Sacral Counternutation

Encouraging sacral counternutation and posterior pelvic orientation may reduce early end-range loading at the ankle and hip. Squat descent is associated with sacral counternutation, while ascent is associated with sacral nutation. Contracting the external anal sphincter can help create sacral counternutation because of its coccyx attachment. The external anal sphincter attaches to the coccyx, which is used as the rationale for cueing sacral counternutation. The holding-in-gas cue can begin a progression toward lumbar flexion or spinal inhalation without requiring a large visible tuck. During squat inhalation, sacral counternutation is paired with anterior rotation of the innominates. A posterior weight shift encouraged by heel elevation may help create the sacral counternutation needed for squat depth. If the sacrum cannot counternutate during descent, the ankle may be asked for more motion. Increased ankle demand from poor pelvic mechanics can reproduce anterior ankle pinching. The holding-in-gas cue is also called the taco squeeze. Sacral counternutation cueing can serve as a graded entry point for highly sensitive people. Sacral counternutation can be cued when even a slight tu…