We’ll begin by demonstrating sacroiliac joint manipulation. To perform this technique, the patient is positioned in the same position the legion was found. For example, if she flexed the right hip and knee and there was failure of movement of the posterior superior iliac spine on the right, she is placed in a left lateral recumbent position and her hip and knee are fully flexed. We can then add counter-pressure to the patient’s shoulder in a fulcrum to either the ischial tuberosity or just beneath the posterior superior iliac spine. The joint is stressed to its end range of motion to lock out any joint play. At that point, there is a very high-velocity, low-amplitude impulse applied to the joint at its end range of motion. Commonly, an audible pop or click occurs.

Dr. Matthew Kowalski is a chiropractor and President of New England Spine Institute. He has more than 25 years of experience providing chiropractic services.