When a postural analysis of a person is given, points of reference on the body are needed. These are called bony landmark references. These points of reference of bony landmarks are used as a guide to give some idea as to, for example, whether a person hip joint is anteriorly tilted, posteriorly tilted of neutral. Once a postural analysis is done, exercises can be suggested for that posture to help that posture improve to a more neutral and comfortable posture. Below are some of the bony landmarks used when analysing a person's posture.

Side View   Front   Back  

SIDE VIEW

Ankle: Look at the angle of the anke joint as created by the front of the shin and centre of the foot. If greater than 90 degrees, it can be considered plantar flexed, if less than 90 degrees, it can be considered dorsiflexed. Oterhwise, neutral.

Knees: Us the greater torchanter and just anterior of the lateral malleolus. If vertical then neutral. If angled back then hyperextended. If angled forwarded then flexed.

Hip joint: ASIS, PSIS and greater trochanter. If distance between ASIS and greater trochanter is greater than the distance between the PSIS and the greater trochanter then the hip is posteriorly tilted. If the distance between the ASIS and the greater trochanter is less than the distance between the PSIS and the greather trochanter then the hip is anteriorly tilted. If the distance from the ASIS to the greater trochanter is equal to the distance between the PSIS and the greater trochanter then the hip is said to be in neutral position.

Pelvis: Use the ASIS and PSIS to determine if pelvis is neutral, anteriorly or posteriorly tilted. A male pelvis is neutral when the PSIS and ASIS are on the same horizontal plane. A female pelvis is often neutral when PSIS and slightly higher than the ASIS.

Lumbar Spine:Feel L1 to L5 with the palm of your hand to get an idea of the curvature - flat or excessive extension

Lower Thoracic Spine: Feel T6 to T12 to get an idea of the curvature - flat or excessive flexion

Upper Thoracic Spine: Feel T1 to T6 to get an idea of the curvature. - flat or excessive flexion

Cervical Spine: Feel C1 to C7 to get an idea of the curvature. - flat or excessive extension

Head:The plumb line should pass through tht eear (auditory meatus) and down through the acromion process.

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FRONT VIEW

Feet:Distinguish where the weight is distributed on the foot to determine whether the foot is neutral, supinated or pronated.

Knees:Stand with the feet together, looking or alignment of femures and tibias to determine whether knees are neutral, knock-kneed or bow-legged.

Pelvis: Palpate ASIS to determine whether it's level, elevated, rotated clockwise or counter-clockwise.

Rib Cage:Thumbs on ASIS and finger on ribcage. Look at subject's sternum to determine whether it is level, elevated, shifted or rotated clockwise or counter-clockwise.

Shoulders:Palpate along the clavicle to the acrom,ion process to determine whether they are level, elevated or depressed.

Head:Stand away from the subject with plum line in front to determine whether head is rotated clockwise or counter-clockwse, neutral, tilted or shifted. Sometimes it helps to look at the nose and sternum to see if they are lined up or not.

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BACK VIEW

Femur:Palpate femoral condyles to determine whether they are neutral, medial or laterally rotated. A straight line between the condyles lying in the coronal plane indicates femurs are neutral.

Pelvis:Palpate PSIS and compare height to determine whether pelvis is level, elevated, rotated clockwise or counter-clockwise.

Scapulae:Find the inferior angle of each scapula and compare distance from the same spinous process. Palpate the medial border from the bottom ot the top. Compare distance between the spinour process of the spine and the top of the scapula and between the spinour prcessa nd bottom of the scapula. Determine whether scapula is netural, profracted, retracted, elevated, depressed, upwardly rotated, downwardly rotated, winging or anteriorly tipped.

Humeri:Palpate the olecranon process to determine if it faces posteriorly or laterally sequencing through the spine.

Sequencing through the spine:Place thumbs on either side of the spine and feel fro any irregular curvature, i.e. flattness in the spine, rotation or muscle imbalances.

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