Back & Neck Pain Exercise Exercises to Relieve Sacroiliac Joint Pain By Anne Asher, CPT Anne Asher, CPT Facebook LinkedIn Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Learn about our editorial process Updated on February 06, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Grant Hughes, MD Medically reviewed by Grant Hughes, MD LinkedIn Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle's Harborview Medical Center. Learn about our Medical Expert Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process Print You have two sacroiliac (SI) joints, one on each side of your spine at the base where it connects to your pelvis. Their job is to support and stabilize your spine when you walk, climb stairs, bend, and lift heavy objects. Damage or injury to your SI joints can make your legs unstable. This often results in lower back pain. SI joint pain is common, but there are a handful of ways it can be treated, from physical therapy to back braces to surgery. Some people find that gentle stretches and exercises that build strength are enough to improve their symptoms. This article discusses the causes and symptoms of SI joint pain along with ways it can be treated. It also includes a list of exercises and stretches you can try at home to strengthen your SI joints and relieve pain. Anupong Thongchan / EyeEm / Getty Images What Is Sacroiliac Joint Instability? If one or both of your SI joints gets injured, they can become weak and unstable. It can cause you to have too much joint movement (hypermobility) or too little movement (hypomobility). This injury is called sacroiliac joint instability or sacroiliac joint dysfunction. You can think of your SI joints as your body's shock absorbers. When you walk, run, or jump, the joints distribute stress across your pelvis and lower body. In doing so, they take pressure off your spine to protect it and keep it stable. Without your SI joints, you would fall forward when you walk or run. Injured and inflamed SI joints are unable to evenly distribute stress across your pelvis. Instead, the stress falls onto your pelvic joints and surrounding tissues, causing pain and other symptoms. People with SI joint injuries may feel that their legs are unstable. They may buckle or give way, for example, when the person bends forward, twists, walks upstairs or uphill, or stands from a chair. What You Need to Know About Sacroiliac Joint Pain Symptoms It's estimated that SI joint instability is the cause of pain in 10% to 25% of people with low back pain. The pain tends to be centered in the lower back, groin, hips, or tailbone. Some people feel dull and achy pain, while others feel sharp, stabbing pain that radiates into their thigh, knee, or foot. Other possible symptoms of SI joint instability include: Numbness or tingling Weakness Leg instability Trouble sleeping due to pain and discomfort Trouble sitting for long periods of time Pain when standing from a seated position SI joint instability may be confused for sciatica or lumbar disc herniation at first, as the symptoms are similar. It's important to see your doctor if you are having the symptoms listed above so that your injury gets the right treatment. First Steps to Treatment with Low Back Pain and Sciatica Risk Factors You can injure or damage your SI joints in an abrupt injury or accident. Or, they may become damaged over time due to aging, chronic illness, or overuse injury. An overuse injury happens when too much stress is repeatedly put on the SI joints over time. Overuse injuries are common among athletes who endure intense, long-term training. Your risk of SI joint injury may higher if: You are pregnant. You are overweight. You have injured your lower back in the past. You exercise more than four times per week. You sit more than six hours per day. Your job puts you at risk for back injury. SI joint instability seems to affect women more than men. One small study from 2021 found that, out of 84 people being treated for low back pain, 69% of those with SI joint instability were women. About 49% of the group were between the ages of 45 and 64. Recap SI joint instability causes pain and weakness in your lower back, hips, and legs. You may have a higher risk for this injury if you are an athlete, pregnant, or have a chronic bone or joint disease like scoliosis or arthritis. Everything to Know About Bone Diseases Treatments In addition to the pain that SI joint instability causes, many people report that it can make many daily activities more difficult. The good news is that, because SI joint instability is so common, there are many treatment options. Treatment aims to reduce inflammation, restore mobility, and stabilize the SI joint. Surgery normally isn't the first option your doctor will consider, but they may suggest it if all other treatment options fail. Possible treatment options include: Cold and warm compresses: Alternate between applying a warm compress and a cold compress to relieve inflammation and pain. Take care to never apply heat or ice directly against your skin. Over-the-counter (OTC) medication: When you need it, take an OTC pain reliever that reduces swelling, such as ibuprofen (Advil), or naproxen (Aleve). Manual manipulation: Contact a chiropractor who can adjust your SI joint to relieve your pain and restore joint stability. Physical therapy: For chronic SI joint pain, gradual physical therapy can help strengthen the muscles around the joint, restore stability, and speed healing. Water therapy: Doing physical therapy exercises in the water is a low-impact way to build strength around your SI joint and help stabilize it. Back braces: If your SI joint pain stems from hypermobility, your physical therapist or chiropractor may recommend a back brace or support. This will stabilize your SI joint so that it can heal. Sacroiliac joint injections: Your doctor may also recommend sacroiliac joint injections to relieve pain. This consists of a steroid and local anesthetic administered into and around the SI joint. Radiofrequency ablation: For this minimally-invasive procedure, a surgeon will use radio waves to heat and disable certain nerves that transmit pain signals from the lower back to the brain. Fusion surgery: In this procedure, a surgeon will fuse one or both SI joints together to restore stability. With your doctor's approval, there are numerous stretches and exercises you can try at home to ease your symptoms. Recap The right treatment for your SI joints depends on how severe your symptoms are and what problems they cause you. People who have chronic pain and instability may need physical therapy or fusion surgery. People with mild symptoms may be able to ease their pain with gentle stretches, warm and cold compresses, and OTC pain relievers. Exercises That Help SI Pain A consistent stretching and exercise program can help strengthen, stabilize, and repair an injured SI joint. The program should include a combination of: Stretching: To improve mobility by loosening up any tight muscles in your back, hips, or buttocks that may be placing extra stress on your SI jointStrength building: To stabilize your SI joint by strengthening the muscles that support it, including your core, gluteus (butt muscles), and thigh musclesCertain light aerobics: To improve blood flow so that oxygen and nutrients can repair soft tissues in the SI joint Exercises therapies for SI joint pain aren't meant to push you too hard. You should avoid anything that triggers your pain or makes it worse. If at any point you feel that your pain gets worse or your SI joint feels weak, stop what you are doing, take a rest, and remove the painful exercises from your routine. Doing the wrong exercises could worsen your pain or cause more injury, so it's important to consult with your doctor before getting started. How Do You Know if You Need Physical Therapy? 1 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. Rest your SI joints by lying face-up on your back. This is called lying in supine position. It provides a lot of back support. It also releases excess tension in your back, which contributes to misalignment. How to Do It In the supine position, bend your knees and place your feet flat on the floor. Gently grasp one knee and bring it towards your chest. Don't worry, you don't have to get your knee all the way to your chest. Only go as far as you can without pain. Hold the position for a second or two. Then set your foot back down 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. 2 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. How to Do It Start in the supine position with bent knees and feet flat on the floor. Bring one knee towards your chest just as you did in the exercise above.Keeping that knee there, do the same move with the other leg.Grasp both legs just below the knees and pull them towards you.Hold for a second or two. Then lower the legs one at a time. 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 make your SI problem worse. 3 Reset Your SI Joint nikitabuida / Deposit Photos To relieve some pain in your misaligned SI joint, you can try to reset it. This is done by triggering your adductors (inner thigh muscles). Some people report getting short-term relief from this move. 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): How to Do It Begin in supine with your knees bent and your feet flat on the floor. Place a soft ball or rolled up pair of socks between your knees.Very gently squeeze for a count of five and then slowly release. Do about three to five of these, but let your pain be your guide. 4 Stretch: Outer Hip Muscles Verywell / Ben Goldstein If you stand up straight and relax your arms down the side of your body, your fingers should just reach your outer 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. How to Do It Start in supine, with your knees bent and your feet flat on the floor.Place the ankle of one foot on the knee of the other.Wrap your hands under the supporting knee.Using your abs, gently lift the supporting knee off the floor, going only as high as you can without pain at the SI joint. Stay up for just a short time and set the leg down again. Do up to five of these and then rest. Repeat on the other side. Recap Gently reset your SI joints using adduction stretches. These moves entail bringing your leg toward the midline of your body. Adduction releases built-up tension, loosening your joints to help them realign. 5 Stretch: Twist Your Spine cirkoglu / Deposit Photos If your pain levels permit, you can move from the supine hook lying position (lying on your back with knees bent and feet on the floor) into a gentle spinal twist. How to Do It Start in supine position with straight legs.Keeping your shoulders flat on the ground, lift your knees, bend them to a 90-degree angle, then lower them to one side of your body.Move gently and monitor for pain. Stay only for a few seconds and bring your legs back up. Return to supine position.Repeat on the other side. 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. 6 Advanced Stretch: Quadriceps Verywell / Ben Goldstein Taking the tension out of your quadriceps muscles may help alleviate some of your SI pain. How to Do It In the image above, the model is demonstrating the easiest type of quadriceps stretch: Lie on one side. Then grasp your foot, ankle, or even your shin behind you.Pull your heel to your bottom.If you can't reach, consider tying a strap or belt around your foot and hanging onto the other side of the strap to pull your foot in. 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 Recap To help prevent injury, always warm up with gentle stretches. Take care to never stretch yourself to the point of pain. If your SI joints hurt or feel tense, stop what you are doing and lie flat on your flat in supine. 7 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. How to Do It Begin in supine position with your knees bent, feet flat beneath your knees, and arms by your side with your palms face down. Squeeze your glutes and keep your shoulders against the ground. Slowly lift your hips.Hold your hips in the air for five seconds.Keep your glutes squeezed as you slowly lower your hips to the ground. Repeat these steps eight to 10 times or until you feel any pain in your SI joint or knees. 8 Strengthen: 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. How to Do It Start on your hands and knees with your chin up, your back flat, and your eyes forward.Slowly arch your back up as you draw your chin towards your chest. Hold for two to five seconds.Slowly bring your chin away from your chest and return your eyes forward as you arch your back down. Hold for two to five seconds. 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. 9 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. This exercise helps stabilize your SI joint by strengthening your core, lower back, hips, and thighs all at once. How to Do It Start by standing with your feet slightly wider than hips-width apart and your arms by your side.Stretch your left hand to the sky.Slowly bend at the waist and bring your right hand towards your left ankle. If you can reach your ankle, go ahead. If not, reach for your calf or knee.Straighten your body back up to the standing position.Alternate sides by reaching your left arm towards your right ankle. 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. 10 Light Aerobic Exercises 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: Walking: This is the simplest way to raise your heart rate either by yourself or with a friend.Water aerobics: Swimming is one of the best low-impact exercises for people with chronic pain. If swimming doesn't work for you, try walking in the pool or wading while holding onto a raft.Stationary cycling: If you don't have a stationary bike at home, think about joining a class. Go at your own pace, and don't feel pressured to keep up with those around you.Tai chi: This gentle workout uses slow, controlled movements and relaxation techniques that stretch, strengthen, and get your blood flowing. When to Call Your Doctor Within three weeks of careful and consistent exercise therapy, you should start to notice your SI joint pain and instability improving. If you don't, let your doctor know so that they can reassess your symptoms and consider other treatment options. Summary Sacroiliac joint instability is a common source of lower back pain. It may start gradually or suddenly due to injury. Your doctor or physical therapist can treat the pain with a variety of options, from back braces and physical therapy to surgery. You can also improve your SI joint symptoms at home with stretches and exercises. Talk with your doctor before you start an exercise program to make sure it's right for you. Take care as well to avoid any exercises that worsen your symptoms. Frequently Asked Questions What other exercises are safe to do with SI joint problems? It can take some trial and error to find exercises that rehabilitate your SI joint without worsening your pain. Focus on strengthening the muscles that support your SI joint, particularly your core, gluteus, and thigh muscles. If you're not sure about an exercise, don't hesitate to ask your doctor's opinion. What exercises may aggravate SI joint pain? 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. Instead, try exercises that keep both of your feet planted on the ground. You should also avoid high-impact exercises like running or jump-roping, as well as cardio machines like treadmills or Stairmaster. Is swimming a good exercise for SI joint pain? 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. A Word From Verywell Explaining your pain to your doctors can be challenging, and you may not get the answers you need right away. Before you see your doctor, you may find it helpful to take notes about the pain you're feeling and what seems to trigger it. If the treatment your doctor offers doesn't improve your condition, let your doctor know so you can you find something that works. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Nejati P, Safarcherati A, Karimi F. Effectiveness of exercise therapy and manipulation on sacroiliac joint dysfunction: A randomized controlled trial. Pain Physician. 2019 Jan;22(1):53-61. Cedars Sinai. Sacroiliac joint dysfunction. Eniz D, Mayer J. Sacroiliac joint hypermobility biomechanics and what it means for healthcare providers and patients. PM&R. 2019 Apr;11(1):1-9. doi:10.1002/pmrj.12176 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 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. 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.