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Common clinical beliefs about the relationship between postural characteristics and pain are based on mainly anecdotal evidence. This study examined the reliability of physical characteristics of the head, shoulders and thoracic spine and identified relationships among them. Measurements were made from photographs of subjects in comfortable erect standing. A forward head position was related to the curvature of the upper thoracic spine, and a forward position of the shoulders to the tilt of the head in the sagittal plane and to upper cervical extension. The magnitude of the relationships, however, was of questionable clinical significance. No relationship was found between a forward head position and forward shoulders, nor between a forward head position and upper cervical spine extension.

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A newly developed clinical method of indexing tibial torsion uses the medial surface of the tibia as the proximal reference; however, the selection of a specific landmark on the medial surface has not been justified. Three different surfaces relating to the tibial tuberosity were tested using 24 dry tibial bones to determine which provides the most accurate and reliable landmark for use as the proximal reference. The medial surface of the tibia at the inferior point of the tibial tuberosity was the most reliable proximal reference that yielded the highest level of association between the newly developed clinical method and true tibial torsion (r = 0.77). The new method has the potential to describe the anatomy of the leg and to improve the clinical measurement of tibiofibular torsion.