Bill Hartman 39:38–42:12
So now I have these orientations where the pelvis starts to move as a single unit. And this is what we start to look for when we're talking about looking at ER measures as a diagnostic for the orientations. And so if I am anteriorly oriented, let's just say I'm doing this symmetrically, what I'm going to see is I'm going to see a loss of the external rotation measure at the hip. Because I have musculature that's above the level of the trochanter that as I tip this forward, these muscles reorient their direction of pull. They become internal rotators and they start to steal my external rotation. So right away I can just say anterior orientation reduction in external rotation. Now, if the left side, if I have a stronger compressive strategy on this left side, and that left side gets a little bit ahead of this right side, which means that the anterior orientation is going to be more on the left, I'm going to lose external rotation on that left side. If I get tipped on an oblique and what that oblique is, it's this. It's where that left side is going up and it drives me up and over the right side. That means the right side starts to lead. It gets a little bit more anterior orientation on that side and I lose external rotation on the right. So it's actually a loss of external rotation that you're going to use to diagnose this anterior orientation, whether it's a left or a right. And it's going to be typically when it's on the left side, it's going to be a little bit more of a flatter turn. When it's tipped over on the right side, it's going to be a steeper turn. It's going to be up on that oblique axis. Now, having said that, let's think this through for a second. So there are situations where you're going to get a magnified external rotation. So if I was looking at my archetype, so if I had a narrow archetype where I'm biased towards that external rotated position of the pelvis and inhale position of the pelvis, right away, that's going to give me a magnification of my external rotation, but there's another way that this external rotation magnification can occur. So think about the end range and traditional hip flexion as you're measuring. I have to have that lumbar spine turning towards the measurement side, the ipsilateral side, to get that true end range external rotation measure. But if I am anteriorly oriented, so I'm anteriorly oriented like this, so that should take away my external rotation, but when I lay people on the table and I have anterior orientation, I can get this type of a turn where the pelvis is moving as a single segment, but the lumbar spine is still free to move. And so under those circumstances, what I'm gonna start to get is this magnification of the external rotation measure. So if I have a spine that is facing the right and I've got an orientation of the pelvis that is turned strongly to the right and I take somebody into a hip flexion measure and they turn towards that hip flexion as I measure it, I can get a magnification of my external rotation. So when I try to turn someone into external rotation and the pelvis turns towards me, what I'm going to get is this magnification of external rotation. So this is where you're going to get a lot of these measures of 80 degrees, sometimes up to 90 degrees of hip external rotation, which is associated with the turn of the spine, even though the pelvis is anteriorly oriented.
anterior pelvic orientationhip external rotation measurementoblique pelvic tiltlumbar spine compensationpelvic archetype