A pure postural analysis, using a plumbline (ear above shoulder, shoulder above hip bone, hip bone above knee and finally knee above outer ankle bone), is used clinically to acknowledge muscle/joint imbalances and compensations. These imbalances generally occur to overcome the forces of gravity and have a strong relationship with long-term postural habits. Assessing posture is Almost like taking a ‘snapshot’ photo and analysing the body from head to toe.
Although it is largely speculative how daily postural habits will transfer across to function/daily activities but for obvious reasons, physiotherapists can clinically justify that certain stiffness and tightness will effective movements.
On the opposite scale is movement analysis. Analysis of movement or function identifies posture within movement. Much harder to ascertain due to the dynamics required during movement. Understanding biomechanics (coordinated movements of muscles and joints) and anatomy is a necessary skill. Of course clinical experience will also benefit the physiotherapist’s ability to assess and diagnose.
For example, if a client is generally found to be in a slouched position at the upper back, they will tend to be stiff in extension from the mid to upper thoracic spine. This then leads to lengthening of the back/shoulder/neck muscles and shortening of the muscles at the front of the body (shoulder/chest/abdomen areas). These imbalances would then make movements such as lifting the arm over the head difficult and more advanced exercises such as an over head squat extremely difficult.
Therefore movement analysis coordinates an understanding of postural habits within movements. If during the movement there are apparent joint/muscle dysfunctions (movements outside of the accepted normal) that are outside of the clients control then it is considered to be a contributing factor to their injury or pain needs. In fact, it can also be considered a potential risk factor for future pain or injury.
In order to reduce these imbalances, the client must firstly be educated on how to move more efficiently and given simple exercises that will strengthen muscles needed for the movement required. Stretches are also generally given to reduce any tightness that may restrict needed movement(s).
As the client improves strength it is then important to start the client with progressive functional exercises that will eventually lead to the required movement or activity. Progressing the client from what will initially be a conscious movement to a more natural movement. The term natural movement is used because all movements are a conscious decision (we must tell our muscles to move). Natural movements occur because the neural pathway (the message sent from nervous system to the muscles to move) is heightened and therefore we don’t have to consciously break down every muscular and joint movement to accomplish the activity/exercise.
Taking the above into account it is important to understand that assessing both posture and movements are a necessity when diagnosing injury and/or pain needs. In that case, physiotherapists must look at the body as a whole and understand anatomy and physiology in detail to offer treatment and a rehab programme that will produce the best results.
Elite Therapy is a multidisciplinary sports therapy and physiotherapy clinic in Coventry. We treat a range of injuries both sporting and non-sporting as well as back, neck and musculoskeletal pain. Elite Therapy’s services include assessment and diagnosis, physiotherapy, sports therapy, massage therapy, taping and ultrasound. There is also an on-site rehabilitation gym and studio for the Pilates and yoga classes.