Part 5 in our video series Performing the Mat Evaluation with blog content by Ana Endsjo, MOTR/L, CLT and video by Stacey Mullis, OTR/L, ATP. See Part 1, Part 2, Part 3, and Part 4.
A pelvic rotation can occur for anatomical reasons, but occurs often when a client does not fit well in their wheelchair, either too wide or too narrow. The client will rotate in the chair to “fit” to accommodate for the underlying issue. It is easy to visually see a rotation when:
- You notice an apparent leg length discrepancy
- One side of the pelvis is flush against the back support and the other side is not making contact
Palpate both ASISs simultaneously and see if one side is more forward.
Much like with the other pelvic abnormalities, the trunk and head can be affected as well.
- The spine also presents with a rotation with one side coming more forward, making less contact with the back support.
- The head usually presents a lateral flexion, rotation, and even forward flexion.
Let’s see Stacey Mullis during this week’s video clip of a live mat evaluation to help us palpate for a rotation more quickly. Next week we will look at the last pelvic abnormality, a windswept deformity.
Transcript (edited for clarity):
A pelvic rotation is another abnormal posture that you might see, and this can be caused by an ill-fitting wheelchair or it can be caused by an anatomical reason.
In order to identify it and really assess it, once again we’re going to go back to our landmark the ASIS and we’re going to see what the pelvis is doing. I’m going to come in with Jamie here and feel her ASIS. Sure enough I can tell that my right side is farther back than the left which means she’s rotating towards her right.
Now what happens when she’s rotated like this her spine is also rotated. Look at the position of her head, it’s pointed laterally. The other thing that you’re going to notice is it almost looks like she has a leg length discrepancy. This side, the left side, is shorter than the right side when she’s in this posture.
Ana Endsjo, MOTR/L, CLT
Clinical Education Manager LTC Division
Ana Endsjo has worked as an occupational therapist since 2001 in a variety of treatment settings. She has mainly worked with the geriatric population, dedicated to the betterment of the treatment of the elderly in LTC centers. Her focus has been on seating and positioning and contracture management of the nursing home resident. With this experience, her hope is to guide other therapists, rehab directors, nurses, and administrators through educational guides, blogs, webinars, and live courses in her role as Clinical Education Manager for the long term care division.