154: Sacroiliac Joints: The Next Level (with Til Luchau & Whitney Lowe) Listener Favorite!

🎙Til 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.

🎧 Listen in for evidence-based insights, hands-on strategies, and nuanced discussion that balances analytical precision with experiential wisdom. 👉Thailand Retreat 2026 Join Til and friends for Finding Balance, an immersive bodywork and movement retreat at a floating retreat center in Thailand. Learn more → https://a-t.tv/thailand-retreat-2026/

🔍Key Points by Time Code:

• 00:00 – Sponsor, catch-up & travel stories; 2022 Fascia Research Congress 

• 03:13 – Today’s focus: sacroiliac joints; Whitney’s Massage & Bodywork article on SI dysfunction

• 03:53 – Til’s Ilia/SI online course announcement (now available on demand)

• 04:50 – Podcast review shout-out: Hands at the Table reviews Til’s course

• 06:11 – Anatomy tour: interlocking joint surfaces, nociceptors, ligament overview

• 08:30 – Weight transfer & keystone analogy; iliolumbar, sacrotuberous, sacrospinous ligaments

• 13:53 – Pain mechanisms: “culprit or victim?” framing

• 15:00 – Motion at the SI joint: small ROM, often misunderstood

• 18:01 – Nutation vs. counternutation explained; clinical relevance

• 24:50 – Assessment: why provocation tests (Laslett cluster) matter more than positional diagnosis

• 28:58 – Treatment approaches: working with sensitivity, remote-site effects, neural target zones

• 30:22 – Clinical reasoning: differentiating nerve tension vs. ligament vs. joint capsule

• 33:20 – Complexity of models vs. simplicity of sensation-first approaches

• 37:14 – Hypermobility paradox: Ehlers-Danlos and individualized load titration

• 45:00 – Gait mechanics: contralateral in-/out-flare with each step; self-exploration drills

• 46:07 – Lateral tilt, functional vs. structural leg-length differences; heel lift caveats

• 58:43 – Self-care: DonTigny-inspired gentle movement in both directions

• 59:30 – Course info recap; live & recorded access options

• 1:00:42 – Closing sponsor; how to find show notes & rate the podcast

Resources:

• Article: “Current Concepts in Sacroiliac Joint Dysfunction” (free, registration required)
• Training: Ilia & SI Joints: Principles
• Review: the Hands at the Table podcast hosts dissect an AMT Principles course 
• Previous TTP SIJ episode: 3: Sacroiliac Joint Pain: Causes, Controversies, and Considerations 
• Whitney’s 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 manipulation® method: Clinical implications for effective pain reduction. Med. 2021;57(7):1-11. doi:10.3390/medicina57070691

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