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Therex final
Posture
| Question | Answer |
|---|---|
| posture | Position or attitude of the body, the relative arrangement of body posture for a specific activity, or a characteristic manner of bearing one's body |
| inert structures that are affected by posture | ligaments, fascia, bone, joints, nerves, blood vessels |
| dynamic structures that impact posture | mm and tendinous structures |
| ____ places stress on inert and dynamic structures as they maintain the body in an upright position | gravity |
| normally, the body aligns itself in a ____ state | balanced |
| postural fault | A posture that deviates form normal alignment but has no structural impairment |
| postural pain syndrome | The pain that results from mechanical stress when a person maintains faulty posture for a prolonged period; the pain is usually relieved with activity |
| postural dysfunction | Adaptive shortening of soft tissues and mm weakness are involved (stretch weakness) |
| postural habits | Can be good or bad. We must work on changing habits and make sure injury does not lead to poor postural habits |
| Deviations from the normal (or optimum) must be counteracted by other forces to maintain the ___ ____. This counter force is provided by either the ___ or ____ structures. | gravity line, inert or dynamic |
| contributors to bad posture | Obesity, Pregnancy, Weak muscles, High heeled shoes, Tight muscles, decreased flexibility, Poor work environment, Poor sitting and standing habits |
| for every 1 inch increased in forward head, there is ___ pounds increased force on cervical mm | 10 |
| where should gravity line fall on ankle | gravity line anterior to joint |
| what is ankle stability provided by in optimal position? | plantar flexors (primarily soleus) |
| where should gravity line fall on knee | anterior to knee joint |
| what structures is knee stability provided by in optimal position? | Stability from ACL, posterior capsule, tightness of posterior muscles, With the knee fully extended no muscle support is required |
| where should gravity line fall on hip | gravity line varies with sway of body. Line passes through the joint, no external support necessary |
| what is occuring if gravity line falls posterior to hip? | posterior rotation of pelvis occurs (tension of hip flexor mm) |
| what provides passive stability of hip in relaxed standing | Y ligament |
| what occurs if gravity line falls anterior to hip? | active support of the hip extensor mm |
| where should gravity line fall on trunk | through the vertebral bodies of the lumbar and cervical vertebrae |
| what mm maintain trunk posture/ stability as trunk shifts | contralateral mm act as guide wires |
| what are extreme or sustained positions of the trunk sustained by | inert structures |
| Thoracic spine extension ____ rib cage and assists with ____ posture | elevates, upright |
| what mm contracts to stabilize with UE motion and works with diaphragm for stabilization | transverse abdominis (TrA) |
| what mm must contract together to increase intra-abdominal pressure and unload spine | diaphragm, transverse abdominus, internal obliques and pelvic floor |
| how can stability be improved | lower COG |
| what happens when COG falls outside of BOS | the structure either falls or some force must act to keep the structure upright |
| BOS | perimeter of contact area between body and it's support surface |
| you need to have ____ stability in order to have ____ stability | segmental, global |
| mechanical stress to structures can cause pain; this pain is NOT due to ____ but to the mechanical stress on a structure with ___ ____ | inflammation, pain innervation |
| If the mechanical stress on structures is not relieved and the stress exceeds the capabilities of the inert or dynamic structures, _____ will occur. | breakdown |
| what will be seen with postural dysfunction | - Compressed tissues - Adaptive shortening of soft tissues and muscle weakness are present (tight weakness) - Over stretched tissues (stretch weakness) - May be due to trauma, injury, habit, work, or sport |
| clinical presentation of postural dysfunction | - Pain from stress to sensitive structures and muscle tension - Decreased range of motion (dysfunctions) - Muscle strength imbalances (dysfunctions) - Altered kinesthetic awareness of normal alignment - Lack of knowledge of posturing to prevent pain |
| lordotic posture | increase in lumbar lordosis, anterior pelvic tilt and hip flexion |
| what is lordotic posture often seen with? | thoracic kyphosis and forward head: kypholordotic posture |
| what does ligament does lordotic posture place stress on? | - anterior longitudinal ligament (ALL) |
| how does lordotic posture affect the disc space and the intervertebral foramen? | narrowing of posterior disc space, intervertebral foramina results in compressed dura and blood vessels |
| what bony structure does lordotic posture compress? | articular facets |
| what mm imbalances can result from lordotic posture | tight hip flexors and lumbar extensors (shortened); stretched abdominals (weak) |
| swayback posture | entire pelvis shifted anteriorly, increased lordosis of L- spine, increased kyphosis of lower T-spine, protracted scapulae (round shoulders), usually forward head (increased flexion of C-T spine and increased extension of upper C-spine) |
| what ligaments does swayback posture place stress on in the pelvic/lumbar region? | - iliofemoral ligaments - ALL (lower L-spine) - PLL (upper L-spine and T-spine) - iliotibial band of elevated hip |
| what is compressed in swayback posture? | blood vessels, dura, nerve roots due to narrow intervertebral foramen |
| what structures does swayback posture place stress on in the thoracic region? | - stress to PLL of T-spine - fatigue to thoracic erector spinae/rhomboid muscles - thoracic outlet syndrome (TOS) |
| what structures does swayback posture place stress on in the cervical region? | - stress to ALL upper C-spine and PLL in lower C-spine and upper T-spine - irritation of facet joints upper C-spine - lower cervical disc lesions - cervical thoracic junction stressed |
| what joint can swayback posture cause pain in? | TMJ |
| how does swayback posture affect the intervertebral foramina of cervical spine | narrowing of intervertebral foramina upper cervical spine |
| how does swayback posture affect the mm of the cervical spine? | - muscle tension or fatigue - TOS due to anterior scalene muscle tightness |
| what mm can impinge the cervical plexus in swayback posture? | levator scap |
| what nerves can be compressed in the cervical region by the upper trap in swayback posture? | impingement of occipital nerves and trigeminal |
| common causes of swayback posture | Attitudinal (comfortable), Fatigue (continued slouching), Muscle weakness, Occupational (especially seen with cervical syndromes |
| what faults in an exercise program may lead to swayback posture? | overemphasis on flexion, only strengthening what is seen in mirror |
| what is swayback at cervical and thoracic spine characterized by? | increased kyphosis with forward head, protracted scapula |
| what structures does cervical and thoracic spine swayback place stress on? | - ALL - Fatigue of thoracic erector spinae, scapular retractors, and capital flexors - May have TMJ symptoms |
| flat low back posture | Decreased lumbar lordosis, posterior tilting of the pelvis |
| what does flat low back posture place stress on? | decreased lumbar curve reduces shock-absorbing effect and predisposes patient to injury; stress on PLL and anterior disk |
| what mm will have imbalance in flat low back posture? | tight or shortened abdominals and hip extensors, stretched/weak lumbar extensor and hip flexors |
| common causes of flat low back posture | - slouching in sitting and standing - compensation for herniated disk symptoms - post laminectomy /post surgical scar tissue formation and shortening - stenosis - narrowing of canal due to DJD |
| overemphasis of ____ in an exercise program could result in flat low back posture | flexion |
| flat upper back and neck posture | decrease in thoracic curve, depressed scapulae and clavicle and decreased cervical lordosis |
| what does flat upper back and neck posture place stress on? | anterior neck mm, thoracic erector spinae, and potentially decreased scapular movement |
| what mm will be impaired in flat upper back and neck posture | scapular protractors and intercostal mm of the thorax |
| what side will ilium be elevated on in leg length discrepancy? | long leg side (lowered on short leg side) |
| in LLD, the long leg side hip will be ____, while the short leg side will be in ____ | adduction, abduction |
| which way will the person side bend with LLD | L spine side bend to LL side |
| with LLD, what side will the intervertebral disc be compressed on | LL side |
| with LLD, what side will lumbar facets be extended and compressed on? | LL side |
| LLD will develop compensatory scoliosis in the ___ and ___ spine | thoracic, cervical |
| in LLD, the long leg side hip will be ____, while the short leg side will be in ____ | adduction, abduction |
| which way will the person side bend with LLD | L spine side bend to LL side |
| what will be seen at foot of long leg side | pronation |
| what will be seen at foot of short leg side | supination |
| what will be seen at ankle of long leg side | Dorsiflexion |
| what will be seen at ankle of short leg side | plantar flexion |
| what will be seen at knee of long leg side | flexion |
| what will be seen at knee of short leg side | extension |
| what will be seen at hip of long leg side | Flexion and Internal Rotation |
| what will be seen at hip of short leg side | Extension and External Rotation |
| what will be seen at innominate bone of long leg side | posterior rotation |
| what side will stenosis of the lumbar intervertebral foramina be seen on with LLD? | LL side |
| lumbar facet compression occurs on what side with LLD | LL side |
| complications of LLD | - disk breakdown - muscle tension, fatigue, or spasm - lower extremity overuse syndromes |
| what will be seen at innominate bone of short leg side | anterior rotation |
| LLD causes degenerative changes in what joints on LL side? | SI and hip |
| what mm imbalances might be seen on LL side? | tight hip adductors, tight iliopsoas, piriformis, erector spinae (mm on concave side) |
| what mm imbalances might be seen on SL side? | tight abductors, stretched/weak hip adductors (mm on convex side) |
| why is important to teach LLD pts posture management | to prevent recurrences |
| posture management for LLD | correct body mechanics, exercises for daily activities, relaxation exercises, and modification of environment |
| Lifting technique for LLD | - set abdominals and gluteals, provides support for back and the pelvic floor - push, pull, then lift - keep load withing BOS - keep load between mid thigh and chest - don't lean back and place load on belly |
| what do pts need to avoid when lifting overhead? | lumber hyperextension |
| treatment for leg length discrepancy | - Relieve pain and muscle tension using modalities, muscle relaxation training - Education for posture - Restore ROM with stretching and flexibility exercises specific to the identified tight musculature - Restore mm balance with resistive exercises |
| treatment for LLD | - Retrain kinesthetic awareness and control of normal alignment with reinforcement techniques - Teach patient how to manage posture - Lifting technique |
Created by:
bdavis53102
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