There are several muscles that connect to the sacrum, hip bones, or pubis bones and help support the pelvis and sacroiliac joint, including those in the groin, thighs, abdomen, and lower back. If these muscles are poorly conditioned and unable to adequately support the SI joint and pelvis, pain may develop.
Some common strengthening exercises for sacroiliac joint pain include:
- Hip abduction strengthening. The hip abductor muscles on the outside of the thighs connect to the thighs from the hip bones (iliac crests). Lie down on the back with both knees bent and place a medium rubber exercise ball (about the size of a dodgeball) between the knees, keeping the back slightly arched. Squeeze the ball with both knees for 5 seconds, and repeat 10 times to strengthen the hip abductors and lower abdominal muscles.
- Hip adduction strengthening. The hip adductors in the groin/inside of the thighs connect to the thighs from a ligament in the pelvis (the anterior pubic ligament). Lie on the back with the knees slightly bent, and a resistance band around the knees. Keeping the back arched, gently pull the knees apart to strengthen the inner thigh. Hold for 5 seconds, and repeat this exercise 10 times. To ensure safety with this exercise, start with a less resistive band before working up to using a heavier, more resistive band.
- Bridge. Lie on the back with the knees bent and the palms flat on the floor. Keeping the palms on the floor, lift the hips into the air and hold for 5 seconds to strengthen muscles in the lower abdomen, lower back, and hips. Repeat this stretch between 8 and 10 times.
- Triangle pose. A more advanced exercise that involves twisting the lower spine is the triangle yoga pose. Begin with the feet a little more than shoulder-width apart, and point the right foot outward. Extend both arms straight to the sides so they are parallel to the floor. Then, slowly bend to the side so the right hand touches the right shin or the floor, and the left arm is over the head. Hold this stretch for 10 to 20 seconds, then repeat on the left side.
- Bird dog pose. Another more advanced yoga pose, the bird dog pose can help strengthen the lower back and core muscles that support the pelvis. Starting on the hands and knees, keep the shoulders square and the face toward the floor. Lift one leg and the opposite arm straight into the air (parallel to the floor) and hold for 5 seconds. Make sure to keep the back and pelvis level while doing the exercise. Build up to repeat this stretch between 3 and 5 times on each side. It may help to have a cushion under the knees.
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Additionally, strengthening exercises such as squats or lunges can help strengthen the gluteus and thigh muscles, which play important roles in supporting the pelvis and SI joint.
Other strengthening exercises may be recommended or prescribed by a doctor, physical therapist, or other health professional. It is important to follow a doctor’s instructions on the kinds of strengthening that can safely and effectively help alleviate SI joint pain.