How can you tell if a patient is dissociating from their abdomen or pelvis during an OMM exam?

• A. Deep diaphragmatic breathing with strong abdominal expansion
• B. Full pelvic floor engagement and regular breathing
• C. Shallow breathing with minimal abdominal motion and nearly absent pelvic floor motion
• D. Rapid chest breathing with abdominal contraction

Answer: (C)

The key idea is recognizing when the chest is doing the breathing while the abdomen and pelvis stay almost still. If a patient is dissociating from the abdomen or pelvis, you’ll see shallow, chest-dominant breathing with very little rise or motion in the abdominal area, and the pelvic floor moves minimally or not at all. This pattern makes it hard to sense the abdominal and pelvic contributions to respiration, which is exactly what dissociation looks like during an OMM exam.

This is why the described pattern is the best fit: breathing that is shallow and chest-focused, with almost no abdominal and nearly absent pelvic floor motion, directly indicates a lack of coordinated movement across the trunk and core regions.

In contrast, deeper diaphragmatic breathing with strong abdominal expansion would show good abdominal involvement; full pelvic floor engagement and regular breathing implies active coordination of the pelvis with respiration; rapid chest breathing with abdominal contraction suggests a different, less dissociative pattern where the abdomen still participates.