Johnson Postural Assessment
Guide
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Created @October 18, 2021 1:16 PM
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Updated @November 30, 2021 3:16 PM
Postural Assessment Guide
Posterior Upper Body
Possible
Steps Meaning
Findings
-Head tilted on one side -Laterally flexed cervical spine -Upper
Ear Level - uneven ear lobes trapezius is tight -Tightness in levator scapulae,
sternocleidomastoid, scalene muscles
Head and -lateral flexion on -same as above -shoulder pain could lead clients to flex necks
Neck Tilt neck to side of pain -could be torticollis, "wry neck"
-client looking
straight, left, right? -
can you see more of
Cervical
the cheek on one -tightness in sternocleidomastoid, scalenes, levator scapulae
Rotation
side? -Is the jaw
more prominent on
one side?
Johnson Postural Assessment Guide 1
Possible
Steps Meaning
Findings
-increased tone on
one side of the
Cervical extensor muscles -
Spine misaligned
Alignment markings on
cervical spine after
palpation
-shortened levator scapulae and upper fibers of trapezius -
Shoulder
-uneven shoulders normal to have more depressed and protracted scapula on
Height
dominant side
Muscle
Bulk and
Tone
Scapular
-protracted
Adduction -rhomboids and lower fivers of trapezius are lengthened and
(abducted)/retracted
and weakened (PROTRACTION)
(adducted) scapulae
Abduction
Inferior
Angle of -an inferior angle is -elevated scapula -shortened upper fibers of trapezius and
the superior to the other levator scapula
Scapula
-upward or -tension in levator scapulae, rhomboid minor, and upper fibers
downward rotation of trapezius; weakness in rhomboid major and lower fiber of
Rotation
of glenoid fossa - trapezius (UPWARD ROTATION) -tension in the lower fibers
of the
displaced medial of trapezius and rhomboids major; weakness in the middle
Scapula
border and inferior and upper fibers of the trapezius, rhomboid minor, and levator
angle scapulae (DOWNWARD ROTATION)
-tilting away of
scapula from the
Winging
spine -medial -True winging can occur because the long thoracic nerve is
of the
border seems damaged or the muscle itself is damaged.
Scapula
prominent along
with inferior angle
-curved, check by -scoliosis; but could be lateral pelvic tilt due to leg length
Thoracic
palpating spinous discrepancy -possibly kyphosis and lordosis, check lateral
Spine
process postural assessment
Johnson Postural Assessment Guide 2
Possible
Steps Meaning
Findings
-rotated thoracic
cage in relation to
head and hips -one
Thoracic -Shortened internal oblique external oblique psoas* lumbar
medial border of
Cage erector spinae Muscles that rotate the neck to the left/right
scapula is more
prominent than the
other
Skin
Creases
Upper -space formed -shortened supraspinatus or deltoid -laterally flexed to the side
Limb between the client's → shorter quadratus lumborum on that side -hitched hip,
Position arm and body pelvis is laterally tilted upwards to flexed side
-uneven olecranon
Elbow process - -shortened subscapularis, pectoralis major, teres major
Position internally/externally (INTERNAL ROTATION)
rotated humerus
Hand -how much of palms - more visible palms, more internally rotated humerus →
Position can be seen shoulder pain
Posterior Lower Body
Possible Meaning
Name
Findings
-straight or
curved -
Lumbar -disc herneation, muscle spasm, scoliosis, muscle imbalance, lateral
deeper skin
Spine flexion due to pelvis being raised on one side
crease on
one side
-lateral
-increased lateral flexion of lumbar spine, deeper skin crease -
tilting
shortened quadratus lumborum, lumbar erector spinae -hip on flexed
Pelvic upwards to
side could be adducted whereas the other abducted -raised pelvis and
Rim the left or
shortened hip adductor on one side, shortened hip abductors on the
right of
other
pelvis
PSIS
Johnson Postural Assessment Guide 3
Possible Meaning
Name
Findings
Pelvic
Rotation
Buttock
Crease
Thigh
Bulk
Gena
Varum
and
Gena
Valgum
Posterior
Knees
Calf Bulk
Calf
Midline
Achilles
Tendon
Malleoli
Foot
Position
Lateral Upper Body
Name Tags
Untitled
Untitled
Untitled
Lateral Lower Body
Name Tags
Untitled
Johnson Postural Assessment Guide 4
Name Tags
Untitled
Untitled
Anterior Upper Body
Name Tags
Untitled
Untitled
Untitled
Anterior Lower Body
Name Tags
Untitled
Untitled
Untitled
Gena Varum
Knees out
Gena Valgum
Knees in
Johnson Postural Assessment Guide 5
Pes Varus
Ankles pointing out
Pes Valgus
ankles pointing in
Calcaneovalgus
Achilles tendon caving in
Calcaneovarus
Achilles tendon bowing out
Johnson Postural Assessment Guide 6
Johnson Postural Assessment Guide 7
HEAD TILT
For example, if your client were laterally flexed to the left, the left levator scapulae,
sternocleidomastoid, and scalene muscles would all be tight, as would the the upper
fibers of the trapezius on the left.
torticollis (wry neck) is a spasming of the neck muscles in lateral flexion and/or
rotation. common for whiplash victims
SHOULDER ALIGNMENT
Shortening in levator scapulae and the upper fibers of the trapezius
if a scapula is elevated, you would expect the inferior angle of that scapula to be
superior to the inferior angle of the scapula on the opposite side
ask client to elevate, relax, depress, relax scapula, and then ask which movement
was easier
if client has stroke, movement would be difficult
dominant shoulder is often depressed and slightly protracted
Johnson Postural Assessment Guide 8
PELVIC TILT
KNEE ALIGNMENT
Johnson Postural Assessment Guide 9
Johnson Postural Assessment Guide 10
FOOT ANGLE
BODY ALIGNMENT
Johnson Postural Assessment Guide 11
