3 exercise modifications to reduce sacroiliac joint pain

8 in 10 women are unaware that sacroiliac joint dysfunction is a leading cause of chronic lower back pain in women who have had children - even years later.

(2018 survey - SI Bone)

The sacrum is right in the middle of the 2 pelvic bones -and so it’s significant during pregnancy and birth as the pelvis needs to widen to allow for growth of the baby and childbirth.

The sacroiliac joints are where the sacrum connects to the pelvis on each side.

Common symptoms of SIJ pain  (one or more):

• lower back pain on one side
• shooting pain down into bottom 
• top of hip pain - usually at the back 
• referring pain down into back of legs
• super tight glutes, especially down the outsides of each
• trouble bending forward without pain
• trouble leaning on one leg without pain 

Now generally speaking the sacroiliac (or SI) joint complex is supposed to be relatively immovable, not like other joints that flex and extend.  So when it causes pain, it’s usually because it's become unstable.

The hormonal release during pregnancy relaxes all of the structures that hold the joints in place (this occurs all over the body). This creates relatively instability across every joint, including the sacroiliac joints.

When the SI joints are unstable, this typically shows up as lower back pain, and pain that runs down one side of the bottom (sciatica-like symptoms).

 How does SI joint dysfunction happen?

The SI joint has a ‘self locking’ mechanism at the pelvis, which is referred to as form closure.

When we have SI joint pain, this mechanism doesn't work well, and it can create pain and inflammation.

Luckily, there’s another way to create stability at the SI joint  - known as force closure.   

Force closure is an active process that uses the surrounding muscles, tendons, fascia and ligaments to hold the pelvis in place. 

This means that we can actively contribute to stability of the SI joints, by doing the right movements.

These specific movements are designed to place the SI joints back into position, and then co-ordinate the right muscles to know how to hold it all in place. 

 Common causes of SI joint pain

If you, like 45% of pregnant women, experienced pelvic girdle pain during pregnancy, and weren’t given a proper back and core strengthening program (like The Postpartum Method), then SI joint pain can show up even years after birth. 

In fact, my 64 year old mum recently realised that her long standing back pain stemmed from child birth (mine!) and once we used some of The Postpartum Method sessions, it reduced her pain almost instantly. 

What can trigger sacroiliac joint pain?

Asymmetrical loading (i.e - to one side of the pelvis, or unevenly carrying weight on one side) is usually what will trigger SI joint symptoms.  Things like:

• leaning on one hip to carry heavy items (like children!)

• jarring, like stepping off a curb without looking

• walking on unstable surfaces, like sand, or slipping on a wet surface 

Repetitive movement at the pelvis (lots of quick leg movements like swimming and running) when the SI joints are out of alignment can also cause flare ups.

Remember the hormones released during pregnancy are designed to loosen off and relax the joints, ligaments and tendons, in preparation for the baby. 

A lot of women are already systemically flexible (known as hypermobility). If this is you, take extra care to stabilise the joints as those postpartum hormones relax them even further. 

The more flexible and loose we are through our ligaments and tendons and other connective structures, the more strength is required from the right muscles to hold the joints in place.  

 If long stretches and poses in practices like yoga provide you with only temporary relief, your body may be craving stability through the right strength training instead. 

How the body copes with sacroiliac joint dysfunction during exercise:

As smart as our bodies are, when it comes to pain and being unstable, the muscles start behaving in some funny (not haha - but strange) ways.

The correct muscles that are supposed to support the area tend to over fatigue, and they wear themselves out, becoming tense, tight and weak.  

Then they stop doing their job to support the joint. 

In response to this, the nervous system calls out to a bunch of other muscles, that aren’t supposed to do the job of stabilising - and gets them to start pitching in instead.  Over-tight hamstrings, glutes or quads anyone?

This can lead to a lot of tension in the body, trigger points, tight spots and a general feeling of weakness as the muscular system starts behaving in these compensatory ways. 

So how do we cure SI joint pain?

To alleviate sacroiliac joint pain permanently, a good exercise program can give you lasting results. The Postpartum Method focuses a lot on pelvic stability for this reason.

A well designed program will show you what symptoms to look for, what exercises to avoid, and what order to start your training in, so you build strength without doing damage. 

In the meantime you can start here with 3 exercise modifications to relieve sacroiliac joint pain:

1 - Change your foot position during squats and deadlifts:

Turn your toes outwards to the corners and widen your stance (knees follow toes).  This secures the joint through that process of force closure we talked about earlier.  Keep the weight in your heels.

2 - Check your pelvic tilt: 

If you’re overarched through the lumbar spine (lower back) your hip bones usually turn downwards away from your belly button at the same time. 

This excessive anterior pelvic tilt has the lower abdominal muscles relax, so that the belly rounds out, and the spine is left unsupported. 

If this is you, a slight pelvic tilt of the hip bones (at the front - known as the ASIS') upwards towards your belly button will correct this.

3 - Make sure you know how to properly activate your deep core muscles that include your pelvic floor:

This whole system is key in stabilising the SI joints.  If you find yourself commonly bracing, breath holding or bearing down on your pelvic floor during exercise, and you have back pain: your deep core and pelvic floor is unlikely to be working correctly.   

Find a structured program, guided by an expert, like The Postpartum Method, to take you through the essential exercise sequences need to first heal, then strengthen the area. 

Using these 3 modifications will enhance the “force closure” mechanism at the sacroiliac joints during exercise.

If you want to get it sorted out for good, come and join the full program - you can currently try the first 2 month for just $24 each. 

Want to know exactly how to connect to you deep core and pelvic floor - in a free video series?  

Access the free video series here - it's the essential first step to healing back pain, leaking and prolapse symptoms.  

Kristy Ahale specialises in merging rehabilitation with strength training in The Postpartum Method: Core and Pelvic Floor program.  She has helped hundreds of women resolve long standing back pain, pelvic floor problems and regain core strength, even decades after they’ve had children.