How to Get Rid of SI Joint Pain - Home Rehab Exercises

What's going on everyone? Dr. Tom from Rehab Science. Today we're going to talk about sacroiliac joint pain, which is a type of back pain that comes from this joint here. We've got one on either side. It's a small bony spot on the back of your pelvis. You might have pain right there near that spot, or maybe it goes down into your buttock, maybe the back of your thigh. If you've got that kind of pain, we're going to look at four exercises that can help ease symptoms and reduce joint irritation. Let's jump into it. For sacroiliac joint pain, or SI joint pain we often call it, we're going to be looking at these two joints. We've got one on the right and left side. It's basically where our sacrum, this flat bone, joins with either a right or left pelvic bone. The SI joint is this small joint right here. It's very close to the low back joints, L4, L5, L5, S1. It can often be hard to differentiate these two things, but the good news is that whether you've got pain coming from somewhere in the low back or from the SI joint, the exercises I'm going to show often help both of those. Really the only way we know people truly have SI joint pain is if they go in and get an injection into that joint, and if that takes their symptoms away, then we can be really certain it's an SI joint pain. There are some clinical tests out there that we do in the PT world for this. There are tests where we try to provoke the person's symptoms, and if clusters of those tests, more and more of them are positive, then we can be more certain that it's coming from the SI joint. You might have this type of pain if maybe you've had a trauma, like you fell on your butt. Maybe you stepped off a curb funny with one leg and kind of jammed your leg. This also is often very common in pregnant females. When certain hormones are present, it can cause sort of irritation, extra movement around the SI joint. It's also really important to know that your SI joints don't move very much. They only rotate about four degrees and only move a few millimeters, so sometimes people think that their SI joints can kind of go out of place and move, and that's really just not true in the majority of cases. We've got these strong ligaments that cross this area, our glute muscles. Those joints are actually very stable, but if you have pain, a combination of some soft tissue release in the kind of glute region, our hip rotators, a little bit of mobility drills for the low back and the hip, and then some motor control kind of strengthening exercises for our core, our lumbopelvic region. Those types of movements are often helpful, so we're going to look at four of those today, and we'll start with soft tissue release, then go to stretching, and then we'll look at some of the stability kind of strengthening exercises, so let's get into the first one. For the first exercise, we're going to look at massaging, so we're doing a self myofascial release of our glute muscles and some of the deep hip rotators, including piriformis. Those muscles, when you're having SI joint pain, can sort of tighten and spasm, so working on them can just help to reduce symptoms and reduce pain. I've got a special kind of trigger point ball here. It's a little bit firmer than a tennis ball, but you don't have to get one of these. If you want to, I'll put a link down in the description for this, but you often can use a tennis ball or lacrosse ball. All you're going to do is lay on your back and kind of find the meaty area here in kind of your upper glute, middle glute region. You're just going to put the ball on the ground, just lay like this, and then kind of roll over those spots, and if you find something, like I've got a really tender spot right there, then you're just going to pause on it, take a few deep breaths, stay there until it feels like it kind of releases, and then you're going to move to another spot. You don't want to put this way back in the middle on the bone. You want to be off to the side on your glutes, and usually people just have SI joint pain on one side, so you can work both sides, but mainly these exercises are meant for the painful side. For the second exercise, we're going to look at mobility, just generally of the low back, SI joint, hip region. So this is one a lot of people are familiar with. It's just a good one for loosening up your low back. So you are going to straighten one leg, and then take your opposite hand and reach across your knee, and just pull that over to the side. Your hip will be at about a 90 degree angle, and you're going to kind of reach back with your other arm. This will stretch your, really your whole spine, but this is the position we often use in physical therapy and chiropractic to manipulate people's low backs, and you know, it kind of helps stretch this whole back side of the hip, right where the SI joint is, into the low back. So again, because SI joint pain is sometimes hard to differentiate from low back joint pain, some of these exercises are used for both things. So you'll go one direction, and then switch. You'll straighten the leg, bring the other one up, and then roll to that side, and I'm quite a bit tighter this way. So you may notice that one direction, it's harder for you to rotate often, it'll be hard to breathe that direction, so maybe something that's good to keep working on, even when your SI joint pain is better. For the third exercise, we're going to start looking at what you might consider stability, or you know, strengthening exercises. So if, for instance, you are a female who's pregnant, and you feel like you're generally just more mobile, you may not see as much benefit from the last stretch, for example. Some people who are really mobile actually even feel worse when they stretch. So if you're a person who's a little more mobile, you may want to focus on these last two, which are more sort of lumbopelvic stability exercises. So this first one, we're going to use a band. This is just a loop band. You can get these lots of places. Again, I'll put a link in the description for one if you need one, but you're going to put it around both legs, and you're going to go up around your knees, okay? So and then we're going to lay back, and we're basically going to do a type of bridge that will also engage our hip rotators. So this will help to add stability to the lumbopelvic region and across the SI joint. So what you're going to do is your hands will be down. You're going to go up into a bridge, keeping tension on the band. The band wants to pull your knees in. You're going to push the band out, which will engage your hip rotators and glutes. You're going to lift up into that bridge, and then when you're up there, you're going to move your legs in and out in a slow, controlled fashion. So you're holding the bridge, which engages your core muscles, and then you're going to go in and out with the band, which will engage your hip rotators and glutes, which all run just adjacent and across that SI joint. So this will just help again to build strength and improve lumbopelvic stability and control, which for a lot of people is really useful for reducing pain and reducing likelihood that this type of issue comes back in the future. So shoot for three sets of somewhere around 10 to 20 repetitions. You basically just want to go until you feel fatigued, and then when you get through a set, you reach fatigue, set your butt back down, rest for 30 seconds to one minute, and then you'll do another set. We'll shoot for three sets in total of this one. Our fourth exercise is another lumbopelvic stability control slash strength exercise. So for this one, you're going to want to have a ball. I've got a soccer ball, a volleyball, or basketball. Any of those can kind of work. You just need one that's a, you know, kind of a medium size like this. So what you're going to do is you're going to get back into that bridge position. We're going to put the ball this time between the knees, and we're going to end up squeezing it with our groin muscles, which are called our hip adductors. If you've ever had this issue and you've gone to see a PT or chiropractor, we will often have people squeeze like this against our arm because it can sometimes create kind of a pop in the hip joint, the front of the hip joint, maybe in the front of the pelvis. We used to think that that pop was resetting the position of the pelvis and would help with SI joint pain. That's probably not the case now, but for whatever reason, like other joints, when you get a pop, it can help relieve tension and pain in many cases. So if you notice something pop when you're squeezing the ball in this exercise, don't stress. It might actually help you. So what you're going to do again is you're going to have your hands down. You are going to have your feet about shoulder width. You're going to squeeze the ball with sort of moderate to heavy kind of pressure with those inner groin muscles. You're going to hold that pressure and then do a bridge. Okay, so keep that pressure on the ball, and you're going to go up and down like that. Like the last exercise, we're going to go, you know, 10 to 15 repetitions in three sets. Again, you're just doing repetitions until you get tired. If you haven't done much training for your groin muscles, much strengthening in the past, just be careful with this one not to squeeze too hard because sometimes people can kind of strain the muscles on the inside of their thigh. So just kind of a moderate squeeze, and then nice controlled slow bridges up and down. Again, this is really working a bunch of your core muscles and focusing on that lumbopelvic kind of core stability. So three sets, 10 to 15 repetitions, and a 30 second to one minute rest between sets. So those are our four exercises. Those are ones that often help people, again, with the SI joint pain on one side, on the back side of that kind of low back, back side of the pelvis, around that little, people always point to that little bump on the back side of the pelvis. If your pain's near that, it could be your SI joint. So we've got a myofascial release with the ball, a stretch, and then two more stability strength-focused exercises. So I hope this is helpful to you. If you have any questions, please leave a comment. I will also put a research article that can be really helpful for learning more about SI. I'll put it, I'll link it in the description if you want to read more about this issue. So all right, I'll see y'all later. Bye.