Introduction
The sacroiliac (SI) joint plays a crucial role in connecting the spine to the pelvis, providing stability and flexibility. Sacroiliac joint pain can occur when this joint becomes irritated or inflamed, often due to poor alignment, injury, or repetitive strain. Fortunately, specific exercises and stretches can relieve SI joint pain by stabilizing and strengthening surrounding muscles and ligaments. This guide provides an overview of SI joint anatomy, effective exercises, and stretches that can help alleviate discomfort.
Understanding Sacroiliac Joint Anatomy
To effectively target SI joint pain, it’s essential to understand the anatomy of the joint and its surrounding structures.
The SI Joint Itself
Structure: The SI joint links the sacrum (base of the spine) to the iliac bones (part of the pelvis).
Function: Primarily responsible for transferring weight and stabilizing the pelvis.
Characteristics: Unlike most joints, the SI joint has limited movement, primarily stabilizing and supporting the upper body.
Ligaments Supporting the SI Joint
Ligaments of the sacroiliac joint. The interosseous ligament is covered by the posterior sacroiliac ligament.
- Anterior Sacroiliac Ligament: Stabilizes the front of the joint, preventing excessive movement.
- Posterior Sacroiliac Ligament: Located at the back of the joint, it provides added stability and strength.
- Interosseous Ligament: Positioned deep within the SI joint, this ligament is one of the strongest and adds robust support to the joint.
Muscles Influencing SI Joint Stability
Following are the five major muscles / muscle groups of sacroiliac stabilization that should be assessed and likely worked with manual therapy when the client presents with a sacroiliac joint condition.
- Piriformis
- Gluteus Maximus (superior deep fibers)
- Coccygeus and Levator Ani
- Paraspinals
- Hamstrings
- Gluteus Maximus and Gluteus Medius: Stabilize the pelvis and hip, essential for balanced SI joint movement.
- Hip Flexors (Iliopsoas): Connect the lower back to the hips and influence the anterior pelvic tilt.
- Hamstrings and Quadriceps: Support leg and pelvic stability, impacting SI joint alignment.
- Core Muscles (Rectus Abdominis, Transversus Abdominis, and Obliques): Provide lumbar and pelvic support, reducing strain on the SI joint.
SI Joint Pain Relief: Exercises and Stretches
These exercises and stretches target the muscles and ligaments supporting the SI joint, helping to alleviate pain by enhancing stability and flexibility.
Pelvic Tilts
- Description: Lie on your back with knees bent and feet flat on the floor. Gently tilt your pelvis by pressing the lower back against the floor, then release.
- Targeted Areas: Core muscles and lower back.
- Benefits: Stabilizes the lower back, increases core strength, and relieves pressure on the SI joint.
- Muscles Targeted: Rectus abdominis, transverse abdominis.
Knee-to-Chest Stretch
- Description: Lie on your back and bring one knee toward your chest, holding for 15–20 seconds. Repeat on the other side.
- Targeted Areas: Lower back and glutes.
- Benefits: Lengthens the lower back muscles and reduces tension around the SI joint.
- Muscles and Ligaments Targeted: Gluteus maximus, lower back extensors, and posterior sacroiliac ligaments.
Piriformis Stretch
- Description: Cross one leg over the opposite knee while lying down, and gently pull the knee toward your chest.
- Targeted Areas: Piriformis muscle and gluteal region.
- Benefits: Alleviates SI joint pain caused by tight piriformis muscles, which can contribute to sciatic pain.
- Muscles Targeted: Piriformis, gluteus maximus, and medius.
Glute Bridge
- Description: Lie on your back with knees bent and feet hip-width apart. Raise your hips toward the ceiling, squeezing your glutes, then lower back down.
- Targeted Areas: Glutes, hamstrings, and core.
- Benefits: Strengthens the gluteal muscles and stabilizes the pelvis, relieving SI joint strain.
- Muscles and Ligaments Targeted: Gluteus maximus, posterior sacroiliac ligaments, hamstrings.
Child’s Pose
- Description: Kneel on the floor and sit back on your heels, extending your arms forward and lowering your chest.
- Targeted Areas: Lower back, glutes, and hips.
- Benefits: Stretches and relaxes the lower back, reducing tension in the SI joint.
- Muscles Targeted: Latissimus dorsi, gluteus maximus, lower back muscles.
Bridge Pose
- Description: Kneel with one knee on the ground and the opposite foot forward. Push your hips slightly forward and hold.
- Targeted Areas: Hip flexors, lower back, and pelvis.
- Benefits: Reduces anterior pelvic tilt, alleviating stress on the SI joint.
- Muscles and Ligaments Targeted: Iliopsoas, anterior sacroiliac ligament, and rectus femoris.
Benefits of Sacroiliac Joint Exercises and Stretches
By incorporating these exercises, patients can experience significant improvements, including:
- Increased SI Joint Stability: Strengthening surrounding muscles reduces excessive movement, decreasing SI joint pain.
- Improved Flexibility: Stretching exercises relieve stiffness and enhance movement around the pelvis and lower back.
- Pain Reduction: Regular stretching and strengthening can alleviate inflammation and discomfort in the SI joint.
- Enhanced Posture and Core Support: A stronger core and improved posture relieve pressure on the SI joint, reducing pain in daily activities.
Who Is a Good Candidate for SI Joint Pain Exercises?
While most people can benefit from SI joint exercises and stretches, they are particularly helpful for individuals who:
- Experience Persistent Lower Back Pain: Especially those with pain localized near the buttocks or hips.
- Have Diagnosed SI Joint Dysfunction: Exercises can help stabilize the joint and reduce discomfort.
- Engage in Sedentary Activities: People who sit for prolonged periods are at higher risk of SI joint stiffness, which can benefit from these stretches.
- Are Recovering from Injury: Those with previous injuries in the lower back, hip, or pelvis may benefit from gentle exercises to regain strength and mobility.
Consulting with a Professional
If you are new to these exercises or experiencing severe pain, consulting a physical therapist or medical professional is advised. At Alleviate Pain Clinic, we specialize in personalized treatment plans, including physical therapy and guided exercises to support SI joint health and alleviate pain.For those with sacroiliac joint pain, these exercises and stretches provide a natural, effective approach to relieve pain and improve joint stability. Try incorporating these techniques into your daily routine and experience the benefits of a stronger, more stable lower back and pelvis.
