10 Exercises to Relieve Sacroiliac Joint Pain

The sacroiliac joint (SI joint) is a very small area that plays a massive role in connecting the spine to the pelvis. If this joint isn’t functioning properly, it can be a significant source of pain. 

Knowledge is power so we’re going to help you understand a bit about the anatomy of the SI joint, discuss the most common causes of SI joint pain, and give you some action steps to alleviate the discomfort and get the SIJ functioning more optimally again.

WHAT IS THE SI JOINT?

The Sacroiliac joint is the connection point between your sacrum (the triangular bone at the base of the spine) and your ilium (the wing shaped pelvic bones). This joint is essential for hip stability and transfer of force between the upper and lower body during physical activity. It’s basically the shock absorber for your pelvis.

The SI joint is supported by a complex network of ligaments and muscles. If they become imbalanced or strained, it can lead to SI joint dysfunction and pain.

THE DIFFERENCE BETWEEN HERNIATED (BULGING) DISCS, SCIATICA, SI JOINT PAIN, AND PIRIFORMIS SYNDROME

Determining the source of pain in the low back and hip can be challenging because the entire pelvic girdle houses a lot of tightly integrated and interconnected tissues. Herniated/bulging discs, sciatica, SI joint pain, and piriformis syndrome can all share symptoms such as: 

• Sharp, stabbing, or shooting pain in the low back. 
• Pain that radiates through the hips, glutes, and sometimes down the leg.
• A sense of instability in the hip or difficulty 

The pain may be similar, but the causes are different.

SCIATICA

“Sciatica” is a general term for any pain you feel in your low back that tends to zing down one or both legs. It’s not the problem itself, but a symptom caused by compression of the sciatic nerve that begins in the spinal column and then runs through the glutes and down both legs.

BULGING/HERNIATED DISCS

Bulging or herniated discs often occur when the spine is not aligned (too much flexion) and is putting uneven pressure on the cushiony discs between the vertebrae. 

Bulging is when the disc is bulging out like a bubble. A herniation is when that bubble “pops” to one degree or another. Both a bulge and a herniation will put pressure on the sciatic nerve, which then causes sciatica pain.

People experiencing bulging or herniated discs often benefit from strengthening their extension muscles to bring their spines into a more upright, neutral position.

PIRIFORMIS SYNDROME

Piriformis syndrome also causes sciatic pain; but instead of the cause originating in the spine, piriformis syndrome is caused by the sciatic nerve being squeezed by the piriformis muscle in the hip.

SI JOINT DYSFUNCTION

Sacroiliac (SI) joint dysfunction can get misdiagnosed when an MRI shows bulging discs in the lumbar spine, but did you know that many people over 40 years old have some degree of disc bulge or degeneration – and never experience pain from it? 

True Sacroiliac joint dysfunction refers to pain in the SI joints caused by either too much movement (hypermobility) or too little movement (hypomobility). Dr. Mike explains in this video how people with too much extension in their low backs and anterior pelvic tilt can find their SIJ is very unhappy with the way it’s being treated.

Other things that can contribute to SI joint pain are:

1. Trauma or Injury: A fall or sudden impact on the SI joint. 88% of cases of SI joint injury are due to either repetitive microtrauma (i.e. poor lifting technique) or acute trauma.
2. Pregnancy: Hormonal changes to help increase necessary joint mobility during pregnancy can put added stress on the SI joint, leading to pain and discomfort, especially in the last trimester. This typically resolves on its own in the months following birth.
3. Degenerative Conditions: Arthritis or degenerative disc disease can affect the integrity of the SI joint.
4. Poor Posture: Prolonged sitting or standing with poor posture can put undue stress on the SI joint, leading to pain and dysfunction over time.

Assessments and diagnoses may or may not be helpful. Even if your provider manages to accurately diagnose the issue, what then? Ultimately, the solution in most cases is found in getting your spine, pelvis, and hips in a good position - and keeping them that way! 

This is the focus of what we do at MoveU, starting with activating and strengthening the muscles responsible for alignment. 

MUSCLES: COLLABORATIVE PARTNERSHIP OR TUG OF WAR?

The SI joint is surrounded by over 40 muscles, but there are four major muscles that connect the spine to the pelvis and femur. They are the piriformis, Quadratus Lumborum, psoas and iliacus.

The interplay between these four muscles is critical. Imagine this area of your body is like a small apartment building and these muscles are the residents. In an optimally functioning body, they support each other in a lovely, collaborative relationship. It’s a lovely day in the neighborhood.

However, if there’s a power dynamic with someone wanting to be stronger or more favored or if there’s a lack of activity (sedentary lifestyle/lots of sitting), the muscles become tense and tight. Sayonara, Mr. Roger’s neighborhood. 

10 EXERCISES TO RELIEVE SI JOINT PAIN

Tight muscles are very often weak muscles. The best thing you can do regardless of whether you’re dealing with SI joint pain or another misalignment is to strengthen the muscles responsible for keeping the joints centered, aligned, and mobile. 

Movement is medicine and stabilization training has been shown to cause a 50% reduction in disability, long term for SI joint injury. However, it takes consistency and a bit of time and patience.

Most people want to stretch tight muscles and we get that. Stretching feels good and can provide short term relief. Just remember, if everyone in the neighborhood is going to be happy and get along again, they need to up their strength game. 

Here are 10 of Dr. Mike’s favorite stretches and exercises to get you started:

Figure 4/Piriformis stretch

1. Lie on your back with both feet on the floor. 
2. Cross your ankle over the opposite thigh (just above the knee) and keep the foot closest to you flexed.
3. Interlace your hands behind your thigh and gently pull in towards your chest.
4. Hold for 5-10 breaths and then switch sides.

Supine Knee to Chest

1. Lie on your back with your knees bent and your feet flat on the ground. 
2. Bring one knee into your chest, keeping the other foot firmly planted on the ground. 
3. Hold and then switch legs. 
4. Do 3 rounds for 30 seconds on each side. 
5. You can get more from this stretch by straightening the leg that isn’t being brought to your chest.

Hip Flexor Stretch

1. Kneel on the floor on one knee like in a resting lunge position.
2. Engage your core, tuck your pelvis under and gently shift your hips forward until you feel a stretch in the front of your hip and down your thigh. Keep that pelvis tucked!
3. Hold the stretch for 20-30 seconds, then switch sides and repeat.
4. Aim to perform 2-3 sets on each side. Remember to breathe into it.

Resisted Cat

We love a full range of motion Cat/Cow. However, if your SI joint pain is caused by too much extension in the lumbar spine, that may trigger flare ups for you. Focus instead on the flexion aspect of this, which is “Cat”. You can add a resistance band if you want more challenge.

1. Begin on your hands and knees in a tabletop position, with your wrists aligned under your shoulders and your knees under your hips.
2. Gently brace your core and exhale as you round your back, tucking your pelvis under and chin towards your chest.
3. Inhale as you return to a neutral tabletop position, maintaining your core brace.
4. Repeat for 8-10 reps.

Banded Clamshells

1. Lie on your side with your knees bent, stacking your knees and ankles.
2. Drive your heels together and open your top knee towards the ceiling like you’re opening a book. Keep your pelvis stable with one hip stacked over the other. Do not allow the hips to shift back.
3. Hold for a moment at the top, then lower your knee back down.
4. Perform 10-15 reps per side, keeping your core engaged and your pelvis still throughout the movement.

Hip Adduction

1. Lay flat on your back with your feet on the floor.
2. Place a squishy ball, foam roller, or compactly rolled towel/folded pillow between your legs near the knees.
3. Keeping the low back flat on the mat, squeeze your knees together for 5 seconds and release the tension by half before squeezing again.
4. Repeat for 15 reps.

Modified Glute Bridges

Most people do Glute Bridges wrong with too much extension in their lumbar (low back) spine. The goal of a Glute Bridge is to work your glutes, hamstrings, and core. If you feel this in your low back, you’re doing it wrong or you’re not ready for it. 

1. Lie on your back with your knees bent and feet flat on the floor.
2. Brace your core and tuck your pelvis as much as you possibly can before starting to peel your spine off the floor slowly, one vertebra at a time. You may or may not get your hips up to a full bridge and that’s okay. If you feel a pinch or pain at any time and your form is spot on, back off until you no longer do. That is your body’s stopping point.
3. Hold whatever the top position is for you for 2-3 seconds, then slowly lower your hips back down one vertebrae at a time. 
4. Aim for 10-15 repetitions, focusing on maintaining proper alignment and avoiding arching your back.

Modified Bird Dogs

The standard Bird Dog is another one that has the potential to trigger SIJ pain if done with too much lumbar extension. Here is a modification that will help create strength and stability in the SI joint.

1. Set up on your hands and knees in tabletop position. Feet should be flexed, knees should be stacked directly under hips, and wrists directly under shoulders. Press the shoulders away from the ears and keep the head aligned with the spine.
2. Brace your core and raise the one arm overhead, palm facing in. 
3. Now, keeping your toes on the ground, slide your flexed foot out until your leg is fully extended. Keep your pelvis tucked slightly. You should feel this in your glute.
4. Bring the arm and leg back into tabletop position and do the other side. This is one rep. Repeat for 10 reps.

*If you find this easy, you can begin raising the foot off the ground slightly. Start with just an inch or two, ensuring you’re keeping that strong tuck of the pelvis to avoid arching the low back.

Side Plank

We all think we know how to do a side plank, but they’re one of the most butchered exercises around. If these are too difficult for you, keep only the top leg straight and bend the lower leg at the knee to support you. 

1. Lay on your side with your elbow supporting you. Pick your foot stance. You can stagger your feet so your top foot is in front of your bottom foot (easier) or stack your feet on top of each other (harder).
2. Press your shoulders away from your ears and scoop your shoulder blade (you can learn how to do that in the MoveU Shoulder Program).
3. Brace your core as you raise your hips so that your body is a straight line from head to heel. 
4. Keep your pelvis tucked so that you’re not arching your back and make sure your hips stay stacked. 
5. Hold for anywhere between 15 seconds to 2 minutes, depending on your ability. Remember to breathe. Repeat 10 times.

Hip Hinge

Most people tend to excessively flex or extend their lower spine and pelvis instead of hinging at their hip joint. We help train people to hinge properly by using a simple stick. We like this one, but any broomstick will do.

1. Stand with your feet hip-width apart and a slight bend in your knees.
2. Place a stick firmly against your forehead and pubic bone. Do not allow this to change throughout the movement. 
3. Keeping your back straight and your core engaged, shift your hips back and hinge forward at your hips until you feel a stretch in the back of your legs. Avoiding rounding or arching your back. 
4. Hold for 2-5 seconds then return to the starting position by driving your hips forward.
5. Repeat for 10-15 reps.

Conclusion

We know sacroiliac joint pain can feel debilitating and interfere with your life. By understanding the anatomy of the SI joint, recognizing the most frequent causes of pain, and focusing on strengthening your body into alignment using the MoveU Method, you can restore function to an area of dysfunction. 

Join the MoveU membership today. You’ll get access to every program we offer, including the Back & Core and Hips & Glutes programs you need to improve SIJ pain caused by misalignments and poor movement patterns. Our private community of members and coaches are ready to support you as you fix yo sh*t!