It is far easier to observe others than to observe oneself, and one of the tricks to learning postural assessment is by observing others and then substituting yourself. It is wise to look at the posture of the individual as a whole. It is recommended that beginners examine their posture from head to toe to assess the symmetry and balance of the muscles in each case with a sense of overview. After studying this chapter, you will have insight into the muscle imbalances that may cause pain, discomfort or limited joint angulation and understand the causes. (1) Step 1 Ear Height The first thing to look for in an individual’s ear height range is to see if the earlobes are equal in height. If the individual has short hair, the ears can be easily observed. If the individual has long hair, the hair should be tied up first so as not to hinder the observation. Some people will instinctively grab their hair up and out. Then avoid making such movements. This will affect the position of the individual’s head, neck and shoulders. What we want to observe is the natural posture of the individual. (i.e., hands hanging at the side of the body, standing easily.) Unequal ears on both sides may indicate that the individual has cervical scoliosis. Cervical scoliosis may be caused by a shortening of the muscles on the side that is bent. For example, if the head is bent sideways to the right, the upper trapezius muscle fibers on this side may be tighter. The right scapularis, right sternocleidomastoid, and right trapezius may also be tighter. Rarely, individuals have one ear that is higher than the other, but do not have cervical scoliosis. They sometimes find this problem because they cannot comfortably wear glasses or sunglasses. (This factor needs to be ruled out). (2) Step 2 Head and neck tilt This step is complementary to step 1, i.e. if you cannot observe the ear in a case, you can use this step instead of step 1. As in step 1, if the head is tilted to one side, this reveals tightness in the lateral bending muscles of the head and neck. (Tilting to which side means that the muscles on which side are likely to be tight). Patients with shoulder pain will often subconsciously tilt their neck to the painful side to minimize movement and avoid discomfort. If an individual has a problem with a wry neck, he or she will have a pronounced scoliosis of the neck. The [crooked neck wry neck] is a spasm of the neck muscles that causes the neck to bend sideways and rotate. It often occurs in whipping syndrome. Whiplash syndrome: Mostly occurs when a person sitting in a high-speed vehicle is hit from behind by another vehicle in motion, causing the neck and head to move backward rapidly because of the different nature of weight support, and then immediately rebounding, which is the most common situation that happens to passengers in a car accident. Next, the cervical spine is tested for rotation. Is the individual’s head facing straight ahead, or is it rotated slightly to the right or left? A tip for assessing whether an individual’s cervical spine is rotated: notice if you can see that one half of the individual’s face is larger than the other. Can you see the individual’s eyelashes on one side and the cheeks on the other side? Because cervical rotation is a very subtle, hard to detect change, but if one has complained of neck pain, it may be related to this. Both of them thought their heads were facing straight ahead. But if you look closely, you will see that the man rotates to the right (his right jaw can be seen to a greater extent), while the woman rotates to the left (her left jaw can be seen to a greater extent). Those who have studied muscles will know that there are many muscles that can make head rotation movements, including the sternocleidomastoid and oblique muscles. The woman shown in the picture may have a tighter right sternocleidomastoid and left oblique angle muscles. In addition, the contralateral muscles associated with these muscles, such as the left scapular lift, may also be tighter.