Table of ContentsView AllTable of ContentsPelvic TiltKnee to ChestBoth Knees to ChestInner Thigh SqueezeOuter Hip StretchSpinal TwistQuad StretchBridgeCat-Cow StretchStanding TriangleLow-Impact AerobicsWhen to See a Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Pelvic Tilt
Knee to Chest
Both Knees to Chest
Inner Thigh Squeeze
Outer Hip Stretch
Spinal Twist
Quad Stretch
Bridge
Cat-Cow Stretch
Standing Triangle
Low-Impact Aerobics
When to See a Healthcare Provider
Frequently Asked Questions
Thesacroiliac(SI) jointsare located on either side of the base of thespine. SI stretches and other exercises that help preserve the health and function of these joints are important when working to improvelower back painbecause of the role they play in your day-to-day movements.
SI joints support and stabilize your spine when you walk, climb stairs, bend, and lift heavy objects. Simply put, if these joints are stressed or compromised, the back can be too.
Fortunately, a consistent exercise program can help. The program should include a combination of:
This article walks you through how to perform SI joint stretches and strength exercises properly, as well as what activities qualify as light aerobics.
You should start to notice your SI joint pain and instability improving within three weeks of careful and consistent exercise therapy.
Occupational vs. Physical Therapy: Patient Questions
Strengthen: Pelvic Tilt for Core
Verywell / Ben Goldstein
It is important to engage your core when doing lower back stretching and strengthening exercises. People with lower back pain often can have difficulty finding their core muscles. An easy move to get you started is the pelvic tilt.
How to Do It
Lying on your back with your feet on the floor and knees bent:
To increase the intensity, add marching:
To add even more intensity, add more reps to each round. Remember to keep your abdominal muscles tight.
Tips
If you have had SI pain for a while, pelvic tilts may feel awkward or uncomfortable due to stiff muscles. The exercise should start to feel more natural after a while, especially if you do it every day.
Stretch: One Knee to Chest
Forgiss / Deposit Photos
It’s best to start your SI joint exercise session with easier moves. Your body’s tissues need to be warmed up before they can be safely stressed. Warming up is key to preventing injury.
Warming up also lets you check your pain levels. Notice how much pain you feel with each move and set limits for what you let yourself do.
In the supine position, bend your knees and place your feet flat on the floor.
You might find that this move feels OK on one side but painful on the other. Again, the rule of thumb here is to move only within pain-free limits. If you have to skip one of the legs, that’s fine.
Stretch: Both Knees to Chest
Blend Images - Jose Luis Pelaez Inc / Getty Images
If your back is up for it, try this double knees to chest stretch. Note that this exercise may be painful for some people with weaker ab muscles.
Start in the supine position with bent knees and feet flat on the floor.
Bringing one leg down at a time is important for your safety. Unless your abs are very strong, putting too much stress on the joint at once may worsen your SI problem.
Strengthen: Inner Thigh Squeeze
nikitabuida / Deposit Photos
Adduction simply means bringing the thigh closer to the middle of your body. You can try that in a standing position. Simply cross the leg on the painful side of your body in front of your other leg.
Adduction can also be done in a supine position (lying on your back):
Begin in supine with your knees bent and your feet flat on the floor.
Do about three to five of these, but let your pain be your guide.
Stretch: Outer Hip Muscles
If you stand up straight and relax your arms down the side of your body, your fingers should just reach yourouter hip muscles. Stretching this muscle group can have the same effect as adduction. It just might be less intense.
This stretch can also release some chronic tension, which may help realign your SI joint.
As with any one-legged move with SI joint issues, this exercise may be more painful on one side than on the other. If it hurts, don’t continue.
Do up to five of these and then rest. Repeat on the other side.
Stretch: Spinal Twist
cirkoglu / Deposit Photos
If your pain levels permit, you can move from the supinehook lyingposition (lying on your back with knees bent and feet on the floor) into a gentle spinal twist.
It may help to place some pillows or blankets where your knees will go when you twist. This may offer a bit more support and help you relax excess muscle tension.
Advanced Stretch: Quadriceps
Taking the tension out of your quadriceps muscles may help alleviate some of your SI pain.
In the image above, the model is demonstrating the easiest type of quadriceps stretch:
This move is not for everyone, especially those who are new to exercising with SI joint pain. Being on your side with your knee bent behind you may stress your SI joint or knee.
Stretches for Tight Quads
Strengthen: Bridge for Glutes and Abs
DjordjeDjurdjevic / Getty Images
Once you have warmed up your SI joint with stretches, you can move on to some strength-building exercises. The goal of these moves is to help stabilize your SI joint.
This first, low-impact exercise is known as a bridge. Add the bridge to your series to build strength in your glutes, abdominal muscles, lower back, and hips.
Repeat these steps eight to 10 times or until you feel any pain in your SI joint or knees.
Stretch: Cat-Cow for Hips and Back
Prasit Photo / Getty Images
The cat-cow exercise is a common pose in yoga. It can be used to warm up. Or, you can use it to stretch and strengthen your back, hips, and abdominal muscles.
This pose places pressure on your knees, so you may want to skip it if you have knee pain or any kind of knee injury.
Repeat these steps eight to 10 times. If you feel any pain or weakness in your SI joint, hips, or knees, stop the exercise and take a rest while lying on your back.
Strengthen: Triangle Pose for Hips, Thighs, and Abs
CasarsaGuru / Getty Images
The triangle pose is another great stretch-strengthen exercise that anyone, no matter how flexible they are, can benefit from.
Repeat these steps five times or until you feel any pain or weakness in your SI joint or knees.
Take special care during this exercise—and any standing exercises—not to lock your knees. Always keep them slightly bent to prevent them from buckling.
Christopher Furlong / Getty Images
The American Heart Association recommends fitting in 150 minutes of moderately intense aerobic exercise each week.
That’s a great goal to work up to. But when it comes to aerobic exercise for SI joint pain, rule #1 is this: Go at your own pace. Although the point is to raise your heart rate, you don’t need to work out with the same intensity as you might in order to lose weight.
Stay focused on your pain and only allow yourself to exercise at a level you find comfortable.
Aerobic exercises you can easily adjust to your pace and pain level include:
Know Your LimitsSI joint pain exercises should not cause pain or weakness. Some muscle tightness is to be expected, but do not push through the pain. If you are unable to do the exercises outlined here, talk to your healthcare provider about getting a referral to physical therapy.
Know Your Limits
SI joint pain exercises should not cause pain or weakness. Some muscle tightness is to be expected, but do not push through the pain. If you are unable to do the exercises outlined here, talk to your healthcare provider about getting a referral to physical therapy.
SI joint stretching and other exercises may be enough to improve pain in some, but talk to your healthcare provider if you:
These are signs that you may need other treatment to reduce inflammation, restore mobility, and stabilize the joint.
This may include cold/warm compresses, over-the-counter anti-inflammatory medications, physical and other therapies, or use of a back brace.
In some cases, more intense medical intervention may be needed. Common treatments for SI joint instability or dysfunction includeinjectionsinto and around the SI joint,radiofrequency ablation(radio waves heat and disable certain nerves that transmit pain signals),andfusion surgery(one or both SI joints are surgically joined).
Summary
Sacroiliac joint stretches and strengthening exercises help to relieve pain and stiffness from SI joint instability. It should take about three weeks of consistent exercise to feel a noticeable difference.
If you are unable to do the above exercises, experience an increase in pain, or do not feel improvement after a few weeks of at-home treatment, talk to healthcare provider. Other interventions may be needed.
Avoid standing exercises that shift weight on your hips, such as leg lunges and other moves where just one foot is on the ground at a time. Also skip high-impact exercises like running or jump-roping, as well as cardio machines like treadmills and stair climbers.
It depends. For some people, light and easy swimming strokes are helpful. For others, certain strokes, such as the breaststroke and butterfly, may irritate your sacrum. If you find that swimming is causing you pain, try the backstroke instead, or stick to walking through the water.
SI joint pain tends to be centered in the lower back,groin,hips, ortailbone. Some people feel dull and achy pain, while others feel sharp, stabbing pain that radiates into theirthigh,knee, orfoot.
SI joint pain is more common in women than men.Age (over 45), pregnancy, overweight/obesity, prior back injury, prolonged sitting, exercising more than four times a week, and having a job that requires lifting, bending, or heavy labor are also risk factors.
Besides pain, symptoms of SI joint instability include:Numbness or tinglingWeaknessLeg instabilityTrouble sleepingdue to pain and discomfortTrouble sittingfor long periods of timePain when standingfrom a seated position
Besides pain, symptoms of SI joint instability include:
The SI joints connect the bony structure above the tailbone (sacrum) to the top part thepelvis(iliac).
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082Barros G, McGrath L, Gelfenbeyn M.Sacroiliac joint dysfunction in patients with low back pain.Fed Pract. 2019 Aug;36(8):370-375.American Heart Association.American Heart Association recommendations for physical activity in adults and kids.Murakami E, Aizawa T, Kurosawa D, Noguchi K.Leg symptoms associated with sacroiliac joint disorder and related pain.Clin Neurol Neurosurg. 2017;157:55-58. doi:10.1016/j.clineuro.2017.03.020Cheng J, Chen SL, Zimmerman N, Dalton JE, LaSalle G, Rosenquist R.A new radiofrequency ablation procedure to treat sacroiliac joint pain.Pain Physician. 2016;19(8):603-615.Yale Medicine.Sacroiliac joint fusion.Asada M, Tokunaga D, Arai Y, et al.Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis.J Belg Soc Radiol. 2019;103(1):36. doi:10.5334/jbsr.1648National Library of Medicine.Sacroiliac joint injury.Wieczorek A, Campau E, Pionk E, Gabriel-Champine M, Ríos-Bedoya C.A closer look into the association between the sacroiliac joint and low back pain.SMRJ. 2021 Apr;6(1):1-6. doi:10.51894/001c.21971Siahaan YMT, Hartoyo V.Sacroiliac joint pain: a study of predisposing factors in an indonesian hospital.The Open Pain Journal. 2019;12(1). doi.10.2174/1876386301912010001Lee A, Gupta M, Boyinepally K, Stokey PJ, Ebraheim NA.Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment.Adv Orthop. 2022;2022:3283296. doi:10.1155/2022/3283296
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082Barros G, McGrath L, Gelfenbeyn M.Sacroiliac joint dysfunction in patients with low back pain.Fed Pract. 2019 Aug;36(8):370-375.American Heart Association.American Heart Association recommendations for physical activity in adults and kids.Murakami E, Aizawa T, Kurosawa D, Noguchi K.Leg symptoms associated with sacroiliac joint disorder and related pain.Clin Neurol Neurosurg. 2017;157:55-58. doi:10.1016/j.clineuro.2017.03.020Cheng J, Chen SL, Zimmerman N, Dalton JE, LaSalle G, Rosenquist R.A new radiofrequency ablation procedure to treat sacroiliac joint pain.Pain Physician. 2016;19(8):603-615.Yale Medicine.Sacroiliac joint fusion.Asada M, Tokunaga D, Arai Y, et al.Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis.J Belg Soc Radiol. 2019;103(1):36. doi:10.5334/jbsr.1648National Library of Medicine.Sacroiliac joint injury.Wieczorek A, Campau E, Pionk E, Gabriel-Champine M, Ríos-Bedoya C.A closer look into the association between the sacroiliac joint and low back pain.SMRJ. 2021 Apr;6(1):1-6. doi:10.51894/001c.21971Siahaan YMT, Hartoyo V.Sacroiliac joint pain: a study of predisposing factors in an indonesian hospital.The Open Pain Journal. 2019;12(1). doi.10.2174/1876386301912010001Lee A, Gupta M, Boyinepally K, Stokey PJ, Ebraheim NA.Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment.Adv Orthop. 2022;2022:3283296. doi:10.1155/2022/3283296
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082Barros G, McGrath L, Gelfenbeyn M.Sacroiliac joint dysfunction in patients with low back pain.Fed Pract. 2019 Aug;36(8):370-375.American Heart Association.American Heart Association recommendations for physical activity in adults and kids.Murakami E, Aizawa T, Kurosawa D, Noguchi K.Leg symptoms associated with sacroiliac joint disorder and related pain.Clin Neurol Neurosurg. 2017;157:55-58. doi:10.1016/j.clineuro.2017.03.020Cheng J, Chen SL, Zimmerman N, Dalton JE, LaSalle G, Rosenquist R.A new radiofrequency ablation procedure to treat sacroiliac joint pain.Pain Physician. 2016;19(8):603-615.Yale Medicine.Sacroiliac joint fusion.Asada M, Tokunaga D, Arai Y, et al.Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis.J Belg Soc Radiol. 2019;103(1):36. doi:10.5334/jbsr.1648National Library of Medicine.Sacroiliac joint injury.Wieczorek A, Campau E, Pionk E, Gabriel-Champine M, Ríos-Bedoya C.A closer look into the association between the sacroiliac joint and low back pain.SMRJ. 2021 Apr;6(1):1-6. doi:10.51894/001c.21971Siahaan YMT, Hartoyo V.Sacroiliac joint pain: a study of predisposing factors in an indonesian hospital.The Open Pain Journal. 2019;12(1). doi.10.2174/1876386301912010001Lee A, Gupta M, Boyinepally K, Stokey PJ, Ebraheim NA.Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment.Adv Orthop. 2022;2022:3283296. doi:10.1155/2022/3283296
Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082
Barros G, McGrath L, Gelfenbeyn M.Sacroiliac joint dysfunction in patients with low back pain.Fed Pract. 2019 Aug;36(8):370-375.
American Heart Association.American Heart Association recommendations for physical activity in adults and kids.
Murakami E, Aizawa T, Kurosawa D, Noguchi K.Leg symptoms associated with sacroiliac joint disorder and related pain.Clin Neurol Neurosurg. 2017;157:55-58. doi:10.1016/j.clineuro.2017.03.020
Cheng J, Chen SL, Zimmerman N, Dalton JE, LaSalle G, Rosenquist R.A new radiofrequency ablation procedure to treat sacroiliac joint pain.Pain Physician. 2016;19(8):603-615.
Yale Medicine.Sacroiliac joint fusion.
Asada M, Tokunaga D, Arai Y, et al.Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis.J Belg Soc Radiol. 2019;103(1):36. doi:10.5334/jbsr.1648
National Library of Medicine.Sacroiliac joint injury.
Wieczorek A, Campau E, Pionk E, Gabriel-Champine M, Ríos-Bedoya C.A closer look into the association between the sacroiliac joint and low back pain.SMRJ. 2021 Apr;6(1):1-6. doi:10.51894/001c.21971
Siahaan YMT, Hartoyo V.Sacroiliac joint pain: a study of predisposing factors in an indonesian hospital.The Open Pain Journal. 2019;12(1). doi.10.2174/1876386301912010001
Lee A, Gupta M, Boyinepally K, Stokey PJ, Ebraheim NA.Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment.Adv Orthop. 2022;2022:3283296. doi:10.1155/2022/3283296
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