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Massage Today
January, 2012, Vol. 12, Issue 01

Practice Building with Postural Analysis

By David Kent, LMT, NCTMB

Postural analysis photos can be utilized like X-rays, CAT scans and MRIs to evaluate, educate, design customized treatment plans and document progress. They are a great tool for attracting new clients and selling treatment packages and can help you build your practice by taking a quick postural analysis and delivering your objective findings using the technology carried with you daily.


Keep the process simple by using the camera and screen built into smart phones, iPhones, tablets and iPads, as they are powerful assessment and educational tools. They allow you to instantly take and review a series of photos. Showing patients pictures of their posture adds a whole new meaning to the saying "a picture is worth a thousand words" (Photo 1). The impact of patients seeing a picture of their high shoulder or forward head posture is very powerful. A lasting impression is made on the patients of your ability to quickly identify the musculoskeletal cause of their pain, provide visual evidence (objective findings) and provide a logical treatment plan.

postural analysis photos - Copyright – Stock Photo / Register Mark Photo 1: Educate patients using postural analysis photos. Having photos taken can be stressful to anyone, so make patients more comfortable by letting them wear their regular clothing. To show the postural changes caused by wearing high heels, it is sometimes helpful to take postural analysis photos with the patient wearing and not wearing their shoes.

Prior to taking postural photos have the patient complete a health intake form that gives you permission. Photos should be treated as confidential medical records.

Reference Lines

Viewing the mid sagital, coronal and transverse horizontal planes against the body makes it easy to spot asymmetries and a logical reason to use a postural analysis chart during assessments. The chart is most effective when used in conjunction with a weight or plumb bob suspended from a line. Hang the plumb line from the ceiling, approximately three feet in front of the 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" from the floor (Photo 2a & 2b). To get the plumb line out of the way and conserve space when not in use, simply hook it over one of the pins holding the chart on the wall. If your chart hangs on the back of a door, hook the plumb line on a hook next to the door frame (Photo 2c).

postural analysis chart - Copyright – Stock Photo / Register Mark Photos 2: A postural analysis chart and plumb line makes it easy to spot distortions. Front & Back

Position the patient's heels approximately shoulder width apart and equally spaced from the plumb line (center line). The plumb line will indicate the position of the midsagittal plane in the photos. Also be sure the client's heels are the same distance away from the posture chart to avoid creating 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 rotate the lower extremities. Step back, align the plumb line with the centerline of the posture chart and take the photo (Photos 2a).

Side Views

Position the client so that the plumb line is immediately anterior to the lateral malleolus. This position allows the plumb line to represent the coronal plane to the body. Ask the client to place their 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 to the coronal plane. Step back, align the plumb line with the centerline of the posture chart and take the photo (Photos 2b).


charts - Copyright – Stock Photo / Register Mark Photo 3: Support your objective finding with charts. One front and side view photo, in many cases, is all that is needed to give a quick overview of your postural analysis findings. Photos make it easy for patients to understand the stresses their musculoskeletal system is enduring as you zoom-in on different postural analysis views and explain how your treatments can help. Reference the tables labeled Anterior View and Lateral View for the relationship of surface anatomy to anatomical structures (photo 4).


Have all the answers at your fingertips with trigger point, joint range of motion and muscle movement charts to explain the myofascial components of the patient's pain. Explain the relationship of your postural analysis and other objective findings to their pain (Photos 3).


Stand out from your competition and market how your assessments and treatments are special. Provide postural analysis as part of a package or to attract new patients. Build your practice by taking a quick postural analysis and delivering your objective findings.

surface anatomy & structures - Copyright – Stock Photo / Register Mark
Photo 4: Tables show the relationship of surface anatomy to anatomical structures.

Click here for previous articles by David Kent, LMT, NCTMB.


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