Though postural assessment is a skill required by most therapists and useful for many health and fitness professionals, few resources offer a complete discussion of the topic to support practitioners in the task. Written for students and practitioners of massage therapy, physical therapy, osteopathy, chiropractic, sports medicine, athletic training, and fitness instruction, Postural Assessment is a guide to determining muscular or fascial imbalance and whether that imbalance contributes to a patient’s or client’s pain or dysfunction.
Jane Johnson, a practicing physiotherapist and sport massage therapist and instructor, breaks down the complex and holistic process of assessing posture into easy-to-assimilate sections. Johnson begins with a discussion of ideal posture and the factors affecting posture as well as how to provide the correct environment for postural assessment, necessary equipment, and the importance of documenting assessment findings. Then she details procedures for executing postural assessments from standing posterior, lateral, and anterior views as well as with the patient or client in a seated position.
The text features tips for improving assessment technique, and What Your Findings Mean sections provide readers—students in particular—with guidance for systematic analysis. Each chapter ends with five Quick Questions, with answers, to assist in gauging understanding of the topics covered.
Information in the text is enhanced with detailed illustrations that offer visual cues to learning postural assessment and identifying anatomical relationships. Line drawings illustrate bony landmarks used in the assessments, and numerous photos show both obvious and subtle postural variations. Reproducible illustrated postural assessment charts in the appendix provide space for recording observations during each step of the assessment.
Postural Assessment can assist practitioners in learning what posture reveals about the relationships among various body parts and in determining whether such relationships cause or contribute to pain or discomfort. As a resource for novices, Postural Assessment offers guidance in observing and identifying common postural forms and interpreting those observations.
Postural Assessment is part of the Hands-On Guides for Therapists series, which features specific tools for assessment and treatment that fall well within the realm of massage therapists but may be useful for other body workers, such as osteopaths and fitness instructors. The guides include full-color instructional photographs, Tips sections that aid in adjusting massage techniques, Client Talk boxes that present ideas for creatively applying techniques for various types of clients, and questions for testing knowledge and skill.
Part I. Getting Started With Postural Assessment
Chapter 1. Introduction to Postural Assessment
What Is Posture?
What Factors Affect Posture?
Is There an Ideal Posture?
Why Should I Do a Postural Assessment?
Who Should Have a Postural Assessment?
Where Can Postural Assessment Take Place?
When Should Postural Assessment Be Done?
Closing Remarks
Quick Questions
Chapter 2. Preparing for Postural Assessment
Equipment Required
Time Required
Postural Assessment Steps
Standard Alignments
Documenting Your Findings
Cautions and Safety Issues
Closing Remarks
Quick Questions
Part II. Carrying Out Postural Assessment
Chapter 3. Posterior Postural Assessment
Upper Body
Lower Body
Quick Questions
Chapter 4. Lateral Postural Assessment
Upper Body
Lower Body
Comparing Overall Posture
Quick Questions
Chapter 5. Anterior Postural Assessment
Upper Body
Lower Body
An Overall View: Body Shape
Quick Questions
Chapter 6. Seated Postural Assessment
Posterior View
Lateral View
Quick Questions
Jane Johnson, MSc, PhD, is a chartered physiotherapist and sport massage therapist specializing in occupational health and massage. In this role she spends much time assessing the posture of clients and examining whether work, sport, or recreational postures may be contributing to their symptoms. She devises postural correction plans that include both hands-on and hands-off techniques.
Johnson has taught continuing professional development (CPD) workshops for many organizations both in the UK and abroad. This experience has brought her into contact with thousands of therapists of all disciplines and informed her own practice. Johnson has a passion for inspiring and supporting students and newly qualified therapists to gain confidence in the use of assessment and treatment techniques.
Johnson is a member of the Chartered Society of Physiotherapy and is registered with the Health Professions Council. A member of the Medico Legal Association of Chartered Physiotherapists, she provides expert witness reports on cases involving soft tissue therapies. Johnson is the author of six titles in the Hands-On Guides for Therapists series. These are, Postural Assessment, Postural Correction, Therapeutic Stretching, Soft Tissue Release, Deep Tissue Massage and Soft Tissue and Trigger Point Release. Postural Assessment has sold over 10,000 copies. She is also the author of The Big Back Book: Tips & Tricks for Therapists.
Jane regularly delivers webinars on popular musculoskeletal topics, as well as on life working as a therapist. In her Facebook group (Jane Johnson The Friendly Physio), she shares tips and tricks in her usual, friendly manner.
Johnson lives in the north of England in an unmodernized house where she creates books and webinars, makes art and rehomes big rescue dogs.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
What is posture?
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort.
What Is Posture?
Ask anyone to demonstrate poor posture, and it's a fair bet that most will adopt a slouched or hunched position, protracting their shoulders and rounding their backs to exaggerate the kyphotic curve in the thoracic spine. Ask for a demonstration of good posture, and most people automatically straighten up, raise their chins, and retract and depress their shoulders in a military-type attitude. Clearly, for most people, the term posture describes an overall body position, the way we hold ourselves or position our bodies, intentionally or unintentionally. Used in an artistic context, it might describe a pose, or a position held deliberately for aesthetic effect.
Good posture requires a person to maintain the alignment of certain body parts; poor posture is often acknowledged as a cause of musculoskeletal pain, joint restriction or general discomfort. When used in the context of therapy—physiotherapy, massage therapy, osteopathy or chiropractic, for example—the term posture more precisely describes the relationships among various parts of the body, their anatomical arrangement and how well they do or do not fit together. Bodyworkers have become familiar with postural terms such as scoliosis and genu valgum, which are used to describe a congenital, inherited position, plus used to describe a position assumed through habit, such as increased thoracic kyphosis resulting from prolonged sitting in a hunched position.
Of course, the postures we assume provide clues to not only the condition of our bodies—traumas and injuries old and new, and mild or more serious pathologies—but also how we feel about ourselves—our confidence (or lack of it), how much energy we have (or are lacking), how enthusiastic (or unenthusiastic) we feel, or whether we feel certain and relaxed (or anxious and tense). Intriguingly, we all almost always adopt the same postures in response to the same emotions.
Observe 10 people feeling confident, motivated, and optimistic, and you will notice that most are standing tall, with their chests out and heads up, and that most have adopted a wide stance, giving themselves a wide base of support. They may be smiling or have a countenance that reflects their positive feelings. By contrast, observe 10 people feeling anxious, demotivated and pessimistic, and you may notice that they have shifted their weight to one leg, reducing their base of support (making them less stable), and that they stoop or flex at the waist, looking to the floor rather than up and ahead. They may touch the chin with one hand the way we sometimes do when we are thinking, and may even cross one or both arms against the chest in a protective manner.
If you are a teacher, you can demonstrate emotional postures to your class. Select one negative emotion and one positive emotion. Ask your class to act as if they were feeling extremely worried (or fearful or anxious or angry). It is important that all class members act out the same emotion. Observe what they do and what postures they adopt for a minute or so. Next, ask them to act as if they had just received a piece of fantastically good news. Again, observe what happens. Be sure to select the positive emotion as the second scenario to avoid students' retaining any sense of negative emotion. Also, suggesting that students carry out this exercise with their eyes closed prevents them copying one another. It is striking to observe how the majority of people adopt the same postures in response to the same emotions.
Although this book focuses on helping you to analyse the physical aspects of clients' postures, it is worth remembering that the postures we adopt reveal more than just the simple alignment of body parts. Our supposedly non-tangible, emotional states are inherently linked to our tangible, physical forms.
Read more from Postural Assessment by Jane Johnson.
Assessing posture through scapular adduction and abduction
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally.
Step 7 Scapular Adduction and Abduction
Next, take a look at the scapulae and their relationship to the client's spine. Observing the relationship between the medial borders of the scapulae and the spine, decide whether the scapulae are adducted (retracted) or abducted (protracted). Many clients, unless engaged in regular exercise or sporting activity involving the upper body, have slightly protracted scapulae. This could be due in part to the kyphotic posture many people adopt when sitting.
TIP If you cannot see the medial border, gently palpate for it. To locate it, ask your client to place his hand behind his back while you do this. Remember that, in doing so, the scapula will change position. You may find that drawing a horizontal line on the skin directly down this border helps you get a better idea of the position of the scapulae.
What Your Findings Mean
Protraction of the scapulae often accompanies poor posture in which the rhomboids and the lower fibers of the trapezius are lengthened and weak bilaterally. Retraction of the scapulae is much less common and occurs when people adopt a military-style posture: chests pushed up and out, shoulders drawn back and down. In this case rhomboids might be shortened on both the left and right sides of the body. Clients engaged in sporting activity in which retraction predominates on one or both sides of the body (e.g., javelin throwers and archers) might demonstrate unilateral shortness in the rhomboids on the side of the retraction. Observation of clients who regularly engage in sporting activities involving bilateral retraction of the scapulae—such as rock climbing and rowing—may reveal hypertrophy in both left and right rhomboids.
Consider, also, what happens to the medial border when the scapulae rotates. With upward rotation the medial border and inferior angle are abducted from the spine, lengthening the rhomboid major and shortening the rhomboid minor and levator scapulae. With downward rotation, the medial border and inferior angle are adducted towards the spine, shortening the rhomboid major and lengthening the rhomboid minor and levator scapulae. Table 3.1 summarises this information. Notice that the serratus anterior has been included in this table because it attaches to the medial border of the scapulae on the anterior surface of the bone. For more information about rotation of the scapula, see step 9.
When assessing the shoulder region, as with any area of the body, be careful not to jump to conclusions regarding the source of shoulder pain. Just because a person stands with protracted scapulae and an internally rotated humerus, for example, does not mean that her scapular pain results from the anatomical positions of these bony structures. There are other possible sources of pain. For example, way back in 1959, Cloward reported on the likelihood of scapular and upper limb pain originating from cervical discs.
Read more from Postural Assessment by Jane Johnson.
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