Posture is best understood as being dynamic, adjustable, and responsive to the environment we live and move in. Nevertheless, it can be useful to classify static standing posture. Though individuals may display features of several postural types, there are some classic, common patterns of alignment.
Plumb Line Alignment
When viewed from the side, the body is observed in relation to a real or imaginary plumb line that hangs just in front of the center of the ankle joint. In ideal alignment, the plumb line –
- bisects the ear
- bisects the shoulder joint
- runs down the bodies of the lumbar vertebrae
- bisects the greater trochanter of the femur
- runs just behind the center of the knee
- runs just in front of the center of the ankle
Any deviation from this central plumb line can be noted individually, but deviations often occur in patterns.
Kyphosis-Lordosis Posture
In kyphosis-lordosis posture, the spine has a curvy, hourglass appearance. The head is held forward, the neck is hyperextended, the thoracic spine is flexed more than usual (and usually, the scapulae are protracted, or rounded forward), the lumbar spine is hyperextended, the pelvis is tilted anteriorly, and the hip joints are somewhat flexed. Typically, the knees are slightly hyperextended and the ankles are slightly plantarflexed.
Sway-Back Posture
Sway-back posture is a languid, "Marlboro Man" stance with hips sinking forward and spine hanging back. (In common use, the term "sway-back" is often also used to describe a lumbar lordosis, but Kendall's use of the term is different.)
In sway-back posture, the head is held forward, the neck is slightly extended, the thoracic spine is displaced backward with a long kyphosis, the lumbar spine is flattened (that is, slightly flexed), the pelvis is tilted posteriorly and held forward of the plumb line, the hip joints are hyperextended, and the knees are also hyperextended. The ankle joints typically remain neutral because of the forward deviation of the pelvis.
Military-Type Posture
In military-type posture the back is exaggeratedly straight with the lower back arched, like a soldier standing at attention.
The head is neutral, the cervical spine keeps its normal curve, the thoracic spine is either neutral or flattened, the lumbar spine is hyperextended, the pelvis is tilted anteriorly, the knees are slightly hyperextended, and the ankles are slightly plantarflexed.
Flat-Back Posture
In the flat-back posture, the spinal curves are all but eliminated. The head is forward, the cervical spine is slightly extended, and the upper thoracic spine is flexed more than usual. The lower thoracic and lumbar spine is flattened, the pelvis is tilted posteriorly, the hips are extended, and the knees are either slightly hyperextended with plantarflexed ankles or slightly flexed with dorsiflexed ankles.
For more information, see:
Florence Peterson Kendall PT FAPTA, Muscles, Testing and Function, edited by John P Butler (Williams and Wilkins, 1993).
How to Do a Standing Static Postural Assessment
Elisabeth Marshall - Elisabeth Marshall is a certified Pilates instructor with an interest in anatomy and biomechanics, imagery, and bodywork. She taught ...
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