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Body reading the pelvis: Posture assessment

This is an excerpt from The Pelvic Diaphragm by Julie Hammond.

Body Reading the pelvis

When Body Reading the pelvis, look at all views—front, sides, and back. The pelvis is body-read in relation to the femur rather than in relation to the horizontal plane of the ground.

The anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) can be used as guides—but they are just guides, as everybody is different, and research highlights how unreliable this method can be. This takes us back to our earlier discussion in this chapter of whether posture is important. The posture assessment is just a tool to help the therapist assist the client to be able to move well and be pain-free. If the pelvis is read in relation to the femur, it gives information on the myofascia connecting these structures, and therefore starts to inform your strategy. In the transverse plane, when Body Reading rotations, place a hand on each ASIS. Is one hand more forward than the other? If one is lower than the other, this could represent a torsion. Ask the client to place their finger on their pubic symphysis. Is it off-center?

Then step back, and view the global relationships. What position are the ribcage, shoulders, head, and neck in relation to the pelvis? Do the feet support the structures above?

Common postural patterns

• An anterior pelvic tilt is the anterior rotation of the innominate bones in the sagittal plane.
• A posterior tilt is the posterior rotation of the innominate bones in the sagittal plane.
• A torsion is the rotation of the left and right innominates around a horizontal axis in opposite directions (Ozudogru Celik et al. 2024).
• A lateral tilt of the pelvis is a tilt of the pelvis in the frontal plane, named for the side the top of the structure is going to. If we have a left tilt of the pelvis, the right side will be higher.
• A rotation of the pelvis is a rotation in the transverse plane, named for the direction the front of the structure is rotating to. For example, in a right rotation the pubis is pointing to the right.
  

In figure 4.9, the client has an anterior shift of the pelvis in relation to her feet. She has a posterior tilt in relation to her anteriorly tilted femur. In figure 4.10, the client’s pelvis is in a left lateral tilt in relation to her feet in the frontal plane. Start to think about the information you have just read about the pelvic diaphragm. How might this pattern affect its function? If the pelvis is in a lateral tilt, the pelvic diaphragm may also be held in a shortened position on the high side and under lengthened tension on the low side.

We need to zoom out and look above, as we can’t view the pelvis in isolation: What is happening above? What position is the lower leg in? We will discuss this more in upcoming chapters.

Figure 4.11 shows a client with an anterior tilt of her pelvis in relation to her femur. There is compression from above, showing as compression in her lumbar spine. In this instance, to create change in the pelvis the upper body needs length first. This will be discussed more in upcoming chapters.

More Excerpts From The Pelvic Diaphragm

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