Bleeds

Adaptive postures and position of comfort

Position of comfort

Habitual posture

Potential problems

Kneea

Flexion

Walking on flexed knee, with hip flexed and/or ankle plantarflexed to compensate

Pain in patellofemoral joint;

stress on ankle; overuse of hamstrings; weak quadriceps

Elbowa

Flexion

Loss of elbow extension, arm may be

carried with shoulder extended

Eventual difficulty with forward elevation of the arm

Anklea

Plantarflexion

Walking on toes, with knee and/or hip flexed to compensate

Ankle in unstable position, with small area of weight-bearing on talus and sole of foot; overuse of calf muscles; pressure on knee

Hip (unusual site)a

Flexion, external rotation

Hip flexed, increased lumbar lordosis, compensatory knee flexion

Incomplete hip extension during gait; compensation with increased rotation of pelvis or spine

Shouldera

Adduction, internal rotation

Arm held close to body

Difficulty with activities related to daily living and self-care

Wrist and fingersa

Flexion

Wrist flexed, hand closed

Difficulty extending wrist and fingers; inefficient grip

Toesa

Extension (dorsiflexion)

Extension (dorsiflexion)

Difficulty wearing shoes

Hip flexor (iliopsoas)b

Hip flexion, some external rotation and increased lumbar lordosis

Hip flexed, extreme lordosis, walking on toes

Back pain; incomplete hip extension; stress on knee and ankle