DPT-305.2-PT Essentials – Non Static Testing: Basic Posture

You must first complete DPT-305.1-PT Essentials – Non Static Testing: Range of Motion before viewing this Lesson

Postural Imbalance

There are many different causes of muscular dysfunction.  Physical stresses imposed on the body in sporting, occupational or general lifestyle activities place a variety of strains on skeletal and soft tissue structures. As a result of these strains, the body adapts to best cope with, and manage, the potentially harmful effects, by adopting certain identifiable postures. The impact of individuals emotional/psychological state on their posture should also not be underestimated (Crozier, 2003).

Muscular dysfunction, whatever the cause, can trigger a chain reaction in the body. This in turn leads to the development of predictable patterns of muscular imbalance. Some muscles will become tight and shorten and their antagonist will become stretched and weak (Prentice, 1999). 

It follows that if poor posture can be identified and analysed, the long-term correction or management of it can be addressed within training programmes. The identification of poor posture would rely on both observational skills and the application of a number of functional assessments which provide specific information regarding which muscles are tight and short (Tunnell, 1998). Once a pattern has been identified flexibility work can be focussed accordingly.

Flexibility Assessments

A more comprehensive assessment of flexibility can be achieved by employing a series of flexibility tests to assess a variety of muscles of the upper and lower body.

It is possible to assess the flexibility of individual muscles/muscle groups and their possible impact on joint motion. These assessments allow more focus in the identification of tight or shortened muscles so that subsequent flexibility work can be more targeted and individualised (Woodruff, 2003). The assessments illustrated below can be used to achieve a useful overview of key musculature. The optimal joint ranges of motion given are taken from Kendall et al (1993).

Hamstrings

Hamstring muscles:

  • client lies in the supine position, arms by their side
  • trainer places one hand underneath the client’s lumbar vertebrae and the other on the leg being assessed
  • trainer raises the leg into hip flexion, until the client starts to go into a posterior pelvic tilt
  • this tilt will be felt as the spinous processes pressing onto the trainer’s hand
  • trainer assesses the angle at which this pelvic tilt occurs. Repeat on the other side and compare with ideal of 70-90°

Alternative:

  • client lies in a supine position, arms by their side
  • trainer lifts the leg being assessed until knee is directly over the hip
  • trainer then asks the client to extend the knee until the client starts to move the upper thigh forward
  • trainer assess the lower leg position in relation to the floor with ideal of 70-90o

Quadriceps

  • client lies in the prone position
  • trainer places one or two hands on the client’s lower leg (shin), leaving the foot relaxed and the knee on the floor
  • trainer raises this lower leg into knee flexion, until the ‘spongy’ end of ROM is reached, or until the pelvis rotates anteriorly.
  • trainer assesses the angle at which this occurs. Repeat on the other side and compare with ideal of 140° or heel to reach the glutes

Ilipsoas

  • client lies in the supine position, arms by their side
  • trainer places two hands on the client’s ‘non-assessed’ lower leg (shin), leaving the foot relaxed
  • trainer raises this lower leg into knee and hip flexion, and pushes the knee towards the chest
  • the pelvis is taken into posterior pelvic tilt, so the client has a flat back and when the hip flexor becomes taught the ‘assessed’ knee starts to lift
  • trainer assesses the angle at which this occurs. Repeat on the other side and compare with ideal of 125°

Adductor Muscles

  • client lies in the supine position, arms slightly out to the side
  • trainer places one hand on the client’s ‘non-assessed’ or far side ASIS (anterior superior iliac spine)
  • trainer places other hand on ‘assessed’ or near leg and pulls this towards them, taking the leg into hip abduction
  • trainer feels for the point where the ASIS starts to move, indicating a pelvic lateral tilt and that the hip adductors have reached their end of ROM.  
  • trainer assesses the angle at which this occurs. Repeat on the other side and compare with ideal of 45°

Pectoralis Major & Latissimus Dorsi

  • client lies in the supine position in a posterior pelvic tilt (flat back), with their arms resting above their head
  • trainer takes hold of the client’s wrists, and instructs the client to completely relax their arms
  • trainer raises the arms into shoulder flexion, then allows the arms to gently fall into their passive end ROM
  • tight pectoral muscles will try to pull the arms into adduction (the ideal would be arms lying flat on the ground – 180°) 
  • tight latissimus dorsi muscles will try to pull the arms into extension (the ideal would be arms lying to the side of the head – 180°)
  • trainer assesses for shoulder extension or adduction on both sides

Calves: Gastrocnemius & Soleus

  • client lies in the supine position in a neutral spine, with their arms resting by their sides
  • trainer takes hold of the sole of the client’s foot, and asks client to relax their lower leg
  • trainer takes the foot into (passive) ankle dorsiflexion, to assess gastrocnemius ROM (ideal of 15-20°)
  • trainer can then assess active gastrocnemius ROM by getting the client to pull their toes back (dorsiflexion) unaided
  • soleus flexibility can be assessed, by repeating the tests above, with one hand under the back of the knee, thus taking the knee in flexion
  • assess the active and passive flexibility of both muscles and on both sides, compare with each other and the norms

References

Crozier, J. (2001). Posture and Body Balance. http://www.ptonthenet.com

Franklin, B. A. (Ed.) (2000) ACSM’s Guidelines for Exercise Testing and Prescription. 6th Edition, Williams and Wilkins.

Kendall, F. P., McCreary, E. K. and Provance, P. G. (1993) Muscles Testing and Function. 4th Edition, Lippinncott Williams & Wilkins.

Kibler, W. B. (1990). The Sport Pre-participation Fitness Examination. Human Kinetics.

PrenticeW. E. (1998). Rehabilitation Techniques in Sports Medicine. McGraw Hill.

Tunnell, P. W. (1998). Muscle Length Assessment of Tightness Prone Muscles. Journal of Bodywork and Movement Therapies,  2 (1).

Woodruff, D. (2002). Postural and Phasic Muscles: Applications in Exercise Protocols., http://www.ptonthenet.com

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