How to Do a Standing Static Postural Assessment

Posture Evaluation Techniques for Bodyworkers and Movement Teachers

Sep 11, 2009

A five-minute alignment assessment can be invaluable in determining a client's areas of tightness and weakness - and in setting goals for manual or movement work.

Various practitioners – such as Pilates, yoga, and Gyrokinesis teachers, massage therapists, and other bodyworkers like Bowen therapists and Thai massage practitioners – may find it useful to be able to quickly and thoroughly assess their clients' posture. This brief evaluation can reveal a stiff or hypermobile spine, tight muscles, kyphosis, lordosis, scoliosis, hyperextended joints, and an array of other alignment and movement issues.

Before Beginning a Postural Assessment

Ask the client's permission to conduct the assessment, and make sure the client is comfortable having you touch him or her. It can help to take brief notes on a checklist or blank paper.

Ask the client to remove shoes and any bulky or restrictive clothing, such as a jacket or thick belt. Have him march loosely on the spot a few times to relax, and then stand in a normal, easy position. Remind him not to correct any perceived postural faults.

Overall Plumb Alignment

Observe the client from the side. Are the major joints – neck, shoulder, hip, knee, and ankle – roughly vertically aligned, or does the body sway or bow forward or backward?

Detailed Bony Landmark Evaluation, Side View

Observe the ankle joint from each side. Is it plantarflexed, neutral, or dorsiflexed?

At the hip, palpate for the greater trochanter of the femur and the top of the iliac crest. If the peak of the iliac crest is forward of the trochanter, the hip is flexed; if behind, the hip is extended.

At the pelvis, palpate the ASIS and PSIS. They should be level – or, in women, the ASIS slightly lower than the PSIS – for a neutral pelvis. If the ASIS is much lower, the pelvis is tilted anteriorly; if higher, the pelvis is tilted posteriorly.

Palpate the curves of the lumbar, thoracic, and cervical spine. Are they flat, neutral, excessively flexed, or excessively extended?

At the shoulder, observe the position of the humerus and scapula. Is the shoulder girdle rolled forward, pressed back, or aligned vertically with the ideal position of the ear? Palpate the humeral head and the acromion process: approximately 1/3 of the head of the humerus should sit in front of the acromion process if the shoulder joint itself is snugly aligned.

Detailed Bony Landmark Evaluation, Front and Back View

Observe the feet and ankles from the front and the back. Are they pronated, neutral, or supinated?

Observe the knees: are they knock-kneed, straight, bow-legged, or rotating inward or outward?

Palpate the two ASIS from the front. Are they level, or is the pelvis tilted or rotated?

Palpate and observe the ribs for asymmetry and rotation. It can be easier to see misalignment from the back.

Observe the shoulders from the front. Are they level? Palpate the shoulder-blades from the back: are they flush with the ribs, winged, tipped anteriorly, rotated, protracted, retracted, elevated, or depressed?

Dynamic Whole Body Assessment: The Roll Down

Have the client perform a full spinal roll down 2–3 times. Observe from the side for spinal articulation: are there flat or immobile areas? From the back, look for asymmetries like rotation and lateral flexion.

Using the Postural Assessment

Trained bodyworkers and movement teachers can use the information gleaned from this postural assessment to design a program that will address clients' specific misalignments, strengthen weak areas, mobilise stiff areas, and encourage better alignment.

The copyright of the article How to Do a Standing Static Postural Assessment in Mind/Body Fitness is owned by Elisabeth Marshall. Permission to republish How to Do a Standing Static Postural Assessment in print or online must be granted by the author in writing.