Occiput Locked in Extension
If the sacrum is maintained in nutation due to an occiput locked in extension, the locked occiput must be released (e.g., utilizing Cranial Sacral therapy). If one tries to reduce the sacral nutation using only a proprioceptive insole, the therapy will fail and the nutation may actually increase (See Animation below).
If the Occiput is Locked in Extension:
The above patient has a mixed postural distortional pattern:
The proprioceptive insole decreases the forward lean (coming from the feet), but concurrently increases the sacral nutation (resulting from a Category II subluxation).
Hence to attenuate the above postural distortional pattern, one must utilize both proprioceptive and cranial sacral therapy.
It is important that the interventions be done serially (not concurrently).