals, and shortened intercostals.
Retracted shoulders are associated with shortness in the rhomboid muscles and in the middle fibers of the trapezius, and some parts of the pectoralis major may be lengthened.
An internally rotated humerus suggests shortness in the muscles of medial rotation, while an externally rotated humerus suggests shortness in muscles such as the infraspinatus and teres minor.

Thorax

A severely kyphotic posture is associated with shortened pectorals, tight intercostals, and perhaps even shallow breathing due to a depressed chest cavity.
Thoracic spine extensors, the middle and lower fibers of the trapezius, and the rhomboids may be lengthened and weak.

Abdomen

Protrusion of the abdomen could be a natural consequence of pregnancy or the result of increased lumbar lordosis, or it could simply be excess adipose tissue due to being overweight.
Clients with restrictions in the muscles and fascia of the chest may appear to have a protruding abdomen, with a distinct change in shape from the chest area.

Lumbar Spine

An increased lordotic curve indicates an anteriorly tilted pelvis, potentially leading to pain resulting from compression of soft tissues in this region.
The correct functioning of the zygapophyseal joints in the lumbar spine may also be compromised if they are compressed.
The rectus abdominis may be longer and therefore weaker than usual, as may the hip extensors, whereas the muscles responsible for lumbar extension may be shortened.

Pelvis

An anteriorly tilted pelvis is associated with lengthened but weak hamstrings, plus a lengthened rectus abdominis.
The psoas may be shortened, and there may be shortened rectus femoris, too.
A posteriorly tilted pelvis is associated with tightness in the hip extensors and longer, and perhaps weakened, hip flexor muscles.

Knees

Flexed knees are associated with tight hamstrings and popliteus muscles and weak quadriceps and soleus muscles.
A flexed knee may accompany an increase in flexion at the hip and an increase in dorsiflexion at the ankle joint.
Certain pathologies affecting the knee inhibit extension of the joint, while hypermobile clients may hyperextend their knees in standing.

Feet

Foot arches can appear normal, dropped, or elevated.
Foot position can be affected by external rotation at the hip joint, lateral tibial torsion, or both.

Anterior Postural Assessment

Clavicles should have smooth contours and be gently angled upwards away from the sternoclavicular joint.
Sharply angled clavicles indicate elevated shoulders.
Uneven contours could indicate a fracture that has healed in mal-alignment or a more recent injury.

Chest

The thorax may shift laterally or rotate relative to the neck and pelvis.
Shifts of the chest occur for many reasons, including lateral curvatures in the spine and muscle imbalances.
When the thorax rotates, compensatory changes occur in the neck and lumbar spine.

Carrying Angle

The carrying angle is the angle formed between the long axis of the humerus and the long axis of the forearm.
A normal carrying angle is 5 degrees in males and 10-15 degrees in females.
An abnormal carrying angle can affect a person's ability to bear weight through the upper limb.

Lateral Pelvis

The anterior superior iliac spines (ASIS) of the pelvis should be level.
A lateral tilt in the pelvis corresponds with a lateral curve in the lumbar spine.

Rotated Pelvis

A rotated pelvis can lead to increased pressure on the lateral or medial side of the foot.

Genu Valgum and Genu Varum

In genu valgum, there is increased pressure on the lateral side of the knee joint, leading to degenerative changes on that side of the knee.
In genu varum, there is increased pressure on the medial side of the knee joint.
Structurally, genu valgum is associated with shorter muscles of the lateral thigh, while genu varum is associated with shorter muscles of the medial thigh.

Foot Position

Feet turned out in a ballet-type stance could result from external rotation at the hip joint, lateral tibial torsion, or both.
External hip rotation could indicate shortening of the gluteus maximus and the posterior fibers of the gluteus medius, along with the iliotibial band.
A client who stands with their feet turned inwards (pigeon-toed) may have shortened internal rotators of the hip, a medially rotated tibia, or both.

Pes Planus and Pes Cavus

In pes planus, the medial side of the foot might even be touching the floor completely, leaving no gap at all.
In pes cavus, there will be a greater-than-normal space between the floor and the medial side of the foot.

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Description

This quiz assesses your understanding of forward head posture, its effects on the neck, chest, and arms, and the implications on cervical extensor muscles.