Twisted Pelvis Check - an extract from 'A Bowen Therapists Notebook'

The following procedures are not intended to replace medical advice, which, due to possible injury to the skeletal system, should be sought in the first instance. (Check that the person has not had a hip replacement operation.)

An unbalanced pelvis is a fairly common. The causes are many and varied, muscles in spasm, injury within muscles and the skeletal structure of the pelvic system. Correction of a pelvis is relatively easy and should be achieved without inducing pain or stress on the system; otherwise other problems can be created.

The pelvis is a cats’ cradle held in place by muscles, associated skeletal system, and ligaments. It forms a major part of the body and contains within it the reproductive system and parts of the digestive system and is the conduit through which passes the nerves and blood supplies to the lower limbs. It is the pivot upon which the rest of the body sits. Any unbalance of it and its parts have far reaching effects upon the person.

The pelvis can be skewed in either the up position, (tilted), or front to back, (twisted). (Figure 1).

Checking the Pelvis for twist and tilt.

Figure 2. The patient lies face up, and is asked to draw her knees up with her feet flat on the couch. However the act of getting onto the couch and adopting this posture will have put an artificial twist in the pelvis. The procedure for removing this twist is shown in figures 3 and 4.

Figure 3. The therapist has to hold her feet onto the couch, and with the other hand applies a restraining pressure on her knees. The patient is asked to raise her hips about two inches, and then gently lower herself.

Figure 4. Persuade the patient to relax and to give you the full weight of her legs, which then should be supported in the manner shown and lowered gently onto the couch.

Figure 5. Position for evaluating pelvic twist or rotation.

Note. If the patient is to remain in this position on completion of the checks then place a pillow under the knees. This will make the patient more comfortable by taking strain away from the lower back.

The first thing to consider is the possibility that the legs are not the same length, in which case the pelvis may have twisted to accommodate the condition, and the patient may have had their shoes built up to correct the unbalance. (In one of these cases I have carried out the pelvic correction procedure to help with an associated, hip, knee and ankle problem. Case No. 22-06-261.)

Figure 6 shows the two methods of confirming relative leg length.

A tailors’ tape measure is used to measure from a point on the hip to the ankle bone.

The difficulty here is finding a definable point on the hips from which to measure from. The two favoured are from either the head of the upper leg bone, (Trochanter of the Femur), or the front projection of the hip bone, (Anterior superior Illiac Spine or A.S.I.S).

Assuming that the legs are balanced then the next areas to address are the ankles and the heels.

Figure 7 shows how to position the thumbs as part of the ankle alignment check.

Standing over the patient’s feet confirm that the thumbs are in line, Figure 8. If not then this is an indication of pelvic tilt. If the thumbs coincide, then look at the heels to see if they are in line, Figure 9. If not, this is another indication of a tilted pelvis.The final check is for pelvic twist.

Stand at the side of the patient and place the tip of one or two fingers of each hand over the two high points of the front of the hips.

(Figures 10 and 6, the ASIS.)

A twisted pelvis will be evident by the point of the finger of one hand being higher than the other.

Many things have to be considered in the causes of pelvis misalignment. Stomach surgery, stresses induced by pregnancy, muscular spasm pulling on the thigh and other areas. Injury, sometimes induced by over- enthusiastic correction of the pelvic problem. (Case note 21-11-041). Hip replacement, (Case note 22-06-261). Pubis Symphysis Disorder, (PSD), where the pelvis has parted at the front, footballing and the stress of childbirth being the main causes.

Damage to the sacro-iliac joint due to load stress from the upper skeletal system.

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