11 Sacroiliac Joint Pain Exercises for Relief and Strengthening

Lower back pain is one of the most common—and often debilitating—forms of pain experienced by adults.

The World Health Organization estimates that around 619 million people suffer from back pain around the world, and that number is calculated to rise to a staggering 843 million over the next few decades.

Among the various causes of back pain, injuries or damage to the sacroiliac joint is a frequent offender. In fact, one 2023 study estimated that around 25% of low back pain is directly linked to the sacroiliac joint.

In this post, we’ll take a look at what causes sacroiliac joint pain, and what you can do about it. We’ll focus particularly on SI joint pain relief exercises that will ease discomfort, improve mobility, and strengthen the muscles around this crucial joint.

By the end of this post, you’ll be armed with all the knowledge you need to better understand and manage pain from SI joint dysfunction or damage.

Understanding Sacroiliac Joint Pain

Causes of sacroiliac joint pain can fall into two categories:

• Traumatic. This includes strain or torsion from sudden or heavy lifting, indirect injuries (such as those sustained during a car accident), soft tissue injuries from falling onto your butt, or pelvic ring fractures.
• Atraumatic. This includes osteoarthritis, scoliosis, infection, previous lumbar fusion, spondyloarthropathy, enthesopathy, a discrepancy in leg length, and pregnancy.

While traumatic pain is more common amongst athletes, the atraumatic causes are more frequent in the general population.

Strain caused by too much stress or torsion (in the case of heavy lifting or car accidents), excessive weight (in cases of pregnancy), or imbalanced wear (in the case of a discrepancy in leg length) can damage supporting ligaments and surrounding tissue around the joint. It may also trigger muscle spasms, which can lead to a sharp, stabbing pain along with inflammation and reduced mobility.

The good news is that in some cases, the pain is improved as tissues recover, but recurrence is common without strengthening and mobility work. However, it will remain a “weak point” and be more likely to be injured in the future unless you take steps to address the issue.

To do that, you need to focus on doing two things: strengthening the muscles and increasing mobility and flexibility.

Stretching Exercise for Sacroiliac Joint Pain Relief and Strengthening

Let’s start off with the simplest and most effective exercises you can do to relieve pain and increase mobility: stretching.

Stretching before your workout, training session, or work day will warm up the muscles, improve mobility which may reduce stiffness around your SI joints before you put them to work. This can reduce the risk of strain or torsion, effectively preventing back injuries. Stretching afterward, too, will work out any knots or kinks that may have formed, and will aid in easing tension in your muscles.

It’s particularly important to stretch before and after every workout. Use the following SI joint stretches as part of your exercise program to keep your lower back healthy and mobile!

Knee-to-Chest Stretch: Relieving Tension

The knee to chest stretch (and its double-leg version, the both knees to chest stretch) is highly effective at relieving tension in and loosening up your lower back muscles.

To perform this stretch:

• Lie on your back on a Yoga mat or soft pad.
• Extend your right leg.
• Bend your left leg, grip your shin in both hands, and gently pull your left knee up as close to your chest as you can.
• Hold for a count of 20, breathing deeply and slowly while you hold the stretch.
• Release and extend your left leg, and repeat with your other leg. Pull your right knee up to your chest and hold for a 20-count.
• Once you finish the right leg, wrap your arms around both legs and pull both knees to your chest for another 20-count.

If you’re feeling pain, stiffness, or soreness, this exercise may help ease that stiffness and improve mobility.

Figure-4 Stretch: Twisting and Pulling

The Figure-4 stretch (also called the piriformis stretch) will loosen up your hips, glutes, and hamstrings, which can get tight from prolonged sitting and thus create tension in your lower back.

To perform this stretch:

• Lie on your back on a Yoga mat or soft pad.
• Bend your right leg and place your right foot flat on the floor.
• Cross your left leg over your right, with your left ankle resting on your right thigh.
• Reach between your legs to grip your right thigh, and pull it toward your face.
• Stop when you feel tension in your hips (and glutes). Hold it there for a count of 15, pulling more with each breath out.
• Release your right leg, return your right foot to the floor, uncross your legs, and repeat on the left side.

Whether you’re heading off to work, out for a run, or into an intense training session, this stretch can help loosen hips and prepare your body for activity.

Cat-Cow Stretch: Enhancing Mobility in the Spine

The Cat-Cow stretch is amazing for increasing spinal mobility and alleviating low back pain. It’s one you’ll often be recommended to do following a lower back injury, a favorite of licensed physical therapists and chiropractors alike.

To perform this stretch:

• Get on your hands and knees, with your knees beneath your hips and your hands beneath your shoulders.
• Begin the stretch by lowering your head and moving your chin toward your chest, while arching your back as high as you can at the same time. Hold for a 2-count, then release and return to the neutral spine.
• Lift your head to tilt your face toward the ceiling, while rounding your spine and pushing your belly toward the floor.
• Keep your breathing controlled and steady through both poses, and your movements slow.

This simple stretch can be very helpful for many people with low back stiffness or mobility issues.

Standing Hip Flexor Stretch: Improving Flexibility

It’s not uncommon for tight hip muscles and flexors to impair mobility, which forces your body to adapt and utilize other muscles (like your lower back muscles) to compensate. This may aggravate SI joint pain or increase your risk of injury.

A basic stretch like the standing hip flexor stretch (also called the Lunge stretch) can help reduce tension and tightness in your hip flexors.

To perform this stretch:

• Start with your feet planted in lunge position, with your right leg in front and the left leg behind.
• Place your hands on your hips and consciously rotate so your upper body is facing fully forward. Sufficient pelvic rotation is crucial for an effective stretch. Lean back slightly to increase the weight on your back foot (and aid in rotation).
• Tuck your pelvis forward and begin to lower into the lunge position. Lower until you feel the stretch in your left thigh and hip flexors.
• Hold for 20 seconds, then switch legs and repeat on the right side.

This stretch is most useful after activity or as part of a flexibility routine.

Doorway Hamstring Stretch: Loosening Your Legs

Tight hamstrings are a common contributor to lower back injury. When you spend hours sitting down, your hamstrings are prone to stiffening and tightening, forcing your lower back muscles to compensate when you lift or move. This one simple stretch will counteract this tension in your hamstrings and allow for greater range of motion.

To perform this stretch:

• Lie on your back on a Yoga mat or soft pad placed in an open doorway.
• Extend your right leg through the doorway so it’s flat on the floor. Lift your left leg to place it against the doorframe.
• Scoot forward until your butt is as close to the wall as possible while your knee remains fully extended. Make sure to keep your foot flat—don’t point your toes.
• Hold the stretch for 20-60 seconds to begin, and repeat as tolerated.
• Release the stretch, adjust your position, and switch legs.

Do the five stretches above at least twice a day—either first thing in the morning, before your workout, or before bed—and you may see improvement in both your lower back mobility and a decrease in SI pain.

Strengthening Exercises for Core Stability

Weak core muscles can increase the risk of SI joint injury and back injuries as a whole…

When your core is unable to support the weight you’re better able to carry or hold a twisted position, the risk of torsion and strain drastically increases. Lack of abdominal strength may cause your back to compensate during a heavy lift, and can lead to injury or damage.

Strengthening all of your core muscles can help protect the SI joint and reduce risk of SI joint pain in the future.

Kettlebell Lateral Swings: Powering Rotation

Kettlebell Lateral Swings are an amazing exercise that will build strength in your abs, obliques, and lower back, specifically aiding in rotational movement of your upper body. It’s an intermediate-level exercise, but one you should absolutely incorporate to maximize twisting power.

To perform this exercise:

• Stand with your feet shoulder width apart, and a kettlebell placed on the ground on the outside of your right foot.
• Bend at the knees to a half-crouch, and reach your left hand across your body to grasp the kettlebell handle.
• In the same move, straighten to a standing position while swinging the kettlebell across your body and up to the height of your left shoulder.
• As the weight swings back down, bend your knees to lower to a half-crouch and let the kettlebell swing across to the right side of your body.
• Stop the swing at what feels like the most natural end of its trajectory, and start again.
• Repeat for 10 repetitions, then switch to the other side.

If you can master this exercise, it can improve your core strength, support safer rotational movements, and reduce risk of strain.

Glute Bridges: Activating the Glute Muscles

Your glutes work with your lower back muscles to support your spine. Strong glutes support pelvic stability and can help protect the SI joint. Glute bridges are one of the best bodyweight exercises to strengthen your glutes.

To perform this exercise:

• Lie on your back on a Yoga mat or soft pad with your knees bent and feet flat on the floor.
• Contract your core muscles to lift your butt off the ground until your body forms a straight line from your shoulders to your knees.
• Hold for 5-10 seconds.
• Rest for 60-90 seconds, then repeat for three sets.

Side-Lying Leg Raises: Strengthening Hip Abductors

Weak hip abductors may reduce stability and contribute to SI stress. Doing side-lying leg raises will target and strengthen your abductors marvellously.

To perform this exercise:

• Lie on your left side on a Yoga mat or soft pad, with your legs straight.
• Place your left arm beneath your head and your right hand on your hip.
• Lift your straight leg as high as feels comfortable, then slowly lower it back to starting position.
• Repeat 15 to 20 times, then switch sides. (Note: If this exercise feels too easy, you can add difficulty by using a cable machine or resistance bands.)

It’s a simple but immensely effective exercise to strengthen your hips and increase lower body mobility.

Pelvic Tilts: Alleviating Pressure on the SI Joint

Pelvic tilts are a great exercise to alleviate pressure on your SI joint, both loosening up your lower back muscles and building strength.

To perform this exercise:

• Lie on your back on a Yoga mat or soft pad.
• Bend your knees, place your feet flat on the floor, and extend your arms flat out to your sides.
• Tighten your core muscles to push your lower back flat against the mat. This will cause your pelvis to tilt and ease pressure on your spine.
• Hold for a 3-count, then exhale, release, and pause for a 2-count before contracting again.
• Repeat 15-20 times.

Wall Sits: Building Strength in the Lower Body

Wall sits are an isometric exercise that involves no motion of your joints, but which keeps the muscles contracted and thus builds strength. It’s a great option for anyone who doesn’t yet have sufficient strength to do more complex lunges or squats.

To perform this exercise:

• Stand with your back against the wall and your feet hip-width apart. Walk your feet forward until, when you bend your knees, your knees form a 90-degree angle with the wall.
• Use your leg muscles to press your back against the wall and slide down until you are “sitting” with your legs at a 90-degree angle.
• Hold for 30-60 seconds (as best you can), taking slow deep breaths steadily throughout.

It’s simple but incredibly effective at building lower body strength!

Yoga Poses for SI Joint Relief

We’ve already talked about one Yoga pose that’s great for SI joint relief (the Cat-Cow Pose), but there are a few more you may want to try to strengthen and stretch your lower back, including:

• Child’s Pose
• Pigeon Pose
• Bridge Pose
• Boat Pose
• Chair Pose
• Downward Dog
• Upward Dog
• Triangle Pose

The truth is that many Yoga poses can help with mobility, strength, and tension relief, though some movements may need modification for SI pain. They can help increase mobility in your entire body (upper body, core, and lower body), and build strength to protect your back against torsion damage and strain. Check with your healthcare provider to see if any of these are unsafe for your SI condition.

Tips for Safe Practice and Progression

A few things to keep in mind as you move through these stretches and exercises:

• Go slow. Take your time, and move slowly and steadily through each exercise. Rushing is how you compromise your posture and increase your risk of injury.
• Do as much as you can, and no more. Pushing your body too hard will, again, increase injury risk and compromise posture. Focus on getting it right rather than doing it for longer.
• Listen to your body. If you feel tightness, you can often breathe and stretch through it. If you feel pain, however, you’re pushing too hard or stretching too far.
• Stretch Regularly. Don’t just stretch once and forget. Make stretching an integral part of your day if your health condition permits. 
• Focus on your weak spots. When you hit the gym, take some time each week to target your core, hips, glutes, hamstrings, and other parts that may be weaker or tighter. Focus on the muscles you need to move efficiently, not just the ones that look good.

With these five tips, you can practice safely and make great progress in unlocking greater strength and range of motion in your lower back.

When to Consult a Healthcare Professional

While you may be able to manage or address a lot of your back pain at home, there are times when the injury or damage is serious enough to require medical intervention.

Contact your doctor, chiropractor, physical therapy specialist, or healthcare provider if:

• The pain grows too severe.
• Your mobility is drastically reduced.
• You notice fever or other signs of infection.
• You experience bladder or bowel control issues.
• You experience sudden numbness or weakness in your lower back or legs.
• You notice significant changes in your gait.
• The pain is persistent and takes longer than usual to heal.

Any of these are likely signs the damage to your SI joint is more serious than a minor tweak, spasm, or strain. In these cases, it’s best to get your doctors involved ASAP to address the issue before it grows more serious.

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Frequently Asked Questions 

What is the best position to sleep in with SI joint pain?

Typically, the best position to sleep in with SI joint pain is either on your unaffected side with a pillow placed between your knees to maintain spinal alignment, or on your back with a pillow beneath your knees to reduce pressure on your pelvis. Avoid sleeping on your stomach if at all possible.

Is walking good for sacroiliac joint pain?

Walking at a gentle pace can help reduce stiffness and maintain mobility, if tolerated. Walking will increase blood flow, loosen tension, and depending on your injury, could help your recovery. However, make sure to keep your walk slow, gentle, and only for short durations—don’t push so hard you cause the back pain to worsen. And as always, consult your doctor if you have any concerns.

Is a heating pad good for SI joint pain?

A heating pad or warm compress can be wonderful for alleviating back pain by loosening up tight muscles and getting blood flowing. However,experts recommend against using it in the first two days following injury. Instead, use cold packs to reduce swelling and spasms, then after a couple of days apply heat to speed up recovery.

Sources:

Sacroiliac Joint Pain

Sacroiliac Pain: Exercises

Sacroiliac Pain: Exercises

Sacroiliac Joint Pain Exercises & Stretches For Relief

Strengthening Exercises for Sacroiliac Joint Pain Relief