Exploring the Link Between Posture and SOT Categories

A Review of Faulkner & Warren (AECC Project List, 2001)

In 2001, a student research project at the Anglo-European College of Chiropractic (AECC) explored an important clinical question:

Is there an association between postural analysis findings and Sacro Occipital Technique (SOT) categorization?

The study — Faulkner JR (student), Warren M (Tutor). An investigation to ascertain any association existing between postural analysis and SOT categorisation. AECC Project List, 2001 — examined whether observable posture patterns correlate with Categories I, II, and III of Sacro Occipital Technique.

This question sits at the intersection of structural diagnosis, neurology, and biomechanical compensation.

Understanding Sacro Occipital Technique (SOT)

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SOT was developed by Major Bertrand DeJarnette in the early-to-mid 20th century. It classifies patients into three primary categories based on sacral, pelvic, dural, and cranial indicators:

• Category I – Dural tension patterns with cranial involvement

• Category II – Sacroiliac joint instability

• Category III – Lumbar disc involvement

The classification system guides pelvic blocking, cranial work, and treatment sequencing (DeJarnette, 1979).

Postural Analysis in Clinical Practice

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Postural assessment has long been used in chiropractic and manual therapy as a global indicator of structural imbalance. Clinicians typically evaluate:

• Head translation and tilt

• Shoulder height asymmetry

• Pelvic obliquity or rotation

• Spinal curvatures

• Weight-bearing patterns

Research has demonstrated that altered posture can be associated with musculoskeletal pain patterns and functional impairment (Kendall et al., 2005; Dolphens et al., 2012).

However, posture reflects both primary dysfunction and compensation — making direct correlation to specific internal categories complex.

Why This Research Question Matters

Faulkner & Warren’s project attempted to determine whether:

• SOT Category I patients demonstrate consistent visible postural traits

• Category II or III cases exhibit distinguishable external patterns

• Or whether SOT categorization is primarily a functional diagnostic construct rather than a visibly predictable one

This question relates directly to broader concerns in manual therapy:

• Reliability of observational posture analysis

• Inter-examiner agreement

• Predictive value of visual screening tools

Systematic reviews have shown that visual postural analysis can have variable reliability depending on examiner training and standardization (Ruivo et al., 2015; Iunes et al., 2009).

Diagnostic Reliability and SOT

One of the central challenges in systems like SOT is determining diagnostic consistency.

Research evaluating components of SOT and related pelvic assessment methods suggests that reliability varies across specific procedures (Cooperstein et al., 2007). While pelvic assessment and leg-length analysis remain commonly used tools, evidence supporting strong predictive validity is mixed.

This does not invalidate the method — but it underscores the importance of structured assessment protocols and outcome tracking.

Clinical Interpretation

Even if strong statistical association between posture and SOT category is limited, that finding itself would be clinically meaningful.

Why?

Because it suggests:

1. Posture may reflect compensation rather than the primary lesion.

2. Internal biomechanical categorization may not always be externally visible.

3. Functional testing may be more diagnostically useful than static observation.

This aligns with contemporary models in musculoskeletal care, where posture alone is no longer viewed as a direct cause of dysfunction but part of a dynamic adaptation system (Lederman, 2011).

Integrating Research Into Modern Structural Practice

For clinicians integrating:

• SOT

• Cranial techniques

• TMJ evaluation

• Proprioceptive rehabilitation

The key takeaway is this:

Posture provides valuable information — but it should not be the sole determinant of categorization.

Instead, posture should be combined with:

• Functional testing

• Load response

• Neurological findings

• Reassessment under correction

Posture and SOT Categories: Conclusion

The 2001 AECC project by Faulkner & Warren represents an important step toward examining chiropractic diagnostic assumptions through investigation rather than tradition.

Whether strong correlations were found or not, the study contributes to an ongoing professional discussion:

• How reliable are our categorization systems?

• What external signs truly predict internal dysfunction?

• And how do we improve reproducibility in structural diagnosis?

As the profession continues evolving toward evidence-informed models, studies like this encourage clinicians to refine both observation and methodology.

References

Cooperstein R, Gleberzon B. Technique systems in chiropractic. J Can Chiropr Assoc. 2004;48(2):101–111.

Cooperstein R, Haneline M, Young M. The reliability of the supine leg check as a measure of leg length inequality. J Chiropr Med. 2007;6(3):100–107.

DeJarnette MB. Sacro Occipital Technique Manual. Nebraska City, NE: DeJarnette Publishing; 1979.

Dolphens M, Cagnie B, Coorevits P, et al. Sagittal standing posture and its association with spinal pain: A systematic review. Eur Spine J. 2012;21(2):299–307.

Iunes DH, Bevilaqua-Grossi D, Oliveira AS, et al. Analysis of reliability of photogrammetry in relation to postural assessment. J Bodyw Mov Ther. 2009;13(4):331–337.

Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles: Testing and Function with Posture and Pain. 5th ed. Baltimore: Lippincott Williams & Wilkins; 2005.

Lederman E. The fall of the postural-structural-biomechanical model in manual and physical therapies. J Bodyw Mov Ther. 2011;15(2):131–138.

Ruivo RM, Pezarat-Correia P, Carita AI. Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain. Braz J Phys Ther. 2015;19(5):364–371.

Faulkner JR, Warren M. An investigation to ascertain any association existing between postural analysis and SOT categorisation. AECC Project List; 2001. (Unpublished student research project.)

Faulkner JR, (student), Warren M., (Tutor). An investigation to ascertain any association existing between postural analysis and SOT categorisation., AECC Project List 2001

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