Posture

Posture - DefinitionThe Human Movement System is comprised of the muscular-skeletal system (muscle, ligament, tendon and fascia), the articular system (joints) and the Neuro System (nervous system). If any of these systems do not work efficiently, compensations and adaptations will occur in the other systems and this will increase the risk of injury and decrease performance. The efficiency and skill of human movement and basketball movement depends on the the bodies structural integrity and alignment and this is known as Posture.

Vladimir Janda, the late physician and physical therapist, was thinking in these terms well ahead of his time, as seen in quotes and research related to this concept in the mid 1960’s. “Only gross changes in muscle function in the sense of weakness and exceptional shortening and tightness are emphasized. There is almost no data about the analysis of movement patterns.” Janda went on to develop these patterns and our movement assessments today are based on this work. “Poor posture during training and activities of daily living will lead to muscle imbalances, joint dysfunctions and postural distortion patterns.” (Janda V Vavorova M: Sensory Motor Stimulation. Body Control Systems. Brisbane, Australia, 1990).

Posture - BasketballProper Basketball Posture is when all major joints are aligned and able to move freely without compensation through the desired range of motion. Posture is a dynamic controlling quality.

Head position while running and cutting, will dictate how hard certain muscles in the neck and upper back will have to work to support it and also to position the torso. In simple terms when the head moves forward, so does the upper back. When the upper back moves forward, the shoulders are repositioned and this will continue down the chain.

Posture – Effects of Poor Posture on Human/Basketball MovementIf the head tilts forward and down while dribbling at high speeds for example, the spine, hips and knees will react and flex in order to compensate as an attempt to balance the weight distribution. These altered movement patterns may reduce speed or lead to poor skill execution and at high speeds may even pose a risk of injury. A correct postural and movement strategy in this example may to utilize the eyes with greater efficiency in order master the task of acquiring the necessary sensory information needed to speed dribble rather than with head movement. To optimize posture would be head straight and eyes looking down scanning at the distance required depending on the speed and complexity of the task will improve movement quality.

A great player will appear well organized and fluid in their movement patterns. With optimal posture comes functional efficiency, optimal shock absorption and efficiency in transfer of force during movement. With optimal landing posture, efficient deceleration patterns, controlled and efficient change of direction patterns, injuries are less likely. This player rarely travels, they do not play in a hurry but they move quickly, they are not out of control because they have the ability to stop and start, whereas other players may move as quickly but are out of control. From a biomechanical perspective, this player will have structural integrity and maintain their center of gravity over their constantly changing base of support why playing and they will have functional efficiency as their stress. This prevents overtraining, cumulative trauma, muscle imbalances and

Posture

decreased performance.

Posture – Effects of Poor Posture on our HealthHealth care practitioners are particularly interested in the negative effects of posture, when posture is not optimal, it creates patterns of tissue overload and dysfunction, this leads to decreased neuromuscular control and initiates the cumulative injury cycle. The cumulative injury cycle causes decreased performance and eventually injury.

Posture – The Spine

The spinal column (or vertebral column) extends from the skull to the pelvis and is made up of 33 individual bones termed vertebrae.

The vertebrae are staked on top of each other grouped into four regions. The cervical spine ( neck) is made up of 7 vertebra, the Thoracic spine (mid back) is made up of 12 vertebra and the lumbar spine ( low back) is made up of 5 vertebra.

The Sacrum ( pelvis) is 5 fused vertebra and the coccyx is the tailbone. A Kyphosis or Kyphotic curve is concave anteriorly and convex posteriorly. A Lordosis or Lordotic curve is convex anteriorly and concave posteriorly

Cumulative Injury Cycle

Muscle Imbalance

Altered Neuromuscular

Control

AdhesionsMuscle Spasm

Inflammation

Tissue Trauma

Posture

Posture – AssessmentStatic posture can be assessed using a plumb line and anatomic landmarks observing from the side, the back and front.

PROPER POSTURE (SIDE VIEW)

Head: Neutral position, not tilted forward or backward

Cervical Spine: Normal curve, slightly convex to anterior

Thoracic Spine: Normal curve, slightly convex to posterior

Scalulae: Flat against upper back

Lumbar Spine: Normal curve, slightly convex to anterior

Hip Joints: Neutral position, not flexed or extended

Posture

PROPER POSTURE (SIDE VIEW)

Head: Neutral position, not tilted laterally

Cervical Spine: Neutral position, no lateral curvatures

Scalulae: Flat against upper back, equal distance from spine with the spine of the scapulae and inferior angle at equal heights

Thoracic Spine: Normal curve, no lateral curvatures

Lumbar Spine: Neutral position, no lateral curvatures

Pelvis: Neutral position, both iliac crests and posterior superior iliac spines should be level on

Posture

PROPER POSTURE (SIDE VIEW)

Head: Neutral position, not tilted laterally

Cervical Spine: Neutral position, no lateral curvatures

Scalulae: Flat against upper back, equal distance from spine with the spine of the scapulae and inferior angle at equal heights

Thoracic Spine: Normal curve, no lateral curvatures

Lumbar Spine: Neutral position, no lateral curvatures

Pelvis: Neutral position, both iliac crests and posterior superior iliac spines should be level on the horizontal plane

Posture

Posture - TypesPosture may also be described as deviations from the normal spinal curvatures, either excessively pronounced (below) or “S” curves (scoliosis) and/or by describing a limitation in spinal curvatures (reduced lumbar lordosis or flat back)

Excessive Lumbar Excessive Thoracic Forward Head Normal Posture

Lordosis Kyphosis Posture

Posture - Distortion PatternsJanda and others have described several common postural dysfunctions. The most common postural distortion patterns include the lower-extremity postural distortion pattern, upper-extremity postural distortion pattern and llumbo-pelvic-hip postural distortion pattern.

References:

Clark MA: A Scientific Approach to Understanding Kinetic Chain Dysfunctionl. National Academy of Sports Medicine ( Publishers). Thousand Oaks, CA 2000.

Posture

Janda V: Physical Therpay of the Cervical and Thoracic Spine. In Grant R (ed). New York, Churchill Livingstone, 1968

Upper Extremity Postural Distortion:

Characterized by rounder shoulders and a forward head posture. This patter is common in individuals who sit a lot or who develop poor postural patterns reading or on devices in bed with their heads propped up on pillows.

Associated joint problems:

Sternoclavicular joint problems, acromioclavicular joint problems, thoracic facet joint sprains and strains,cervical facet joint sprains and strains

Associated Movement Dysfunctions:

Overhead actions, rebounding, passing and catching overhead; dynamic stabilization of cervical spine; pushing movements, contact in basketball play, supporting falls, aggressive play; pulling movements, catching and controlling the ball

Common Injury Patterns

Upper Extremity Postural Distortion

Short Muscles: Long Muscles:

Pectoralis Major Romboids

Pectoralis Minor Lower Trapezius,

Levator Scapula, Teres Serratus Anterior

Major, Upper Trapezius

Anterior Deltoid Posterior Deltoid

Subscapularis, Latissimus Teres Minor,Dorsi, Teres major infraspinatus, PostLatissimus Dorsi Deltoid

Sternoclenoidmastoid, Longus Coli/CapitusRectus capitus, scalenes

Posture

Rotator Cuff impingement, shoulder instability; biceps tendonitis; thoracic outlet syndrome, headaches

Lumbo–Pelvic–Hip–Postural Distortion:

Characterized by lumbar lordosis and anterior pelvic tilt

Associated joint problems:

Subtalar joint; proximal tibiofibular joint; tibiofemoral joint, illiofemoral joint; illiosacral joint; lumbar facet joint

Associated Movement Dysfunctions:

Decreased stabilization of lumbar spine during functional movements; pushing movements, contact in basketball play, supporting falls, aggressive play; pulling movements, catching and controlling the ball

Common Injury Patterns:

Hamstring strains; anterior knee pain; lower back pain; headaches

Lower Extremity Postural Distortion:

Characterized by excessive foot pronation, knee flexion, internal rotation and valgus (knocked kneed) during functional movements; increased foot pronation (flattens) and knee collapses during squatting, lunges, cutting

Associated joint problems:

1st MTP joint sprain;ssub talar joint, talo crural joint, proximal tibio fibular joint; sacraoiliac joint, lumbar sacet joints

Lumbo–Pelvic–Hip–Postural Distortion

Short Muscles: Lengthened Muscles:

Iliopsosis Gluteus maximus

Rectus femoris Hamstrings,

Gluteus maximus

Tensor fascia latae Gluteus mediusShort adductors Gluteus medius

Erector apinae Transversus Abdominus, Multifidus, Internal Oblique

Gastrocnemuis, soleus Anterior & posterior

tibialis

Posture

Movement Dysfunction:

Running, Jumping, cutting; dynamic stabilization of foot/ankle; dynamic deceleration

Common Injury Pattern:

Patellar tendinitis, posterior tendinitis (shin splints); anterior knee pain, low back pain; sterno-clavicular joint

Posture

Lower Extremity Postural Distortion:

Characterized by excessive foot pronation, knee flexion, internal rotation and valgus (knocked kneed) during functional movements. Increased foot pronation (flattens) and knee collapses during squatting, lunges, cutting

Associated joint problems:

1st MTP Joint Sprain, Sub Talar Joint, Talo Crural Joint, Proximal Tibio Fibular Joint, Sacraoiliac Joint, Lumbar Facet Joints

Movement Dysfunction:

Running, jumping, cutting, dynamic stabilization of foot/ankle, dynamic deceleration

Common Injury Pattern:

Patellar tendinitis, posterior tendinitis (shin splints), anterior knee pain, low back pain, sternoclavicular

Lower Extremity Postural Distortion

Short Muscles: Lengthened Muscles:

Peroneals Tibialis, Flexor Dignitorum Longus, Flexor Hallicus Longus

Gastrocnemius Anterior Tibialis,

Soleus Posterior Tibialis

Posture

Posture – Basketball Stance

MIKE – this may be a natural place to talk about stance if you agreeAlthough proper posture is not difficult to learn, it can be difficult to train, usually requiring a conscious effort. Basketball movement starts with the proper stance. If you don’t have a good stance on defense and offense for example, you wont have a good defensive slide, and you will be out of position and off balance. The starting stance in basketball players is the optimal position to start any movement and when ready in this stance, it is easier to sprint, jump. Slide, stop, pivot and hold their position.

A little more that half of your weight should be distributed to the fronts or balls of your feet. Heel should still be in contact with the ground. Stable base, feet straight ahead. Hips back and knees bend, butt should be behind the heels and your knees should be pointing forward Butt down – staying in a stable position with your butt down enables you to stay balanced and engage the gultes which is the most powerful muscle in the lower body. Shoulders over knees – your shoulders should be over your knees with your chest out and back straight. Don’t lean too far forward or backward. If you tend to be two upright, keep your hands straight in front in order to allow your butt to go back

Postural Hygiene – Activities of Daily LivingPosture Hygiene is simply maintaining the three natural spinal curves of the spine, one in the neck (cervical lordosis), one in the mid back (thoracic kyphosis), and one in the low back (lumbar lordosis). When an improper posture is maintained for extended periods of time, the some muscles can become weak and fatigued while others become tight. Some muscle groups become overstretched while other muscle groups become shortened. This abnormal posture condition is called postural dysfunction.

Postural dysfunction and its symptoms can generally be resolved with proper prehab and a conscious effort to maintain good alignment. You should try to attain proper posture as often as possible during your day. The latest headline is the Sitting is the Next Smoking. Therapeutic exercise may also be used to stretch the short muscles and strengthening the weak muscles. Over time, the spinal joints become involved and this may require manual orthopaedic joint therapy.

Be conscious of not slouching and stand straight, strong and tall Feet shoulder width apart and positioned in supination Slightly bent knees just to unlock, drop hips back as if to sit in a chair Develop tension between the shoulder blades, shoulders back and down Develop tension in the glutes and trunk Chest up and forward keeping the neck neutral and eyes straight ahead Hands should be facing towards you and not backwards

Posture

DESKTOP COMPUTERS

Ergonomics is the study of adapting the workplace to maintain optimal posture. In other words the workplace or school place and home office should be adapted to you and not the other way around. Optimal posture sitting at a desk should look like this:

• Hips and knees should be at 90 degrees, feet flat on floor.• Shoulders should be relaxed (not elevated) and elbows should be

held at 90 degrees.• Monitor should be at eye level• Keyboard should be positioned so wrists are not bent up or

down or twisted and on a keyboard tray below the standard desk height

• A lumbar roll or support should be used to provide low-back support

A WORD ABOUT LAPTOP COMPUTERSLaptops have great portability however often the positions or locations of use is in less than favorable conditions. Sitting with the lap top in ones lap, in bed, ½ sitting on a couch or in cramped spots on small tables or desks are hazardous to your neck and back. The bad news is that from an ergonomic standpoint, there is no way to sit properly and optimal posture on a laptop computer.

Laptops were first designed for short time use, the fact that the keyboard and monitor are attached make it impossible to sit in good posture. To raise the monitor up to the proper height is ineffective because the keyboard is too high and an increased stress will be place on the shoulders. If the keyboard is placed at the proper level so that the wrists are kept in a neutral position, then stress is placed on the neck and back muscles as the head and body are forced to lean forward and look down at too sharp of an angle. Laptop keyboards tend to be smaller and tend to cause increased stress to the wrist and promotes more slouching of the upper body. The best scenario is:

• Use a desktop when possible and minimize your time sitting at a laptop.• Sit at a desk to use your laptop• The mid back should be straight up and not slumped forward.• When sitting, the hips and knees should be at 90-degree angles.• A lumbar support can help maintain a natural curve in the low back.