Sacroiliac (SI) Joint Pain: 9 Exercises to Relieve Discomfort

If you’ve ever experienced a dull ache or sharp pain in your lower back, hips, or butt, you might be dealing with sacroiliac (SI) joint pain. 

You have two SI joints — one on each side of your sacrum, the triangular bone that sits below your lumbar spine (low back). The SI joints connect your spine to your pelvis and help keep your body stable. 

When an SI joint becomes irritated, it can cause one-sided lower back and butt pain known as SI joint pain (or sacroiliitis). It’s easy to mistake SI joint pain for low back or hip pain, or even sciatica. But if you suspect your pain could be due to irritation or inflammation in your SI joints, you’re in the right place. Movement is one of the best ways to ease SI joint pain, and targeted exercises and stretches can help a lot. 

Read on to learn about the SI joint pain stretches and exercises Hinge Health physical therapists recommend. 

Interested in getting a personalized exercise therapy plan? Learn more about Hinge Health’s digital physical therapy programs and see if you’re eligible.

9 SI Joint Pain Exercises 

The following SI joint pain exercises are recommended by Hinge Health physical therapists to strengthen the muscles around your SI joint, promote flexibility, and help you move with less pain.

“This amazing exercise targets your glutes and hamstrings, which are really important for stabilization of the SI joint,” explains Nikki Bond, PT, DPT, a physical therapist at Hinge Health. Hip thrusts also activate and help strengthen your core. A strong core helps SI joint pain because improved strength and stability around the SI joint means there’s more support in the area, explains Dr. Bond. The pelvis and SI joints are key to maintaining your center of gravity. While these joints are designed to move a little bit, their stability enables you to shift weight and transfer force between your legs and trunk.

How to do it:

• Sit on the floor and lean your back against a couch with the bottom of your shoulder blades resting near the top of the couch cushion. Your knees should be bent with your feet flat on the floor, hip distance apart. 

• Push through your feet to lift your hips off the floor.   

• Lower your butt down to the floor. 

• PT Tip: You can increase the difficulty of this exercise by placing a resistance band around your thighs, or decrease the difficulty by doing a traditional glute bridge.

Get more information on how to do a hip thrust.

This move stretches your glutes and low back muscles. Tightness in these muscles can sometimes put strain on the SI joint and contribute to pain. “You can do this stretch on the floor or lying on a bed or sofa — whatever is most comfortable,” says Dr. Bond. 

How to do it: 

• Lie on your back with your legs straight and relaxed. 

• Lift one leg up toward your chest, bending your knee and holding the back of your thigh with your hands. 

• Gently pull your leg closer to your chest. 

• Relax your leg back to the starting position.

This move works your hamstrings, which are the muscles on the back of your thigh. “When your hamstrings get too tight, they can cause pain in the SI joint, changing how you move because of the pain,” says Dr. Bond. 

How to do it: 

• Sit at the edge of a chair and straighten one leg out in front of you while resting your heel on the floor. 

• Hinge at your hips to lean your chest toward the floor and hold. 

• Return to the starting position. 

• PT Tip: You can modify the stretch by lying on your back and doing it. 

Get more information on how to do a seated hamstring stretch.

“This is a sneaky thigh strengthener and balance exercise that is great for improving gluteus medius strength, which plays a really big role in supporting your pelvis and adding strength to the outside of the hip,” explains Dr. Bond. 

How to do it: 

• Stand with a looped resistance band placed around your knees and your feet hip-width apart. 

• Bend your knees to lower yourself into a mini squat.

• While you hold the squat position, step one foot directly out to your side, stretching the band. 

• Slowly step your foot back, and then repeat with your other leg.

“The dead bug works your deep abdominal muscles, which offer significant support throughout your core, including the SI joint,” explains Dr. Bond. Core weakness can be a contributor to SI joint pain, and strengthening your core muscles can go a long way in relieving pressure on your back. 

How to do it: 

• Lie on your back with your arms extended toward the ceiling and your knees bent 90 degrees, feet lifted off the floor. 

• Reach one arm straight back by your ear as you extend the opposite leg toward the floor. Your extended arm and leg shouldn’t touch the floor, but hover several inches above it.

• Slowly return your arm and leg to the starting position and repeat on the opposite side.

• PT Tip: Focus on keeping your back flat on the floor (don’t let it arch up) and keeping your core muscles tight as you extend your arms and legs.  

Get more information on how to do a dead bug.

This is an abdominal strengthening exercise that also improves back extension strength and glute strength, essentially targeting your front and back pelvic stabilizing muscles. (It’s kind of like a dead bug done from all fours.)

How to do it: 

• Get into a comfortable position on your hands and knees with your hands below your shoulders and your knees under your hips.

• Lift and extend one leg behind you while you reach your opposite arm off the ground. Your leg and arm should form a straight line with your back. 

• Return to the starting position.

• Repeat on the opposite side, lifting your other arm and leg off the floor. 

• Return to the starting position.

Get more information on how to do a bird dog.

This move strengthens your oblique and core muscles, as well as your outer hip muscles. This improves pelvic stability and reduces strain on the SI joint.

How to do it: 

• Lie on your side with your knees bent and your legs stacked. 

• Place your forearm on the floor, under your shoulder. 

• Push through your knees, lower legs, and forearm to lift your hips up toward the ceiling. Focus on squeezing your core muscles as you hold this position. 

• Lower your hips back to the floor.

“This is a great stretch for the low back muscles that attach to your pelvis and SI joint,” says Dr. Bond. “These muscles can get tight if you sit a lot, or spend too much time in the same position, such as leaning forward to look at a computer screen.” 

How to do it: 

• Begin on all fours with your wrists under your shoulders and your knees under your hips. 

• Look over and behind one shoulder toward your foot, allowing your hips to tilt a little in the opposite direction. 

• Return to the center. 

• Repeat on the opposite side.

This targets the piriformis muscle, which attaches to the sacrum (triangle-shaped bone at the base of your spine) and the femur (thigh bone). “The sciatic nerve travels below or through this muscle. Tightness here is a common contributor to low back pain,” explains Dr. Bond. Stretching this muscle and keeping it loose is super helpful in preventing and treating low back pain.

How to do it: 

• Sit in a chair with one foot resting on your opposite thigh. Your other foot should be resting flat on the floor.

• Hinge at your hips by moving your chest toward the floor until you feel a stretch in your leg or hip. 

• Return to your starting position. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Personalizing Your SI Joint Pain Stretches

Note: Some of these moves may feel challenging if you’re dealing with pain flares in your SI joint. On the other hand, if you’re doing these moves proactively to prevent pain, some may feel subtle or too easy. Working with a Hinge Health physical therapist can help make sure your exercises are the right amount of challenge for you. 

Benefits of SI Joint Pain Exercises 

The right exercises can make a big difference in managing and alleviating SI joint pain. Not only can they help you feel better in the short term, but they also promote long-term joint health by improving strength, flexibility, and stability. Here’s more on the benefits of doing SI joint pain exercises. 

• Improved pelvic stability. Strengthening the muscles around your pelvis, such as the glutes and core, helps support the sacroiliac joint. This reduces excessive movement and strain on the joint, which can alleviate pain.

• Enhanced core strength. A stronger core supports your spine and pelvis and stabilizes the SI joint during movement, helping to protect against pain flare-ups or discomfort.

• More comfortable posture. Many SI joint exercises target core and pelvic muscles. While there’s no such thing as perfect posture, strengthening these areas does help you change positions frequently and find postures that work for you. This helps ease pressure on your SI joint and improve overall spinal health.

• Increased flexibility. Exercises that stretch the hamstrings, hip flexors, and lower back can improve flexibility, relieving tension in muscles connected to your pelvis, which can affect SI joint pain.

• Injury prevention. Strengthening the muscles that support the SI joint lowers the risk of injury by promoting healthy movement patterns and relieving stress on the SI joint.

• Reduced risk of muscle imbalances. SI joint exercises often involve strengthening both sides of the body equally, helping to correct muscle imbalances that can contribute to joint pain.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Kiapour, A., Joukar, A., Elgafy, H., Erbulut, D. U., Agarwal, A. K., & Goel, V. K. (2020). Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain. International Journal of Spine Surgery, 14(1), S3–S13. doi:10.14444/6077

2. Nejati, P., Safarcherati, A., & Karimi, F. (2019). Effectiveness of Exercise Therapy and Manipulation on Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Pain Physician, 22(1), 53–61. 

3. Yan, H., Zhao, P., Guo, X., & Zhou, X. (2024). The effects of Core Stability Exercises and Mulligan’s mobilization with movement techniques on sacroiliac joint dysfunction. Frontiers in Physiology, 15, 1337754. doi:10.3389/fphys.2024.1337754