Aerobic Exercise for SI Joint Dysfunction

Aerobic exercise is an important part of any exercise program, as it helps improve cardiovascular health and distribute essential nutrients throughout the body more effectively. It can also help with weight loss, which can in turn reduce the pressure on the sacroiliac (SI) joint.

In general, it is recommended that adults should engage in 30 to 60 minutes of moderate-intensity aerobic physical activity or 15 to 30 minutes of vigorous-intensity aerobic physical activity 5 times a week. ¹ Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020-2028. https://pubmed.ncbi.nlm.nih.gov/30418471/

Potential Benefits of Aerobic Exercise for SI Joint Pain

Multiple studies have shown that aerobic exercises may benefit patients with lower back pain. ² Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022 ^{, 3} Meng X-G, Yue S-W. Efficacy of aerobic exercise for treatment of chronic low back pain: a meta-analysis. Am J Phys Med Rehabil. 2015;94:358-365. http://doi.org/10.1097/PHM.0000000000000188 ^{, 4} Chan CW, Mok, NW, Yeung EW. Aerobic Exercise Training in Addition to Conventional Physiotherapy for Chronic Low Back Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2011;92:1681-1685. https://pubmed.ncbi.nlm.nih.gov/21839983/

• Aerobic exercises help increase the blood flow and nutrients to the soft tissues in the back, improving the healing process and reducing the stiffness that results in back pain. ² Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022 ^{, 3} Meng X-G, Yue S-W. Efficacy of aerobic exercise for treatment of chronic low back pain: a meta-analysis. Am J Phys Med Rehabil. 2015;94:358-365. http://doi.org/10.1097/PHM.0000000000000188 ^{, 4} Chan CW, Mok, NW, Yeung EW. Aerobic Exercise Training in Addition to Conventional Physiotherapy for Chronic Low Back Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2011;92:1681-1685. https://pubmed.ncbi.nlm.nih.gov/21839983/
• Additionally, engaging in aerobic exercise for 30-40 minutes has been shown to increase the body’s production of endorphins, a hormone that binds to the pain receptors in the brain and spinal cord to decrease the perception of pain. ⁵ Kenney WL, Wilmore JH, Costill DL. Physiology of Sport and Exercise. 5th ed. Champaign, IL: Human Kinetics; 2012.

It is important to note that some forms of high-impact aerobic exercise, such as running, jogging, or playing racket sports that involve twisting or sudden forward bending of the spine may cause or exacerbate SI joint pain. ² Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022 For this reason, low-impact aerobics that are easier on the low back and pelvis may be recommended.

Exercise Walking

Exercise walking is gentler on the sacroiliac joint than running or jogging and has the added benefit of being easy to fit into a regular schedule and has a low injury rate. ² Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022 ^{, 6} Hurley DA, O'Donoghue G, Tully MA, et al. A walking programme and a supervised exercise class versus usual physiotherapy for chronic low back pain: a single-blinded randomised controlled trial. (The Supervised Walking In comparison to Fitness Training for Back Pain (SWIFT) Trial). BMC Musculoskelet Disord. 2009;10:79. http://doi.org/10.1186/1471-2474-10-79 For instance, exercise walking can be done on a lunch break, around the neighborhood, indoors at a mall, or on a treadmill.

Stationary Biking

Stationary biking provides low to moderate-impact aerobic exercise while avoiding the bumps and jolts of biking on uneven terrain that may potentially inflame the SI joint(s).

Swimming or Water Aerobics

Exercising in water provides an effective low-impact aerobic workout that does not put excess pressure on the SI joint due to the natural buoyancy of the water. ⁷ Verhagen AP, Cardoso JR, Bierma-Zeinstra S. Aquatic exercise & balneotherapy in musculoskeletal conditions. Best Practice & Research Clinical Rheumatology. 2012;26(3):335-343. https://doi.org/10.1016/j.berh.2012.05.008 ^{, 8} Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM R. 2009;1(9):859-872. http://doi.org/10.1016/j.pmrj.2009.05.017 Additionally, the water’s resistance provides a gentle workout for the muscles that dampens the force of potentially painful movements. ⁹ Becker BE, Cole AJ. Comprehensive Aquatic Therapy. 3rd ed. Pullman, Washington State University Publishing, 2017. Specific water aerobics exercises, water walking, or swim strokes may be recommended as part of a physical therapy program. ¹⁰ Cole AJ, Eagleston RE, Moschetti M, Sinnett E. Spine pain: aquatic rehabilitation strategies. J Back Musculoskelet Rehabil. 1994;4(4):273-286. http://doi.org/10.3233/BMR-1994-4407

Read more: Water Therapy Exercise Program

Some trial and error may be needed to find an enjoyable aerobic exercise that helps relieve SI joint pain. One of the most important factors for success with an exercise program is maintaining regular exercise, so it is important to find a method of aerobic exercise that one is likely to continue.