Posture stability and Balance. Posture Principles Definition of “good” posture Examples...

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Transcript of Posture stability and Balance. Posture Principles Definition of “good” posture Examples...

  • Posture stability and Balance

  • Posture PrinciplesDefinition of good postureExamples of poor posture

  • PostureInherent to concept of posture are alignment and muscle balanceGood mechanics require that joint ROM be adequate, but not excessiveThe more flexibility, the less stabilityThe more stability, the less flexibility

    Why do only some people get pain?Posture may be faulty, but individual has mobility so position can change readilyPosture may appear good, but mobility lacking so position cannot change readily

  • Mechanical ImbalanceAn alteration of structure and function which is reflected in combinations of muscle tightness and weakness, ligamentous laxity and/or poor alignment of body segments

  • Posture - PrinciplesFaulty alignment results in undue stress on bones, ligaments and muscleAdaptive shortening can develop in muscles that remain in a shortened conditionStretch weakness can occur in muscles that remain in elongated conditions

  • Mechanical ImbalancesKyphosis-lordosis posture Flat back posture

  • Kyphosis-Lordosis Postureincreased lumbar lordosis, promotes a forward pelvic tilt and a slightly flexed position of the hipLeads to increased stress on L4L5 disc and facets and the sacroiliac (SI) jointscause early recruitment of the lumbar extensorsincreased knee flexion at heel strike increasing the potential for patellar tendon and patellar femoral joint injuries

  • Posture typesNormal sway Kyphoticflat

  • Kyphosis-Lordosis PostureHead forwardCervical spine hyperextendedScapulae abductedThoracic spine increased kyphosisLumbar spine increased lordosisPelvis anterior tiltHip flexedKnee slightly hyperextendedAnkle slight plantarflexion

  • Kyphosis-Lordosis PostureElongated and weakNeck flexors, upper ES, external obliquesElongated, may be weakhamstringsShort and StrongNeck extensors, hip flexorsStrong, may be shortLumbar ES

  • Posture

  • Flat-back Posture Head forwardCervical spine slightly extendedThoracic spine upper increased flexion; lower straightLumbar spine flattened (flexed)Pelvis posterior tiltHip extended Knee extendedAnkle slight plantar flexion

  • Flat-back PostureElongated and weakOne-joint hip flexors Short and StrongHamstrings, upper fibers of internal obliqueStrong, not shortLumbar ES

  • General populationSwayback: Approximately 30% of men and 20% of women. Kyphosis-Lordosis: Approximately 20% of women and 15% of men. Flatback: Approximately 10% of men and women. Only 5% of persons may have the optimal posture depicted to the left, with a further 15% coming reasonably close

  • SummaryPostures that deviate from ideal can produce adaptive shortening, strengthening, elongating and weakening that can affect structures quite distal to the poor posture culpritUse a postural assessment to guide your specific assessment and treatment plans, especially for chronic, non-traumatic problems

  • Regaining postural stability and balanceCoG is located just above your pelvis. In order to remain balanced, your CoG must remain within the limit of stability LOS.balance is the ability to maintain the bodys segments in alignment within a limit of stability (LOS).Balance is the single most important element dictating movement strategies with in the closed kinetic chain.

  • Regaining postural stability and balanceIs both StaticDynamic

    Dynamic for example, walking, climbing stairs, etc

  • MOVEMENT STRATEGIESWhat are the 3 movement strategies that are used by the body to maintain the CoG within a stable base of support?1. ankle2. hip3. stepping

  • MOVEMENT STRATEGIESWhen would each strategy be used?

    Ankle: when small, slow movements, close to CoG

    Hip: larger, quicker movements required. Also if CoG gets closer to LOS.

    Stepping: if CoG gets out of Limit Of Stability.

  • INJURY AND BALANCEStudies of the knee and ankle show that there is a decrease in proprioceptive feedback from damaged ligaments to the CNS (sensory/afferents).Therefore, is decreased reflex excitation of motor neurons (efferents) to the muscles responsible for preventing sway/controlling balance.

  • BALANCE TRAININGMUST improve the balance and postural equilibrium of the athlete in order for them to return safely and effectively to the playing field.

  • BALANCE TRAININGGeneral rules when developing a balance training program:Exercises must be safe, yet challengingStress multiple planes of motionIncorporate a multi-sensory approachBegin with static, bilateral, stable. Progress to dynamic, unilateral, unstable.Progress to sport-specific

  • BALANCE TRAININGCLASSIFICATIONS OF BALANCE TRAINING/EXERCISES1. static:2. semi-dynamic:3. dynamic:4. functional:

  • BALANCE TRAININGstatic:CoG is maintained over fixed base of support on a stable surface.i.e. Rhomberg tests

  • 2. semi-dynamic: 2 types(a) maintain CoG over fixed base of support while on moving surface or unstable surface (BAPS/Wobble board)(b) transfer CoG over a fixed base of support to areas within the LOS while standing on a stable surface (pick up pens)

  • BALANCE TRAINING3. dynamic: CoG maintained within the LOS, while over a moving base of support on a stable surface.Requires a stepping strategyi.e. hopping, walking on a balance beam

  • Balance Training4. functional: same as dynamic, except also have sport specific tasks included.i.e. catching/throwing a ball while running.

    *Multiple planes of motion flexion vs extension, adduction vs abductionMultisensory approach eyes open vs eyes closedBegin with static, bilateral, stable. Progress to dynamic, unilateral, unstable.Various surfaces wobble boards, pillow, trampoline, etcSport specific exercises are always done last*More into plymetics hopping, climbing, jumping, up stairs, down stairs, etc

    Ex dynmaic test for basketball player shuffle side to side on their ownFunctinal/sport specific have the basketball player mimic the motions of the trainer