Static Postural Assessment

There are many elements involved with a detailed static postural assessment. The postural observation discussed here will be a simplified version of an ideal assessment that would be performed by a physician or physical therapist.

In general, one should be checking for neutral alignment, symmetry, balanced muscle tone, and specific postural deformities. It is important that the client be viewed in a weight-bearing position (standing) from multiple vantage points (anterior, posterior, lateral). The fitness professional should look for gross deviations in overall posture.

Kinetic Chain Checkpoints

Postural assessments require observation of the kinetic chain (human movement system). To structure this observation, NASM has devised the use of kinetic chain checkpoints to allow the personal trainer to systematically view the body in an organized fashion. The kinetic chain checkpoints refer to major joint regions of the body including the:

  1. Foot and ankle

  2. Knee

  3. Lumbo-pelvic-hip complex (LPHC)

  4. Shoulders

  5. Head and cervical spine

Anterior View (Figure 6.23)

  • Foot/ankles: Straight and parallel, not flattened or externally rotated

  • Knees: In line with toes, not adducted or abducted

  • LPHC: Pelvis level with both anterior superior iliac spines in same transverse plane

  • Shoulders: Level, not elevated or rounded

  • Head: Neutral position, not tilted nor rotated

Lateral View (Figure 6.24)

  • Foot/ankle: Neutral position, leg vertical at right angle to sole of foot

  • Knees: Neutral position, not flexed nor hyperextended

  • LPHC: Pelvis neutral position, not anteriorly (lumbar extension) or posteriorly (lumbar flexion) rotated

  • Shoulders: Normal kyphotic curve, not excessively rounded

  • Head: Neutral position, not in excessive extension (“jutting” forward)

Posterior View (Figure 6.25)

  • Foot/ankle: Heels are straight and parallel, not overly pronated

  • Knees: Neutral position, not adducted or abducted

  • LPHC: Pelvis is level with both posterior superior iliac spines in same transverse plane

  • Shoulders/scapulae: Level, not elevated or protracted (medial borders essentially parallel and approximately 3 to 4 inches apart)

  • Head: Neutral position, neither tilted nor rotated