Spine & posture diagnostics

Spine and posture – briefly explained

The spine is divided into cervical, thoracic and lumbar sections with the sacrum and coccyx. Their physiological curvatures (lordosis/kyphosis) distribute loads, absorb shocks and enable movement. A healthy posture arises from the interaction of bones, intervertebral discs, ligaments, muscles, fascia and nervous control.

• Cervical spine: mobility and balance of head posture
• Thoracic spine: breathing mechanics, core stability, shoulder girdle connection
• Lumbar spine: Power transmission between upper body and pelvis/legs
• Pelvis/lower extremities: Foundation for static and dynamic posture

Postural abnormalities are often multifactorial. That's why we always look at the entire system - static (standing) and dynamic (walking, function).

When does posture diagnostics make sense?

A structured posture and spine analysis helps to better understand symptoms, define therapy goals and objectively measure the course. Typical reasons:

• Recurrent or chronic back, neck or shoulder pain
• Abnormal posture (e.g. rounded back, hollow back, tilted pelvis, suspected scoliosis)
• Sports-related complaints, stress or overuse pain
• Functional limitations after injuries or operations (follow-up)
• Age of growth with changes in posture (careful, low-radiation progress measurement)
• Workplace-related complaints (e.g. sitting for long periods of time, working from home)
• Prevention: Status quo before training begins, re-check after therapy

If there are warning signs such as severe, sudden pain, neurological deficits, fever or an accident, a medical evaluation and, if necessary, further imaging are carried out first.

Methods: precise, low-radiation, function-oriented

We combine clinical examination with modern measurement methods. The selection is made based on the indication – as detailed as necessary, as conservative as possible.

• Clinical posture check (visual, tactile findings, functional tests)
• 3D spine measurement using raster stereography (radiation-free)
• Video gait analysis and functional movement diagnostics
• Ultrasound of paraspinal muscles and soft tissues
• Elastography to assess tissue stiffness
• Neuro & muscle functional diagnostics (e.g. strength, coordination, EMG-oriented tests)
• Cone beam computed tomography (CBCT) only for specific questions

The strength lies in the combination: morphology, function and resilience form a complete picture - the basis for an effective, conservative therapy plan.

3D spine measurement (raster stereography)

Raster stereography captures the surface of the back using light lines and reconstructs the spatial shape of the spine - without any X-rays. These are measured, for example: B. Shoulder and pelvic position, spinal curvatures, rotation components and the sagittal course.

• Radiation-free, repeatable – ideal for follow-up checks
• Objective characteristics instead of just a sense of proportion
• Suitable for postural abnormalities, suspected scoliosis, postural pain
• Limits: no statement about intervertebral discs, nerves, inflammatory processes

The procedure does not replace imaging diagnostics such as MRI or CT for certain questions, but can enable many checks without radiation.

Video gait analysis and functional movement diagnostics

Attitude is reflected in movement. Using video-assisted gait analysis and standardized functional tests, we assess axis control, pelvic stability, core strength, timing and compensation. In this way, the causes behind pain become visible and training priorities become clear.

• Analysis of step width, rhythm, foot strike and rotation patterns
• Functional tests such as single leg squat, plank variations, balance checks
• Derivation of concrete exercise programs with clear target parameters

Ultrasound of the back muscles

We use high-resolution ultrasound examinations to assess muscles, tendon junctions and bursae. This helps to better classify myofascial triggers, irritations or tears - dynamically, in real time and without radiation exposure.

Details about the method can be found under ultrasound diagnostics.

Elastography: Making tissue stiffness visible

Elastography complements ultrasound and measures the elastic properties of muscles and tendons. Increased or decreased stiffness can indicate overload, scarring or imbalances.

• Objective measurements for monitoring progress during training
• Useful for chronic myofascial complaints
• No substitute for MRI for structural issues

Neuro & muscle functional diagnostics

Strength, endurance, coordination and neuromuscular activation determine whether a posture functions stably. Standardized tests and – depending on the question – additional measurements support training control and risk assessment.

• Side comparison of strength and mobility
• Screening for imbalances and neuromotor deficits
• Derivation of concrete target values ​​for rehabilitation

CBCT: when detailed representation is necessary

We only use Cone Beam CT (CBCT) selectively when bony details are crucial and other procedures are not sufficient. We always check the benefits and radiation exposure beforehand. For intervertebral disc or nerve issues, MRI remains the method of choice.

• Targeted, indication-based application
• Clarification about benefits and limitations
• No routine checks in postural diagnostics

Process in our practice

Structure provides security. This is how your spine and posture diagnostics typically work:

From analysis to plan: how we use findings

Measured values ​​are only as good as the consequences. We translate findings into comprehensible measures, prioritize conservative therapy and measure progress.

• Transparent findings reports with core parameters and graphics
• Individual target values ​​(e.g. core strength, range of motion, symmetry)
• Therapy recommendations based on evidence and suitability for everyday use
• Clear re-check dates to check effectiveness
• In the case of red flags or resistance to therapy: rapid further clarification and interdisciplinary collaboration

Common Findings – Examples

Not every finding is pathological. What is crucial is the connection to symptoms and function. We often see:

• Increased thoracic kyphosis (“hunched back”): often with shortened anterior chain and weak back/scapula muscles
• Lumbar lordosis (“hollow back”) with anterior pelvic tilt: frequent combination of hip flexor and back extensor dominance
• Functional pelvic tilt: muscular/coordination related, dynamically changeable
• Scoliotic poor posture versus structural scoliosis: Differentiation for the right approach
• Axial deviations of the lower extremities, which secondarily influence the spine (foot–knee–pelvis–trunk chain)

Conservative therapy components that can be followed

Our focus is on conservative, active measures. The exact selection depends on your findings and goals.

• Targeted exercise programs (trunk stability, hip control, mobility) – independently and in physiotherapy
• Posture training and ergonomic adjustments in everyday life/office
• Medical training therapy with progression and goal metrics
• Manual therapy and myofascial techniques for short-term relief as a supplement
• Respiratory and chest mobility for thoracic spine/cervical spine complaints
• Sensorimotor training/balance to improve neuromuscular control
• Orthoses/corsets only if there is a clear indication (e.g. progressive scoliosis) and with information
• Injections/drug measures only selectively and according to indications - not a replacement for active therapy

Limits, risks and education

Radiation-free procedures are safe and easily repeatable. Limits exist where internal structures (intervertebral discs, nerves, inflammation) need to be assessed - then MRI or other procedures are indicated. We only use CBCT/CT after careful consideration.

• Measurements provide snapshots; Follow-up checks increase informative value
• No promise of cure – effectiveness depends on findings, activity and adherence
• Data protection: Video and measurement data are processed securely and not passed on without consent

Prepare and bring with you

• Comfortable, close-fitting sports clothing; clean sports shoes
• Preliminary findings/images (MRI/CT/X-ray), surgical reports, physio reports
• List of current medications and previous illnesses
• If available: training protocols/apps for progress documentation
• Come as rested as possible; Avoid very intense stress shortly before the appointment

Location & date

You can find us at Dorotheenstraße 48, 22301 Hamburg (Winterhude). You can easily request appointments for spine and posture diagnostics via Doctolib or by email. We plan your appointment so that there is enough time for diagnosis and advice.

Related Services

In addition to postural diagnostics, other procedures can be useful - depending on the indication - for example ultrasound, elastography, neuro-muscular functional diagnostics or laboratory analyzes if inflammatory or metabolic factors are suspected.

• Ultrasound diagnostics: Soft tissue and muscle findings in real time
• Elastography: objective measurement of tissue stiffness
• Neuro & muscle functional diagnostics: strength, coordination, activation
• CBCT: high-resolution bony detail for specific questions
• Metabolic & inflammatory diagnostics: if systemic factors are suspected
• Micronutrient & vital substance analysis: only if there is a clear indication and after informed consent