VIDEO 3. Posture

Posture is the placement of each part of the body in the most optimal position relative to the adjacent segment and the entire body. In other words, the combination of joint positions during every movement of the body is also defined as posture. The body achieves proper alignment through the coordinated efforts of many muscles working together, often with the support of ligaments, to provide stability during muscle activity or to form the foundation for a movement. Posture can be static or dynamic, where static posture refers to a stationary posture. It requires muscles to contract statically to stabilize the joints and resist gravity. In essence, it encompasses postures during activities such as sitting, standing, and lying down. On the other hand, dynamic posture is essential to facilitate any movement. It is an active posture that continuously adapts to changing conditions and results from the movement performed. In summary, static posture pertains to positions during activities like sitting, standing, and lying down, while dynamic posture is the active and adaptive posture required for movement.

The normal sagittal plane curvatures across the regions of the vertebral column. The curvatures define the neutral position for each region, often referred to as ideal posture while standing.

Postural assessment is conducted from the anterior, lateral, and posterior directions, and changes in existing kyphotic and lordotic curves are defined as postural problems, involving either an increase or decrease. Common postural issues that may arise include lordotic posture, kyphotic posture, kyphotic-lordotic posture, flat back, sway back and forward head posture.

Lordotic Posture (will be given in e manual)

The lordotic posture represents a faulty posture that differs from the good one by the following: (1) increased lumbar lordosis and (2) increased pelvic anteversion (anterior tilt). Increased anterior tilt of the pelvis leads to increased flexion of hip joints. The knees can be in hyperextension and, due to this knee position, the plantar flexion of the feet occurs.In the lordotic posture the head line runs down posteriorly to lumbar vertebral bodies, passing near the intervertebral facet joints, which results in extensive overloading within the facets. The head line is also anterior to the knee joint axis, which leads to the overloading of the anterior knee compartment. The head line may overlap the base line, or in the case of head protraction, it may run in front of it.

Kyphotic posture (will be given in e manual)

The kyphotic posture represents a faulty posture that differs from the good one by the following: (1) increased thoracic kyphosis, (2) head protraction, (3) flattened or reversed lower cervical lordosis, (4) increased upper cervical lordosis, and (5) protraction of shoulders and scapulae. In the kyphotic posture, the head line is shifted anteriorly to the thoracic spine, lumbar vertebral bodies, and hip and knee joint axis. The base line usually runs at the back of the head line.

Kyphotic-lordotic posture (will be given in e manual)

In some individuals, the combination of the two aforementioned sagittal misalignments can be noted in the form of kyphotic-lordotic posture. In this case, the influence of kyphotic and lordotic posture on the musculoskeletal system is combined.

Flat-back posture (will be given in e manual)

The flat-back posture represents a faulty posture that differs from the good one by the following: (1) flattened lumbar lordosis and (2) flattened lower part of thoracic kyphosis. Moreover, increased kyphosis in the upper part of the thoracic region as well as kyphotisation of the cervico-thoracic junction may be present. Pelvis remains in a neutral position or in a decreased anterior tilt . In the flat-back posture, the head line and the baseline usually overlap and pass anteriorly to the lumbar vertebral bodies (leading to their flexion overload) and posterior to the hip joint axis. The head may be moved anteriorly to the base line.

Sway-back posture (will be given in e manual)

The sway-back posture represents a faulty posture that differs from the good one by the following: (1) anterior pelvic shift, (2) thoracic kyphosis extended to the upper part of the lumbar spine (longer thoracic kyphosis is observed), (3) apparently shorter lumbar lordosis, (4) normal or slightly decreased anterior pelvic tilt. In the sway-back posture, the pelvis is in front of the head line, while the upper part of the trunk is usually moved posteriorly to this axis. The head line and the baseline usually overlap each other suggesting the normal position of the head. However, the head is in a protraction because of the chest position that is in inclination in relation to the base and the head line. The head line passes posteriorly to the lumbar vertebral bodies (resulting in their extension overload) and posteriorly to the hip joints axis (leading to overload of the hip joints).

The literature on myofascial bands will be analysed in detail and current sources including the latest researches will be included in the E-Manual.