Posture is the position a person adopts at rest or during activity. It can be influenced by anatomy, habit, comfort, fatigue, strength, mobility, pain, vision, balance, sport demands, work demands, confidence and environment.
Postural Assessment is commonly used to document visible features such as head position, shoulder height, spinal curves, pelvic position, knee alignment, foot posture and side-to-side asymmetry.
It may be performed using:
visual observation
photographs
video
app-based posture tools
plumb line or grid reference
inclinometer or goniometer where relevant
task-specific observation
Postural Assessment is useful when it is standardised and interpreted cautiously. It should not be used to make unsupported claims such as “this posture caused the pain” or “this alignment must be corrected”.
Assessment name: Postural Assessment
Category: Observation-based screening assessment
Body region: Whole body or region-specific
Common positions: Standing, sitting or task-specific positions
Main purpose: Document visible alignment, asymmetry and resting posture
Best used for: Baseline screening, education and comparison over time
Key limitation: Posture findings do not diagnose pain causes or dysfunction on their own
Postural Assessment is the observation and documentation of a client’s body position in a standardised posture or task.
It may include observation from:
front view
side view
rear view
sitting position
single-leg stance
sport-specific stance
occupational or task-specific position
The assessment may document:
head and neck position
shoulder position
thoracic curve
lumbar curve
pelvic position
knee position
foot and ankle posture
side-to-side asymmetry
weight distribution
visible guarding or tension
The aim is to record what is observed, not to over-interpret why it is present.
Postural Assessment is used because it provides a quick snapshot of a client’s resting or task-specific alignment.
It may help professionals:
establish a baseline
document visible asymmetry
support client education
guide further movement assessment
compare change over time
identify where more detailed testing may be useful
discuss work, training or sport positions
improve communication in reports
Posture should be interpreted alongside symptoms, goals, strength, mobility, balance, movement testing, workload and professional judgement.
Postural Assessment observes visible body position.
It may provide insight into:
resting alignment
side-to-side differences
habitual positions
visible guarding
weight shift
spinal curve presentation
shoulder, pelvic or lower-limb asymmetry
task-specific posture strategies
It does not directly measure:
diagnosis
pain cause
tissue damage
joint dysfunction
injury risk
muscle activation
strength
flexibility
movement quality during dynamic tasks
sport readiness
work readiness
Postural Assessment may be useful for:
exercise professionals
rehabilitation practitioners
strength and conditioning coaches
performance coaches
allied health support teams
workplace health professionals
movement assessment professionals
students learning observational assessment
It may be relevant for clients with:
postural concerns
neck, back, shoulder or hip symptoms
sport-specific posture demands
work-related posture exposure
visible asymmetry
movement confidence concerns
balance or weight-shift observations
general movement screening needs
Use Postural Assessment when you want to document resting posture, visible asymmetry or task-specific positioning.
It may be useful at:
initial assessment
baseline screening
movement profile review
workplace setup review
sport or gym technique review
reassessment
progress review
client education session
It is most useful when followed by movement, strength, mobility or task-specific testing.
Use caution when:
posture is being used to explain pain without evidence
the client is anxious or self-conscious about body shape
the assessment may increase fear or body vigilance
the position is painful or not representative
the client cannot stand or sit comfortably
the score or observation is being used as a diagnosis
the result is interpreted without broader assessment context
Postural Assessment should not be used to:
diagnose a condition
identify tissue damage
prove the cause of pain
label posture as “bad”
predict injury on its own
determine sport readiness
determine work readiness
replace functional assessment
replace professional judgement
Postural Assessment may require:
clear assessment space
stable floor
appropriate clothing for observation
consent for observation or photos
posture grid or wall reference, if used
plumb line, if used
camera or video device, if used
inclinometer or goniometer, if used
consistent lighting and camera position for photos
Photographic or video-based assessment should only be performed with informed consent and appropriate privacy safeguards.
Explain the purpose of the assessment.
Example wording:
“We are going to observe your posture as one part of the assessment. This does not diagnose the cause of symptoms, but it gives us a baseline and helps decide what movement or strength tests may be useful next.”
Common standing setup:
client stands comfortably
feet in a consistent position
arms relaxed
eyes looking forward
normal breathing
no forced correction
minimal cueing
consistent footwear or barefoot status
If using photos, standardise:
camera height
camera distance
lighting
background
foot position
view angle
clothing
instructions
Common views include:
anterior view
posterior view
left lateral view
right lateral view
Task-specific views may include:
seated posture
single-leg stance
squat setup
running stance
cycling position
work task position
lifting setup
Ask the client to:
stand or sit naturally
avoid forcing “perfect posture”
breathe normally
report discomfort
maintain the position briefly
follow the same setup at reassessment
Common observation points include:
head position
shoulder level
scapular position
thoracic curve
lumbar curve
pelvic tilt or rotation appearance
knee alignment
foot and ankle posture
weight shift
side-to-side asymmetry
visible guarding or tension
Retest using the same:
position
footwear
instructions
view angles
lighting
camera distance if used
time of day where possible
relevant activity context
Postural changes should be interpreted cautiously and alongside function, symptoms and goals.
Postural Assessment is low risk, but professionals should avoid language that increases fear, shame or unnecessary concern.
Use neutral wording such as:
“This is what we observed today”
“This gives us a baseline”
“We’ll compare this with movement and strength findings”
Avoid language such as:
“Your posture is bad”
“This is causing your pain”
“Your body is out of alignment”
“This must be corrected”
Postural Assessment may be recorded descriptively or using a structured checklist.
A simple structure may include:
position observed
view used
region observed
finding noted
side-to-side comparison
symptom response
confidence in observation
next assessment step
Some tools use scores, categories or photographic measurements. If using a formal tool, follow the tool’s instructions rather than creating unsupported categories.
A postural finding may suggest:
a useful baseline observation
a side-to-side difference worth monitoring
a region to assess further
a task or position to explore dynamically
a possible relationship with comfort, habit or exposure
A finding should not be assumed to explain pain.
An unremarkable postural assessment may suggest no obvious visible asymmetry or resting posture feature in that position.
It does not exclude symptoms, movement limitations, strength deficits or task-specific problems.
Postural Assessment does not prove:
diagnosis
tissue damage
pain cause
injury risk
movement dysfunction
muscle weakness
poor technique
need for correction
work or sport readiness
Example wording:
“Your postural assessment gives us a baseline of how you naturally stand or sit today. We will use it alongside your symptoms, strength, mobility and movement tests rather than treating posture alone as the cause of pain.”
For general fitness clients, postural observations may help guide exercise setup, comfort, awareness and movement assessment.
Findings should not be used to label the client’s posture as wrong.
For athletes, posture may reflect sport-specific adaptations, training history or task demands.
Interpretation should include performance context, movement testing and sport-specific exposure.
For workplace clients, posture should be interpreted in relation to task duration, variation, load, breaks, workstation setup and fatigue.
A single posture snapshot should not be treated as the only cause of symptoms.
For older adults, posture may be influenced by strength, balance, vision, spinal changes, confidence, pain and general health.
Interpretation should focus on comfort, function, safety and goals.
For youth clients, posture may vary with growth, confidence, activity and development.
Avoid fear-based messaging or appearance-focused language.
Postural Assessment is not usually interpreted using MCID or MDC values unless a validated measurement tool is used.
Meaningful change should be judged by:
consistent measurement method
repeated observation
symptom change
function change
comfort change
goal progress
physical assessment findings
client confidence
Small visual changes should not be over-interpreted, especially when setup, camera angle or instructions differ.
There is no single universal “ideal posture” that applies to every person.
Posture varies by:
age
anatomy
sport background
work demands
fatigue
pain state
culture
confidence
body shape
training history
footwear
testing setup
Practical comparison guidance:
compare the client with their own baseline
standardise setup at retest
avoid using one ideal posture model for everyone
interpret posture with symptoms and function
focus on comfort, capacity and task tolerance
avoid unsupported cause-and-effect claims
Reliability and validity depend on the method used.
Visual observation alone can be influenced by assessor experience, positioning, lighting, clothing, camera angle and subjective judgement.
Photogrammetry and app-based methods may improve measurement consistency when standardised, but they still require careful setup and validation.
Reliability is stronger when:
the protocol is standardised
landmarks are clearly defined
photos are taken consistently
measurements are repeated
assessors are trained
the same method is used at retest
Validity is weaker when posture findings are used to infer pain cause, injury risk or dysfunction without supporting evidence.
Common errors include:
labelling posture as “bad”
blaming pain on posture alone
using one ideal posture model for all clients
ignoring symptoms and function
over-interpreting small asymmetries
comparing photos taken with different setups
not gaining consent for photos
ignoring sport or work demands
using static posture instead of assessing movement
Limitations include:
posture varies naturally
visual assessment can be subjective
static posture may not reflect dynamic movement
camera setup affects measurements
posture is not a diagnosis
posture findings do not prove pain cause
norms are limited and context-dependent
Postural Assessment may help professionals:
document a baseline
observe visible asymmetry
guide further movement testing
support client education
monitor comfort and position changes over time
discuss work or sport exposures
improve communication in reports
For general fitness clients, it can help guide exercise setup and comfort.
For workplace clients, it can support discussion about task variation and ergonomic context.
For sport clients, it can provide a baseline for sport-specific positioning, but should always be linked with dynamic assessment.
It observes resting or task-specific body position, alignment and visible asymmetry.
Posture alone should not be assumed to cause pain. Pain is influenced by many factors, and posture findings need broader context.
No. Posture varies between people and should be interpreted in relation to comfort, function, goals and activity demands.
Both can be useful. Static posture gives a baseline, but dynamic movement assessment is often more relevant to function.
Photos can be useful when consent is provided and setup is standardised. Camera angle, lighting and positioning must be consistent.
No. It is an observation tool, not a diagnostic test.
They should be combined with symptoms, goals, strength, mobility, balance, movement testing and activity exposure.
Reassess when it is relevant to goals, education or progress tracking, using the same setup each time.
Postural Assessment is an observation-based screening method.
It can document resting or task-specific alignment and asymmetry.
It does not diagnose pain causes or dysfunction on its own.
There is no single perfect posture for every person.
Static posture should be interpreted alongside dynamic movement and function.
Standardised setup improves reliability.
Use neutral, non-fear-based language when discussing posture.
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Karbalaeimahdi, M., Minoonejad, H., Mousavi, S. H., & Rajabi, R. (2025). Photogrammetry-based smartphone applications for spinal posture assessment: A systematic review and meta-analysis. Scientific Reports, 15, 32708. https://doi.org/10.1038/s41598-025-32708-1
Khan, K. S., et al. (2025). Development and validation of the observational static posture assessment tool: A mixed-methods study. Sport Sciences for Health. https://doi.org/10.1007/s11332-025-01345-6
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