POSITION

STARTING POSITION AND DERIVED POSITION
The position, which is adopted, by the patient or
an individual to perform the exercise or the
movement, to gain relaxation and stabilize the
body is called as starting position. To perform a
movement or exercise, the person should adopt
one stable position. “Every movement begins in
posture and ends in posture”. It is applicable for
the day-to-day activities too. For example,
drinking bed coffee. In this example, the person
has to come out of the lying posture and attain
sitting posture to drink the coffee or tea. So, the
every activity, which we do in our day-to-day life
also starts in one posture and ends in some
other or same posture. There are five fundamental
positions are found by which all the positions
are derived. Whatever position we adopt for
exercise or movement, it is the position, which
altered from the five fundamental positions.
1. Standing
2. Sitting
3. Lying
4. Kneeling
5. Hanging.
DERIVED POSITIONS
These are the positions, which are derived from
the starting position. From the five fundamental
positions, depend on the patient convenient
as well as therapist’s convenient, the positions
are altered to perform an activity or movement.
Uses
1. To increase stability
2. For relaxation
3. To perform a particular exercise
4. For reducing the muscle work
5. For localizing the activity.
These derived positions may be useful for
our daily activities or to perform an exercise.
This chapter elaborately explains about the
position, which is helpful for an exercise and
for the day-to-day activities with the relevant
examples. The muscle work for a particular
derived position is not explained in this chapter
instead of that the movements, which occur in
that particular position, are mentioned.
STANDING
Introduction :
The whole body is supported or aligned by the
smaller base. So that this position is most
difficult to adopt for longer period. There will
be a lot of coordinated muscle activity to
maintain this posture.
Position
• Foot is placed together and toes placed
slightly apart.
• Knees are extended and aligned straight.
• Hip is in neutral position and slight lateral
rotated.
• Spine is erect.
• Shoulder adducted and slightly retracted.
• Upper limb is hanging closely to the body.
• Neck is aligned straight.
• Eyes look forward.
Muscle Works
• Flexors and extensors of neck muscles
counteract and align the neck in straight
position.
• Evertor of the mandible closes the mouth.
• Retractors and adductors of the shoulder
keep it in the adducted and slightly retracted
position.
• Normally arms are relaxed or sometimes
muscle work is minimal or nil.
• Spinal extensors work more to stabilize the
spine in erect position.
• The spinal flexor counteracts and balances
the spinal extensors.
• Hip extensors maintain the hip in neutral
position and the flexors counteract on it for
balancing the limb.
• Hip lateral rotator keeps the hip in slightly
rotated position.
• Ankle plantar and dorsiflexors counteract
and keeps in neutral position.
• Toe flexors work more and make the ball of
the toe grip with the floor.
• Intrinsic muscles of the foot stabilize the
foot.
Derived Positions—Standing
Many of the derived positions can be derived
from the standing by altering the arm, trunk
and the lower limb. These positions can be
utilized for the different types of exercise
regimen, relaxation and stability.
By Altering Lower Limb
a. Walk standing
b. Stride standing
c. Step standing
d. Toe standing
e. Close standing
Walk standing: One leg is placed forward and
the base is increased. So, stability will be more

in this position .
Movements:
• Hip—Flexion
• Knee—Extension
• Ankle—Mild plantar flexion.
Uses :
• Starting position for jogging.
• To perform the hip, knee, ankle, and trunk
muscles self-stretching.
• Relaxation from the prolonged standing.
Example :
• Balancing on rope or rod.
Stride standing: Both the foot kept apart in
the side ways. It gives more lateral stability
Movements
• Hip abduction
Uses :
• To perform the trunk, hip, knee exercises.
• Used for stability.
• Helps to stretch the hip adductors.
Examples :
• Sailors standing position.
• Standing posture while traveling in the bus.

Toe standing: Standing with the toes and toes
raise the body. This is also one of the unstable
position because the COG increases and the
BOS decreases in this position
Uses :
• Strengthening the plantar flexors and toe
extensors.
• Stretching the dorsiflexors.
Example :
• Raising the body by the toes to see the
invisible things in the crowd.
 step standing :    One foot is kept on the stool
or on height. Hip and knee is  flexed. This is
also one of the stable postures
Movements
• Hip flexion
• Knee flexion.
Uses in exercise therapy
• For stretching the knee ankle, hip and trunk
muscles.
Examples
• Position adopted to tie the shoelace.
• Position adopted to cutting the toenails.
Close standing: Both the foot is kept closer
and parallel to each other. It is difficult to
maintain this posture due to the tension created
in the leg muscles.
Movement
• Hip internally rotated.
Uses:
• To perform hip, trunk bending and
rotational exercises.
• Arm swinging exercises.
• Starting position for sit-up exercises.
• To perform the upper and lower extremity
exercises.
Examples:
• Suriya namaskar position.
• Erect standing posture in military.
• Standing posture during national anthem.
Lunge standing: The feet are placed right angle
to each other. If the forward leg bends, the
weight transmitted to the same leg
Movements
• Hip abduction and lateral rotation.
• Knee flexion of the relaxing leg.
Uses in exercise therapy
• Weight transmitting exercises.
• To perform balancing and coordination
exercises.
• Lower limb stretching exercises.
Example
• Relaxed standing positions after prolong
standing.
By Altering Arm
a. Wing standing
b. Bend standing
c. Reach standing
d. Stretch standing
e. Yard standing
f. Stoop standing
g.fallout standing
Wing standing: Both the hands are placed on
the pelvic region of the either side
Movements
• Shoulder abducted and medially rotated.

• Elbow flexed.
• Thumb abducted.
• Fingers adducted and flexed.
• Forearm pronated.
Uses in exercise therapy
• To perform trunk bending exercises.
• To perform neck exercises.
• To perform lower limb strengthening and
stretching exercises.
Example
• Relaxing position after prolonged walking
or jogging.
Bend standing: Elbow is flexed and hands
placed on the same side of the shoulder
Movements:
• Shoulder abducted and laterally rotated.
• Elbow flexed.
• Forearm supinated.
• Fingers flexed.
Uses in exercise therapy
• Shoulder rotation exercises.
• Trunk bending exercises as well as neck
exercises.
Examples
• Policeman fixing the star in his shoulder.
• Removing dust from the shoulder.
Reach standing: The upper limbs are kept
parallel and right angle to the body
Movements
• Shoulder flexed and elevated.
• Elbow extended.
• Forearm in midprone position.
• Wrist and fingers extended.
Uses in exercise therapy
• To perform wrist exercise.
• Grasping the horizontal bar with the hand
can perform sit-up exercise.
Examples
• Position adopted to carry the child.
• Walking style in the dark place to avoid
dashing on the objects.
Yard standing: Upper limbs are kept in the
sides and perpendicular to the body with palm
facing up
Movements
• Shoulder abducted, laterally rotated and
extended.
• Elbow extended.
• Forearm supinated.
• Wrist and fingers extended.
Uses in exercise therapy
• To perform trunk rotation and bending
exercises.
• To perform wrist, elbow, and finger
exercises.
• To perform arm swinging movements.
Example
• Balancing while walking on the rope or rod.
• Umpire’s wide signaling in cricket.
Stretch standing: Upper limb is totally elevated
up and placed parallel to the body line
Movements
• Shoulder flexed and medially rotated.
• Elbow extended.
• Wrist and finger extended.
Uses in exercise therapy
• To perform arm swinging exercises.
• To perform trunk exercises.
Examples
• Repairing the ceiling fan.
• Overhead activities.
Stoop standing: Trunk is inclined forward and
upper limb placed parallel to the bodyline to
this position .
Movements
• Trunk flexed.
• Hip flexed.
• Shoulder adducted, extended and laterally
rotated.
• Elbow is extended.
• Finger and wrist extended.
Uses in exercise therapy
• Pendular movements of the shoulder.
• Trunk bending and stretching exercises.
Example
• Rickshaw pulling position.
Fallout standing: One leg kept forward with
knee bending, the other leg remains straight
and the trunk inclined forward
Movements
• Forward leg: Hip flexed and knee flexed.
• Backward leg: Hip extended, knee extended
and ankle dorsiflexed.
Uses in exercise therapy
• Stretching the hip flexors.
• Strengthening exercises to the forward leg
can be performed.
Example
• Pulling the loaded bullockcart.
SITTING
The position adopted while sitting on the stool
or the chair is considered as the fundamental
position of the sitting. The thighs and the legs
are relaxed and the foot is resting on the floor.
From the trunk to head the position is same as
 Stoop standing said in standing posture. The base of support is
Fallout standing more, so the COG lies down. Due to the downward
movement of the COG the position gets
more stability than the standing and the muscle
work required is also less
Muscle Works:
There is no muscle work in the lower limb
because the stool supports thighs and legs, and
the foot is resting on the floor. Remaining parts
from the trunk to head the muscle work is same
like the standing posture.
Derived Position—Sitting
1. Cross sitting
2. Side sitting
3. Crook sitting
4. Long sitting
5. Stoop sitting
6. Ride sitting
Cross Sitting
Both the legs are crossed and the weight is
transmitted through both the hips
Movement
Both the side hips are flexed, laterally rotated
and knee flexed.
Uses in exercise therapy
• Breathing exercise and reduce the respiratory
distress
• Hip adductor stretching
• Trunk and neck exercise.
Example
• Some floor level activities like eating,
cutting vegetables, etc.
Side Sitting
This position is possible either one side of the
hip. In right side sitting the right hip remains
like the cross sitting the left hip flexed, adducted
medially rotated and knee flexed and kept in
side. Weight is transmitted on right side
Uses in exercise therapy
• Progression from prone to sitting in mat
activity.
• To perform trunk exercises.
Example
• All floor level activities like cutting vegetables
and garland making.
Crook Sitting
Knee and hip are flexed in, and the feet are
kept forward while sitting in the floor
Movements
• Hip flexed,
• Knee flexed, and
• Ankle in neutral position.
Uses in exercise therapy
• To perform mat activities.
• To perform breathing exercises.
• To perform neck and ankle exercises.
Example
Relaxed wall sitting while watching T.V.
Long Sitting
• Hip is flexed, knee is extended and resting
on the floor
Uses in exercise therapy
• To perform hip rotational movements.
• To perform ankle and knee exercises.
• To perform trunk exercises.
Example
• Traditionally adopted position by the old age
people for floor level activities.

Stoop Sitting
Sitting on the stool and the trunk is leaned
forward
Movement
• Trunk flexion.
Uses in exercise therapy
• Used for back and neck massage
• Back muscles relaxation
• To perform breathing exercises.
Example
• Lazy sleeping position in the classroom.
Stride Sitting
Both the hips are abducted and placed in either
sides of the stool. If the foot rests on the floor,
the position will be more stable .
Uses in exercise therapy
• To perform leg swinging exercises.
• To perform neck and trunk exercises.
• To perform upper limb exercises.
Example
• Bike riding posture.
• Horse riding posture.

LYING
Starting Position—Lying
Lying on the floor or on the plinth, in supine
position with arm by the side of the body and
legs are kept straight. It is the most stable
posture than the any other fundamental
starting position due to the lower placement of
the COG and the broader base. This position
can be adopted for prolonged period than any
other starting position
Muscle Works
In this posture the muscle work is minimal.
Maximum muscles are relaxed except some
positions
• Neck side flexors counter balanced to keep
the head in neutral position.
• Flexors of the lumbar spine counteract with
the spinal extensors to maintain the lumbar
lordosis.
• Medial rotators of the hip keep the hip in
neutral position.
Uses
It is very much useful position to perform many
of the upper limb, lower limb, trunk, neck
exercises like strengthening, stretching,
aerobic and anaerobic and breathing exercises.
Derived Position—Lying
a. Prone lying
b. Half-lying
c. Crook lying
d. Side lying.
Prone Lying
Anterior portion of the total body is turned
towards the couch or floor. This position is
inconvenient for maintaining for longer period.
All the body parts are relaxed and if the head also
gets relaxed, if it turned and kept apart. This
position is very much difficult for the respiratory
distress and elderly patients
Uses in exercise therapy
• Spinal extensor and neck extensor exercises
can be performed.
• This position can be used for back massage.
• Some of the upper and lower extremity
exercises can be performed.
Example
Toppled position of getting blessing from the
elders.
Half-lying
Same like the supine lying and upper portion
is lifted and kept inclined. Some amount of spinal
muscle work may be present in this posture
Uses in exercise therapy
• To practice breathing exercise and postural
drainage.
• To perform Frenkle’s exercise.
• To perform upper limb, lower limb, and
trunk exercises.
Example
• Relaxed position to adopt while reading book
or watching TV.
Crook Lying
Modifications are made in lower limb in the
supine lying posture. The hip and knee are
flexed, and the feet is kept forward.
Uses in exercise therapy
• Abdominal muscle strengthening exercises
can be performed.
• Pelvic bridging exercises can be performed.
Example
• Relaxing position after yoga exercises.
   
Side Lying
Lying one side of the body. It is most inconvenient
to maintain for longer period. The upper
extremity which is placed under the body will be
more painful and positioning the lower limb
also very much difficult. Upper extremity, which
is below the body, is flexed and kept under the
head, and the lower limb which is up to be placed
forward to reduce the inconvenient
Uses in exercise therapy
• Many of the upper limb and lower limb
exercises can be performed.
• Breathing exercises and postural drainage
can be done.
Example
• Daily-unknown activity while sleeping.
maintain for longer period. Even though the
COG falls down and the larger BOS, it is inconvenient
to adopt due to the weight transmitted
through the knee joint
Muscle works
• The leg is relaxed except the plantar flexors
of the ankle, which keeps the ankle in
plantar flexion state.
• Hip flexors, extensors counteracts with each
other and keeps in vertical position and
prevents the pelvic tilt.
• Remaining muscle is as said in standing
posture.
Uses in exercise therapy
• Many of the upper limb and trunk exercises
can be performed.
• To perform the mat activities.
• To perform coordination and balancing
exercises.
Example
• Christians prayer position.
Derived Position—Kneeling
1. Half-kneeling
Crook lying
 Side lying
KNEELING
This position is like the fundamental position
of standing but the weight is transmitted
through the knee joint due to the right angle
alignment of the knee to the body. The leg is
resting on the floor and the ankle is plantar
flexed. It is the very much difficult position to maintain
1. Half Kneeling
2. Kneel sitting
3. Prone kneeling
4. Inclined prone kneeling.


Half-kneeling
It is like the kneeling position and weight is
transmitted through one side knee. Another
side hip is flexed 90°, the thigh and leg is kept
right angle to each other and the foot is placed
on the floor forward.
Movements
• Forward lower limb: Hip flexed 90°, knee
flexed 90°.
• Kneeling lower limb: Hip is in neutral
position, knee flexed 90°.
Uses in exercises therapy
• To perform the balancing and coordination
exercises.
• To perform trunk bending and neck
exercises.
• To perform upper extremity strengthening
and stretching exercises.
• To perform the mat activities.
Example
• To practice some of yogic exercises.
: Kneel sitting
Sitting on the heel by flexing the hip and knee
Uses in exercise therapy
• To perform trunk bending and stretching
exercises.
• To perform neck exercises.
• To perform the stretching and strengthening
exercises for the knee and hip muscles.
Example
• Playing posture adopted by the child.
• To perform some of the yogic exercises.


Prone Kneeling
It is otherwise called as quadruped position or
animal position. Trunk is inclined forward and
is stabilized by the upper limb by placing on the
floor, remaining are same like kneeling .
Movements
• Trunk forward bending.
• Shoulder flexed, elevated and medially
rotated.
• Elbow extended.
• Wrist and finger extension.
Uses in exercise therapy
• To perform mat activity.
• To perform coordination exercises.
• Cat and camel exercises.
Example
• Child crawling position.
Inclined Prone Kneeling
This is the modified variety of quadruped
position. In this quadruped position the head
also inclined forward and placed on the upper
limb, which is flexed and kept on the floor
Movements
• Trunk forward bending.
• Shoulder abducted, flexed and medially
rotated.
• Elbow flexed.
Uses in exercise therapy
• To perform breathing exercises and postural
drainage technique.
Example
• Muslim Namaz position.
HANGING
Total body is suspended by grasping a horizontal
bar with the hand
Movements
• Shoulder flexed, adducted and medially
rotated.
• Elbow is extended.
• Fingers flexed and grasping the rod.
Muscle works
• Adductor and medial rotators of the shoulder
work strongly.
• Flexors of elbow carry more weight and also
strain.

• Finger flexors work strongly and grasping
the bar.
• Adductors of hip keep it in adducted posture.
• Plantar flexors keep the ankle in plantar
flexed position.
• Trunk, knee and remaining muscles of the
hip is free from the work and movement.
Uses in exercise therapy
• To perform total body swinging movements.
• To perform upper limb strengthening and
body-building exercises.
• To perform stretching exercises.
Examples
• Mostly helpful in gymnastic activities.
• Bar exercises.
Derived Position: Hanging
Half-hanging
Same like hanging, but the body is hanging with
one side upper limb support. It is also a difficult
posture to maintain for longer period. Total
body weight is carried out by one side upper
limb so that the shoulder, elbow and muscles
are facing more strain.
Uses in exercise therapy
It is the most advanced strengthening program
for the upper extremity. Generally, it is helpful
for the body-builders and gymnastic peoples.
Example
• Normally, it is used in gymnastic activities.