One of the first things we do after reviewing the history form with a patient is to do a postural analysis. Postural evaluation is really a test of muscular balance and overall muscular function. If a person is well balanced in their hips and pelvis, that illustrates proper balance and tone of the attaching muscles. These muscle groups would be primarily the iliopsoas, gluteal, lumbar erector spinae, and quadricep muscle groups. The muscles that help balance the hip/pelvis alignment are the abdominal and hamstring muscle groups. As well, if the torso and shoulders are in good alignment that lets us know as practitioners that the person has good muscular balance between the pectoral, serratus anterior, and rhomboid/middle trapezius muscle groups.
When we look at a person from the front we are looking to see if the ankles, knees, hips, shoulders, and eyes are level with the ground. If one side of the body is elevated compared to the other there is a lack of stability on that side of the body and a reduction in muscle function of the muscle groups compared to the other side. Therefore, correction of the alignment will need to include exercises that improve the stability of the involved joints to improve load bearing, as well to, restore the function of the muscles on that side of the body.
Viewing the patient from the back looks at the same major joints, as well as the alignment of the spinal column to see if there are any curvatures, shifts or segmental rotations. We are also able to see if the muscles are balanced throughout the spinal column.
The side view is a measurement of the frontal plane of the body. We are looking to see if the knee, hip, shoulder, and head are balanced over the ankle. The ankle is used as the reference point as it is the closest to the ground. It is very common to see hips that are in front of the ankle which informs us there is a weakness of the muscles that hold our hips in proper alignment on the frontal plane. This will lead to stress being applied to the knees, hips, low back and neck as the head will move forward as well in an attempt to stay balanced over the hips.
As therapists, our goal is to help people improve their alignment and balance. This will result in a decrease in physical stress throughout the body, and generally a reduction in symptoms. We use manual therapy techniques to restore mobility to connective tissues that have been under tension [fascial stretching], to restore mobility to muscles which have become adhered and shortened, and to joints which have lost ideal mobility. Combining manual therapy with specific exercise programs designed to restore muscular balance throughout the body is very effective in helping people attain a higher level of function.