In 1982 Dr. Donald Harrison proposed a normal spinal postural alignment. By 1996 this proposed model was accepted in the scientific literature and published in the renowned medical journal, SPINE. In summary, the front view of the spine and posture should be straight. This alignment allows the body the best opportunity for equal and bilateral muscle effort and maintenance of posture with minimal energy expenditure.
To analyze the spine, the patient stands in what they perceive to be their neutral position. The side view of the spine is based on a symmetrical concept of the head over the shoulders, the shoulders over the pelvis and the pelvis over the knee and ankle. A plum line should be able to be drawn from the ear down and each of the following should be in line from the top down:
- Center of Pelvis
- Side of Knee
If these areas are not in line then a postural distortion exists.