The Sacroiliac (SI) joint connects the lower spine to the pelvis and is located on each side of the sacrum spine between the two pelvic bones. The sacroiliac joint pain can be felt in your buttocks or lower back, groin, and can extend down one or both thighs. Prolonged standing, putting more weight on one leg, taking longer steps, lying on the involved side, or stair climbing can worsen the pain.
Sacroiliac joint pain results from injury of traumatic nature, arthritis, pregnancy, and less commonly by infections. As a result, the sacroiliac joint becomes either hypermobile(unstable), hypomobile (fixation), or malaligned. In pregnancy, the hormones cause the laxity or loosening of ligaments supporting the Sacroiliac joint leading to a hypermobile joint. The following exercises help with the SI joint pain relief.
- Bridging-This exercise helps to build strength in your glutes and lower back, helping to support the SI joint. Start with supine lying with knees flexed together and pointing towards the ceiling, arms by your side with palms facing down. Inhale and push through your heels, lift your lower back and hips, so that the whole body from knees to shoulder is aligned in a slanting line. Your body must be resting on your upper back and shoulders. Hold for 10-15 seconds and repeat ten times.
- Standing hip abduction with weights– Stand with a weight cuff tied above your ankle joint, lift the leg with the weight cuff sideways. Hold for 5seconds and return to the starting position. Repeat 10 times on each side.
- Hip Adductor Isometric Hold– Lie down on the back with both knees bent and place a medium rubber exercise ball or a pillow between the knees. Keeping the back slightly arched, squeeze the ball between knees for 10 seconds. Repeat 20 times.
- Bird Dog Exercises-This exercise will work your lower back and abdominal muscles to help gain stability of the lumbar spine. Go on to your hands and knees, keeping your shoulders over your hands and your knees spaced hip-width apart. Simultaneously straighten and raise your left leg and right arm, keeping your pelvis and shoulders in a neutral position. Hold for 5-10 seconds and go back to the starting position. Repeat on the other side.
- Knee to Chest Stretch– Lying on your back, pull one knee to the chest by grasping below the thigh. Keep the other leg straight. Hold for 10 seconds and repeat 10 times on each side.
- Lower Trunk Rotations-Lie on your back with knees bent and feet flat on the floor. Keep the shoulders flat on the ground. Gently rotate the knees to one side, hold for 5 seconds, and then move to the other side. Repeat 10 times on each side. Lower trunk rotation helps increase flexibility in your low back and hips, which may help relieve pressure on your Sacroiliac joints.
- Child pose of yoga-Get down on your hands and knees on the floor, with knees just under the hips. From this position, sit on your heels and outreach your arms with hands and forearms touching the ground. Hold this stretch for 15-30 seconds and repeat 3 times.
- Piriformis stretch--Lie on your back with knees bent and feet flat on the floor. Now place the ankle of one foot on the knee of the other. Wrap your hands under the supporting knee and lift the knee off the floor till you feel a little stretch type pain at your SI joint. Hold this stretch for 10-15 seconds and repeat 3-5 times.
- Hip Clams-Lie on your side with your knees bent and hips one over the other. Keeping your feet together, slowly raise your top knee toward the ceiling. Do not roll back. Hold for 5 seconds and slowly bring back knees together. Repeat 10 times on each side.
SI joint brace or belt can also be used to temporarily support the pelvis, in case of an unstable joint. It is wrapped around the hips to hold the SI joint tightly together and reduce pain.
- Avoid sitting with knees crossed that put uneven weight on one side.
- Avoid standing with the knees hyperextended and weight shifted to one side.
- Avoid stair climbing or walking up steep inclines.
- Don’t take longer strides.
- Avoid twisting to one side repetitively.
- Avoid sleeping on one side with a lack of support under the waist and between the knees.
- Exercises like heavy weightlifting, contact sports, and excessive biking should be avoided that put excessive pressure on Sacroiliac joints.
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