Stretches and Exercises to Help Ease SI (Sacroiliac) Joint Pain

What are SI joints?

You have one SI joint on each side of your lower spine. More specifically, these joints are found where the flat bone at the base of your spine (known as your sacrum) meets your ilium or hip bone.

SI joint irritation may feel like pain in the lower back, buttocks, or legs.

There are various causes of SI joint pain, including:

• injury
• osteoarthritis
• sudden or repeated heavy lifting
• ankylosing spondylitis
• SI joint dysfunction

SI joint pain is also common during pregnancy because your body produces more of a specific hormone called relaxin. This hormone makes your joints more elastic to allow your pelvis to widen during childbirth.

Although pregnancy is a common cause of SI pain, the source of the pain in this case stems from hypermobility, or “too much motion.” Therefore, stretching may not be helpful if pregnancy is the source of your pain.

Stretches and exercises for SI joint pain

Stretching the muscles around your SI joint can potentially help you loosen up tight areas. This may help relieve tension in your lower back and make it easier to move around with less pain and discomfort.

Try to set aside some time each day to stretch. Even doing a couple of stretches once or twice daily can go a long way.

If you have ongoing SI joint pain that doesn’t seem to improve with gentle stretches, you may want to visit a physical therapist.

1. Knee-to-chest stretch

The knee-to-chest stretch helps elongate the muscles in your hip. If you’re having trouble reaching your knee, you can hook a strap or band behind your knee.

To do this stretch:

1. Lie on a mat or other comfortable surface.
2. Grab your left knee and pull it toward your chest until you feel a stretch in the back of your leg.
3. Hold for up to a minute, then repeat on the other side.

2. Knees-to-chest stretch

The double knee-to-chest stretch may help ease SI joint pain by reducing tension in your lower back, hamstrings, and hips.

Similar to the stretch above, you can try hooking a strap behind your knees if you’re having trouble reaching them.

To do this stretch:

1. Lie face-up on a comfortable surface.
2. Grab both of your knees and pull them toward your chest as far as you can. Try not to let your back come off the ground.
3. Hold for up to a minute.

3. Figure-4 stretch

The figure-4 stretch targets multiple muscle groups at the same time. You’ll likely feel this stretch primarily in your outer hip and glutes. You can use a strap or band if you’re having trouble reaching your knee.

To do this stretch:

1. Lie face-up on a mat with your knees bent and feet planted on the floor.
2. Place your right ankle just above your left knee.
3. If you can, raise your left leg and gently pull it toward your chest until you feel a stretch.
4. Hold for up to a minute and repeat on the right side.

4. Trunk rotation stretch

Trunk rotations help stretch the muscles on the sides of your core. When performing this stretch, only twist as far as you can comfortably. Stop immediately if you experience severe pain, numbness, or tingling.

To do this stretch:

1. Lie on the ground with your feet flat on the floor and your arms outstretched in a T-position. Your knees should be together and pointed toward the ceiling.
2. Keeping your knees together and your shoulders pressed against the floor, drop your knees to one side as far as you comfortably can.
3. Switch to the other side and perform 10 twists on each side.

5. Quad stretch

The quad stretch is a simple stretch that targets the quadriceps muscle in the front of your thigh. When stretching, don’t force your heel to your butt if it’s uncomfortable. Instead, just bring it as close to you can.

You can hold onto a chair or other surface to balance if you need to.

To do this stretch:

1. Stand tall. Hold on to a chair or wall if you need help balancing.
2. Grab your left ankle and pull your foot to your buttocks with your knee pointing downward.
3. Hold for up to a minute and repeat on the other side

6. Adductor squeeze

The adductor squeeze isn’t a stretch. Instead, it’s a gentle exercise that can help reduce stiffness in the muscles surrounding your SI joint.

It requires a softball or similar sized object.

Perform the exercise for 2 to 3 sets, with 10 reps per set.

To do this exercise:

1. Lean back, weight on your elbows, and bend your knees to about 90 degrees. Place a Pilates ball or a similarly sized object between your knees.
2. Squeeze the ball as hard as you comfortably can and hold for about 3 seconds.
3. Relax and repeat for 10 repetitions.

7. Band abduction

This exercise, like the one above, isn’t a stretch, but this movement can help reduce the stiffness in the muscles surrounding your SI joint.

It requires a loop resistance band. Try to use a relatively thin band that won’t cause discomfort in your lower back during the exercise.

Perform the exercise for 2 to 3 sets, with 10 reps per set.

To do this exercise:

1. Lie on your back with your knees bent to about 90 degrees and your feet flat on the floor. Put a band around your knees.
2. Push your knees apart and pause for a moment.
3. Repeat for 10 repetitions.

What else can help?

In addition to regular stretches, the following habits may also help reduce or prevent SI joint pain.

• Limiting prolonged sitting: This can cause tightness and stiffness in your back, which can worsen SI joint pain. Try to get up and move around, stretch, or take a short walk at least once every 50 to 60 minutes.
• Changing your sitting position: The best way to sit with SI joint pain is to keep your hips level with each other and your “sit bones” in contact with your chair. This can prevent straining of the ligaments around your SI joint. Keep your knees slightly apart and avoid crossing your legs. Often, it is more comfortable for the SI joint if your hips are positioned above your knees, allowing you to maintain the natural curve of your back.
• Strengthening your glutes: Research suggests that glute strengthening may be helpful for people with persistent SI joint pain and weak glutes.
• Alternating heat and cold: To help manage pain and stimulate blood flow, try alternating heat and ice for 15 to 20 minutes at a time.
• Considering physical therapy if your pain doesn’t improve: A physical therapist can design a custom program to help you manage your SI joint pain.

When to get medical help

Some SI joint pain may require treatment by a doctor.

If your SI joint pain is severe or worsens, whether on its own or with exercise, it’s best to talk with an orthopedic specialist. These specialists diagnose and manage issues with the muscles, joints, and bones.

They may recommend imaging tests to visualize the structures of your body. This may guide additional treatment options for SI joint pain, such as physical therapy or medication.

Takeaway

Stretching the muscles around your SI joint may help reduce pain by relieving tension in your lower back.

When stretching, it’s better to be too gentle than too aggressive. Stretching too vigorously may cause your muscles to become tighter and worsen your symptoms.

If you have chronic SI joint pain, a physical therapist may be able to help. They can help create a custom-designed stretching and strengthening program specifically for you.