Get Moving to Tame SI Pain

After an injury, your sacroiliac (SI) joint needs time to heal. So you’ll need to take a break from some of your usual activities, especially those that may have caused the problem, like running or a sport. But eventually, getting -- and staying -- active can give you relief from SI joint pain.

Here are some safe ways to keep moving while your joint heals.

Physical therapy: A physical therapist can teach you exercises to gently strengthen the muscles around your SI joint to help the area heal and prevent another injury. How you move your body every day could be adding to your SI pain, so your therapist may show you better ways to sit, lift, or carry heavy things. She can also guide you through other therapies, like water aerobics, Pilates, or yoga. Usually, people with SI problems meet with a physical therapist about 3 times per week for a few weeks.

Water therapy: You don’t need to be a strong swimmer to try water therapy. Workouts happen in the shallow end of a pool. During each session, an instructor will guide you through exercises to make your stomach, glutes, and leg muscles stronger. You’ll also stretch out your back, hips, hamstrings, and calf muscles. Since the water supports your weight, you’ll find it easier to move around and improve your flexibility without much risk of hurting yourself.

Walking: It’s a good way to care for your lower back. Start slow with 20 minutes, twice a week. Make sure you wear comfortable, low-heeled shoes. If you don’t notice any pain, add more time to your walk or speed up your pace. Aim for 30 minutes daily.

Bike riding: Some people get relief from SI pain by riding a stationary or recumbent (reclined) bike at the gym. It increases blood flow to your sore lower back and hips without putting stress on the SI joint.

Yoga: The practice combines physical poses with breathing exercises and meditation. Regular sessions can reduce lower back pain. It’s important to work with a trained teacher who can help you change or leave out some moves so you don’t hurt yourself. Iyengar yoga is a good choice for people who have low back pain. It focuses on standing poses that correct your posture and build strength in the muscles that affect the SI joint.

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Pilates: The workout was created to help dancers recover from injuries. Its focus is improving stability in your core muscles. You’ll sit or lie down on a machine that has cables, pulleys, springs, and sliding boards. Then, an instructor will show you how to use your body to slowly move each device. Some gyms also offer Pilates mat classes, where you do exercises standing or lying on the floor.

Tai chi: Sometimes called “meditation in motion,” this gentle workout started in China as a martial art. It uses slow, controlled movements and relaxation techniques to build balance, flexibility, and strength. One 40-minute class every week for 10 weeks can ease lower back pain.

You’ll need to work out on a regular basis to keep the muscles around your SI joint strong. Even when you’re not working out, it’s important to watch your posture and try to sit and stand up straight. If your pain gets worse when you work out or you run a fever, feel weak, have a “pins and needles” sensation in your legs, or lose control of your bladder or bowels, call your doctor right away.

For some people, exercise alone isn’t enough to stop SI pain or prevent another injury. If so, talk to your doctor about other ways to heal your back.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on December 17, 2017

Sources

SOURCES:

Rydeard, R. Journal of Orthopaedic and Sports Physical Therapy, July 2006.

Laslett, M. The Journal of Manual and Manipulative Therapy, 2008.

Henley, C. Post-Polio Health, Summer 2006.

University of New Mexico Hospital Pain Center: “Sacroiliac Joint.”

American Council on Exercise: “Pilates Primer.”

Mount Sinai Hospital: “Sacroiliac Joint Pain Information.”

Shnayderman, I. Journal of Clinical Rehabilitation, July 31, 2012.

Hall, A. BMC Musculoskeletal Disorders, May 28, 2009.

Hall, A. Arthritis Care & Research, November 2011.

Williams, K. International Journal of Yoga Therapy, No. 13 (2003).

Aniyoshi, M. The Kurume Medical Journal, 1999.

American Physical Therapy Association: “Physical Therapist’s Guide to Sacroiliac Joint Dysfunction,” “10 Exercises to Do in the Pool.”

Harvard Medical School: “Daily Moves to Prevent Low Back Pain,” “The Health Benefits of Tai Chi.”

National Institute of Neurological Disorders and Stroke: “Low Back Pain Fact Sheet.”

Cayuga Medical Center: “Physical Therapy in Water.”

Medscape: "Sacroiliac Joint Medication," "Sacroiliac Joint Injury Treatment & Management."

Scott M. Schreiber, DC, DACRB, DCBCN, MS, LDN,  Cert. MDT, CKTP, CNS,  chiropractor, Delaware Back Pain & Sports Rehabilitation Centers,  Newark, DE.

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