Ashley Wejrowski

Manual Therapy II

Sacral Pull Manual Therapy Technique

Clinical Uses of Technique

The sacral pull technique can be used for patients with lumbar and sacral joint pain. The

technique provides relief/traction to the sacral area by decompressing the sacrum on the lumbar

spine. The technique can specifically reduce myofascial pain, decrease pelvic congestion,

stabilize activity in the pelvis and mobilize the lumbar spine2. Patients with lumbosacral

hypomobility could benefit from this manual therapy technique.

Description of Technique

The patient starts in a hook-lying position near the end of a table. The therapist asks the

patient to lift their hips off of the table. When the patient has both of their glutes off of the table

the therapists explains that they are going to put their hand on the patient’s sacrum. The

therapist’s hand will be in a “cupping position” on the sacrum. The therapist will ask the patient

to then “sit on the therapist’s hand” by lowering their hips down onto the table. The patient must

relax and put all of their weight into the therapist’s hand in order to get maximal benefit. The

therapist will then pull their hand caudally towards the end of the table. During this technique

there are two force vectors. There is force from the patient’s body weight into the therapists

“cupping hand” and force from the therapist’s hand pulling caudally. The two force vectors help

create traction at the L5/S1 joint/junction.

Viewpoints on Technique

After practicing this technique on different body shapes and sizes I’ve realized that this

cannot work on all patient sizes. If the patient has a large body mass and the therapist cannot
maintain a “cupping hand” the patient does not get as much relief from the “pull”. In this case

you can try other techniques in side-lying to provide relief to the patient. Also, this isn’t a

technique that a therapist would want to do for longer than 15-20 seconds. Since the patient is

putting all of their weight into the therapist’s hand, the therapist may find the technique to be

tiring and cumbersome to their hand. What I like about this technique is that you can provide

relief to the patient with traction and if they had a nutated or counter nutated dysfunction, you

could move into performing the osteopathic sacral rocking technique.

Origin of Technique

This technique originates from osteopathic methods. The sacral pull technique can also

be called “sacral cupping”. The technique can be found in “Principles of Manual Sports

Medicine” by Steven Karageanes. The technique can also be found in the lumbosacral

decompression slide on the lecture PowerPoint “Osteopathic Manipulative Treatment Options for

Common Conditions” by Jennifer Wilson.

 References

1. Karageanes, S. J. (2005). Principles of manual sports medicine. Philadelphia: Lippincott

Williams & Wilkins.

2. Wilson, J. (2017). Osteopathic Manipulative Treatment Options for Common Conditions

[PowerPoint Slides].

https://c.ymcdn.com/sites/okosteo.siteym.com/resource/resmgr/2017_Summer_CME_Se

minar/0800_-_OMT_Options_for_Commo.pdf