Postural Assessment
Postural Assessment
Postural Assessment
&
FAULTY POSTURES
Start to pay attention to the way people sit, stand and move around. Try to identify what posture type
they have. This is good practice for when you start to assess clients. When you first start out, take
photographs from all four sides and take a medical and health history. It will give you time to take a
really good look so that you can make the correct assessment and choose the best exercises to help
them. We’re going to take a look at the most common faulty postures, the causes and the Pilates
exercises that will bring better balance to the client. Always try to work with a client’s back care
specialist.
Swayback
This is probably the most common posture (left) you will notice.
Swayback Ideal
Pelvis pushed forwards in front of centre of gravity, so from side view, the hips are in front of
the shoulder and ankle
Posteriorly rotated pelvis (tipping backwards)
Flat lower lumbar
Hyperextension of thoracolumbar junction (long kyphotic curve)
Hyperextension of hip, long weak hip flexors
Hyperextension of knees
Neutral ankle with body weight tending towards balls of feet
Head poked forward
Upper back curved forward/sunken chest
Shoulders protracted (rounded)
Tight upper abdominal, weak core, long weak external obliques
Short, tight internal obliques pulling ribs forward
Short, tight hamstrings
Weak, flattened glutes
Wear and tear of the hip joint, lower back pain, facet joint degeneration, disc bulges, headaches,
shoulder problems are all possible health issues.
Swayback Prescription
The best exercises to help correct this type of posture will stretch the hamstrings and strengthen the hip
flexors, glutes, external obliques and core and strengthen the mid back area. Some exercises that will
help are: -
The above picture shows other common faulty postures. I am going to leave scoliosis as this is more
complex and is best left until you have developed skill and experience. This is definitely one of those
postures where you should be working on the advice of a back care specialist.
Flat Back
The main thing you will notice about this posture is the absence of the natural curves of the spine. The
characteristics are: -
Head is forward
Cervical spine is slightly extended
The rectus abdominis and external obliques are tight and become the most dominant of the
abdominal muscles
The hamstrings are tight
The one-joint hip flexors are found to be long and weak
The pelvis is posteriorly tilted
Back erectors are slightly stretched Knees are slightly flexed
The ligaments and discs of the lumbar spine are put under a great deal of strain and back pain is the
normal symptom.
Lordosis
An exaggerated lumbar curve, this posture is often seen with a kyphosis. The characteristics are: -
Anterior tilt to the pelvis (tipping forward) causing hollow, arched lower back
Flexed hips
Short, tight hip flexors and erector spinae
Abdominals, hamstrings and glutes are usually weak
Short tight psoas.
A lordotic posture will negatively impact on the entire hip and pelvic areas. Some exercises to correct
this posture are: -
The Hundred with table top knees and Single Leg Stretch. Watch that the tight hip flexors don’t
do the work of the core. Feet on the floor, knees bent and a lift of the upper body instead is a
good option.
Supine pelvic tucks and rocking knees to chest to open up the lower back and stretch the tight
back muscles, as will Spine Twist. Corkscrew for an advanced option.
Roll Ups and Roll Overs although modifications will be needed. Even Roll Back will be difficult to
start with. These will stretch the back muscles but also strengthen rectus abdominis.
Shoulder Bridge with plenty of peeling away and rolling down for hamstring and glute strength
and mobility for the spine.
Hip flexor stretch: Drop down onto your right knee (in line with hip and shoulder) and bring your
left foot forward with right angles at the hip and knee. Just tucking the tailbone under and
moving the hips forward by 10cms should be a good stretch for the hip flexors for this posture
type (similar to Yoga Crescent Moon, but smaller range).
Back and shoulder pain, even migraines can be attributed to this posture type. Exercises to help are: -
Double Leg Kick, especially the arm stretch part which will really open up the chest and
shoulders.
Swimming which will be challenging. To modify, it can be done on hands and knees, engaging
core whilst lifting and lengthening opposite limbs.
Swan prep just lifting the upper body up to increase thoracic mobility.
Rocking, although not the best choice if lordosis is also present.
Any stretches for the arms and shoulders, for example, triceps stretches: reach down between
the shoulder blades with one hand and up with the other and see if you can link the fingers. If
not, use a strap to bridge the gap.
Dumb Waiter: sit with your back against the back of a dining chair, upper arms squeezed in to
the ribs, elbows bent, palms up. As you exhale, upper arm stays squeezed in whilst you
externally rotate your forearms. Take care: this seems easy, but is very strong. Very good for
stretching front of shoulders.