04/24/2026
Do you have someone who comes in with low back pain?
Do this first â it can change everything. đ
Before you touch anything else, check the sacrum.
Run your thumbs down to the inferior lateral angles (ILA) â
those two bony landmarks at the lower corners of the sacrum, just before the tailbone.
Now compare:
đ Is one side sitting higher than the other?
That gives you a huge clue.
What I often see:
đ˝ Lower ILA â overactive piriformis
đź Higher ILA â guarding multifidus
These asymmetrical patterns can drive tension into L4, L5, S1.
This is where symmetrical treatment fails.
If you treat both sides the same, youâre guessing.
If you treat the pattern, you get results.
For piriformis:
Rotate the leg (~45°), find it near the top of the greater trochanter (not below).
Have them resist â feel it engage â then release.
For multifidus:
Targeted release on the high side.
Restore balance in the systemâŚ
and the sacrum will often self-correct.
Chronic back pain.
Sudden onset.
Post-fall.
đ Check the ILA first.
Work smarter, not harder. đ¤
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