SI joint pain in pregnancy is treatable with the correct exercises. Learn how to self-treat and relieve back pain at home with these top 5 physical therapy recommended exercises.

This post contains affiliate links. For more information, see my disclosures here.

SI pain in pregnancy can really cause a lot of pain in your lower back and legs, which is extremely uncomfortable and not what we want when we are trying to grow a little baby inside of us. The good news is that it’s treatable, and you can do something about it now so you can feel better sooner rather than later. 

As we near the end of our 9 month pregnancy, we are getting more and more uncomfortable, and the last thing we want to do is walk around waddling sideways and limping on our leg with an irritated nerve. No way.

In this article, I want to share with your my physical therapy expertise on how to properly and safely treat si joint dysfunction during pregnancy and what exercises you can do to help alleviate the pain. These are easy to do in the comfort of your own home.

What Is SI Joint Pain and Sciatica?

SI stands for sacro-iliac which is the combination of the sacrum=tailbone (sacro) and ilium = pelvic bones (iliac) which are two bones in our low back region. 

For short, people call this the SI joint. The primary function of the sacroiliac joint is to absorb shock between the upper body and the pelvis and legs.

A lot of movement takes place here, especially during transitions between sitting and standing, while walking and during pregnancy. 

The joint also entraps a nerve called the sciatic nerve. The nerve that is located at the SI joint runs all the way down the back of our thigh and into our calf and beneath our foot. It’s quite large and extremely long. It’s a big one. So when people complain of pain to the sciatic nerve, it is frequently reported to be the most severe pain they have ever experienced in their entire life.

So when you hear someone say they have “SI” pain or sciatica, they are closely related and sometimes go hand in hand.

Why does SI Joint Pain Occur?

SI joint pain, also known as Posterior Pelvic Pain, in pregnancy occurs for multiple reasons. It’s important that you understand that the added body weight and the weight of your baby can play a huge role in the pain that is going to occur in your back. The increased tension on your SI joint and ligaments is simply caused by the gravitational pull of your growing belly.

With this gravitational pull on your growing belly, your posture will naturally change. The curve in your spine will become more pronounced and can cause malalignment in your spine. The lower spine, called the lumbar spine, is directly connected to your sacrum and, therefore, your sacrum will begin to become mal-aligned within your ilium or between your iliac crests

Your ligaments are already lax from the increase in hormones that occur during pregnancy. Relaxin, a hormone that makes your ligaments more lax and stretchy, plays a large part in SI dysfunction during pregnancy. It’s what we want for childbirth, but sometimes in pregnant women, the SI joint becomes too lax and too much movement occurs too soon during pregnancy.

Also during pregnancy, as your uterus and your belly grow, the muscles around your core will stretch and become weaker. With weakness comes injury and with injury comes pain. I’m not talking about a blunt trauma type injury but an injury to your SI joint where it’s not working properly and there is dysfunction between the joint. This is all related to normal muscle and ligament changes that occur during pregnancy. Some women just so happen to have extreme muscle and ligament changes that need some repairing to alleviate pain.

Top 5 Exercises for SI Joint Pain in Pregnancy

1. Cat-Camel

Go down slowly on your hands and knees on a carpeted or cushioned but stable surface (not the bed).

Place your shoulders directly over top of your hands and your hips overtop of your knees.

Slowly arch your back and look down at the ground as if you are turning into a scared cat, hold for 5 seconds and then release slowly to neutral spine.

Then slowly sink your back down as if your belly is getting closer to the floor making a camel like appearance with your spine (two humps). Hold for 5 seconds and then repeat for 5-10 repetitions.

2. Hand-Heel Rocks

Go down slowly on your hands and knees on a carpeted or cushioned but stable surface (not the bed).

Place your shoulders directly over top of your hands and your hips over top of your knees.

Slowly rock your body forward onto the floor but maintain your arms in full extension (keep your elbows straight).

Extend your head as you look straight, not allowing your shoulders to shrug close to your ears.

Allow your pelvis to sink down and relax into the floor holding for 5-10 seconds.

Then slowly return to the starting position with a neutral spine and sit back on your heels, keeping your hands in place and resting your head down between your arms. Hold for 5-10 seconds and repeat for 5-10 repetitions.

3. Bridging

Slowly lie down on the floor on a soft, comfortable surface like a yoga mat.

Lie down using a log roll where you go down on your side first, then log roll onto your back keeping your knees, hips and shoulders aligned.

Place your feet flat on the floor with your knees bent.

Slowly push through your feet as you raise your hips up off the ground, one vertebrae at a time.

Lift as high as you can tolerate and then lower back down to starting position. Repeat for 5-10 repetitions.

4. Resisted Hip Abduction

Sit with your back straight and your knees bent at a comfortable position. Feet flat on the floor.

Wrap a belt or a high resistance band (something with no give and strong resistance) around your thighs just above your knees while your knees are touching. A plyable theraband will not work for this exercise. You don’t want any give in the strap.

Once you have your band securely in place, open your thighs to pull against the strap slowly holding for 3 seconds and then slowly return back to starting position. The should be little movement in your legs. Repeat for 5-10 repetitions. 

5. Hip Adduction Ball Squeezes

Sit with your back straight and your knees bent at a comfortable position. Feet flat on the floor.

Place a 9 inch size Pilates ball or something similar in size and weight between your knees.

Gently squeeze the ball as hard as you comfortably can and hold for 5 seconds. Slowly release without letting the ball drop. Repeat for 5-10 repetitions. 

Let’s Review The Proper Way To Treat SI Joint Pain in Pregnancy

To review, SI joint dysfunction is very common in pregnancy due to the changes that take place with your growing belly and the hormone, relaxin, that causes stretching to occur. It is treatable and the pain can be diminished with the proper treatment. A good way to start is by doing these five simple exercises for pain relief: Cat-Camel, Hand-Heel Rocks, Bridging, Resisted Hip Abduction and Hip Adduction Ball Squeezes.

He may also recommend a belly band or a type of brace to wear to assist in this problem. 

Your therapist will evaluate you and determine where the dysfunction is specifically on your body. He will also decide which manual therapy techniques are the correct techniques for your particular situation.Your physical therapist may also teach you how you can do manual therapy or an MET (muscle energy technique) on yourself. It’s quite easy and really effective. 

But what’s most important is that you get a thorough evaluation and get the proper treatment for your particular diagnosis because, otherwise, you could be doing more harm than good. 

Please comment below with questions or contact me on my contact page if you want to know more about what’s going on in your pregnant body.

If you need to find a physical therapist in your area, visit the APTA (American Physical Therapy Association) website.

Keep Smiling,

Dr. Jena Bradley, DPT

This post contains affiliate links. For more information, see my disclosures here.

**It is important to always consult your doctor before beginning any exercise program and get medical clearance. Always warm up thoroughly and stretch after all workouts. LiveCoreStrong.com and Jena Bradley will be not be responsible or liable for any injury sustained while exercising at home, gym or elsewhere. Perform exercises at your own risk.

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-Jena