Exercises for Sacroiliac Joint Pain

In this article, we will explore exercises for relieving Sacroiliac Joint Pain before delving into the exercise protocol for Sacroiliac Joint Pain. Let's know about the sacroiliac joint and associated structures. The sacroiliac joint (SIJ) links the sacrum, at the spine's base, to the pelvis's ilium. This synovial joint, stabilized by ligaments (anterior/posterior sacroiliac) and muscles (gluteus maximus, piriformis), has interlocking surfaces limiting mobility to slight gliding and rotation. It transfers weight between the upper body and lower limbs, ensuring stability and shock absorption.

The lumbar spine (L1-L5) supports flexion, extension, lateral bending, and minimal rotation. Its robust vertebrae and muscles, such as the erector spinae, maintain posture and facilitate movement. The hip joints, ball-and-socket structures, connect the femur to the pelvis, allowing for flexion, extension, abduction, adduction, and rotation. They are stabilized by the acetabulum, labrum, and ligaments, such as the iliofemoral ligament.

The SIJ, lumbar spine, and hips form a kinetic chain, where dysfunction in one impacts others. Limited hip mobility can strain the lumbar spine, while SIJ instability may alter gait, affecting hip and lumbar function. Proper alignment and muscle balance are crucial for pain-free movement and musculoskeletal health.

Causes of Sacroiliac Joint Pain

1. Trauma: Direct injury or impact to the pelvis or lower back.
2. Arthritis: Osteoarthritis or inflammatory conditions like ankylosing spondylitis.
3. Pregnancy: Ligament laxity and increased pelvic stress from hormonal changes.
4. Hypermobility: Excessive joint movement due to weak ligaments or muscles.
5. Hypomobility: Reduced joint motion causing stiffness and pain.
6. Muscle Imbalance: Weak or tight muscles (e.g., glutes, hamstrings) alter joint mechanics.
7. Leg Length Discrepancy: Uneven leg lengths stress the SIJ.
8. Gait Abnormalities: Altered walking patterns increase joint strain.
9. Infection: Rare bacterial infections affecting the SIJ.
10. Scoliosis: Spinal curvature impacting pelvic alignment.
11. Repetitive Stress: Activities like running or heavy lifting overload the joint.
12. Post-surgical Changes: Altered biomechanics after hip or spine surgery.

Symptoms of Sacroiliac Joint Pain

1. Pain in the lower back, especially the left or Right side of PSIS.
2. Pain feels when changing sides on the bed from left to right or right to left.
3. Pain while walking, deep squat position, and forward bend.
4.  Sitting and sit to standing.
5. Sometimes pain feels gluteus region and the back of the thigh.
6. Severe Sacroilitis; pain in feels inguinal region.

Management of Pain

Effective management of SIJ pain involves a multimodal approach to reduce inflammation, restore mobility, and strengthen supporting muscles. Key strategies include:

• Piriformis Muscle Stretching: Relieves tension in the piriformis, which can compress the SIJ or sciatic nerve.

• SIJ Mobilization and Rotation: Manual therapy techniques to restore joint alignment and mobility.

• Hot Compress: Applied for 15-20 minutes to relax muscles and improve blood flow.

• Transcutaneous Electrical Nerve Stimulation (TENS): Used for 10-15 minutes to reduce pain through electrical stimulation.

Exercises for Sacroiliac Joint Pain

Targeted exercises can strengthen and stabilize the SIJ, improve flexibility, and reduce pain. Below are four effective exercises, with step-by-step instructions:

1. Cat and Camel

• Purpose: Enhances lumbar spine mobility and gently mobilizes the SIJ.

• How to Perform:

  1. Start on all fours, with hands under shoulders and knees under hips.

  2. Cat: Arch your back upward, tucking your chin toward your chest.

  3. Camel: Lower your back, lifting your head and tailbone slightly.

  4. Repeat 8-10 times, moving slowly and breathing deeply.

• Benefits: Improves spinal flexibility and reduces SIJ stiffness.

2. Child’s Pose

• Purpose: Stretches the lower back, hips, and piriformis, relieving SIJ tension.

• How to Perform:

  1. Kneel on the floor, sitting back on your heels.

  2. Slowly lower your torso forward, extending your arms in front and resting your forehead on the ground.

  3. Hold for 20-30 seconds, breathing deeply, then return to the starting position.

  4. Repeat 3-5 times.

• Benefits: Gently stretches the SIJ and surrounding muscles, promoting relaxation.

3. Hip Thrust

• Purpose: Strengthens the glutes and core, stabilizing the SIJ.

• How to Perform:

  1. Lie on your back with knees bent and feet flat, hip-width apart.

  2. Engage your glutes and lift your hips toward the ceiling, forming a straight line from shoulders to knees.

  3. Hold for 3-5 seconds, then lower slowly.

  4. Perform 10-12 repetitions for 2-3 sets.

• Benefits: Enhances pelvic stability, reducing SIJ stress.

4. Clamshell

• Purpose: Strengthens the gluteus medius to improve hip and SIJ stability.

• How to Perform:

  1. Lie on your side with knees bent at a 45-degree angle and legs stacked.

  2. Keeping feet together, lift the top knee as high as possible without rotating the pelvis.

  3. Slowly lower the knee. Perform 10-15 repetitions for 2-3 sets per side.

• Benefits: Targets hip abductors, supporting SIJ alignment.

Precautions and Tips

1. Start Slowly: Begin with low repetitions and progress as tolerated to avoid aggravating pain.

2. Consult a Professional: Work with a physical therapist to ensure proper form and tailor exercises to your condition.

3. Avoid Painful Movements: Stop any exercise that increases discomfort and consult a healthcare provider.

4. Combine with Other Therapies: Pair exercises with stretching, hot compresses, or TENS for optimal relief.

Conclusion: 

Sacroiliac joint pain can stem from various causes, but targeted exercises like Cat and Camel, Child’s Pose, Hip Thrust, and Clamshell can alleviate discomfort by improving mobility, strength, and stability. Understanding the SIJ’s role in the kinetic chain underscores the importance of balanced muscle function and proper alignment. With consistent practice and professional guidance, these exercises can help manage SIJ pain, enhance movement, and improve quality of life.

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Read more

1. Chronic Hamstring Tightness and Lower Back Pain
2. Lumbar Spinal Stenosis Exercises
3. Causes of Spine Stress Fractures
4. Quadratus Lumborum Pain: Stretch & Exercises
5. Piriformis Syndrome Exercises and Stretches: Quick Relief!

FAQs

How do you treat sacroiliac joint pain?

Treat sacroiliac joint pain with piriformis stretching, SIJ mobilization, hot compresses (15-20 minutes), and TENS (10-15 minutes). Perform exercises like Cat and Camel, Child’s Pose, Hip Thrust, and Clamshell to improve mobility and strength. Consult a physical therapist and avoid painful movements for optimal relief.

Where to massage for SI joint pain?

Massage the gluteus maximus, piriformis, and lower back muscles near the posterior superior iliac spine (PSIS) to relieve SI joint pain. Focus on the sacral and iliac regions, avoiding direct pressure on the joint. Use gentle, circular motions and consult a professional for proper technique.

What does sacroiliac joint pain feel like?

Sacroiliac joint (SIJ) pain typically feels like a dull, aching discomfort in the lower back, often on one side near the posterior superior iliac spine (PSIS). It may worsen when transitioning positions (e.g., rolling in bed, sitting to standing), walking, squatting, or bending forward. Pain can radiate to the glutes or back of the thigh, and in severe cases of sacroiliitis, it may extend to the inguinal (groin) region. The sensation is often described as a deep, localized ache or stiffness, sometimes accompanied by a feeling of instability in the pelvis.

Will sacroiliac pain go away?

Sacroiliac joint (SIJ) pain can often improve or resolve with proper treatment, depending on its cause. Acute cases from trauma or strain may subside in weeks with rest, stretching, and exercises like Cat and Camel or Hip Thrust. Chronic conditions, like arthritis or hypermobility, may require ongoing management, including physical therapy, mobilization, or TENS, to reduce symptoms. Most patients see significant relief within 4-12 weeks with consistent care, but severe or underlying conditions (e.g., ankylosing spondylitis) may persist longer, necessitating medical intervention. Consult a healthcare provider for tailored treatment to maximize recovery.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Consult a doctor for personalized guidance.