On the Clinical Management of Situs Inversus
What are some PRI considerations for a practitioner treating a patient with situs inversus? I have a patient who is a mirror twin diagnosed with situs inversus, confirmed by MRI. He presented with hip impingement type symptoms - difficulty bending forward in a sitting position to put his socks on in the morning due to radiating pain from the right groin down the front of the right thigh to the knee.
I have only worked with 2 individuals with situs inversus that had issues that made them seek attention from me. Honestly, I cannot remember the reason or reasons why they sought treatment from me. But, I do remember that I treated them by balancing their chest wall expansion, using PRI techniques that may have to be reversed for the establishment of air flow into the lungs. Cortically, they still have the same brain that a non situs individual has, which is why you still have to go after AFIR on the left, ground them on the left at the floor, hip, and scapula thoracic region.
Specific advice would depend on the individual. But, the bottom line is, the more the practitioner can do to expand and open up the posterior chest wall and lower back, through wall reaches, 90-90 hip lifts with a balloon, the better chances of reducing their symptoms and restoring trunk and hip rotation. I would start some overhead pulley work and lat hangs, if tolerated. Lateral intercostal wall opening with a Swiss ball next to a wall that could be repeated on both sides as a balloon is blown up would also be recommended.
Remember that their left brain will still want the body it owns, to go to the right, stand more on the right, sit more on the right and adapt with sensory processes that bias the left Wernicke and Broca regions.
- Ron Hruska, MPA, PT
