• Shoulder/arm/hand pain 
  • Chest pain (lateral) 
  • Low Back Pain Thigh pain (lateral) 
  • Knee/ankle/feet problems 
  • TMJ symptoms - TMJ reciprocates with the SI Joint.  The TMJ will change its position to compensate for a Category II Subluxation.  This can result in changes in the occlusion (bite), balance, hearing and neck position.

Torsion in the sural membrane tilts the pelvis

Three Categories of Sacral Occipital Lesions (courtesy of:  Howat J. Chiropractic: The Anatomy and Physiology of Sacro Occipital Technique).  

It is theorized that if there is a structural block preventing the normal extension/flexion between the occiput and sacrum, the following subluxations (postural distortions) can result:

Category I Subluxation (typically seen in pediatric patients): a misalignment of the innominates on the sacrum in which one innominate is more anteriorly rotated relative to the ipsilateral innominate (referred to as the sacral boot mechanism):

  • A distortion (twist) occurs in the dural membrane surrounding the brain and spinal cord (see animation below)
  • This twist in the dural membrane results in a sagittal plane rotation of the innominates
  • The sagittal plane rotation of the innominates unlevels the pelvis. This unleveling of the pelvis results in a global postural shift referred to as BioImplosion



  • Pattern II: Head tilts right, shoulder drops to the left, the pelvis (sacrum and both innominates) tilts right 

Cranial Sacral Theory

Pattern I (functionally short right leg):

This  pattern can reach the level of the foot resulting in foot twist (supinated right foot - pronated left foot) 

  • Neck and/or ear pain 
  • Tinitis 
  • Headaches (lateral) 

Common symptoms associated with a Category II Subluxation:


TMJ symptoms - TMJ reciprocates with the SI Joint.  The TMJ will change its position to compensate for a Category II Subluxation.  This can result in changes in the occlusion (bite), balance, hearing and neck position.

Mixed postural distortional pattern:  

  • PreClinical Clubfoot Deformity  
  • Category II, Pattern II Cranial Sacral Subluxation  

Muscles that typically are in spasm:

  • Temporalis 
  • SternoCleido Mastoides 
  • Latissimus Dorsi 
  • Sartorius 
  • Gracilis 

Pattern II (functionally short left leg):

This pattern can reach the level of the foot resulting in foot twist (supinated left foot - pronated right foot)

Category III Subluxation: the sacral iliac ligaments are torn, allowing a greater separation within the weight bearing SI Joint.  This results in degenerative changes within the spinal intervertebral discs.  

Common symptoms associated with a Category III Subluxation:

  • Numbness/ pain and/or burning down back of the leg 
  • Chronic leg tightness 
  • Bowel and/or bladder dysfunction 
  • Pain on sitting/rising Pain on coughing 
  • Coldness in the feet and hands 


Typical body lean patterns seen with a Category I-III Subluxations:

  • Forward (sagittal plane) leans 
  • Lateral (frontal plane) leans  (See Photo Below)

Trauma to the occiput (back of the head) can result in a locked saccral nutation (sway back).  If severe enough, will compress the sciatic nerve.

Common symptoms associated with a Category I pelvic rotation:

  1. Visceral disturbances 
  2. Skin Disorders Numbness in the Facial Structures 
  3. Numbness in the extremities 
  4. Low Back Pain 
  5. Anxiety 
  6. Headaches 
  7. Weight Problems 

The interactions between the two postural distortional patterns result in a skewed postural shift

  • In a pure Category II, Pattern II Subluxation, the pelvis would be tilted to the right

Category II Subluxation:  Sacral iliac ligaments stretch allowing the sacral iliac joint to separate.  This hypermobility of the sacral iliac articulation results in postural distortions: the sacrum slips (tilts) to one side resulting in a functional leg length discrepancy; the spine unbalances and the head tilts to one side.

Classical postural distortional patterns associated with a Category II subluxation:

  • Pattern I:  Head tilts left, shoulder drops to the right, the pelvis (sacrum and both innominates) tilts left