Posture and Body Mechanics

 Posture and Body Mechanics - Biomechanics Blog 5

In the picture below, is my 1^st cousin, Cori. Cori is a very sassy 4-year-old, as I am sure you can tell! Pediatrics isn’t an area I have had a lot of experience observing, so I thought analyzing this photo for the blog would be a good educational moment for myself. This is because children are constantly growing and changing which makes this picture with the car seat so much more interesting to dissect.

My Girl, Cori!💕

            Cori’s posture in the car seat will aide her for a more proper sitting position. She is demonstrating a slight posterior pelvic tilt and her spinal curves will be supported by the car seat. This is because most car seats have a area near the lumbar region that is convex to encourage a healthy, normal lordotic curve. This is important to children because at the age of 4, her curves have not 100% developed yet. This car seat will be helpful to her as she grows to allow her to continue having the proper support on her spine when in the car. You can also see that her hips and knees are in approximately 90˚ of flexion each which is optimal for sitting. However, the ankles are not supported by anything; they are just hanging off the edge of the seat. This is okay for short drives, but longer drives may have an affect on the blood flow to the ankle. Therefore, it is important to stop every hour to allow the child to walk a little. The optimal sitting position would have the ankles at a 90˚ of dorsiflexion supported on a flat surface.

                As for Cori’s shoulders, if you look, she has on the proper car seating seat belt which allows her thoracic region to stay in the proper optimal sitting position and her scapula to be supported by the extra cushion nearing the top of the cervical spine down the thoracic spine. You can tell from the picture that this position is comfortable because she is able to move her arms and head freely. The shoulder is flexed in the sagittal plane and the head is rotated in the transverse plane. The pose she is demonstrating is called, “Ry Ry, this is not peace! It is scissors!”.

                The position is very stable – that’s why car seats are required. If her ankles were supported in 90˚ of dorsiflexion and the pelvis was a little more in an anterior pelvic tilt, this would be optimal position for getting ready to be mobile. This position is going to be very difficult to get out of, especially for a 4 year old with not very strong trunk control. She will need assistance from an adult to pull her out of this position in the car seat. The way we know this position is stable is because the base of support is very large. It begins at the area in the cervical region where the head/neck is supported and supports her body all the way down to her tiny popliteal fossa area. As stated in the paragraph above, you can see from the sassy peace sign her UE are very free for movement in the sagittal plane and also in the frontal plane. The only limitation of the UE would be for shoulder extension due to the car seat and seatbelt holding her thoracic cavity back. This position of the car seat does support proper postural alignment; however, since the pelvis is in a slight posterior pelvic tilt this can place extra pressure on the ischial tuberosity. If seated for too long in this position, it can lead to a stage one pressure ulcer and even put strain on the lumbar and sacral portions of the spine. In my opinion, I believe after an hour, even in optimal sitting position, anyone will begin to get uncomfortable. I think that especially for a child who is growing, letting them out of the car seat every hour to hour and a half is important to relieve ischial tuberosity pressure and to allow them to stretch their spine, legs and get some more blood flow to their ankles.

Johnathan and Hayes 😎 guess Johnathan's posture! 

              Proper body posture is very important to practice and have daily. This will aide in appropriate breathing, decrease back pain and it will allow you to walk and participate in ADL’s with more ease. Without proper posture, you will experience pain, be very imbalanced and unstable in your daily endeavors. This is why it is so important to educate our future clients on proper posture, because it can allow them to have better overall occupational performance and quality of life. One of the most common areas of bad posture if the cervical and thoracic region (excessive kyphosis or sway back). We as OT practitioners can educate our clients on proper optimal sitting positions (back supported, arms rested, hips and knees at 90˚ of flexion and a slight anterior pelvic tilt with the ankles at 90˚ of dorsiflexion as well). Most clients experience back pain from desks jobs, advising that they have a chair will enough back support is very important as well. A way to start to practice posture is to be aware of your shoulder alignment. For interventions in the clinic or in a home, I would practice being “tall” with the client and practice squeezing shoulder blades together periodically while participating in daily tasks. This will eventually, hopefully form a habit for the client to reinforce proper posture. However, if the client is not grasping the concept of how to practice the conscious corrections, I would then recommend either a lumbar pillow or a back posture brace depending on their curvatures to help reinforce proper posture.

Tiana doing some coloring! 💛