According to the physical therapist practice teaching manuals,
posture is the alignment and the positioning of the body in relation
to gravity, center of mass, or base of support. Good posture promote
musculoskeletal balance which protects the supporting structures of
the body against injury or progressive deformity. Postural deviation
or malalignment can have a serious, negative impact on body
mechanics, function, activities of daily living, and sport specific
The patient’s posture should be assessed from various angles. When
examining the patient from the side, the ear should be in line with
the middle of the shoulders. Typically the height of the dominant
shoulder is lower than that of the non-dominant shoulder.
Using a plumb line, the general landmarks for posture should line up
at the earlobe going down through the acromioclavicular joint, into
the lateral hip at the greater trochanter then to the outside of the
ankle at the lateral malleolus. Frequently observed postural
abnormalities that are seen include head forward posture, rounded
forward shoulder posture, and hyperextension at the lower back or
Posture is also affected by scoliosis. Scoliosis refers to
side-to-side curvature of the spine greater than 10 degrees. A curve
at the upper spine towards the right is the most common type of
scoliosis. When one finds one curve a second corrective curve should
be looked for. Commonly there can be a triple or a quadruple curve.
Another condition where posture is important is in the management of
cervical nerve stretch syndrome notably the brachial plexus.
Maintaining a head up and chest out posture helps reduce compression
at the neural foramina of the neck and opens the thoracic outlet.
The thoracic outlet is the passage between the chest and the neck
that is used by the brachial plexus as well as several blood
Taras V. Kochno, M.D.
Board Certified in Physical Medicine & Rehabilitation
Copyright July 2, 2012