Diagnostic Lumbar Spine Supine

Have the person lie down on their back with arms beside the body. Palpate the Spina Iliaca Anterior Superior (SIAS) and take the heel of the foot, lift the leg, and feel the Spina Iliaca Anterior Superior (SIAS) as it moves dorsally, meaning when the os Ilium rotates dorsally. Also, observe any inhibition when lifting the leg. Compare the Range Of Movement (ROM) and end feel of the left and right legs.

Bend the knee and place the foot level with the other knee, then place the other foot at the same level. Take the pelvis at the level of the abductors and thumbs at the level of Spina Iliaca Anterior Superior (SIAS), let the person lift the pelvis and perform a small passive flexion (kyphosis). Straighten the legs again one by one. Compare the positions of the Malleoli Medialis relative to each other. Pay attention to small differences in presented leg lengths; this indicates a preference for lateral flexion. Then ask the person to sit upright and remain attentive to the differences between the Medial Malleoli. The difference between the Malleoli Medialis is now caused by the rotational (preferred) position of the Lumbar spine.

The therapist pushes the legs one by one into external rotation using the foot. Feel the difference in end feel and Range Of Movement. The therapist now pushes the legs one by one into internal rotation using the foot and feels for the difference in end feel and Range Of Movement. Note the difference in Range Of Movement and end feel. Combine the movements by pushing one leg into external rotation and the other into internal rotation. Repeat this movement in the other direction. Range Of Movement and end feel should be observed.

The therapist places one foot next to the other knee and perform a combined flexion/external rotation/abduction of the hip joint. Place one hand at the level of the Spina Iliaca Anterior Superior (SIAS) and feel when it passively moves. Compare the Range Of Movement and end feel of both hip joints. After that, Place one foot on the other knee and perform a combined flexion/internal rotation/adduction. Place one hand at the level of the Spina Iliaca Anterior Superior (SIAS) and feel when it moves. Compare the Range Of Movement and end feel of both hip joints.
The therapist bends both legs and pushes them further into flexion. Place the other hand under the Sacrum. Perform a flexion and feel if it can be passively executed. In the flexed position of the Lumbar Spine, perform a lateral flexion. By performing a second parameter, the third parameter will become apparent. Performing a right lateral flexion in a flexed position of the Lumbar Spine will automatically result in a left rotation (A-position). Performing a left lateral flexion will cause a right rotation (C-position).