Sports Screening: Postural Assessment
Original Editor - Wanda van Niekerk
In athletes postural assessment is key, because of the inter-relationship between the lower quarter, trunk and core musculature and the upper quarter. Although the postural assessment as part of the screening process is subjective, there are evidence of correlations between injury and posture. Abnormal postures can influence muscle function.
The athlete is barefoot and stands in a relaxed position/posture. There should be sufficient distance between the athlete and the assessing physiotherapist to adequately view the athlete's posture. The various components of the postural assessment is viewed anteriorly, posteriorly and from the side as well.
Examples of the various components that can be included in the postural assessment:
- Head on neck position
- Shoulder: Symmetry - are the shoulders level from anterior and posterior view
- Shoulder: Roundedness -assessed anteriorly and from the side. Are the shoulders in internal rotation? Is there anterior translation of the humeral head?
- Thoracic spine:assessed from the side. Is an increased or decreased thoracic kyphosis present?
- General spinal curvature: assessed posteriorly. Is there a spinal scoliosis present?
- Lumbar spine: assessed from the side. Is there an increased lumbar lordosis or a flattened lumbar spine? Assessed from the back - any visible muscle spasm? Hinging at the thoracolumbar junction?
- Pelvis - assessed from the front, rear and side. Assess levels of ASIS, PSIS. Assess levels of iliac crests. Is pelvis in anterior or posterior tilt?
- Hips: Symmetry - are hips level. Are hips in internal or external rotation? Is there a visible gluteal bulk? Are the hips in extension or flexion - viewed from the side?
- Knees: are the knees in hyperextension when viewed from the side?
Where possible, identify the overall postural type (e.g. Flat back, Sway back, Normal, Lordosis, Lordosis/Kyphosis) as this can provide clues to what structures are at risk.
Reliability: A basic musculoskeletal postural assessment is sufficiently reliable when performed by trained clinicians. Posture, mobility and movement can be assessed with adequate reliabililty.
- Kolt GS, Snyder-Mackler L. Physical Therapies in Sport and Exercise. 2nd ED. Edinburgh. Churchill Livingstone. Elsevier. 2007
- Toivo K, Kannus P, Kokko S, et al Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study BMJ Open Sport & Exercise Medicine 2018;4:e000376.