C&T Observation & Functional

• Observation - informal and formal:

  • posture types and variants
  • muscle tone and bulk
  • soft tissues
  • patients attitude and behaviour
• Observation - Anterior view:

  • shoulder heights
  • shoulder girdle position
  • position of humeral head
• Observation - Lateral view:

  • chin position relative to trunk
  • cervicothoracic junction
  • shoulder girdle position - protraction/elevation
  • positioning of humeral head - any anterior displacement?
  • kyphosis/lordosis
• Observation - Posterior view:

  • shoulder height - shoulder girdle muscle activity (may cause asymmetry)
  • scapula position - inferior angle & medial border should be in line with each other and equal distance from spine on both sides
  • spinal curvature - symmetry and depth
  • prominence of ribcage - signs of trunk rotation
  • waist creases
  • iliac creases
  • buttock contours and creases, knee creases
  • space between arms and back
• Functional test:

  • based on the patient subjective history of mechanism of injury or aggravating and easing factors
  • often patients will report a specific position or activity that aggravates or reproduces their symptoms or restrictions of why they have come to see you
  • patients may report a specific position or activity that eases their symptoms or restrictions
  • allows us to assess the clients functional movement
  • reproduce pain with their functional movement
  • structural differentiation