Are you pregnant and have SI joint pain?
You are not alone.
This article will teach you everything you need to know about SI joint pain in pregnancy, including:
- What SI joint pain is,
- Why it happens, and
- What you can do about it
Ok. Let’s dive right in.
What Is The SI Joint?
The sacroiliac (SI) joint is the connective tissue that connects your sacrum (the lowest part of the spine) to your iliac crest (which is the back of the pelvis).
There are two SI joints, one on each side of the pelvic bone.
This joint can cause pain and discomfort during pregnancy, a condition known as SI joint pain or posterior pelvic pain.
What does SI joint pain feel like?
SI joint pain can feel like a dull or achy discomfort in the lowest part of your back and hips.
However, some women experience it as a sharp or stabbing pain.
The pain may radiate up your lumbar spine and down your buttocks and can present on one side (unilateral) or both sides (bilateral).
What activities aggravate SI joint pain?
In general, SI joint pain is made worse with lower body movement, especially in activities involving standing on one leg.
Unfortunately, many normal daily activities can worsen SI joint pain, such as:
- prolonged standing,
- climbing stairs,
- standing up from a seated position, and
- sitting for prolonged periods of time.
What Causes It?
SI joint dysfunction or posterior pelvic pain is caused by instability and increased mobility at the SI joint. During pregnancy, your body releases a hormone called relaxin.
This hormone is responsible for “relaxing” your pelvic bones and making them looser. While this is a normal physiologic response, some women experience excessive joint laxity.
The same mechanism is responsible for pubic symphysis dysfunction.
In addition, the growing uterus can also place mechanical stress on the pelvic bone, further increasing pressure and pain in this area.
As always, there are probably some genetic risk factors that increase your risk of developing this condition.
What helps sacroiliac joint pain during pregnancy?
If you suffer from sacroiliac joint pain during pregnancy, you may benefit from pelvic stability exercises.
However, before you do any exercise, you must see your doctor first.
They can perform a physical exam and provide a referral to physical therapy if they determine that SI joint pain is the cause of your discomfort.
The second thing you can try is a pelvic stability belt. You can purchase these belts over the counter.
Read through the reviews on Amazon for a sacroiliac belt like this one to see if it could fit your needs.
The third thing you can try is using ice packs.
Ice can help reduce any swelling and inflammation in the hip joint.
Now let’s go over some strategies in more detail.
3 Strategies To Get Relief From SI Joint Pain While Pregnant
Ok, so now let’s go over what you can do to get some relief.
The three things are:
- avoiding aggravating activities,
- maintaining a healthy pregnancy weight, and
- doing exercises that help stabilize your pelvis.
Let’s go over each one.
Avoid aggravating activities
The first thing you need to do is avoid activities that make the pain worse, which is easier said than done.
You might get significant SI joint pain from walking.
The goal is to try and minimize time spent in compromising positions.
- When going up or downstairs, do one at a time, or go sideways.
- When getting dressed, do it from a seated position.
- Walk with short strides, and take frequent breaks.
- When getting out of a car, swivel your hips and keep your legs together.
These simple tweaks may prevent SI joint pain from flaring up.
Maintain a healthy pregnancy weight
The second thing you can do is avoid excessive weight gain in pregnancy.
Being overweight can increase the mechanical stress placed on your pelvis, theoretically increasing the risk of developing pelvic girdle pain and low back pain.
So how much weight should you gain?
It depends on your pre-pregnancy weight.
Here are the American Collge of Obstetricians and Gynecologists’ recommendations:
|Starting BMI||Suggested Weight Gain|
|Underweight (BMI <18.5)||28-40 lbs|
|Normal Weight (BMI 18.5 – 24.9)||25-35 lbs|
|Overweight (BMI 25-30)||15-20 lbs|
|Obese (BMI > 30)||11-20 lbs|
Do SI joint-friendly exercises:
The last thing you can do is perform pelvic stabilizing exercises during your pregnancy.
Again, don’t forget to get an evaluation by your healthcare provider before starting any exercises.
Your posterior pelvic pain might be related to something else that may require other treatment. If your provider determines that your pain is musculoskeletal in origin, they will likely refer you to a trained physical therapist.
One last thing.
If any of these exercises cause you ANY pain or discomfort, stop doing them immediately.
Alright, let’s get to the movements.
What Muscles Should You Strengthen With Pelvic Girdle Pain?
In general, you want to strengthen muscles that help stabilize your pelvis. These muscle groups include:
- the hip adductors (your inner thighs),
- the hip abductors (your outer thighs),
- the gluteal muscles (your butt),
- and the transverse abdominal muscles (the deep core muscles).
Let me show you how.
7 Exercises for SI Joint In Pregnancy
Ok, now let’s go over the actual exercises. They are:
- Seated ball squeeze
- Posterior pelvic tilts
- Banded hip abductions
- Standing hip extensions
- Kneeling squats
- Modified side plank
Let’s go over them one by one.
Seated Ball Squeezes
The seated ball squeeze will strengthen the muscles of the inner thighs (the adductors) and the pelvic floor muscles. You will need a ball or a cushion to do it.
- Sit close to the edge of your seat and place a ball or a cushion in between your knees.
- Next, sit up tall and engage your core.
- From here, squeeze the ball between your knees without moving your feet.
- Hold the contraction for 5 seconds, release, and repeat for 8-10 repetitions.
Posterior Pelvic Tilts
The following exercise will strengthen the deep transverse abdominis muscles and other abdominal muscles in a safe position.
- Stand against a wall with your feet a few inches away from the wall.
- Make three contact points with the wall: your head, upper back, and buttocks.
- There should be a natural gap between your low back and the wall.
- From here, contract your abdominal muscles to flatten the curve in your spine and begin tilting your pelvis backward.
- This should place your low back flat against the wall.
- Hold this contraction for 5 seconds, release, and repeat for 8-10 repetitions.
Banded Hip Adductions
The following exercise is the banded hip adduction. This movement will strengthen the muscles in your outer thighs and your glutes. To do this exercise effectively, you will need some resistance bands.
- Place the resistance band around your knees and sit close to the edge of your seat.
- Keep your feet flat on the floor, heels together.
- From here, separate your knees slowly to place the band on tension.
- You should feel the muscles on the outside of your hips turning on.
- Hold the contraction for 3 seconds, slowly return to the starting position, and repeat for 8-10 reps.
Standing Hip Extensions
The standing hip extension is an excellent exercise for isolating and strengthening your gluteal muscles. To get the most out of this exercise, you should place a resistance band around your lower legs.
- Stand up against a wall with your hands outstretched and a resistance band around your lower legs.
- Brace your core and squeeze your glutes.
- From here, lift one leg and bring it straight back behind you.
- Try to keep your toes pointing forward, your knee straight, and your low back flat.
- You should feel your butt muscles contracting as you do this exercise.
- Do 8-10 repetitions per side.
The bird dog is a classic exercise that is good at improving just about everything, and hip stability is one of those things.
- Get into a quadruped position (on hands and knees) with a flat back.
- Next, brace your core and posteriorly tilt your pelvis to round your lower back.
- Lift one knee off the ground and extend that leg straight behind you.
- At the same time, lift the opposite arm and extend it straight out in front of you.
- Hold this position for 3 seconds while keeping your abs and glutes engaged.
- Repeat for 8-10 repetitions before switching sides.
The glute bridge is an excellent exercise for strengthening the glute muscles. However, you need to be lying on your back to do it. Instead, you can do the kneeling squat to get all the same benefits as the glute bridge without being on your back.
- Roll up a yoga mat and kneel on it with both knees, keeping your knees about hip-width apart.
- From a tall kneeling position, sit back and down until your buttocks contact your heels.
- Next, brace your core and squeeze your buttock muscles to extend your hips to return to a tall kneeling position.
- Hold this contraction for 3 seconds, and slowly return to the starting position.
- Perform 8-10 repetitions.
Modified Side Plank
The last exercise is the modified side plank. This is one of the best exercises for strengthening the oblique muscles and the other stabilizers in your hips and core.
- Lie on your side and support yourself on your elbow and forearm.
- Next, keep your bottom knee bent and your top knee extended.
- Elevate your hips by squeezing your glutes and engaging your core.
- Do your best to keep your spine straight and not let your body sag.
- Hold this position for 20 seconds and then switch sides.
Other Related Questions
How common is SI joint pain?
SI joint pain in pregnancy is very common.
One study of 1500 pregnant women found that over 75% were diagnosed with the condition.
However, SI joint pain is often lumped together with general low back pain, so the true prevalence is difficult to know.
When does SI joint pain start in pregnancy?
SI joint pain can begin as early as the first trimester but typically worsens as the uterus enlarges in the second trimester.
I started experiencing SI joint pain around 24 weeks.
Does SI joint pain get worse at night?
SI joint pain can get worse at night if you spend the day on your feet and doing a lot of activities.
Also, your sleeping position may aggravate the pain.
Many women find relief from sleeping on their side and placing a pillow in between their knees.
Is walking good for sacroiliac joint pain?
Walking is one of the best exercises you can do during pregnancy, and being active may help your SI joint pain.
However, some women experience severe pain just from walking.
If walking does not cause you hip pain, start low and go slow to see how your body responds to short bouts of walking.
Are there any stretches I can do for SI joint pain in pregnancy?
Below are a few hip stretches you can do that may help your SI joint pain. These stretches will help increase the flexibility of your hips, glutes, and thighs.
The first stretch is:
Kneeling hip flexor stretch:
The kneeling hip flexor stretch will open up the muscles in the front of your pelvis. These muscles often get tight during pregnancy as the weight of your uterus shifts your center of gravity forward. As a result, your pelvis tilts anteriorly, tightening the hip flexors.
- Place on a pillow on the floor and kneel on it. Lift the other knee off the floor and place that foot flat on the ground.
- Next, contract the glute muscle of the knee that is on the floor. This should straighten out the curve in your low back.
- From here, lean forward slightly without changing your back angle.
- You should feel a nice stretch in the front of your thigh by your pelvis.
- Hold this stretch for 30 seconds before switching sides.
- To increase this stretch further, feel free to flex your back knee. Make sure your pelvic alignment does not change.
Side-lying quad stretch:
This next stretch will help improve the flexibility of your quadriceps muscles. These muscles sit in the front of your thighs and are tight in most women.
Here’s how it looks:
- Place a yoga mat on the floor and lie down on it, on your side.
- Next, flex your top knee to bring your heel close to your butt. Try to keep your pelvis posteriorly tilted.
- From here, reach back and grab your foot with your top hand.
- Squeeze your glutes, and try to bring your heel to touch your butt.
- You should feel a nice stretch along the entire front side of the thigh.
- Hold this stretch for 30 seconds before switching sides.
Seated hip external rotation stretch:
The last stretch is the seated hip external rotation stretch which will improve the flexibility of your butt muscles. My favorite part of this stretch is that it can be done at any time while you are sitting.
Here’s how to do it:
- Sit close to the edge of a chair with your feet hip-width apart.
- Next, bring one foot up on top of your knee so that your shin is parallel to the floor.
- From here, sit tall and press down on the elevated knee while keeping your ankle in place.
- You should feel a nice stretch along the buttock of that leg.
- Hold this stretch for 30 seconds before switching sides.
You can do these 3 stretches twice, three times per week.
Does massage help SI joint pain in pregnancy?
There are some studies looking at the effectiveness of massage on pelvic pain, and the results are not promising.
With that said, there is very little downside to getting a massage during pregnancy. It might be worth giving it a try and seeing if it helps you.
Just make sure that the masseuse is experienced in doing prenatal massages.
Does SI joint pain go away postpartum?
The good news is, the majority of posterior pelvic pain improves after pregnancy.
One study of over 380 women found that SI joint pain went away in 99% of the cases. However, it may not always go away after pregnancy.
Some women report pain and discomfort up to 1 year postpartum.
Also, symptoms may come back in a subsequent pregnancy.
Final Words On Sacroiliac Joint Dysfunction
So those are all the treatment options you can do to try and get some pain relief in your hip bones.
Now I want to hear from you.
What have you tried to improve the symptoms of SI joint pain?
Comment below and let me know!
Related Posts On Pregnancy-Related Pain
- 7 Exercises For SPD During Pregnancy [To Help You Get Relief]
- Wrist Pain in Pregnancy [What You Need To Know]
- Lordosis in Pregnancy [How To Relieve Your Symptoms]
Get Four Free Workouts To Help Strengthen Your Pelvic Floor & Heal Your Mommy Tummy!
Brittany Robles, MD, MPH, CPT
Brittany Robles is a full-time OBGYN physician, a NASM certified trainer, and a prenatal and postnatal fitness specialist. She holds a Master of Public Health degree in maternal health with a special interest in exercise and nutrition. She is also the co-author of The White Coat Trainer. Learn more about her here.
Sharing is Caring – Send This To A Mom In Need!