In case 76 I'm joined by Dr. Clay Case, a recent MDT diploma graduate and physical therapist from the Buffalo, NY USA area. He presents a 48 year old female with asymmetrical sacral and buttock pain. The unique nature of this patient encounter including his initial few visits and then cessation of care with the patient falling off and his leaving the clinic for the 9 week practicum portion and then re-initiation provided some great learning opportunities for Clay and now for us. His failure to deliver a resolution for his patient initially, then a positive outcome after his return gives clarify to his, and many of our common faults in our clinical reasoning and management. Lumbar versus SI joint versus hip origin differentiation and persistence in finding a reductive force are both highlights of this case. (1hr 35min 57sec)