Therapeutic Lec 1.pdf

Dr. Yasmein mohammed Posture is a “position or attitude of the body either with support during muscular inactivity, or by the means of the coordinated action of many muscles working to maintain stability or to form an essential basis which is being adapted constantly to the movement which...

Dr. Yasmein mohammed Posture is a “position or attitude of the body either with support during muscular inactivity, or by the means of the coordinated action of many muscles working to maintain stability or to form an essential basis which is being adapted constantly to the movement which is supper- imposed upon it. 1.Inactive postures 2. Active postures Static postures Dynamic postures  POSTURE acronym for east reference: ▪ P:- Pelvis is neutral, with weight distributed. ▪ O:- On the whole foot ▪ S:- Stable joints. ▪ T:- Tight abdominals. ▪ U:- Upright ribs. ▪ R:- Retracted midway shoulders ▪ E:- Ear same level over shoulder being adapted constantly to the movement which is supper-imposed upon it.  Attitude adopted for resting or sleeping. Used for training general relaxation. All essential muscular activity reduces to minimum Integrated activity or action of many muscles is required to maintain active posture It may be Static posture Posture Assessment: The key to good posture is the position of the spine. The spine has three natural curves - at your neck, mid/upper back, and lower back. Correct posture should maintain these curves, but not increase them. Your head should be above your shoulders, and the top of your shoulder should be over the hips. In an ideal posture, the line of gravity should pass through specific points of the body. This can simply be observed or evaluated using a plumb line to assess the midline of the body. This line should pass through the lobe of the ear, the shoulder joint, the hip joint, though the greater trochanter of the femur, then slightly anterior to the midline of the knee joint and lastly anterior to the lateral malleolus. When viewed from either the front or the back, the vertical line passing through the body's center of gravity should theoretically bisect the body into two equal halves, with the bodyweight distributed evenly between the two feet. While assessing posture, symmetry and rotations/tilts should be observed in the anterior, lateral and posterior views. Assess: Head alignment Cervical, thoracic and lumbar curvature Shoulder level symmetry Pelvic symmetry Hip, knee and ankle joints Risk factor of bad posture: Misalign your musculoskeletal system Increase pressure on the spine, making it more prone to injury and degeneration Cause neck, shoulder, and back pain Decrease flexibility Affect how well joints move Affect balance and increase risk of falling Make it harder to digest food Make it harder to breathe In women it can lead to imbalance in the core muscle leading to incontinence and/or pelvic organ prolapse The Relationship Between Posture and Pain There are many theories that bad posture is a contributing factor in low back pain, some studies have shown that improved posture and postural control can have a positive effect on pain. Common Causes of Poor Posture: Muscle tension or muscle weakness Over Weight Occupation Pain or past injuries Low nutritional state Hereditary Extra weight Bad Habits Lifestyle and fashion The examiner must be able to separate the parts of the body from the whole and in turn assess the sum of these parts, in reference to their interaction in the entire anatomical structure In correct posture, the gravity line passes through the axes of all joints , Therefore, the closer a person’s postural alignment lies to the center of all joint axes; the less gravitational stress is placed on the soft tissue components of the supporting system Bad posture may occur when one muscle groups becomes tight and the antagonist elongated. Synergistic muscles around a joint may be unbalanced as well as the agonists Malposture of different sports: Many sports over-strengthen some muscles e.g. the quadriceps. This leads to an unbalanced ratio of quadriceps-to-hamstring strength, which in turn pulls the front of the pelvis down. The result is anterior pelvic tilt. This alters the position of the spine resulting in a hyperlordosis, which then shuts down the hip flexor muscle group. Cyclists may develop a kyphotic thoracic spine. Volleyball is a discipline associated with high training loads. The sport involves a number of asymmetrical techniques, including the serve and the attack. Volleyball can result in an imbalance between the muscle tone and length and thus contribute to asymmetry of the spine. Lordosis in the power athlete is common Kyphosis in the swimmer is also common. Soccer is an endurance sport with repetitive complex motion sequences, as well as a high risk of body injury. The frequency of injuries among adult male players is high with most injuries occurring in the lower limbs (the ACL in particular). The mechanics of the lumbar-pelvic-hip complex and the thoracolumbar fascia, participate in the transfer of loads between the lower and upper limbs, the spine and the pelvis. The analysis of possible pelvic asymmetries in posture measurements may stem from injuries in the lower limbs Pectus excavatum, also known as sunken or funnel chest, is a congenital chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest Pectus carinatum is a rare chest wall deformity that causes the strnum to push outward instead of being flush against the chest. It is also known as pigeon chest or keel chest. When the chest wall develops, the cartilage that connects the ribs usually grows flat along the chest. Arthritis can stiffen the chest causing the ribs to become fixed in their most expanded position, giving the appearance of a barrel chest. Barrel chest also refers to an increase in the anterior posterior diameter of the chest wall resembling the shape of a barrel, most often associated with emphysema Chains around body due o bad posture: