9 Best Stretches for Sacroiliac Joint Pain

7 Best Stretches for SI Joint Pain

Do you suffer from sacroiliac joint pain? If so, you’re not alone. Unfortunately, this type of pain is prevalent, especially among active people. The good news is that several stretches and sacroiliac joint pain exercises can help relieve the pain.

This blog post will discuss the nine best stretches for sacroiliac joint pain. We will also provide instructions on how to do each stretch correctly. So, if you’re looking for relief, keep reading!

What are the best SI joint stretches?

The best SI joint stretches address the muscles that surround the joint.  They include the hip rotators and the hip flexors.  Learning how to sit, stand, and sleep with SI joint pain will help with rest and healing.

What is the sacroiliac joint?

The sacroiliac joint is between the sacrum and the ilium bones of the pelvis. It is a robust and weight-bearing joint that helps to stabilize the pelvis. The joints are held together by ligaments and muscles.

What causes SI joint pain?

Anatomy of gluteus maximus, gluteus minimus, gluteus medius

There are several different ways that the sacroiliac joint can become injured or dysfunctional. The most common cause is an imbalance in the muscles and ligaments that support the joint.

The muscles that support the sacroiliac joint are the gluteus minimus and medius, the piriformis, the obturator internus and externus, and the quadratus lumborum. These muscles, when isolated, will rotate the hip, but with activities such as walking or running, these muscles will stabilize the pelvis.

The main ligaments of the sacroiliac joint are the posterior, anterior, and interosseous sacroiliac ligaments. The posterior sacroiliac ligament is the strongest of the three and runs from the back of the sacrum to the back of the ilium.

The anterior sacroiliac ligament runs from the front of the sacrum to the front of the ilium. The interosseous sacroiliac ligament is located between the two bones and runs diagonally from the front of the sacrum to the back of the ilium.

What are the different sacroiliac joint disorders?

There are many different diagnoses associated with sacroiliac joint dysfunction. These include:

Sacroiliitis

Sacroiliitis is inflammation of the sacroiliac joint and can be caused by infection, arthritis, or injury. The most common symptom of sacroiliitis is a pain in the lower back and buttocks. The pain may radiate down the leg and is often worse with activity or standing for long periods. Other symptoms can include stiffness in the lower back and difficulty moving the hips.

Sacroiliitis can be difficult to diagnose because the symptoms mimic other conditions, such as a herniated disc or spinal stenosis. An X-ray or MRI can often show joint changes, but these changes can also be seen in other conditions. A CT scan can confirm the diagnosis.

Sacral insufficiency fractures

These fractures occur when the pelvis’s bones cannot support the body’s weight. They are most common in postmenopausal women. Sacral fractures are a medical emergency as they can result in nerve damage. Therefore, it is essential to be evaluated by a doctor if you suspect the possibility of a sacral insufficiency fracture.

Pelvic instability

Pelvic instability is a condition in which the pelvis is not stable. It is caused by ligamentous laxity, muscle imbalance, or injury.

A physician typically diagnoses pelvic instability after taking a thorough medical history and completing a physical examination. Imaging studies, such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans, may also be used to confirm the diagnosis or rule out other potential causes of the pain.

Pelvic instability is a condition that can cause pain in the lower back and pelvis. It occurs when the sacroiliac joint connects the spine to the pelvis and becomes loose or unstable. This can happen due to injury, pregnancy, or other factors. Pelvic instability is often treated with a combination of physical therapy and medication.

Piriformis syndrome

Piriformis syndrome is when the piriformis muscle located in the buttocks becomes tight or spasms. The piriformis can compress the sciatic nerve and cause pain in the lower back and leg. Physical therapy, stretching, and massage can help treat this condition.

What are the symptoms and risk factors of sacroiliac joint dysfunction?

The most common symptom of sacroiliac joint pain is a dull, aching pain in the lower back or buttocks. The pain may radiate into the groin or thighs. Other symptoms include stiffness, instability, and difficulty walking.

There are several risk factors for sacroiliac joint dysfunction. These include:

Pregnancy or postpartum

The hormones relaxin and progesterone loosen the ligaments in the pelvis during pregnancy and can lead to instability in the joints and pain. The pain is often worse in the second and third trimesters.

Previous low back or pelvic surgery

If you have had surgery in the lower back or pelvis, it can lead to scar tissue and stiffness around the joints. In addition, changing the physiology of the region through surgery can put you at risk for sacroiliac joint dysfunction.

Trauma or injury

Any trauma or injury to the lower back or pelvis can put you at risk for sacroiliac joint dysfunction.

Arthritis

Arthritis of the spine or pelvis can lead to inflammation and joint pain.

How is sacroiliac joint pain diagnosed?

A physician typically diagnoses sacroiliac joint pain after taking a thorough medical history and completing a physical examination. In addition, standard orthopedic tests can diagnose sacroiliac joint dysfunction.

Orthopedic tests for sacroiliac joint pain include:

The Gaenslen test

The Gaenselen test is used to assess for pain in the SI joint. First, the patient lies on their back with their knees bent. The physician then places one hand on the patient’s lower back and pushes down while the other hand grasps the patient’s ankle and pulls up. This maneuver should reproduce the patient’s pain.

Patrick Faber test

This test is used to assess SI joint instability. The patient lies on their back with their knees bent and hips flexed to 90 degrees. The physician then grasps the patient’s knee and ankle on one side and lifts the leg while pressing down on the opposite side of the pelvis. This maneuver should reproduce the patient’s pain.

Sacroiliac Compression Test

This test is used to assess for SI joint inflammation. The patient lies on their back with their knees bent and hips flexed to 90 degrees. The physician then grasps the patient’s knee and ankle on one side and presses down on the opposite side of the pelvis. This maneuver should reproduce the patient’s pain.

Sacroiliac Brace Test

This test is used to assess for SI joint inflammation. The patient lies on their back with their knees bent and hips flexed to 90 degrees. The physician then places a hand on the patient’s lower back and presses down while the other hand grasps the patient’s ankle and pulls up. This maneuver should reproduce the patient’s pain.

The purpose of SI joint stretches

When the sacroiliac joint is painful, supporting its structures can provide relief. For example, stretching the hip rotator muscles and gently mobilizing the sacroiliac joint can help alleviate some of the pain (1). Sacroiliac joint pain exercises are also for strengthening and supporting the SI joint.

Gentle stretches that alleviate sacroiliac joint pain involve addressing the soft tissues of the area. Strengthening and exercises can also help alleviate chronic si joint pain.

Nine best stretches for sacroiliac joint pain

Hamstring stretch on the wall

Hamstring stretch on the wall

  • Sit with your hips as close to a wall as possible and shoulders flat on the floor.
  • Lie back and swing your legs up the wall.
  • Rest your heels on the wall.
  • If you feel increased tension in your hamstrings or behind your knees, soften your knees until the stretch is more comfortable.
  • If they’re not, straighten your legs. Let your arms rest by your sides, palms up
  • Stay in this pose for 30 seconds to 2 minutes
  • Repeat three to five times

Hip opener with spinal decompression

Hamstring and decompression stretch

  • Lay on your back in a comfortable positions
  • Slowly lift your left leg, bend your knee, and grab the heel of your foot with your left hand
  • Gently rest your left forearm on the inside of your left lower leg
  • Keep your right leg straight with your toes up
  • Gently straighten your left knee until you feel a stretch in the back of your left leg. You will most likely need to keep your left leg bent.
  • At the same time, push your right heel away from your body and feel slight traction on your low back
  • Hold 30 seconds to one minute
  • Repeat on the right side

Kneeling quadriceps stretch

Kneeling quad stretch for SI joint

  • Start in a kneeling lunge position with your right leg forward and left leg back. Your right knee should be at a 90-degree angle, and your left knee should be resting on the ground. Place your hands on your hips.
  • Keep your core engaged and tuck your pelvis under slightly, engaging your right glute
  • With your core and glute engaged, slowly lean forward and feel a stretch in the front of your right quad
  • If you are able, reach behind and grab your right ankle with your right hand, deepening the stretch (don’t worry if you can’t do this)
  • You will feel a deep stretch in the front of your right quad. Hold for 30 seconds to two minutes
  • Repeat three times on each side

Child’s pose

Child's pose for sacroiliac joint

  • Start kneeling with your hips over your knees and your forehead resting on the ground.
  • Extend your arms in front of you, palms resting on the floor.
  • Slowly begin to lower your torso and rest it between your thighs.
  • Your hips should remain over your knees, and you should continue to rest your forehead on the ground.
  • If you can, rest your forehead on the floor.
  • When you are in the position, focus on deep breathing and relaxing your whole body.
  • Gently reach to your left and right sides, feeling the stretch along the side of your body.

Sacroiliac joint mobilization

SI joint mobilization exercises

  • Start by laying on your back with your knees bent and together and with your upper body relaxed
  • Slowly and gently, allow your knees to fall to the right side, focusing on lower trunk rotation
  • Keep your left hip on the floor and feel a pull through your low back
  • With a continuous and slow movement, bring your knees back up to midline and then slowly allow them to fall to the left side, focusing on lower trunk rotation
  • Keep your right hip on the floor and feel the pull through your low back
  • Gently bring your knees up to midline again
  • This is a gentle mobilization exercise, and your movement should be slow, gentle, and continuous
  • Repeat 20 times

Piriformis stretch

Piriformis stretch for sacroiliac joint

  • Start by lying on your back with both knees bent, feet flat on the floor, and upper body relaxed
  • Cross your left ankle over your right knee
  • Use your left hand to grab hold behind your right thigh, just below the knee
  • Gently pull your right leg toward you while keeping your left ankle crossed over the right knee
  • You should feel a stretch in your left buttock
  • Hold for 30 seconds to two minutes, and then repeat on the other side
  • If you don’t feel a stretch, try moving your crossed ankle further away from your right knee
  • You can also place a pillow under your right knee for additional comfort.

Double knee to chest stretch

Double knee to chest stretch

  • Start by lying on your back with both knees bent and feet flat on the ground.
  • Place your hands on your lower legs, just above the knees.
  • Gently pull your knees toward your chest, using your hands for added pressure if needed.
  • You should feel a stretch in your lower back and buttocks.
  • Hold for 30 seconds
  • The knee-to-chest stretch will help decompress the low back and hips

Single knee to chest stretch

Single leg hip stretch

  • Start by lying on your back with both knees bent and feet flat on the ground.
  • Place your hands on your right lower leg, just above the knees.
  • Gently pull your right knee toward your chest, using your hands for added pressure if needed.
  • You should feel a stretch in your lower back and buttocks.
  • Slowly press your left heel away from you to add a little traction in the hip and low back
  • Hold for 30 seconds
  • Repeat both sides
  • The single knee-to-chest stretch will help decompress the low back and hips

Frequently Asked Questions

How do I get immediate relief from SI joint pain?

Medication is usually the fastest way to pain relief. NSAIDs (non-steroidal anti-inflammatory) medication found over the counter for SI joint pain relief can be very effective. However, if you have severe pain or OTC medication such as ibuprofen or naproxen is ineffective, consult your physician, and prescription medication may be necessary for SI joint pain relief.

What aggravates SI joint pain?

The most common movement that aggravates SI joint pain is twisting. However, other activities such as lifting, carrying, bending, and sitting for long periods can also exacerbate the SI joints.

How do I loosen my sacroiliac joint?

The sacroiliac joint is robust and normally stable. However, it is challenging to mobilize it independent of manual manipulation and therapy. The best way to add movement to the sacroiliac joint is to perform gentle mobilization exercises such as those listed above and stretch the surrounding muscles.

Conclusion

There are a few stretches that can help alleviate SI joint pain. These stretches should be gentle and slow and focused on mobilizing the sacroiliac joint. If you have severe pain, consult your physical therapist or physician for professional medical advice.

Stretching and exercise are essential to relieve pain in the sacroiliac joints, but medication may be necessary for severe cases. Consult your physician if over-the-counter options are ineffective.

Avoid any movement that aggravates the SI joint, and focus on gentle mobilization exercises. With proper treatment, you can find relief from SI joint pain.

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