Stretches and exercises to relieve SI joint pain

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SI joints are some of the largest weight-bearing joints in the body. They connect the spine to the pelvis. Their main function is to distribute weight from the top half of the body over the hips and legs. They also act as shock absorbers for the spine.

A 2020 review explains that SI joints are stable, with a minimal range of movement. They are held in place by strong ligaments and surrounded by some of the body’s strongest muscles, including the abdominals, back muscles, and glutes. Pelvic floor muscles also help to stabilize the joint.

Tightness in any of the muscles around the SI joints can interfere with the joints and cause lower back pain. Stretching the muscles may bring relief, while strengthening exercises help reduce the chances of the injury recurring.

Learn about physical therapy.

In 2018, researchers concluded that weak glutes — the muscles in the buttocks — contribute to SI joint pain. The paper, published in the International Journal of Sports Physical Therapy, recommends people with SI joint pain include the following gluteus maximus strengthening exercises in their programs.

Bridge

1. Start by lying on the back on a mat on the floor.
2. Keep the legs hip-distance apart and bend the knees so the feet are flat on the floor. Keep the arms by the sides, palms facing down.
3. Breathe in, and pull in the tummy to engage the core. While breathing out, lift the buttocks and hips off the ground. Try to keep the hips level, and make sure not to pinch into the neck by only lifting onto the shoulders.
4. Breathe in at the top, and then return to the mat while breathing out.

Once the person is confident they can keep their hips level, they can add a variation to the bridge, such as the unilateral bridge below.

Unilateral bridge

This exercise is sometimes called a single-leg bridge.

1. Lie on the back on a mat on the floor. Bend the knees and keep the feet flat on the floor. Lift one foot, and straighten the leg, keeping the leg at roughly 45 degrees to the floor.
2. Breathe in, and tighten the tummy muscles. Lift the buttocks and hips off the floor while exhaling, pushing upward until the shoulder, hips, and knees are in a straight line.
3. Breathe in at the top, then slowly lower the hips and buttocks back to the floor, keeping the leg straight.
4. Perform the same number of repetitions on each side.

Hip abduction on all fours

This exercise is sometimes called the fire hydrant or dirty dog.

1. On hands and knees, place the hands underneath the shoulders and knees underneath the hips.
2. Breathe in to prepare, and engage the core. While breathing out, lift one bent leg away from the body, out from the hip — similar to a dog cocking a leg.
3. Slowly lower the leg back to its starting position.
4. Perform the same number of repetitions on each side.

Hip extension in prone

1. Lie facing down on a mat on the floor. Place the hands on top of each other underneath the forehead to rest the head on the hands.
2. Breathe in and pull in the stomach muscles. While breathing out, lift one leg a few inches off the floor.
3. Keep the leg straight, but do not lock the knee. Hold this pose for a few seconds.
4. Breathe in to prepare, then slowly lower the leg back down to the mat.
5. Complete the same number of repetitions on each side.

Hip abduction using a resistance band or loop

1. Sit down on the back on a mat on the floor. Bend the knees, keeping feet flat on the floor. Take a light resistance band and tie it in a loop just below the knees.
2. Breathe in and tighten the tummy muscles. While breathing out, push the knees apart and hold for a moment.
3. Breathe in while returning to the starting position.
4. Complete the desired number of repetitions.

Knee-to-chest stretch

1. Lie on the back on a mat on the floor.
2. Breathe in, engage the core, and bend one leg so the knee is above the hip.
3. While breathing out, wrap the hands around the shin, just below the knee, and pull the leg toward the chest. Hook a resistance band behind the knee if it is difficult to reach.
4. Breathe into the stretch. Take a breath in, and while exhaling, try to hold the stretch or even extend it by easing the knee closer to the chest.
5. When ready, breathe in to prepare, then breathe out and return the leg to the floor.
6. Repeat on the other side.

Lower trunk rotation

1. Lie on the back on a mat on the floor. Bend the knees and keep feet flat on the floor.
2. Breathe in and pull in the tummy muscles. Lift the pelvis slightly so the lower back presses into the mat.
3. Keeping the shoulders down on the mat and knees together, breathe out and slowly roll as far as possible to one side.
4. Breathe in while returning to the starting position
5. Complete the same number of repetitions on each side.

Exercise and physical therapy are very effective at treating SI joint pain. However, the effects may not be immediate.

Some people benefit from wearing surgical girdles and braces. These help support the SI joints and a person’s trunk.

According to NINDS, other ways of managing lower back pain include:

• Avoiding sitting in the same position for long periods. Switching positions, standing up, stretching, and walking around regularly, can all reduce pain.
• Placing a small pillow or rolled-up towel in the small of the back when sitting to help support the lower back.
• Achieving and maintaining a moderate weight.
• Sleeping curled up in the fetal position on one side, which may relieve pressure on the back.

SI joints connect the spine and the pelvis, and any injury or dysfunction in this area often causes lower back pain.

Exercises and stretches can help release the joints and relieve a person’s pain.

People can usually do the exercises at home, but physical therapists can tailor a program specifically to a person’s needs if they do not benefit from home workouts.

Doctors recognize that exercises are extremely effective but remind people that the results are not immediate.