Printer friendly PDF version: Postural Analysis: A Professional Tool for Building Your Practice
By: David Kent, LMT, NCTMB
When patients go to the dentist with a toothache, they expect the dentist to take x-rays, perform an exam, and explain the findings: the patient needs a filling, root canal, crown, or an extraction. Likewise, when patients go to the doctor or chiropractor complaining of headaches or back pain, they usually expect the doctor to run assessment tests and/or take x-rays or an MRI, both of which produce images that pinpoint the nature of the injury and the origin of pain. Doctors often use these images to educate their patients in an effort to instill confidence that the problem can be properly treated. This article will discuss how massage therapists can use postural analysis and photos to educate their clients, as well as deliver their objective findings in a professional manner, while subsequently building their practice.
First, your health history and intake forms should include wording that gives you permission to take postural analysis photos. Always treat these photos as confidential medical records and inform the client of this as well.
The x-ray tech at the dentist’s office can develop and deliver results in just a few minutes. In the same amount of time, you too should be able to conduct a postural analysis that includes photos, report your findings, and describe how your treatments can help. This process must be quick, easy and non-threatening to your client.
Clients must feel safe, comfortable and respected. For the initial set of postural analysis photos, ask your clients to remove their shoes and jacket, but let them leave on whatever other clothing they came in wearing. The photos will still show key distortions, such as a high shoulder or forward-head posture, and provide enough information to help them commit to a series of therapy treatments.
The human body is designed with a great deal of symmetry, or balance. The body has the same bones and muscles on each side. Muscles in the front and the back of the body balance each other, and muscles also determine where the bones are moved or held in space. Muscular and skeletal charts are useful for showing the symmetry that exists in the body.
Postural analysis grid charts make it easy for anyone to see asymmetries in the body. Charts are available in different sizes and hang easily. Large charts can be hung on a wall; however, when wall space is limited, a space saver version of the chart fits on the back of a door.
A postural analysis chart is most effective when used in conjunction with a plumb line, which is a straight line that suspends a weight or “Bob” on its end. This system has been used since the time of the Egyptians to ensure that structures were being built perfectly upright. When the weight is made of lead (plumbum in Latin), it is referred to as a lead weight or Plumb Bob. A plumb line is used for many reasons during a postural analysis, as it will:
- ensure the posture chart is hanging straight;
- guarantee the client is viewed from a 90-degree angle;
- determine placement of the client’s feet prior to taking postural analysis photos; and
- supply a visual reference of the midsagittal and coronal planes in the posture photos. This shows clients where their body is being held in space by the muscles, why the muscles hurt, and how you can help.
Hang the plumb line from the ceiling, approximately 3 feet in front of your posture analysis chart. This distance will allow clients of all sizes to stand between the posture chart and the plumb line without touching either one. The Plumb Bob should be suspended from the ceiling and hang approximately ¼-inch from the floor. To get the plumb line out of the way and conserve space when the posture chart is not in use, simply hook it over one of the pins holding the chart on the wall. If you are using the door version of the chart, hook the plumb line behind the hinges.
The use of a construction-grade plumb line to suspend the Plumb Bob will prevent a lot of problems—just make sure the line is securely attached to the ceiling. A professional Plumb Bob kit comes with ceiling anchors and a construction-grade line attached to a professional Plumb Bob.
Have the client stand between the postural analysis chart and the plumb line. Be sure his/her body is not touching the plumb line or the posture chart. It is important for the client’s feet to be placed in the identical position from one photo to another to guarantee consistency. Use tape, a template or a piece of Plexiglas on the floor to mark the client’s position.
Anterior and Posterior Views
There are a few things to remember when taking anterior and posterior posture analysis photos. First, place the medial (inside) aspects of the client’s heels shoulder width apart and equally spaced from the plumb line (Photo 2). This position allows the plumb line to indicate the midsagittal plane of the body in your photos. Then you can also use postural analysis photos to show the client that his/her body is to the right or left of the midsagittal plane (Photo 1). Second, position the back or posterior aspect of the client’s heels the same distance away from the posture chart to avoid creating the illusion of a twist, torque or rotation in the body.
By positioning the feet using the medial and posterior aspects of the heels, the client is free to laterally rotate the lower extremities, thereby revealing more postural distortions.
For lateral views, position the client so that the plumb line is immediately anterior to the lateral malleolus. (Photo 5) This position allows the plumb line to represent the coronal plane of the body. Ask the client to place his/her hair behind the ears to expose the external auditory meatus: an anatomical landmark used as a reference point to determine the position of the head on the coronal plane.
Camera and Photos
The camera you use does not have to be elaborate. Most massage therapists can simply use a cell phone camera. If using a cell phone camera, however, make sure to implement the necessary safeguards to protect your client’s privacy, such as setting security codes or downloading the photos to a secure computer for storage and retrieval.
Once you have taken the photos, keep it simple. The easiest way to review your findings with the client is on the screen of the camera. If you wish, you can download and print the photos later for the client’s file.
Anterior and posterior view photos can reveal a number of issues, including a high shoulder (Photo 3) or high hip, the space between the torso and the upper limb, the positions of the hands, an externally rotated lower limb, a fallen arch, or if the head and/or torso are held to the right or left of centerline, to name just a few. (Photo 1)
Lateral view photos make it easy to point out a forward head (Photo 6), rounded shoulders, and a slumped abdominal posture, as well as the angle of the innominate bones and the position of the knees; they are also helpful in identifying a twist or rotational pattern. (Photo 4)
Just like chiropractors advertise free “spinal exams” to attract new patients, you could provide free “postural analysis” to attract new clients. Include the postural analysis as an added value during the initial visit; then include a second complimentary postural analysis once the client completes a series of treatments. This is not only a great way to sell packages, but it also demonstrates the client’s postural progress and shows the effectiveness of your treatments.
Everyone likes to be remembered. In addition to helping you ascertain the client’s structural issues, postural analysis photos can help you remember what your clients look like, so that you can greet them by first name. Clients often return months or years after receiving therapy; your photos can help you notice a new hairstyle or the weight the client lost, which makes them feel important and special.
You know what they say: A picture is worth a thousand words. Integrating postural analysis into your practice helps you stand out from other therapists in your area. The public will perceive your unique practice as a cut about the rest. Postural analysis raises your level of professionalism and credibility in the mind of your clients, while providing client education and building your practice at the same time. Postural analysis photos only take a moment to snap, but they are an invaluable resource to you and your clients.
Ten Advantages of Taking Postural Analysis Photos
1. Educates clients about postural distortions
2. Shows which muscles are stressed and over-lengthened
3. Explains visually and logically the muscular causes of pain
4. Helps clients decide to purchase a series treatments
5. Documents posture before, during and after a series of treatments
6. Shows clients, physicians and insurance companies treatment progress
7. Presents clients with customized treatment plans
8. Records and documents client’s postural changes
9. Reflects the professionalism of your practice
10. Helps build your practice
Postural Analysis Checklist
o Obtain written permission to take photos.
o Hang plumb line 3 feet in front of posture chart.
o Hang Plumb Bob approximately ¼-inch off the floor.
o Instruct client to remove shoes and jacket, and place hair behind the ears.
o Have client stand between the postural chart and the plumb line.
o Anterior view: Place heels an equal distance from the plumb line and posture chart.
o Lateral view: Position client so that plumb line is immediately anterior to lateral malleolus.
o Handle photos as confidential medical records.
David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic Muscular Pain Relief Center is in Deltona, Florida, where he receives referrals from various healthcare providers. David teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Personalized Essential Office Forms™, Muscle Movement Chart, and DVD programs. Visit www.KentHealtht.com or call (888) 574-5600.
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