154: Sacroiliac Joints: The Next Level (with Til Luchau & Whitney Lowe) Listener Favorite!
šTil Luchau and Whitney Lowe go deep into the sacroiliac (SI) joints in this listener-favorite rebroadcast of Episode 74, where they unpack anatomy, mechanics, assessment controversies, and treatment strategies. From the relationship between pain, stability, and mobility, to ligamentous support, gait mechanics, and the limits of positional models, they offer both clinical clarity and practical takeaways. Along the way, they share road stories, podcast crossovers, and resources for further learning.
š§ Listen in for evidence-based insights, hands-on strategies, and nuanced discussion that balances analytical precision with experiential wisdom.
šThailand Retreat 2026
Join Til and friends for Finding Balance, an immersive bodywork and movement retreat at a floating retreat center in Thailand. Learn more ā https://a-t.tv/thailand-retreat-2026/
šKey Points by Time Code:
00:00 ā Sponsor, catch-up & travel stories; 2022 Fascia Research CongressĀ
03:13 ā Todayās focus: sacroiliac joints; Whitneyās Massage & Bodywork article on SI dysfunction
03:53 ā Tilās Ilia/SI online course announcement (now available on demand)
04:50 ā Podcast review shout-out: Hands at the Table reviews Tilās course
06:11 ā Anatomy tour: interlocking joint surfaces, nociceptors, ligament overview
08:30 ā Weight transfer & keystone analogy; iliolumbar, sacrotuberous, sacrospinous ligaments
13:53 ā Pain mechanisms: āculprit or victim?ā framing
15:00 ā Motion at the SI joint: small ROM, often misunderstood
18:01 ā Nutation vs. counternutation explained; clinical relevance
24:50 ā Assessment: why provocation tests (Laslett cluster) matter more than positional diagnosis
28:58 ā Treatment approaches: working with sensitivity, remote-site effects, neural target zones
30:22 ā Clinical reasoning: differentiating nerve tension vs. ligament vs. joint capsule
33:20 ā Complexity of models vs. simplicity of sensation-first approaches
37:14 ā Hypermobility paradox: Ehlers-Danlos and individualized load titration
45:00 ā Gait mechanics: contralateral in-/out-flare with each step; self-exploration drills
46:07 ā Lateral tilt, functional vs. structural leg-length differences; heel lift caveats
58:43 ā Self-care: DonTigny-inspired gentle movement in both directions
59:30 ā Course info recap; live & recorded access options
1:00:42 ā Closing sponsor; how to find show notes & rate the podcast
Resources:
Article: āCurrent Concepts in Sacroiliac Joint Dysfunctionā (free, registration required)
Training: Ilia & SI Joints: Principles
Review: the Hands at the Table podcast hosts dissect an AMT Principles courseĀ
Previous TTP SIJ episode: 3: Sacroiliac Joint Pain: Causes, Controversies, and ConsiderationsĀ
Whitneyās references:
Physiotutors web clip on Laslett SI joint test cluster: https://www.youtube.com/watch?v=g8txpsqHYpQ&t=197s
Szadek KM, Hoogland P V., Zuurmond WW, de Lange JJ, Perez RS. Nociceptive Nerve Fibers in the Sacroiliac Joint in Humans. Reg Anesth Pain Med. 2008;33(1):36-43. doi:10.1016/j.rapm.2007.07.011
Bertoldo D, Pirri C, Roviaro B, et al. Pilot study of sacroiliac joint dysfunction treated with a single session of fascial manipulationĀ® method: Clinical implications for effective pain reduction. Med. 2021;57(7):1-11. doi:10.3390/medicina57070691
Sponsor Offers:Ā
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Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at:Ā academyofclinicalmassage.com/cheatsheet
Tilās upcoming retreat, Finding Balance in an Out-of-Balance World, happening March 2026 in Thailand. Use code āthinkingā for $100 off: https://a-t.tv/thailand-retreat-2026/Ā Ā
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š Get the full transcript at Til or Whitney's sites!Ā
Whitney Loweās site: AcademyOfClinicalMassage.comĀ
Til Luchauās site: Advanced-Trainings.com Ā
About Whitney LoweĀ | About Til LuchauĀ |Ā Email Us: [email protected]
(The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)