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 F

STARTING POSITION
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INTRODUCTION

DR. ABDUL RASHAD

DPT, MPhil,(OPT)MPPTA (SL)
UNITED COLLEGE OF PHYSICAL
THERAPY (UCPT)
3 CONTENTS
Introduction to Posture
Postural Reflexes
Starting Positions
Fundamental Positions
Summary
References
4 DEFINITION OF POSTURE
Position & Attitude Which Is Assumed By Body Parts
Relative Arrangement Of Body Parts for a Specific
Activity
To Maintain Stability And Balance With Minimum
Effort
Least Strain During Supportive And Non
Supportive Positions.
5 TO THE KINESIOLOGIST….
It Is The Measure Of
Mechanical Efficiency Of Muscles, Balance And Of
Neuromuscular Coordination.

The “Good Posture” Is

The Posture In Which The Body Segments Are
Balanced In The Position Of Least Strain And Maximum
Support.
6 POSTURE
A Good Posture Is
The State Of Muscular And Skeletal Balance
Which Protects The Supporting Structures Of The Body
Against Injury And Progressive Deformities
Irrespective Of The Attitude In Which These Structures Are
Working Or Resting.
7 POSTURE
 There Is No Single Best Posture For All Individuals.
 Each Person Must Take The Body He / She Has
 Make The Best Of It.
 The “ Good Posture” Is The One That Suits One’s Own
Condition And The Condition Of The Environment.
8 POSTURE
When Good Posture Is Adopted
The Muscles Will Function Most Efficiently
The Optimum Positions Are Afforded For The
Thoracic And Abdominal Organs.
For Example
During Attention, The Normal Posture Will
Be Erect,
In Extreme Fatigue, The Normal Posture Will
Be That Conserves Energy.
9 POSTURAL REFLEXES
 The postural reflexes support control of balance, posture and
movement in a gravity based environment. Postural
reflex development is mirrored in the infant's increasing ability
to control its body, posture and movements.
10 POSTURAL REFLEXES
Maintenance Of Posture Is Gained
Through A Series Of Reflexes Known As Postural Reflexes
Stability And Balance Is Gained
By Equilibrium Of Forces Acting On Body Via Isometric
Contraction Of Muscles
The Strength And Distribution Of Isometric Contractions
Is Controlled By Postural Reflexes
Development Of New Patterns Of Movements Require
Voluntary Effort
11 STARTING POSITIONS
Every movement Begins in posture and Ends in posture
The position from which movement is initiated are known
as starting position
There are 5 basic or fundamental starting positions
All other positions except fundamental positions are
Derived positions
12 FUNDAMENTAL POSITIONS
Standing (St.)

Kneeling (kn.)

Sitting (sitt.)

Lying (ly.)

Hanging (hg.)
 STARTING POSITION
STANDING
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14 CONTENTS
Definition of Standing
Mechanism of Standing
Muscle Work
Effects
Uses
References
 DEFINITION
15
 Standing is a human position in which
the body is held in an upright position
and supported only by the feet.
 Most difficult position in all fundamental
positions because
 Need more stabilization
 need balance
 Need more muscle co-ordination
 Having smaller base of support

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.32
16 MECHANISM OF STANDING (ST.)
 Body is erect with arms by the sides.
 The feet are slightly apart at the toes
 Whole body must be balanced and
stabilized in correct alignment
 Base is small
 Coordinated work of many muscles is
required to maintain position

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.32
17 MECHANISM OF STANDING (ST.)
Heels together and on same line, toes
slightly apart
Knees together and straight
Hips extended and slightly laterally
rotated
Pelvis is balanced on the femoral heads
Spine stretched to its maximum length
Vertex is stretched upwards, ears level
and eyes looking forward
Arms hang loosely, palms facing inwards
towards the body

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.32
18 MUSCLE WORK
Good Balance And Body Alignment Requires
 Lesser Effort Or Reduced Muscle Work
Poor Balance, Faulty Alignment Tend To Disturb
 Equilibrium Leading To Greater Muscle Work To
Stabilize Body
Erect Posture Results By
 Action Of Anti Gravity Muscles

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.33
19 MUSCLE WORK
Foot: Intrinsic Muscle Of Foot
Ankle: Planter Flexors, Dorsiflexors, Evertors (Pool With
Three Ropes, “Three Guy Ropes”)
Knee: Extension, No Muscle Work Or Slight Muscle Work
Hip: Extensors, Lateral Rotators
Spine: Extensors, Flexors
Neck: Extensors
Atlanto-axial Joint: Flexors And Extensors
Scapula: Retractors
Arms: Relaxed, Lateral Rotators May Work Slightly
The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.33
20 EFFECTS
Relatively Unstable Position
Difficult To Maintain For Patients
Thorax Is Free
Abdominal Viscera Are Well Supported

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.34
21 USES
Minimum Muscle Work Required When Body Is Balanced
Perfectly
Attaining And Holding Satisfactory Standing Pattern
Reduces Fatigue
Conditioning Of Postural Reflexes
Position Of Alertness

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.34
22 SUMMARY
 Standing is a human position in which the body is held in an
upright position and supported only by the feet.
 Erect Posture Results By Action Of Anti Gravity Muscles
 Poor Balance, Faulty Alignment Tend To Disturb Equilibrium
Leading To Greater Muscle Work To Stabilize Body
 Standing is a Position of alertness
 SUMMARY
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Heels Together, in same line, toes slightly apart

Knees Together & straight

Hips Extended & slightly laterally rotated

Pelvis Balanced on femoral heads

Spine Stretched to maximum length

Vertex Thrust upwards, ears leveled & eyes look straight forward

Shoulders Down & back

Arm Hang loosely to sides

Palm Facing inwards towards body

 SUMMARY
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Intrinsic muscles of feet Stabilizes feet
Prevents toe curling

Plantarflexors Balances lower leg on foot

Dorsiflexors Counterbalances action of plantarflexors

Support medial longitudinal arch of foot

Evertors Counterbalances action of invertors

Presses ball of great toe on ground

Knee extensors Works slightly

Hip extensors Maintains hip extension

Balances pelvis on femoral heads

Hip lateral rotators (slight action) Bracing of legs & foot arches
25 SUMMARY
Spine extensors Keeps the trunk upright

Lumbar flexors (abdominal) Prevents over action of lumbar extensors

Maintain correct angle of pelvic tilt
Supports abdominal viscera

Pre-vertebral neck muscles Controls extensive neck extension

Straightens cervical spine

Flexors/extensors of atlanto-
occipital Joint Works reciprocally to balance head

Elevators of mandible Closes the mouth

Draws the scapulae backward (glenoid cavity faces

Scapular retractors laterally)

Arms Relaxed
 STARTING POSITION
KNEELING
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27 CONTENTS
Definition of Kneeling
Kneeling Mechanism
Muscle Work
Effects
Uses
Summary
References
28 DEFINITION OF KNEELING (KN.)
 Kneeling is a Basic Human Position
where one or both knees touch the
ground.
 It can be used:
 As a resting position
 As an expression
 As a mark of respect
 In conjunction with crawling in young
children

Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.34
29 MECHANISM OF KNEELING (KN.)
 Body is upright from the knees
 which are held at a Right angle.
 Arms are by the sides
 body is supported on the knees
 which may be together or slightly apart.
 The lower leg rests on the floor with the feet plantar flexed
 The rest of body is held as standing.

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.34
30 MUSCLE WORK
 Leg is relaxed, body is supported on knees
 Interplay of flexors & extensors of knee
 Rest of muscle work is same as standing except
 Hip extensors & lumber flexors work more strongly

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
31 EFEECTS
 Low COG
 Slightly more stable then standing
 Uncomfortable

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
32 USES
 Starting position for sagittal plane movements
 To train control of the hip joints and lower trunk to prepare
patient for standing
 Legs act as bracket
Extensors of knee
Dorsifelxors of foot
Feet are pressed against the floor

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
33 SUMMARY
 Kneeling is a Basic Human Position where one or both knees
touch the ground
 Kneeling is slightly more stable then standing
 It is common for one leg to be kneeling, while the other leg is
 Squatting with the heel down
 Squatting with heel up
 STARTING POSITION
SITTING
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35 CONTENTS
Definition of Sitting
Sitting Mechanism
Muscle Work
Effects
Uses
Summary
References
36
DEFINITION
Adopted position on stool or chair
known as SITTING
 It is taken on Chair
 In this Position the body rests on
the tuberosity of ischium
 The hip, knee, and ankle joints
should all for, Right angles

www.oxforddictionaries.com/definition/sit
37
MECHANISM OF SITTING (ST.)

 Body Is Erect,
 Arms By The Sides,
 Thighs Are Fully Supported And Together.
 Right Angles Are Maintained At The Hips, Knees And
Ankles
 Position Is Taken Out On A Chair/Stool

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
38 MECHANISM OF SITTING (ST.)
Height & Width Of Stool Allow The Thighs To Be
Fully Supported
 Hips & Knees To Be Flexed To A Right Angle
 Knees Are Sufficiently Apart
 Feet Rest On Floor

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
39
MUSCLE WORK
 Heels Vertically Below The Knees
Legs: No Muscle Work To Hold The Position
 Hips: Flexors
 Rest Of Body Work: Same As Standing

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
40 EFFECTS
 Comfortable, Natural & Stable Position
 No Muscle Work For Legs
 No Weight Bearing For Legs
 Pelvis Mobility Is Eliminated
 More Stable Than Standing & Kneeling Due To Greater
Base & Lower Centre Of Gravity

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
41 USES
Starting Position For Those Who Can’t Maintain
More Difficult Position I.E. Standing Or Kneeling
 Localized Movements To The Spine
 Non Weight Bearing Activities For Knees Or Feet
 Correction Of Habitual Bad Posture
 Teaching Of Correct Sitting Patterns

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.35
42 SUMMARY
Sitting is an adopted position on stool or chair which
is Comfortable, Natural & Stable Position.
Localized Movements To The Spine
 STARTING POSITION
LYING
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44 CONTENTS
Introduction of Lying
Mechanism of Lying
Muscle Work
Effects
Uses
Summary
References
 INTRODUCTION TO LYING

This is the Easiest fundamental position of the body in which

the body is fully supported and fully stable on a horizontal
surface in supine position
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46 MECHANISM OF LYING (LY.)
 The Body Is Supine With The Arms By The Sides And
Legs Straight.
 Easiest Of Fundamental Position
 Body Is Completely Supported In Supine Position
 Maximum Stability Is This Position
 Large Base
 Lower COG

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.36
47 MUSCLE WORK
Minimal
Body Is Relaxed On Hard Surface
Head May Roll To One Side
Lumber Spine Is Hallowed
Hips In Lateral Rotation
All Above Changes Do Not Occur When Body Is On
Some Soft Resilient Surface

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.36
48 MUSCLE WORK

On A Hard Surface, These Muscle Groups May Work

Slightly
Head Rotators Of Both Sides
Extensors Of Hips & Flexors Of Lumber Spine
Medial Rotators Of Hips

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.36
49
EFFECTS

Easy Position
The Most Stable Position
No Weight Of Head & Shoulders At Trunk
Same Alignment As Standing But In Horizontal
Position
Impaired Breathing
Return Of Blood Hindering
Unsuitable For Cardiac Or Chest Diseases Patients
The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.36
50
USES
Position For Examination & Treating Patient
Suitable For Many Exercises
Head & Neck
Upper Limb
Lower Limb
Posture Training In Horizontal Position
Gravity Counter Balanced Activities
Spine Deformities Treatment
Cervical
Lumber
The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.36
51 SUMMARY
Lying position is easiest in all fundamental position
as the trunk of the body is relaxed.
It is the Position in which spinal deformities are
assessed and treated.
 STARTING POSITION
HANGING
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53 CONTENTS
Definition of Hanging
Hanging Mechanism
Muscle Work
Effects
Uses
Summary
References
54
DEFINITION OF HANGING

The Body is suspended by

grasping over a horizontal bar,
hands being pronated, arms
straight with at least shoulder
width apart
55 MECHANISM OF HANGING (HG.)
Body Hangs From a Beam Or Overhead Support.
 Body: Suspended By Grasping Over A Horizontal
Bar
 Forearms: Pronated
 Arms: Straight
 Shoulder Width Apart

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.37
56 MECHANISM OF HANGING (HG.)
Scapula: Drawn Down & Together
Neck: Appears Long
 Trunk & Legs: Hang Straight
 Heels: Together
 Ankles: Plantar flexed

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.37
57 MUSCLE WORK
 Finger: Flexors
 Wrist: All Muscles Around The Joint To Reduce
Strain & Also Act As
 Synergists
 Fixators
 Elbow: Flexors
 Neck: Pre-vertebral & Posterior Neck Muscles

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.37
58 MUSCLE WORK
 Shoulders: Adductors
 Scapula: Depressors, Retractors, Medial Rotators
 Lumber Spine: Flexors
 Hip: Extensors, Adductors
 Foot: Plantar flexors

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.37
59 EFFECTS
Suitable For Strong People Only
 Thorax Is Fixed In Inspiratory Position
 Breathing Is Impaired
 Weight Of Legs Exerts Traction On Spine
 Stretching Effect Is Stimulated
 Uncomfortable For Weak Patients Or Patients
With Cardiac Or Respiratory Conditions

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.37
60 USES
To Stimulate Stretch Effect, Specially In Children
 Traction on Spine
 Strengthening Of Upper Extremity
 Exercises for Abs, Lower Extremity

The Principles of Exercise Therapy, M. Dena Gardiner, Fifth Edition, Part-I Page No.37
61 SUMMARY
 The Body is suspended by gasping over a horizontal bar,
hands being pronated, arms straight with at least shoulder
width apart, It is Suitable For Strong People Only and this
position is uncomfortable For Weak Patients Or Patients With
Cardiac Or Respiratory Conditions
62 REFERENCES
The Principles of Exercise Therapy,
M. Dena Gardiner, Fifth Edition
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64