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The Best Exercises to Target SI Joint Pain

by Jaydee Vykoukal, PT, DPT April 29, 2020 0 Comments

Bridge Exercise

Whether it’s strength, flexibility, or the way you move, having an SI joint pain exercise program can make a huge difference. When chosen carefully and practiced regularly, they can help correct imbalances in the pelvis and help the recovery process. Keep reading to learn more about which of these exercises are best for you.

Hamstring Exercises

The hamstring muscles attach directly to the bottom of the pelvis and play a role in pelvic alignment. If this entire system is out of balance, it can easily put too much strain on the SI joint and affect the role it plays in proper weight transfer between the trunk and lower body.

  • Modified Bridges

    While traditional bridges focus on the glutes, changing the position of your heels can address both the glutes and hamstrings at the same time. Lie on your back with the knees bent and feet flat on the floor to start. You will focus on keeping the core and glutes tight as you lift the butt of the floor. Adjust the position of your heels to target the hamstrings: the straighter your knees are the more your hamstrings will have to work.

    Complete 15 repetitions for 2-3 sets.

  • Swiss Ball Hamstring Curl

    Lie on your back with the heels resting on an exercise ball (knees and hips bent to around 90 degrees to start). Then, squeeze the butt and core as you lift your lower body off the ground. Slowly, attempt to straighten the knees as you can go before returning them to the starting position.

    Complete 10-15 repetitions for 2-3 sets. If this is too hard to start, you can try it without lifting your butt off the ground.

Hip Flexor Exercises

The hip flexor muscle groups insert into the front of the pelvis. These muscles are notoriously too tight and overused because of poor posture or an imbalance of muscle strength in the pelvis. Exercise can help with balance and circulation, but don’t forget to stretch too.

  • Seated Leg Extension

    Sit on the edge of a chair or large yoga ball. Keeping upright posture, straighten one leg out in front of you. Hold for up to 5 seconds and then return it to the floor. You can alternate or focus on one side at a time.

    Repeat 10-15 repetitions for 2-3 sets. For added resistance, you can use a therapy band or ankle weights as needed.

Hip Adductor Exercises

The hip adductor muscles connect into the bottom of the pelvis near the groin and pelvic floor. By now, you should be starting to understand that each muscle group around the pelvis plays a role in keeping the entire area in balance.

  • Ball Squeezes

    Choose one of three positions depending on your comfort and core strength. Lie on your back with the legs out straight, bent with the feet flat on the floor, or hips and knees at 90 degrees with your feet off the ground. Then, place a ball or small pillow between the thighs. Squeeze as hard as you can without pain and hold for 5-10 seconds.

    Repeat 10-15 times for 2-3 sets. This exercise is great for alternating with hip abductor exercises for full pelvic balance.

Hip Abductor Exercises

The hip abductor muscles located on the outside of the hip play a large role in lateral stability of the hips and pelvis. Due to the smaller size of these muscles, they are notoriously weak and not properly activated with daily activities. Thus, exercise should focus on strengthening and using these muscles correctly.

  • Clam Shell

    Lie on your side with your legs stacked and knees bent to about 90 degrees. Try to keep your feet, hips, and shoulders all in one line. Then, lift the top knee off the bottom one toward the ceiling while keeping the feet together. Keep your hand on your hips to monitor and prevent rotation of the trunk. How high you lift depends on your ability to stay in control and not increase pain.

    Repeat 10-15 times until you feel a burn in the side of your butt muscles. Complete 2-3 sets. To add intensity, use a looped therapy band or add weight on your knee.

  • Standing Hip Abduction

    Stand comfortably near a chair or counter for balance if needed. Lift one foot off the ground and then move the entire leg out to the side. Keep the abs tight, toes pointing straight forward and avoid leaning toward the opposite side as you move your leg. Take extra care to keep the pelvis parallel to the ground (use a mirror and put your hands on your hips to see if they are inline).

    Repeat 10-15 times for 2-3 sets. You can progress to standing on a balance disc or foam pad. In fact, any single-leg balance exercise is a great progression once your SI joint can tolerate it and you can control the motion.

Core Exercises

Core strength is essential for all normal body movement and lower back health. For the SI joint, it is of particular importance since it helps provide enough support to tolerate weight transfers, impact, and much more. 

  • Supine Marching

    Lie on your back with the knees bent and the feet flat on the floor. First, tighten the core by flexing your ab muscles. Then, lift one foot off the ground until the hip is at 90 degrees, then return it to the floor. Alternate between sides as if you’re marching. Do not let the spine rotate or low back arch further.

    Complete 10 repetitions on each leg for 2-3 sets. Don’t forget to breathe. You can progress by bringing both legs up together.

  • Plank

    This is a great full-body strength exercise that addresses the core. From your hands and knees, shift your weight into your forearms and either your knees or feet. The key is to keep good posture with the low back only slightly arched and upper back relatively flat. Keep the abdominal muscles and glutes tight. The whole body should create a straight line, with no sagging of the back or bending at the hips.

    Hold for 20-60 seconds for 2-3 sets. For a progression, you can add a yoga ball under your forearms or add toe taps with the legs.

The Best Exercise for SI Joint Pain

The main focus with any SI joint exercises is to promote circulation, healing, and better movement patterns to minimize aggravation and further pain. The SI joints are in a unique place where the pelvis and low back meet. It requires targeting a variety of different muscle groups that help support the entire trunk and lower body. The best exercise for SI pain is the one that is most safe and effective for you.

Is Walking Good for SI Joint Pain?

Movement is always good for the SI joint. However, one of the biggest aggravators of SI or sacroiliac pain is poor coordination with single leg activities. Since walking is essentially a repetition of single-leg stands, you need to be wary of how you’re walking. For SI joint pain, keep your steps small and controlled. Plus, focus on keeping the core tight, and pelvis aligned. Stop and take frequent breaks if you experience fatigue or onset of SI or lower back pain.

If you do experience an exacerbation of SI joint pain, check out your other SI joint pain treatment options to help with recovery.

Exercises and Activities to Avoid

There are a variety of movements that are particularly aggravating to the SI joint. Avoid these movements initially to allow healing and pain relief. With time, you may be able to re-introduce these exercises. If you’re not sure where to start or how to progress, consider physical therapy. These aggravating activities include:

  • Lumbar flexion for core strengthening like crunches or situps
  • Running, speed walking, or any other activity that prolongs single-leg stance
  • Leaning to one side with sitting, standing, or even sleeping. 
  • Prolonged seated positions or exercises like biking. Check out our tips for better sitting with SI joint pain
  • Heavy weightlifting
  • Any sport or movement that requires a lot of twisting like tennis or golf

Learn proper sleeping positions to reduce pain.

Staying Safe While Exercising

SI joint dysfunction and pain can be a hard spot to treat due to its involvement in pretty much every move the body makes. That’s why a full-body lower body workout is important. If you aren’t sure where to start, talk to a physical therapist or your physician today for a full assessment and recommendations.

SI joint pain can easily be confused with other leg and low back injuries as well, so talk to a trusted healthcare professional if you experience an exacerbation of symptoms such as neurological symptoms or severe pain.

Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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