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Sacroiliac (SI) joint pain is a frequent source of lower back, hip, and pelvic discomfort, but it is often overlooked or mistaken for other spine or hip conditions. The SI joint, at the junction where the spine meets the pelvis, plays an essential role in transferring force from the upper body to the legs. When this joint becomes irritated or unstable, everyday movements such as standing, walking, or rolling over in bed can become painful.
In many cases, SI pain is caused by instability rather than stiffness. This is why traditional stretching routines often fail to provide relief and may even worsen symptoms. A stabilization-based approach focuses on supporting the joint through controlled muscle activation rather than forcing additional movement through an already-stressed area.
Exercise can be an effective part of managing SI joint pain, but it is not always the only solution. Persistent or worsening symptoms may require further evaluation, and in some cases, medical treatments such as an SI injection are used alongside targeted exercises to improve pain control and function.
The SI joint is not meant to move like the hip or spine. Its primary function is stability, acting as a shock absorber and force transmitter between the torso and lower body. It allows only a few degrees of movement, just enough to adapt during walking and bending.
A common mistake people make is assuming SI pain comes from tight muscles or a lack of flexibility. As a result, they focus on aggressive hamstring stretching, deep spinal twists, or mobility drills. These approaches can increase stress across the SI joint and worsen symptoms.
When stabilizing muscles such as the glutes, deep core, and pelvic stabilizers are not doing their job, the SI joint absorbs excessive load. Over time, this instability leads to inflammation, recurring SI pain, and difficulty with daily activities.
SI joint pain related to instability often follows recognizable patterns. Common signs include:
If symptoms are persistent, severe, or unclear, it is essential to confirm the diagnosis before starting exercises. A healthcare provider may recommend physical testing, imaging, or diagnostic SI injections to rule out hip or spine conditions.
The glute muscles are one of the most important protectors of the SI joint. When they activate properly, they help control pelvic motion and reduce stress on the joint.
How to perform it correctly:
Common errors to avoid: arching the lower back, pushing through the feet instead of the glutes, or lifting too high. These mistakes can shift stress back onto the SI joint.
The bird dog trains coordination between opposite sides of the body, which improves pelvic control during walking and standing.
Slow, controlled movement is more effective than speed or high repetitions. This exercise reinforces stability patterns that the SI joint relies on during daily movement.
The gluteus medius plays a key role in preventing uneven loading across the pelvis.
This exercise helps balance pelvic forces and reduce strain on the SI joint. Resistance bands can be added later, once pain levels are stable.
Deep core muscles help limit unwanted motion through the SI joint.
Safer plank options include:
Planks should feel controlled and steady. If you experience pelvic shifting, sharp pain, or loss of form, this movement should be avoided or modified.
Specific exercises can aggravate SI pain, especially during flare-ups. These include:
Trying to “stretch the SI joint” can backfire. The joint benefits far more from support and control than from increased mobility.
Exercises should reduce pain during daily activities such as walking or standing. If symptoms worsen during or after workouts, volume or intensity may need to be adjusted.
Exercise may not fully resolve SI pain if:
In these cases, physical therapy, diagnostic imaging, or an SI injection may be recommended. Injections can reduce inflammation and confirm the source of pain, allowing stabilization exercises to be more effective.
Chronic SI pain is best managed using a multidisciplinary approach, which may include:
Because SI pain can mimic hip, disc, or nerve-related issues, precise diagnosis is essential for long-term improvement.
Effective SI joint pain relief depends on stability, not excessive movement. Targeted exercises that improve core and glute strength help the SI joint function properly and reduce repeated strain, while aggressive stretching or impact activities can worsen symptoms.
Proper evaluation plays a critical role in successful treatment. At Apex Interventional Pain & Spine, our team takes a thorough approach to identifying SI joint pain and determining whether conservative care, physical therapy, or interventional treatment is needed.
If ongoing SI pain is limiting your mobility or comfort, contact us today to explore a treatment plan designed around your specific needs.FAQs
Yes. SI pain often radiates to the hip, buttock, groin, or upper leg.SI joint pain typically worsens with weight-bearing and improves with rest or compression.Ice is usually helpful during flare-ups, while heat may relax surrounding muscles once pain decreases.Yes. Hormonal changes and pelvic stress can increase SI joint instability during and after pregnancy.Poor posture can contribute to altered pelvic alignment and muscle activation over time.
