While the incidence of injury in cross-country skiing remains relatively low, overuse problems affecting the lumbosacral region may be on the rise, particularly among elite athletes. In this study, a certified "Part A" (Canadian Physiotherapy Association) manual therapist performed lumbosacral physical assessments on 18 elite cross-country skiers and 15 normal subjects. Results indicated sacroiliac (SI) joint dysfunction occurred significantly more often in the skier population (p < 0.007). Incidences of SI joint asymmetry and lumbar spine dysfunction did not differ between groups. The predominant use of asymmetrical ski-skating techniques may play an influential role in the pathogenesis of SI joint dysfunction in elite cross-country skiers.