Sphinx position involves having the patient lie prone, then prop themselves up on their elbows to extend the lumbar spine and flex the sacrum (Figure 1). This can be very uncomfortable for extended or backward torsion sacral dysfunctions. See "Diagnosing sacral somatic dysfunction."

Sims position is a modified version of lateral recumbent. Have the patient lie in the lateral recumbent position, then rotate their torso toward the table so their chest lies against the table. For treating forward sacral torsions, the patient should be lying on their front (Sims position). For treating backward sacral torsions, the patient should be lying on their back (lateral recumbent with torso rotated back to lock out their lumbosacral junction).