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32 m a s s a g e & b o d y wo r k j u l y/a u g u s t 2 0 2 2 The Twisting Sacrum: Ilia Rotation Technique In walking, the two pelvic bones rotate (green) around the sacrum, which twists between them at the SI joints due to the spine's transmission of torque from contralateral arm swinging (orange). Image redrawn and used with permission from RL DonTigny, 2018. 1 TECHNIQUE By Til Luchau THE SOMATIC EDGE KEY POINTS • The sacrum twists slightly within the pelvis in walking and trunk rotation. • Left/right evenness seems to be more clinically important than position or amount of movement. • SIJ and low-back pain, as well as movement freedom and ease, can all be improved by helping our clients feel and use this small sacral motion. Your sacrum is part of your spine. And when you twist your spine, your sacrum twists too. Within the bony ring of the pelvis, the sacrum twists just a little—but enough that when the stiff, shock-absorbing sacroiliac joints (SIJs) are sensitized, the twisting forces of walking (Image 1), turning, or bending can trigger sensations of stiffness, discomfort, or pain. Sources disagree about the precise amount of sacral movement the SIJs allow, and there is an even greater range of opinions about the clinical significance of SIJ movement. 1 But most all sources agree that the function of whatever movement the SIJs allow is (a) shock absorption, (b) force attenuation, and (c) a potential source of nociception. Like other SIJ-related sensations, SIJ-related nociception can be felt either at the joints themselves, or referred to the low back, pelvis, pubic symphysis, gluteals, hip joints, etc.