4 Simple Sacroiliac Joint Exercises that Strengthen & Stabilize Your Pelvis (Video)

Do you need sacroiliac joint exercises that are safe for your pelvic floor?

This Physical therapist video shows you 4 simple buttock strengthening exercises that are commonly used for sacroiliac joint (SIJ) rehabilitation and pelvic instability.

Read on below this video for more information on sacroiliac joint exercises including Physical Therapist safety tips and current approaches to treating chronic SIJ pain.

Suitability: Individual seeking buttock (gluteal) strengthening exercises that are pelvic floor friendly.

Video duration: 8.5 minutes

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Exercise Video Content

Sacroiliac Joint Exercises

These 4 buttock exercises are demonstrated in this sacroiliac joint exercises video along with exercise progressions and safety tips:

1. Floor bridge

Position

Lying down on a firm surface on your back, knees bent, feet flat and head supported

Action

• Push down through your heels
• Lift your buttocks off the mat
• Breathe out as you raise your body
• Slowly lower your body down to starting position

Progression

Place a weight on your pelvis to load your hips

2. Clam 

Position

Lying on a firm surface on your side, knees bent and head supported

Action

• Raise the top leg just above the lower leg*
• Keep your uppermost foot resting on your lower foot throughout
• Slowly lower the lifting leg back to starting position
• Repeat lying on the other side

*Avoid rolling the trunk during this exercise by lifting the top leg too far from the lower leg

Progression

Position a weight on the upper outer thigh close to the knee

3. Alternate arm and leg raise

Position

• Lying prone with or without a pillow supporting the hips and pelvis
• Forehead down and supported on the back of the hands

Action

• Gently contract the lower abdominal muscles
• Raise one leg held straight just off the ground
• Lower the leg back to the ground
• Repeat on the opposite side

Progression

If the shoulders are comfortable with the arms extended out from the body, lift and lower the alternate arm and legs simultaneously

4. Heel prop

Position

• Lying prone with or without a pillow supporting the hips and pelvis
• Forehead down and supported on the back of the hands

Action

• Bend one leg at the knee to approximately 90 degrees (right angle)
• Lift the bent leg pushing the flexed foot towards the ceiling
• Lower the bent leg back to starting position
• Repeat with the other leg

Tips for Safe Sacroiliac Joint Exercises 

• Use a small pillow or cushion to support your his and pelvis when lying prone for comfort
• Keep the exercises small range when starting out and gradually progress according to your physical comfort
• Cease any buttock exercises that causes SIJ discomfort
• Avoid over bracing (tensing) your deep abdominal and pelvic floor muscles during these exercises.

The pelvic floor muscles and/or deep abdominal muscles may involuntarily spasm with SIJ pain ². The deep abdominal muscles can be gently activated during these exercises. Aim to keep your pelvic floor muscles relaxed during these exercises.

How Many Exercises?

• Start out doing that number of exercises that feels comfortable for your body
• Generally aim to perform around to 10-12 repetitions of each exercise at a time (1 set)
• Repeat up to 3 sets of exercises on one day
• Strengthening exercises can be performed 3-5 times per week

Current Approaches to Treating Sacroiliac Joint Dysfunction

Current approaches to treating SIJ dysfunction vary from one country to another ¹.

1. Exercise for SIJ Dysfunction

Sacroiliac joint exercises are used by many therapists worldwide treating sacroiliac joint problems. Exercise therapy is often used in addition to SIJ treatment techniques such as joint manipulation, massage, acupuncture, bracing and muscle stretching.

Research has shown that the buttock muscles help stabilize the SI joint ³ and the hips ⁴. Some studies have shown that buttock muscle activation is altered with SIJ pain ³. The buttock muscles have been shown to contribute to SIJ stability ^3,4.

Training the lumbopelvic stabilizing muscles has been shown improve pain and physical disability in some individuals with chronic lower back and pelvic pain ⁵. Some studies show that SIJ treatment with exercises is effective while others show no benefit ⁶.

2. Multidimensional Management of Chronic SIJ Pain

Some researchers have recently suggested that pelvic girdle pain is not caused by joint instability or dysfunction ².

Instead they suggest that the pelvic support structures such as the deep ligaments that support the pelvic joints become increasingly sensitive causing pain (including SIJ pain). Research has demonstrated that some women with chronic lower back and pelvic pain after pregnancy have a fear of movement, sleep deprivation and altered body image ⁷.

Treatment based upon this new approach involves individualized therapy that normalizes cognitive (thinking and beliefs) and function (movement patterns). Sacroiliac joint treatment strategies using this approach may include strategies such as reducing stress, addressing fears and beliefs related to moving and correcting movement patterns ².

References

¹ Beales, D & O’Sullivan, P (2013) SIJ pelvis – Pelvis Series In Touch Series. https://www.pain-ed.com/wp-content/uploads/2013/08/SIJ-pelvis-In-Touch-Beales-OSullivan.pdf

² Beales, D Bjarne, J Torgeir, H Sandvik, H. et.al. (2015) Current practice in management of pelvic girdle pain amongst physiotherapists in Norway and Australia. Manual Therapy, Volume 20, Issue 1, February 2015, 109-116.

³ Hides J, Jull G, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine (Phila Pa 1976) 2001; 26: E243–E248.

⁴ Grimaldi A (2011). Assessing lateral stability of the hip and pelvis. Manual Therapy. 16: 26-32.

⁵ O’Sullivan P, Phyty G, Twomey L, Allison G. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 1997; 22: 2959–2967.

⁶ Laslett, M (2008) Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint J Man Manip Ther. 16(3): 142–152.

⁷  Beales, D Lutza, A Thompson, J et al. (2016) Disturbed body perception, reduced sleep, and kinesiophobia in subjects with pregnancy-related persistent lumbopelvic pain and moderate levels of disability: An exploratory study. Manual Therapy Volume 21, Volume 21, Feb. 69-75.