The How & Why Of Postural Assessments
Before a client has their first personal training session with a Shashido Warrior Coach, they will receive a comprehensive postural assessment, both standing still, and while moving. Faulty posture, often refered to as malalignment, alters body biomechanics, joint function, and causes the wrong muscles to become activated. Here’s an example: At least 80% of society have poor pelvic alignment, with most having frontal pelvic tilt. This needs to be addressed because the gluteals ( the muscles we sit on ) have stretched, and ceased to receive nerve impulses to contract when required. Instead, the back muscles ( extensors ) bear the extra load, giving rise to a very real risk of developing lower back pain, over time. The pelvic position stretches the hamstrings like a rubber band, so the biceps femoris ( hamstring ) could tear even if the hamstrings were warmed up. The pelvic tilt affects hip joint position, causing the foot to excessively pronate ( roll inward ), possibly causing ACL ( knee ligament ) injury, or frontal knee pain/injury. So, the benefits of proper postural alignment are a greatly reduced risk of injury, and enhanced performance. The postural assessment will help determine your exercise prescription to provide you with the best solution to achieve your goals within the shortest time.
STATIC ASSESSMENT
We divide the body into left side versus right side, checking asymmetry, checking from the rear, and front, and central alignment.
Starting from the ground and working my way up the client’s body, as follows:
WEIGHT DISTRIBUTION
Bodyweight should be evenly distributed between both feet, with approximately 60% to the front, and 40% rear. Excessive frontal weight bearing indicates tight and shortened calves, which limits ankle dorsi-flexion ( dorsi-flexion is demonstrated when you try to lift your foot off the ground as far as you can, while keeping the edge of the heel in contact with the ground ). In other words, you have poor ankle mobility, and this plays a key role in causing foot, ankle, knee, hip, and back pain and/or injury. Believe it or not! This limited flexibility precipitates the development of Quadricep ( frontal thigh muscles ) dominant patterns when the gluteals should be firing. This condition causes an imbalance between front and rear thigh, as the quads become too strong for the hamstrings, which, in itself can cause hamstring tears; added to this, the quads bear too much of the workload, become inflexible,and pull the hips forward out of their natural alignment. The rectus femoris is both a quad and a hip flexor, and is the main culprit. It’s usually the muscle that breaks in cases of quadricep tears.
Let me give you a hypothetical situation. If you presented to me recently recovered from a hamstring tear, or a quad tear, or a chronic low back pain, where do you think I’ll look for the root cause? The answer is I’ll focus initially on the ANKLES. I’ll inspect foot patterns and angles, ankles, calf flexibility, and then I’ll move further up the chain. Always remember, the root cause is rarely at the site of injury, and it’s usually found BELOW it! Furthermore, when we injure one side of the body there is a tendency to shift the bodyweight to the other side to relieve the discomfort. Depending on the injury, this could go on for months as debilitating movement patterns develop. For example, the side carrying the greater load is risking either a knee or hip injury, and also functional limb length discrepancies may result.
FEET/ANKLES
External rotation ( turned out ) 10 degrees is ok. Beyond that, can point to several anatomical imbalances involving tight calves and/or external hip rotators, especially piriformis. It is a sign of thigh bone internal rotation which will be coupled with internal kneecap rotation, which are danger signals for forthcoming knee pains. If the external hip rotators are very tight, then this is a danger signal for low back pain and possibly referred pain down the legs, so stretching the piriformis is very important!
Flat feet indirectly results from tight/shortened hip flexors and weak external hip rotators. Usually seen with thigh bone internal rotation, which encourages the condition. Kneecaps are slightly inward and are the tell-tale sign. Knees turned outward may indicate tight external hip rotators ( piriformis again ) and is commonly found in military personnel, dancers, gymnasts, etc.
KNEES
Hyperextended knees ( locked knees ) is a condition often caused by a very tight and short rectus femoris, which is the only quadricep muscle that is both a knee extensor and a hip flexor. This muscle is one of the most important focal points in my exercise prescriptions. Thigh bone is internally rotated with ankle pronation, which stresses the external hip rotators , causing lateral knee pain, and eventual knee injury. This change in muscle length/tension increases anterior pelvic tilt, thus increasing pressure on the joints and nerves in the lumbar region and lead to back pain.
Knock-knees is also caused by tight hip flexors. This condition makes you very prone to knee injuries and chronic pain, is very pronounced in client’s with a large Q-angle( pear-shaped, wide-hips )
HIPS
Checked from side-on to look for anterior hip displacement, relative to the shoulders. If present, it will lead to pain in the lumbar spine, and probably referred down the legs due to compression of the nerves. The knees should form a perpendicular line with the hips and feet, but will often roll in relative to the hips and feet, and is a sign of femoral internal rotation, frequently due to tight hip flexors and weak gluteals. I would expect to find anterior pelvic tilt, knock-knees and flat feet. Hips should also be checked from front/rear, to ascertain that left and right hips are parallel.
LUMBAR SPINE
Checked from the side for excessive curvature ( lordosis ), and tested to measure the severity. Taken into account with other indicators,such as flat feet, splayed feet beyond 10 degrees, frontal weight distribution, knock-knees, locked knees, tenderness upon palpation of ITB ( a long band going down the centre of the outer thigh ), knee pain, tight/short quads/hip flexors, and lumbar pain. All of these are indicators of anterior pelvic tilt.
There may be insufficient curvature in the minority of clients. We call this posterior pelvic tilt ( backward rotation of pelvis ), generally associated with a tight posterior chain, particularly hamstrings, causing a flattenning of the lumbar curvature, thoracic kyphosis ( excessive flexion of the upper spine ), which, in turn, causes increased cervical extension with head protruding forward ( “poke-neck” ).
THORACIC SPINE
Most people, but not all, have some degree of excessive thoracic flexion, a condition we also refer to as “round shoulders”, often resulting from tight/short anterior shoulder muscles ( internal rotators ). Otherwise, I might see the opposite condition, where the shoulders are pulled back too far, indicating excessively activated external shoulder rotators. Some muscle testing needs to be done to confirm my suspicions, but there is obviously an imbalance between the internal/external shoulder rotators, requiring the weaker to be strengthened, while the tight opposing muscles are stretched
SCAPULAE ( shoulder blades )
If I’ve found excessive kyphosis, then there will be scapular elevation and protraction, and a tendency to anterior scapular tilt. Optimal shoulder function will never be attained unless optimal thoracic spine position can be maintained. It is vital that I address the lack of thoracic spine extension, and restabilize the scapulae, otherwise, injury to the shoulder joint ( gleno-humeral ) WILL occur, if it hasn’t already, leading to joint degeneration, impingement, rotator cuff tendonitis/tendinosus or tears, and labrum injuries. Scapulae are viewed from behind, checking for misalignment.
SHOULDERS
Viewed from in front/behind, checking height. If uneven, this can indicate upper trapezius tightness, lat tightness, structural limb length discrepancy
HUMERUS ( upper arm bone )
View from front and behind for internal rotation, which is generally caused by excessive shortening of the pec major and latissimus dorsi. The back of the hands will be visible when viewed from front, and the hands will often rest in front of the thighs rather than by the sides.
HEAD
Looking for “poke neck” which has already been noted. My concern here is the stress on nerves passing through cervical spine, leading to headaches and neck pain, as well as affecting areas below this point. I primarily check the head position from side view.
shane shiels
