If you have a constant ache in your lower back or bottom — especially on one side, just above your hip — you might have sacroiliac joint pain (SIJ). This common problem causes 15-30% of long-term low back pain 1Source: Clinical Spine Surgery, but many people don't know their SI joint is causing their discomfort.
The good news? Most people don't need surgery or long-term medication to feel better. 2Source: NCBI Many of our patients see major pain relief within 1-3 months using exercise and hands-on therapy.
In this guide, you'll discover which exercises can help relieve your SIJ pain and which movements to avoid to speed up your recovery.
Why Exercise Helps Sacroiliac Joint Pain
Your SI joint connects the bottom of your spine to your hip bones. It doesn't move much, but it plays an important role in transferring weight between your upper body and legs. When this joint gets swollen or unstable, the muscles around it need to work harder to support it.
Exercise helps SIJ pain in three ways:
- First, it builds your buttock muscles, which are the main support for your SIJ. These muscles act like a natural support belt for your body.
- Second, it develops your deep core and back muscles. These muscles work together to keep your pelvis stable and prevent the joint from moving too much.
- Finally, when your muscles work properly, they spread weight more evenly across your lower back and pelvis, taking pressure off your SI joint during everyday movements.
The results speak for themselves. Studies show that many people can get rid of their pain completely in just 2-5 weeks when they do the right strengthening exercises regularly, especially ones that work the buttock muscles.
Best Techniques for SI Joint Relief
Core Strengthening Exercises
Glute Bridges
This exercise builds strength in your bottom and lower back, helping to stabilise sacroiliac joint dysfunction.
- Lie on your back with your knees bent and feet flat on the floor, hip-width apart
- Squeeze your buttocks and lift your hips until your body forms a straight line from shoulders to knees
- Hold for 5-10 breaths, making sure to squeeze your buttocks rather than arching your lower back
- Lower slowly and repeat 8-12 times
Bird Dogs
This exercise trains your whole core to work together, which is exactly what your SI joint needs for lasting stability.
- Start on your hands and knees with your back straight
- Reach your right arm forward and left leg backward, keeping your hips level
- Hold for 5 seconds, return to start, then switch sides
- Do 6-10 repetitions per side
Hip Strengthening Exercises
Clamshells
This simple movement works a hip muscle that's often weak in people with SIJ problems.
- Lie on your side with your knees bent and feet together
- Keep your feet touching and lift your top knee as high as feels comfortable without twisting your pelvis backward — you can use a resistance band to make this more difficult if you wish
- Lower with control
- Do 10-15 repetitions on each side
Ball Squeeze
This exercise develops the inner thigh muscles that help stabilise your SIJ.
- Lie on your back with knees bent and place a ball or cushion between your knees
- Squeeze the ball for 5 seconds, using your inner thigh and lower stomach muscles
- Release gently and repeat 10 times
- Do 3 sets daily
Stretching Exercises
Knee-to-Chest Stretch
This stretch releases tension in your buttock and lower back muscles that can strain your SI joint when tight.
- Lie on your back with both legs out straight
- Slowly bring one knee toward your chest, holding it gently with both hands
- Keep your other leg straight or slightly bent, whatever feels better
- Hold for 30 seconds, breathing deeply, then switch sides
- Repeat 2-4 times per leg
Piriformis Stretch
The piriformis muscle connects to your lower spine and thigh bone, so tightness here can make SIJ pain worse.
- Lie on your back with both knees bent
- Cross your right ankle over your left knee, making a figure-4 shape
- Reach through the gap and hold your hands behind your left thigh
- Gently pull your left thigh toward your chest until you feel a stretch deep in your right buttock
- Hold for 30 seconds, then switch sides
Start with just a few repetitions of each exercise and slowly increase as you get stronger. You should feel muscles working, but never sharp pain.
Exercises and Activities to Avoid
Just as some exercises can help your SI joint heal, others can make it worse. Knowing what to avoid is just as important for your recovery.
High-Impact Activities
Running and jogging put a lot of stress on your SIJ with every step.
Jumping exercises like box jumps and skipping are even worse; when you land, the force on your pelvis is 3-5 times your body weight.
While you're recovering, stick to walking at a steady pace on soft surfaces instead.
Twisting and Rotating Movements
Sit-ups and crunches put strain on the area connecting your pelvis and SI joint. Research shows you should avoid these exercises while your SIJ is healing.
Sports like golf and tennis also involve quick twisting movements that can hurt your SIJ, especially when your hips stay still during the swing.
Heavy Weight Exercises
Deep squats with heavy weights push down hard on your spine and put too much strain on your SI joints. This gets worse when your technique gets worse as you get tired.
The leg press machine causes the same problem; your back can't move naturally, so all the pressure goes straight to your SI joint.
If you want to do squats, do shallow ones using just your body weight or very light weights.
One-Sided Movements
Lunges put uneven pressure on your pelvis because you shift your weight from one leg to the other.
Step-ups cause the same problem: one SI joint has to support most of your upper body weight.
While your SIJ heals, stick to squats that keep your weight evenly distributed on both legs.
Guidelines for Different Stages of Recovery
Your exercise plan should match your stage of recovery. If you do too much too soon, you could make things worse. But if you're too cautious for too long, you might not recover fully.
First Stage (First 2-3 Days)
During this first period, focus on managing pain and protecting the joint rather than heavy exercise.
- Put ice on the area for 15-20 minutes every few hours during the first two days to reduce swelling — this is very important!
- Work out which movements or positions make your symptoms worse so you can avoid them
- Gentle stretches may help a bit, but don't push through pain
- See a physical therapist, such as a chiropractor for hands-on treatment and a personalised exercise programme tailored to your specific needs
- Get back to your normal activities as soon as you can handle them — usually within 1-2 days — but avoid anything that increases your pain
Middle Stage (3 Days to 8 Weeks)
This is when your active recovery really starts.
- Begin by stretching overly tight muscles — especially your hip flexors, hamstrings, and lower back muscles
- Start strengthening weak muscles, focusing particularly on your buttocks and core
- Do your exercises daily, slowly building from a few repetitions to 12-20 as you improve
Most people notice improvement within their first few visits to a physical therapist during this stage, with many patients improving within 2-5 weeks.
Final Stage (8 Weeks and Beyond)
Once your pain has improved a lot, focus on maintaining your progress and stopping it from coming back.
- Keep doing your strengthening exercises at least three times weekly
- You can now try harder versions, add resistance bands or light weights, and start doing movements that copy your daily activities or sports
This maintenance work isn't optional, it's what keeps you pain-free long-term.
If You're Pregnant
Pregnancy makes SI joint problems more common. About half of pregnant women get pelvic pain such as Pelvic Girdle Pain (PGP). 3Source: Mary Ann Liebert This happens because pregnancy hormones make your ligaments looser, and you're carrying extra weight in a different way.
After 20 weeks, don't do exercises where you put weight on just one leg. Do squats instead of lunges. Keep your legs together rather than spread wide apart.
Good exercises include:
- glute bridges with pillows under your shoulders
- clamshells lying on your side
- gentle pelvic tilts
- and exercises on your hands and knees.
An SI belt can help with any form of back pain during pregnancy, especially when you're active or standing for a long time. These belts support your joint while your muscles get stronger.
Always talk to your doctor before starting any exercise during pregnancy.
Warning Signs to Stop and Get Help
Whilst most SI joint pain gets better with exercise and therapy, certain symptoms mean you need professional help rather than self-treatment.
Loss of Bladder or Bowel Control
Get immediate medical help if you lose bladder or bowel control, which may mean nerve damage needing urgent treatment.
Fever and Chills
Fever and chills with your back pain suggest a possible infection that requires quick treatment.
Severe, Constant Pain
Severe, constant pain that doesn't improve with position changes or rest — especially with unexplained weight loss — requires immediate investigation.
Prolonged or Worsening Symptoms
See a healthcare professional if your pain lasts beyond two weeks without improvement, if you get numbness, tingling, or growing weakness in your legs, or if your symptoms stop you doing daily activities or sleeping.
Getting Help
A chiropractor, physiotherapist, or sports medicine specialist can confirm whether your SIJ is causing your pain through specific tests. Physical therapy approaches such as hands-on treatments like whole body adjustments and joint mobilisation address the underlying problem.
At Rasura Chiropractic Centres, our experienced chiropractors help Sunshine Coast residents overcome SIJ pain by restoring proper alignment and movement, often providing immediate relief. They identify which muscles are weak or tight and spot movement habits that cause your pain to create a personalised treatment plan, including hands-on therapy and specific exercises.
This expert guidance ensures you perform exercises correctly, which helps you recover faster and avoid getting hurt again.
Your Path to Recovery
SIJ pain can be frustrating, but you now know what to do to feel better. The most important thing is to stick with it: do the right exercises regularly, avoid movements that hurt, and build up slowly as you get stronger.
Pick two or three simple exercises from the strengthening and stretching sections above. Do them every day, focusing on getting them right rather than doing lots of them. Many people feel better within the first month, and recovery is faster when combining exercises with physical therapy.
Remember, your SI joint is a very complex joint that takes on a lot of weight daily. Because it is very hard to rest this particular joint, it takes a while to heal. Be patient with the process, listen to your body, and don't hesitate to get professional help if you're unsure about your technique or if your symptoms aren't improving as expected. With the right approach, you can reduce your pain, move more freely, and get back to the activities you love.
Are you struggling with SIJ pain or low back pain? Contact our friendly receptionists today to book an appointment and discover how our expert care can help you get back to living pain-free.
