Certificate III / IV in Fitness
Topic 5
Week 12
Postural analysis
Session 4 & 5
Todays session will cover the
following topics
Client postural screening
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Occupational influences on posture
Range of movement
Static postural analysis
Dynamic postural analysis
Weekly review
Question time
Postural appraisal for low-risk
participants
This session involves application of the following topics:
 introduction to postural appraisal
 postural variances
 range of movement assessment
 static posture assessment
 dynamic posture assessment.
Postural appraisal for low-risk
participants
Aims of postural appraisal
 The aims of a postural appraisal will vary from client
to client, but in general the overall focus is to:
• identify abnormalities
• determine the degree and origin of the deviation
• determine the effect on proposed or current exercise plans
and goals
• identify contraindications and postural risk factors
associated with exercise
• identify postural risk factors associated with increased risk of
injury
Postural appraisal for low-risk
participants
– Posture is assessed in two different ways:
• Static postural appraisal involves observations and
measurements from the anterior, posterior and
lateral views of a client. Generally it may include
standing, sitting or lying positions
• Dynamic postural appraisal involves the
assessment of clients while they perform exercises
or general movements and actions
What is good posture?
– Good posture, or ideal postural alignment,
requires all body parts to be in good balance and
harmony with each other
– In this state, pressure and tension acting upon
supporting structures (ligaments, tendons and
cartilage) are minimal
– Poor posture is less efficient than good posture
and becomes less stable over its base of support
What is good posture?
– The muscular system should possess the strength
and endurance to resist the force of gravity and other
forces imposed on the body during muscular effort
– The task for the fitness trainer is to identify and
evaluate the muscles that are affecting the standard
posture and to implement an exercise program
designed to improve function
– If dysfunction is the cause of continued pain or
restriction, and the implementation of an exercise
program has an element of risk or contraindication
refer to AHP
When should I refer?
– The following flags will inform the decision to
refer:
• History of injury, musculoskeletal or nervous
• Responses to questions relating to chronic
conditions
• Hypomobility/Hypermobility of joints
• History of neck or back injuries
• Current contact with an AHP
Postural variances
– The inhibition of specific muscles or a muscle
group may lead to postural changes
– Fitness trainers undertaking a postural appraisal
should note that, when observing any
dysfunction, the possibility of it being due to the
inhibition of a single muscle is limited
– There are various muscular tests available to
identify potential muscle imbalance
Postural variances
– Areas above or below muscle inhibition can
result in the displacement of the skeletal
system or compensatory changes, including:
• change in the centre of gravity, due either to weight
adjustment or pregnancy
• structural skeletal changes
• joint impingement
• joint compression
• joint separation or stretching
• joint hypermobility or hypomobility
Muscle development and poor posture
– One of the principle functions
of muscles is to move the
body and give support to the
skeletal structure
– muscular development will
support the skeletal structure,
soft tissue reliability and
neurological control
– Removal or breakdown in one
of these factors may result in
instability, weakness and, on
occasion, injury
Muscle development and poor posture
– Example of poor posture:
• If the hip flexors (iliopsoas and rectus femoris) are stronger
than the hip extensors (gluteals and hamstrings) it will cause
the joint to be held in a flexed position (anterior pelvic tilt)
• Over time, the joint capsule and ligaments on the side of the
flexors will become shortened, thicker and tight
• When the extensors contract, they will be required to exert
increased levels of force to stretch the shortened capsule
and ligament
• Very tight hip flexors may be a source of constant pain,
severely limiting hip extension, adversely affecting function
Occupational influences on posture
– Considering that most people
spend many hours at work,
occupational influences can
have a profound effect on
posture
– Reflect on the postural
position you are currently in
while reading this book:
• Looking down continuously at
reading material on a flat
desk – as a student or office
worker does, over many
hours, day after day – place
considerable tension on the
neck, shoulders and back
Occupational influences on posture
– In order for the fitness trainer
to develop an exercise
program aimed at stretching
and strengthening the affected
muscles, it is imperative to first
identify them
– If the scapula becomes
restricted, unstable due to
rotator cuff dysfunction, or
there is a muscle imbalance or
weakness, this may impact on
the shoulder rhythm or motion
Occupational influences on posture
– Sitting and manual handling:
• Assessing a client’s sitting or lifting posture is
especially important if much of your client’s time at
work involves one of these activities
• It is accepted that a seated posture will deviate
from the optimum at times. However, it is important
that a minimum amount of time is spent in these
alternative, often poor postures
Occupational influences on posture
• If a person sits up straight, at a 90-degree angle, disc
pressure is high. If a person leans forward while
seated, thus decreasing the previous angle, disc
pressure is greatly increased
• Clients should be instructed to allow the vertebral
column to lengthen into a natural position, as it would in
a standing position
• Sitting with a slight lean backwards anteriorly rotates
the pelvis, thus reducing disc pressure. In this position
the vertebral column assumes its normal ‘S’ curve
Occupational influences on posture
• There are two common mistakes people make
when lifting objects:
– The first one is using the wrong muscles. People often
rely on the strength and endurance capacity of the back
musculature rather than that of the legs and buttocks
– The second mistake is attempting to lift an object that is
too far from the body or reaching out in front of the body
with a weight
Exercise and poor posture
– Incorrect training techniques, muscular imbalance,
non-adherence to fundamental training principles and
numerous other factors will have an impact on
posture
– Sportspeople with a lordotic posture may experience
a loss of efficiency and possible complications in the
knees, hip and/or lower back. Muscles that are often
tight with lordosis are:
• trunk extensors (erector spinae and quadratus lumborum)
• hip flexors, particularly iliopsoas (rectus femoris is the third
hip flexor)
Exercise and poor posture
– Fitness trainers incorporating leg raises, hanging
leg raises, sit-ups (legs anchored) or straightlegged sit-ups are accentuating the lordotic
condition by further strengthening the hip flexors.
The more appropriate program would include the
following stretches:
• trunk extensor (erector spinae and quadratus
lumborum)
• hip flexors (in particular the iliopsoas muscle)
Footwear and poor posture
– Wearing supportive footwear when standing or
participating in exercise is important for good posture
– Continually wearing high-heeled shoes, for example,
may:
• lead to the development of bunions, claw toes and corns and
thickening of the nails
• have ankles are placed in an unfamiliar position for extended
periods, causing the Achilles and gastrocnemius to be held in
a shortened position
• move the knees and hips out of equilibrium, potentially
causing the spine to exaggerate its curvature
Footwear and poor posture
– Flexibility is essential in the design and selection
of footwear. There should be appropriate levels of
lateral and longitudinal flexibility within a shoe
– The desired level of flexibility will be determined
by the purpose for which the shoe is to be used
– Generally footwear should:
• fit correctly
• provide shock absorption
• provide stability for side-to-side movements
Age and poor posture
– In many elderly people, there is;
– increased thoracic kyphosis and a flattening of the lumbar
curve
– either posterior pelvic tilt or a compensatory increase in
lumbar lordosis
– the hip and knee joints become increasingly flexed with the
ankle dorsi flexed to counter these changes
– Generally, there is a loss of height due to this imperfect
posture
– Exercise in the opposite direction to the bending
at a joint is advisable in order to regain better
posture
Obesity and poor posture
– In obese people, there can be;
– weak and often protruding abdominal muscles can
prevent maximum expiratory pressure
– altered pulmonary mechanics and as a result less
oxygen is delivered to working muscles
– muscle atrophy which is a precursor to postural change
and associated injury
– Exercise designed to promote a positive
lifestyle and behavioural changes
Pregnancy and poor posture
– During pregnancy, there can be;
– rapid weight gain associated with pregnancy, along with
altered weight distribution
– with the development of the foetus, the centre of gravity
shifts forward and upward. The common outcome of this is
usually an increase in lumbar lordosis and compensatory
thoracic kyphosis
– any muscular adaptations will be further compounded by
breast enlargement
– The focus of the fitness trainer is instruction in
proper postural habits, which will minimise strain,
especially on the back, and the risk of injury
Legislation and regulatory requirements
– A fitness trainer must obtain informed consent as part
of the client induction process
• should happen via the client reading the document, or the
trainer reading it out loud
• the client must sign that they agree to the document
– The fitness trainer must always explain the postural
appraisal process clearly and completely. Particularly
in relation to the reason for privacy during screening
– The trainer must also explain the recording of
deviation
Legislation and regulatory requirements
– What is the Privacy Act?
• The federal Privacy Act 1988 governs the collection,
use, disclosure, quality and security of personal
information
• With respect to postural screening this would relate to
the capture of photographs/images and information
about the client
– Child protection
• as a fitness trainer you should always be aware of your
states legislation with respect to child abuse and
reporting
Assessing range of movement
– An individual’s range of movement (ROM)
describes the degree to which a joint can move
– ROM varies from joint to joint. A subjective
assessment of an individual’s ROM in any
particular joint is easily achieved by comparing it
with the other side
– Range of movement screening will help you
decide if goniometric measurement is required
Assessing range of movement
– Using a goniometer
• A goniometer is a device that measures, in degrees, a
joint’s angle or ROM. It does not identify the cause of
any limitations in that joint
• For the fitness professional the main benefits of
quantifying this information are to:
– measure the progress in the return to either ROM or
functional movement which is free from limitation or pain, or
– identify any abnormal or restricted ROM that may need
further investigation by a suitably qualified health
professional.
Assessing range of movement
– A traditional goniometer is a protractor with
extending arms. The following steps will assist
fitness trainers assess accurately:
1. Place the axis of the goniometer with the axis of rotation for that joint with
the stationary arm along the stationary line of the body and the moveable
goniometric arm along the moveable portion of the body
2. Record the starting position, in degrees
3. Instruct the client to move their joint in the desired direction according to
their full ROM
4. As the client has reached their furthest ROM for that joint, record this
reading from the goniometer
5. Comparisons can be made with standard values or,
alternatively, comparisons can be made with the opposing
joint
Static postural assessment
– When assessing a client’s static posture,
fitness trainers have the option of using a
range of equipment (e.g. plumb line, posture
grid, video cameras or computer programs)
– Understanding the processes involved in lowtech postural assessment will more likely
provide the fitness trainer with the confidence
and competence to apply postural analysis in
the workplace
Static postural assessment
– When assessing a client’s static posture,
fitness trainers have the option of using a
range of equipment (e.g. plumb line, posture
grid, video cameras or computer programs)
– Understanding the processes involved in lowtech postural assessment will more likely
provide the fitness trainer with the confidence
and competence to apply postural analysis in
the workplace
Static postural assessment
– When conducting a postural assessment,
following a set procedure helps improve the
reliability and validity of the results:
1. Select a flat surface for the client to stand on
2. Ask the client to wear minimal clothing (e.g. swimwear). This allows for
unrestricted observation
3. Ask the client to take up a neutral stance on a line marked on the floor in
front of the posture grid or screen
4. Suspend a plumb line just in front of this line
5. Take up a position that provides a clear and unrestrictive view of the client –
no less than 3 m from the client should be satisfactory
6. Ask the client to relax and breathe normally
Impact of non-ideal postural alignment
– In the ideal postural alignment stance the tension placed
on the musculoskeletal system is minimal, allowing an
individual to stand relaxed in their typical position
– A non-ideal postural alignment can affect the range of
movement of muscles and joints, as well as overall
functional capacity
– Fitness trainers must have a solid understanding of the
musculoskeletal system, as correct identification, location
and action of the inhibitive muscle (or muscle group) will
have obvious consequences on exercise selection
Postural examination
– When examining a client’s posture, it is necessary to
be prepared. Developing competency in postural
screening requires practice and the use of a set
procedure
– Clients who are left standing in a static position for an
extended period may begin to fatigue and succumb to
strain or nervous tension
– Completing the examination quickly and accurately
allows you to move on to the next stage of the client
screening process. Therefore, it is important to
become proficient in examining clients
Postural examination
– The Anterior and Posterior view:
• if using a plumb line or assessment grid;
– have the client stand behind it for the Anterior view, and in
front for the Posterior
– ensure the client is not touching the line/grid
– instruct them to have their arms relaxed, with hands neutral
• use a recording sheet which will allow the trainer to
identify all anatomical segments and important
deviations
Postural examination
– The Lateral view:
• for this view the client should stand with the plumb
line/grid to their side
• the client should stand in the same position as for
the anterior/posterior observation
• use a recording sheet which will allow the trainer to
identify all anatomical segments and important
deviations
Static postural deviations of the spine
– Lordosis:
• increased curvature of the spine, usually lumbar.
• can also affect thoracic and cervical areas of the spine
• Lumbar lordosis relates to pelvic deviation (anterior/posterior
tilt)
– Kyphosis:
• increased posterior curvature of the spine, usually thoracic.
• can be from structural (eg shape of spine) or functional (eg
work habit) issues
• chest muscles are often tight, erector spinae, rhomboids and
trapezius week
Static postural deviations of the spine
– Scoliosis:
• vertebrae with a lateral deviation
• will appear with lateral flexion and rotation of
vertebrae
• two types;
– C curve: single curve
– S curve: two curves
Static postural deviations of the pelvis
– The pelvis is in a natural position when the
anterior superior iliac spine (ASIS) and the
symphysis pubis are in vertical alignment
• An anterior pelvic tilt refers to a position in which the
ASIS is forward, or anterior to the vertical plane
• A posterior pelvic tilt is a position where the ASIS is
posterior to the vertical plane
• A lateral pelvic tilt is present when there is an obvious
side lean of the pelvis
Static postural deviations of the legs
– Genu valgum (knock-knees) is the slanting of the
knees either unilaterally or bilaterally towards
each other
• may be developed or retained from;
–
–
–
–
trauma to growth cartilage
congenital anomalies
genetic disorders
metabolic bone disease
– Gena varum (bowed legs) is observed when the
feet and ankles remain together and knees wide
apart. Infants are born with bowed legs
Static postural deviations of the legs
– Genu recurvatum (knee hyperextension) is
the posterior bowing of the knees while in a
standing position
• may be functional or congenital from;
– poliomyelitis
– fibrosis
– trauma to growth cartilage
– limb length discrpancies
Static postural deviations of the scapulae
– The scapulae should sit nicely against the rib
cage wall, forming the scapulothoracic joint
– If the scapulae are protruding posteriorly from this
position, it is known as scapular winging
– Scapular winging is often associated with nerve
pathology and involves weakening of the
surrounding musculature, including;
• rhomboids and, in particular, the lower portion of the
serratus anterior
Dynamic postural assessment
– As an extension to the static postural evaluation,
dynamic posture can be considered as a series of
movements that are linked to produce a degree of
effort
– The purpose of a dynamic postural assessment is to
observe how the body responds to movement under a
reduced load, that being the force of gravity
– The trainer could carried out a dynamic postural
assessment via; running, walking, placing clothes on
a line, picking up children, lifting a box, weightlifting
Dynamic postural assessment
– Assessing dynamic posture:
• the key purpose is to identify bilateral imbalance,
fault or instability
• some examples of assessments;
– overhead squat
– single leg raise assessment (Trendelenburg test)
– single leg squat assessment
– pushing movement assessment
– pulling movement assessment
Take home message from todays session:
• This might be an area that scares the crap out of you, but once
conquered can help build your confidence tenfold!
• Occupational influences on posture
• Range of movement
• Static postural analysis
• Dynamic postural analysis
Take home message from todays session:
• For all of the new methods that you have been shown in the
strength and conditioning sessions, please review and explore in
more details to develop your own specialised understanding.
• Try to choose an area of interest and pursuit it!