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Lower back

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LUMBAR LORDOSIS

Observe the curvature of the lower back from the lateral side of the patient. Look for a curve in the lower back which would indicate a lordosis. You can also compare the position of the SIAS, if they are in a anterior position compared to the pubis, then the pelvis is anteriorly tilted.

if there is an indication of lumbar lordosis, consider the following patterns:

Anterior tilt pelvis

Extension of lower back

  • Erector Spinae
    • Iliocostalis
    • Longissimus
    • Spinalis
  • Transversospinalis
    • Semispinalis
    • Multifidus
    • Rotatores
  • Quadratus Lumborum
  • Interspinalis

FLAT BACK

Can also be called a reverse lordosis.

Observe the curve of the patient's lower back, if the lower back looks more flat than curved, then it indicates a 'flat back' position. You can also compare the position of the SIAS, if they are in a posterior position compared to the pubis, then the pelvis is posteriorly tilted.

Check the following patterns if the patient demonstrates a flat back:

Posterior tilt of pelvis

Extension of hips

PELVIC HEIGHT

Measure the height levels of both crista iliacas and note any height difference between the two sides.

You can also measure the height levels between left and right SIPS (Spina Iliaca PosteriorSuperior) and notice any difference in height.

A third option is to look at the gluteal lines, notice if one side is higher/lower than the other.

For these observations the following patterns may be involved:

Elevation of pelvis

Depression of pelvis

Adduction of hip, ipsilateral to elevated pelvis

Abduction of hip, contralateral to elevated pelvis

Depression of pelvis, contralateral to elevated pelvis