Diagnostic Lumbar Spine Lying Prone

Instruct the person to lie down in a relaxing prone position with the head turned to the left side, the left arm alongside the body, and the other arm under the head. Lift the left leg from above the knee and observe the height and end feel of the leg extension. Use the other hand to feel the extension in the Lumbar Spine and gently press on the processi transversaria on the right side to accentuate a corresponding left rotation of the vertebrae. Perform the same for the os sacrum. Change the position of the arms and head, and note any differences. Lift the other leg in the same manner and observe the end feel and height of the right leg.

With both hands under the head, bend the knee on one side and execute an inward and outward rotation of the articulatio coxae. Pay attention to the range of movement and end feel in the hip and pelvis movements. Repeat the movements with the head turned the other way. Movements of the articulatio coxae follow the rotations of the Lumbar Spine; a left rotation in the Lumbar Spine accompanies an outward rotation (exorotation) of the left hip and an inward rotation (endorotation) of the right hip. A right rotation of the Lumbar Spine induces an exorotation of the right hip and an endorotation of the left hip.

Note that the end feel and range of movement may change with the position of the head and arms. Rotation of the head to the right side facilitates the same rotation in other parts of the vertebral column. In a prone position, rotating the head to the right is accompanied by a right rotation of the Cervical Spine, followed by an extension of the right shoulder (and anteversion of the left shoulder).