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Postural Ergonomic Assessment

Postural/Ergonomic Assessment

Pilates Point of View: Postural/Ergonomic Assessment

In STOTT Pilates, the basis of exercise is based on the Five Basic Principles to create better awareness of the body movements and postural alignments. The Five Basic Principles consist of breathing, pelvic placement, rib cage placement, Scapular Movement and Stabilization, and Head and Cervical Placement.

STOTT encourages three-dimensional breathing, expanding the ​​rib cage laterally and posteriorly to avoid overuse of accessory breathing muscles and tension around the neck and shoulder. Breathing pattern used in STOTT encourages the engagement of the deep stabilizers such as transversus abdominis, multifidus, pelvic floor muscles and obliques.

The placement of the pelvis has a direct impact on the curvature of the lumbar spine. In neutral, there should be a normal lordosis (slightly convex anteriorly) present in the lumbar spine. A simple gauge the check the pelvis placement, is to form a triangle with the ASIS and the symphysis pubis. In neutral, the triangle should lie parallel to the floor when lying supine, or perpendicular to the floor in standing..

The rib cage placement and the alignment of the thoracic spine is controlled by the abdominal muscles as it is attached to the lower ribs. Proper engagement and recruitment of the abdominal muscles is necessary to avoid flaring of the ribs with overextending thoracic spine or collapsing of the ribcage with excessive thoracic flexion (hunch).

The scapular (shoulder blade) should lie flat on the rib cage and glide smoothly across it without any obvious winging. The front and back of the shoulder girdle should maintain a sense of wide across to avoid overly round forward or squeeze completely together (from behind). The stability of the scapula on the rib cage serve as an anchor for the arms as well as support the cervical spine. When stability is absent, the muscles around the neck and shoulders are bound to overwork.

In neutral the cervical spine should hold its natural curve (slightly convex anteriorly) with the head balance directly above the shoulders

Postural Assessment

In STOTTS Pilates, the normal curve of the spine describes a normal curve convex forward in the neck (cervical region) and lower back (lumbar region), and convex backward in the upper back (thoracic region).  An imaginary plumb line from the floor to the head, is often used to assess for an ideal posture

Observing the plumb line from the side of the body, the line should be slightly anterior to the ankle (lateral malleolus), moving up slightly anteriorly to the midline of the knee, passing approximately through the hip joint (greater trochanter) of the thigh bone (femur), and passing midway through the trunk reaching through the shoulder joint and bodies of the neck (cervical bone), ending at the crown of the head through ear lobe.

The posture is also assessed anteriorly and posteriorly to note for any inward or outward rotation of the feet and lower extremities, rotation or hiking of the pelvis, winging of the scapula and tilting or rotation  of the head.