The sacroiliac (SI) joint is a strong, powerful joint that connects the upper body to the lower half of the body via the sacrum, which is the bottom bone of the spine, and the ilium, which is part of the pelvis.

The joint is not responsible for a great deal of movement, but its main job is to transfer the weight and movements of the upper body to the legs.

How does it get injured?

Since these joints carry and transfer all the weight of the upper body, the cartilage that cushions the joint can wear away and cause SI joint problems. But many other conditions cause SI joint pain: arthritis (degenerative, osteoarthritis, psoriatic and rheumatoid), spondylitis, gout, and, of course, just getting older.

Hormonal changes during pregnancy cause ligaments to relax, and with an extra human to carry around on the pelvis, the SI joint pain is a common symptom.

Trauma to the lower back or tailbone, a difference in leg length, an abnormal gait, being bow-legged, and pain in knees or foot problems that lead to compensation can also cause SI joint pain.

Major symptoms of SI joint problems:

  • Lower back pain
  • Numbness, tingling, or weakness in lower extremities
  • Pain in the hip, pelvis, buttock or groin
  • Pain while standing
  • Leg instability
  • Unable to sleep on a certain hip for a long period
  • Unable to sit for long periods on one side

Treatment options

Several options exist for the treatment of SI joint pain:

Ice, heat, and rest are always good. Start out with icing until inflammation reduces. Using heat right away may ease sore muscles but cause more swelling.

Medication like over the counter anti-inflammatories over several days can reduce pain and inflammation.

Chiropractic manipulations help with joint issues stemming from unaligned hips, leg length difference, lower back issues.

If the joint issues are more extreme, supports or braces may aid in supporting the upper body and ease the stress on the SI joint.

Physical therapy and exercise are key to all Si joint issues. The best way to keep a joint healthier is regular exercise and stretching to strengthen the muscles around the joint.

Sacroiliac joint injections are also an option. Usually done outpatient in a doctor’s office, the joint is injected with a steroid to combat the inflammation.

Exercises and stretches to strengthen and prevent further injury

Core or abdominal muscles, hip extensors, abductors, external rotators, and the muscles in the lower back form a group of muscles that affect the health of the SI joint. To prevent or minimize SI joint issues, these muscles surrounding the joint need to be strengthened.


With all exercises, try to do three sets of each exercise, with each set consisting of 12-15 reps for maximum benefit. Beginning with one set is okay. As you strengthen, you will work into more sets.

Hip Extensions

  • Stand with one foot slightly off the floor. If needed, balance yourself on a sturdy chair or wall.
  • Extend the leg that has the suspended foot back.
  • Hold for a second or two.
  • Return leg to the starting position.


  • Begin this exercise by lying face-down on the floor.
  • Extend your arms above your head.
  • Slowly raise your legs and arms just off the floor, your face down and do not tense your neck.
  • Count to 10 then return to the starting position,


  • Start with your feet hip-width apart and your toes pointing slightly out to each side. Keep your back straight.
  • Slowly bend your knees and lower yourself down into a sitting position. Knees should not extend, and your buttocks should stick out when you squat.
  • Hold for a few seconds and return to a standing position.

Squats can be done with weights or without weights, but if just starting out, your body weight will be enough.


  • Stand with your feet together.
  • Step forward with one foot and bend the knee as you move your hips forward. Lower yourself down, keep your back straight and your hips forward.
  • Raise yourself back up to your starting position.


Along with strengthening the surrounding muscles, stretching is equally important to keep the joint flexible.

  • Knee-to-Chest Stretch
  • Knee Rotation
  • Bridge
  • Cobra
  • Triangle Pose
  • Child’s Pose Stretch
  • Bird Dog

Movements to avoid

With all injuries, certain movements can aggravate the injury, causing more harm or delaying the healing process.

For SI joints, lifting heavy weights, full sit-ups, any exercise that involves twisting and turning, like golf, biking for long periods of time, and contact sports are all activities that cause more problems for SI joint pain suffers.