Therapist Notes – Pain Along One Side of the Sacrum

Therapist Notes include
Anatomy review,
Syndromes and Conditions,
Assessment notes,
Treatment Preparation,
NMT protocols and more…

Effective relief starts with an understanding of the anatomy.

About the coloring of the illustrations…

Multifidi and rotatores are interspinous muscles that manage tension and balance between vertebrae.

Release of the lumbosacral joint relieves this trigger point.

Specifically, the sacrum is posterior on the side of pain. Gentle sustained anterior pressure with slight inferior traction will cause the sacrum to shift and the swelling and tenderness to release immediately. I’ve demonstrated this many times in classes to the surprise of students who struggle with this release.

Pelvic balancing to prevent this from shifting back is helpful.

This protocol releases the iliolumbar ligament and the surrounding tissues that support the problematic lumbosacral joint.

This is the classic protocol for the sacroiliac ligament, which addresses the trigger points on the posterior sacral sulcus. It also tends to free the sacrum on this side, which releases the underlying joint restriction.

These self-care recommendations can be essential in offering relief and stabilizing this area.


This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


Weekly Featured Post

Can’t Reach the Pain
Under the Shoulder Blade

This pain and tension under the shoulder blade may be the most common pain pattern that I see. It isn’t always the primary complaint as people have gotten used to the constant ache.

It is usually combined with this pattern in the upper neck, which creates upper neck tension to go with the shoulder blade pain.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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