In previous blogs, we have discussed posterior and anterior pelvic tilt causes, interventions, and goals. In this blog we will address rotation of the pelvis. When the pelvis is rotated, one anterior superior iliac spine (ASIS) is forward of the other. As a result, the client may appear to have a leg length discrepancy as one knee may be more forward of the other. The client will most likely face forward and the spine may rotate with the pelvis as our brain is wired to view the world face-on – rotating the spine in relation to the pelvis. Causes and Interventions Range of Motion Limitations Pelvic rotation is most often…

Kent is a 14 year old young man with the diagnosis of cerebral palsy. He was referred for evaluation of his wheelchair positioning and access to a communication device. Kent was seen at school with his mother, school team, and supplier. Mat exam:Kent had adequate range of motion for sitting, though he had significant internal rotation of his right lower extremity and external rotation of the left lower extremity. He demonstrated significant tone and posturing. His postures were influenced by a strong ATNR and included neck hyperextension and generalized extension and rotation. He appeared to have a kyphotic area of his mid-thoracic spine. Posture in Manual Wheelchair:Kent was seated in…

An anterior pelvic tilt occurs when the top of the pelvis is tipped or rotated anteriorly. This leads to extension of the lower spine (lordosis). In a significant anterior tilt, pressure may occur on the coccyx (against the back of the seating system) and even the pubic symphysis (against the cushion). As the position of the pelvis impacts the position of the trunk and subsequently the head, we need to reduce this tendency, as much as possible. What Causes an Anterior Pelvic Tilt?• An anterior pelvic tilt may be caused by low tone or muscle weakness in the trunk, leading to forward collapse.• Lordosis may present initially, pulling the pelvis…