This is great Ryan, thanks! Very clear. My instinct is that I’m probably not using as much force or have them squeeze enough to see the symptomatic change. Also, I get confused if it doesn’t change much that there could be a simultaneous sacral sheer issue, then I don’t know how to treat, give them all the exercises, etc. Any guidance on that you suggest? Also, how often are you typically seeing them in clinic throughout the plan? I’m cash pay like you and wondering how to structure things best for success. Apologies for the long post, I just want to get this right to help more people. Grateful for your help!

I do a bunch of other stuff like TMR and I also do SoftWave shockwave therapy, then use the myofascial referral technique sporadically. I definitely haven’t been a successful as I wish I could be. The SI joint protocol and sickle shear has been good to give me an approach, but sometimes I get a bit lost if they occur at the same time. I just need to clean up my approaches so they are super clear to what I need my clients to do as part of their home exercise program, but also clear on what I need to specifically do for that person based on confidence of my palpation findings and assessments.

I know your protocol for SI and sacral shear seems pretty clear but I’d like more manual instruction so I’m confident doing the right things.