Best 5 Exercises for Sacroiliac Joint Pain

At Surrey Physio, we see a fair few sacroiliac joint pains. Lots of people come to us and using Dr Google, they tell us they have sacroiliac, or SIJ pain. This is where the pain is at located between the sacrum and the pelvis, low down on the spine, just lateral of the central position of the spine.

To find the SIJs, feel the bony bump each side just above your butt. If you come inward and down slightly, you will be on the sacroiliac joint.

There are a few problems associated with the sacroiliac joint:

Sacroiliac Joint Dysfunction:

This occurs when the SI joint is painful, and there is no key pathology or disease process. The SIJ is usually diagnosed as either moving too much (hypermobility) or too little (hypomobility). Hypermobility can be due to weak ligaments, genetic factors, and over-strain. Hypomobility, often caused by degenerative joint diseases, can result in pain over the SIJ too, but less commonly so. It I s fairly normal for the SIJ to be stiff – it is a very incongruent joint. For this reason, it is unusual for a stiff sacroiliac joint to be painful. In more cases, a hypermobile or unstable sacroiliac joint can be more painful. This will not show up on an MRI scan.

Diagram showing the sacroiliac joint

Sacroiliitis:

This is the inflammation of one or both of the SI joints. It can cause pain in the buttocks, lower back, and sometimes extend down the legs. Sacroiliitis can be associated with inflammatory conditions such as ankylosing spondylitis, psoriatic arthritis, or Crohn’s disease. Fortunately, this is not common, however it can be diagnosed by MRI scan.

SI Joint Arthritis:

Osteoarthritis can occur in the SI joints, just as it can in other parts of the body. This typically occurs in older adults and can cause pain and stiffness. However, it is not particularly common, as other areas tend to be more commonly affected with arthritis, such as the lower lumbar spine.

Pregnancy-Related SIJ Pain:

Hormonal changes during pregnancy can cause relaxation of the ligaments in the SIJ, leading to increased mobility and pain. This is almost always associated with hypermobility. Also, the pelvis shape can change slightly to accommodate the baby, placing strain on the SIJ and pubic symphysis (this is known as pubic symphysis disorder). Additionally, the added weight and altered gait during pregnancy can put extra stress on the SIJ.

Fracture:

A fall, impact, or other injury can fracture the SIJ. This is highly unusual though, and in 23 years of clinical work, I’ve not seen this yet.

Best 5 Exercises for Sacroiliac Joint Pain

1. Glute Stretch

This will target a stretch to the glutes and hip. Lie on your back, and bring your knee towards your opposite shoulder to feel a stretch in your bottom. Tip: changing the angle you take the leg will change the position of the stretch and you can play around with the position to find the stretch that feels most effective for you. Hold for thirty seconds, and repeat three times on the affected side.

2. Hip Forward-Back Swing

A good way to mobilise a stiff sacroiliac joint. Hold on to a table, and swing your leg in front of you and then behind you in a controlled way. It’s a great way to dynamically warm up your leg and hip, but also used to gain more mobility to your hip joint. Repeat 25 swings, three times on the affected side.

3. Supine Bridge

A good strengthening exercise for the core, hamstring, glutes and spine, the supine bridge is the one. This version below is a hard one, so only progress to this when you are comfortable using both feet planted. Lie flat on your back on a bed or the floor with your arms by your side, and with your knees bent. Squeeze your bottom muscles and lift your back upwards and straighten one leg. Make sure you maintain good posture (do not over-arch your lower back) and contract the deep abdominal muscles by squeezing your tummy towards your spine. Repeat for 10 reps each side, for two sets.

4. Superman Alternate

A useful mobilisation and strengthening exercise for the SIJ and lower back. Facing the floor in a prone position raise one hand above your head and bring your chin off the ground. Simultaneously raise the opposite side foot off of the ground and hold for one second before returning to the start position, repeat the movement with the opposite arm and foot alternating between reps. Repeat ten reps each side, holding for five seconds each.

5. Child's Pose

A good mobilisation exercise for the lower back and SIJ. Kneel down on the mat, and rest your buttocks on your heels. As you keep your buttocks on your heels, roll forwards and slide your arms forward creating a gentle stretch and lengthening in your back. Hold the stretch for 30 seconds, and repeat three times.

Before starting these exercises, it's important to consult with a physiotherapist or osteopath or one of our amazing team members at Surrey Physio. This is to ensure they are safe and appropriate for your specific condition. They can also provide guidance on proper form and modifications if needed. Additionally, it's crucial to listen to your body and avoid any movements that exacerbate your pain. Please call us on 0208 685 6930 for more information about sacroiliac joint pain and who best to see in our team. Or email us [email protected]