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Writer's picturePenny Welch

The Keystone of the Body: The Sacrum

In osteopathy, the sacrum is often called the “keystone” of the body—a small but powerful triangular bone at the base of your spine that plays a vital role in balancing your entire structure. Positioned snugly between the two large pelvic bones (known as the innominates), the sacrum provides stability and support to the spine, pelvis, and the rest of the body.


Why the Sacrum is Called the Keystone


The term “keystone” comes from the sacrum’s unique role in holding everything together. It connects to numerous ligaments that anchor it to the hips, spine, pelvic organs, and legs...even the arms! This means the sacrum serves as a central point of balance and alignment, able to influence—and be influenced by—different areas of the body.


For instance, any adjustment or imbalance in the lower legs can send a ripple effect up through the sacrum, impacting the spine, hips, and beyond. Likewise, changes in the head, neck, or upper body can lead the sacrum to shift subtly, realigning the body to compensate - leading to imbalances in the lower limbs.


The Adaptive Nature of the Sacrum


The sacrum isn’t rigid; it’s designed to be adaptable and responsive. Its multiple planes of motion allow it to respond to various forces and postures. Ligaments help control this movement, but they don’t completely restrict it, allowing the sacrum to adapt to changes. This adaptability is key to its role as a “keystone,” but it also means that subtle imbalances can lead to discomfort. Sciatica, piriformis syndrome, lower back pain, and hip pain can often be traced to shifts in the sacrum.


This does not necessarily mean that the sacrum is the problem, it may had adjusted for something above and/or below. These symptoms are expressions of too much work and strain placed on an area of the body - its the osteopathic practitioners job to figure out the WHY.


Osteopathic Perspective on Sacral Imbalance


In osteopathy, practitioners understand that pain terms like "low back pain" or "sciatica" are simply labels for where you feel discomfort; they don’t reveal the underlying cause. By examining the body holistically, osteopaths look for compensations and imbalances that may be contributing to symptoms. Even a minor shift—like a rib that’s slightly out of position—could impact the sacrum and lead to pain elsewhere, such as in the hamstrings and knee.


Osteopathy's approach to addressing sacral and related pains goes beyond symptom relief. By restoring balance and motion, osteopathic practitioners aim to improve overall function and comfort, often providing long-lasting relief for complex issues.


Why the Sacrum Matters in Daily Life


The sacrum is integral to activities like walking, sitting, and lifting, and even to seemingly small actions, such as bending or twisting. Taking care of this “keystone” can be an investment in maintaining balance, reducing pain, and supporting healthy movement patterns throughout your life.


In the hands of an osteopathic practitioner, sacral health isn’t just about managing pain—it’s about optimizing your body’s natural harmony. Through careful observation and skilled adjustments, osteopaths work with the sacrum to restore balance and help patients move with greater ease. So next time you feel a tweak in your lower back or a pinch in your hips, consider the sacrum’s role—it may just be the key to unlocking relief.





Ready to restore balance and ease discomfort? Book your osteopathy appointment today! Whether you're managing pain, recovering from an injury, or seeking overall wellness, our treatments focus on addressing the root cause of your symptoms. Visit Welch Osteopathy to schedule your session and experience the benefits of a holistic, hands-on approach to health and alignment.

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