Therapy Notes – Iliolumbar Ligament

The iliolumbar ligament is largely located on the anterior aspect of the upper sacroiliac joint and can be difficult to access for many reasons. The client may not care for face-down work or may have excess adipose tissue.

Pelvic balancing provides longer-lasting results so that direct treatment is easier, more effective, and longer-lasting.

Each therapist has their own method of pelvic balancing. I prefer craniostructural work with SOT blocking but also use METs, strain-counter strain, and some NMT techniques. Use the pelvic balancing approach that works best for your particular bodywork approach.

An anterior shear governs tension on the iliolumbar ligament and is usually present when the trigger point is active. This simple posterior mobilization from Integrative Craniosacral – Transition to Integrative Bodywork is easy and almost always releases the alignment. Gentle posterior pressure for 90 seconds or until the ilium shifts usually works.


This post has a classic neuromuscular protocol for the iliolumbar ligament. It calls for a good bit of T-bar work, which I and can be done with gentle sustained pressure using my hand directly.


At this point, if the ligament is still producing symptoms, gentle abdominal work to release it from the front is very effective. It can be palpated in the pedicle groove of L5. This area is tight and, with gentle pressure, L5 shifts as the ligament releases. If there is some reason that I am interested in keeping the client supine, this approach is particularly handy.

Self-Care can be very important when this problem is a result of habitually torquing the pelvis through poor seating practices, strong muscular imbalances or a hyper-mobile pelvis.



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.


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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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read, more accessible, and
to include more patterns with better self-care. In the meanwhile, there will be inconsistency in formatting, content, and readability until we get the old posts updated. Please excuse our mess.