SI Joint Pain In Pregnancy (What You Can Do About It)

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 is SI join pain,
  • Why it happens, and
  • What you can do about it

Ok. Let’s dive right in.

SI-joint-pain-in-pregnancy

Disclaimer

***READ FIRST***

Although I am a doctor, I am not your doctor. This information is for informational purposes only and should not substitute the advice from your healthcare professional. Please read my full Disclaimer for more information. Also, this post may contain affiliate links: meaning I may receive a commission if you use them.

Ok, moving on.

What Is The SI Joint?

The sacroiliac (SI) joint is located in the back of your pelvis and connects your lumbar spine to your pelvis.

sacroiliac-joint

The name says it all. It connects your sacrum (lowest part of your spine) to your iliac (which is the back of the pelvic bone).

During pregnancy, this joint can cause pain and discomfort – a condition known as SI joint pain or posterior pelvic pain.

What does SI joint pain feel like?

SI joint pain can feel like either a dull pain, or a sharp pain in the lowest part of your back and hips. The pain can radiate up your lower back and down your thighs. It can be present on one side (unilateral) or both sides (bilateral).

What makes SI joint pain worse?

In general, SI joint pain is worsened with any type of lower body movement. This is especially true for activities that involve standing on one leg.

Unfortunately, this includes activities of normal daily living such as:

  • walking,
  • climbing stairs,
  • standing up from a seated position, and
  • sitting for prolonged periods of time.

What Causes It?

Posterior pelvic pain seems to be 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.

This is very similar to what happens at the pubic symphysis in pubic symphysis dysfunction.

As always, there is probably a genetic component that can put you at higher risk of developing this conditon.

In addition to that, the weight of the uterus can also place mechanical stress on the pelvic bone, further increasing pressure and pain in this area.

What helps sacroiliac joint pain during pregnancy?

Before doing anything to try and help SI joint pain during pregnancy, it is important that you see your doctor first.

They can evaluate you and provide you with a referral to a trained physical therapist if SI join pain is thought to be the cause of your discomfort.

The good news is, exercises that promote pelvic stability are the first line treatment for this condition.

exercises-for-si-joint-pain-in-pregnancy

I’ll go over some of the exercises you can do in just a minute.

The other thing you can try is a pelvic stability belt. These can be purchased over the counter.

Read through the reviews on Amazon for a product like this one to see if it could fit your needs.

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.

How common is SI joint pain?

SI joint pain in pregnancy is very common.

This is because SI joint pain is often lumped together with general low back pain. One study of 1500 pregnant women found that over 75% of them were diagnosed with the condition.

But all help is not lost. There are a few things you can do to improve your pain.

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 that you need to do is avoid activities that make the pain worse. Obviously, this is easier said than done.

You might get significant SI joint pain where you can’t walk for very long.

The goal is to try and minimize time spent in compromising positions. Here are some strategies you can try in your day to day. These are actually the same tips I share for SPD pain in pregnancy as the two conditions are similar.

  • When going up or down stairs, 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.

Maintain a healthy pregnancy weight:

The second thing you can do is, maintain a healthy pregnancy weight.

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.

weight-gain-in-pregnancy

Do SI joint-friendly exercises:

The last thing you can do is perform pelvic stabilizing exercises during your pregnancy. But before you do this, it is important that you get an evaluation by your healthcare provider.

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, you will likely be referred to a physical therapist.

Now, it’s important that you consult with them before doing any of these exercises.

He or she may or may not want you doing some of these exercises.

They can give you individualized exercises that are tailored for YOU.

One last thing.

If any exercise causes you ANY level of pain or discomfort, stop doing it immediately.

Okay?

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:

  1. Supine ball squeeze 
  2. Posterior pelvic tilts with hip flexion 
  3. Banded hip abductions
  4. Standing hip extensions 
  5. Birddogs
  6. Kneeling squats 
  7. 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). You will need a ball or a cushion to do it.

seated-ball-squeeze
  • 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, all you are going to do is squeeze the ball between your knees.
  • Hold the contraction for 5 seconds, release, and repeat for 8-10 repetitions.

Posterior Pelvic Tilts With Hip Flexion

This exercise will strengthen the deep transverse abdominis muscles as well as other abdominal muscles in a safe position.

pregnancy-pelvic-tilts
  • Stand with your back against a wall with your feet approximately 6-12 inches away from the wall.
  • Make three points of contact 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 next exercise is the banded hip adduction. This movement will strengthen the muscles in your outer thighs as well as your glutes. To do this exercise effectively, you will need some resistance bands.

If you don’t have one, you can get them here.

banded-seat-abductions
  • Place the resistance band around your knees and sit close to the edge of your seat.
  • Keep your feet flat on the floor, approximately hip-width apart.
  • From here, all you are going to do is 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 back to the starting position, and repeat for 8-10 reps.

Standing Hip Extensions

The standing hip extension is a great 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.

Banded-Kick-Backs
  • Stand up against a wall with your hands outstretched and resistance band around your lower legs.
  • Brace your core and squeeze your glutes.
  • From here, simply 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 your butt muscles contracting as you do this exercise.
  • Do 8-10 repetitions per side.

Birddogs

The birddog is a classic exercise that is good at improving just about everything. Hip stability is one of those things.

bird-dog
  • Get into a quadruped position (on hands and knees) with a flat back.
  • Next, brace your core and posteriorly tilt your pelvis as you did in the prior exercise..
  • From here, lift one knee off the ground and extend that leg straight back 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.

Kneeling Squats 

The glute bridge is a great 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 needing to be on your back.

Here’s how:

kneeling-squat
  • 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 are in contact with your heels.
  • Now, brace your core and squeeze your buttock muscles to extend your hips back to the tall kneeling position.
  • Hold this contraction or 3 seconds, and then slowly come back down to the starting position.
  • Perform 8-10 repetitions.

Modified Side Plank

The last exercise is the modified side plank. As you know, this is one of the best exercises for strengthening the oblique muscles, as well as the other stabilizers in your hips and core.

modified-side-plank-in-pregnancy
  • Lie on your side and support yourself on your elbow and forearm.
  • Next, keep your bottom knee bent and your top knee extended.
  • From here, elevate your hips by squeezing your glutes and engaging your core.
  • Do your best to keep your spine straight and do not let your body sag.
  • Hold this position for 20 seconds and then switch sides.

Other Related Questions

Are there any stretches I can do for SI joint pain in pregnancy?

Yes!

There are a few stretches you can do to 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, which tightens the hip flexors.

kneeling-hip-flexor-stretch
  • Place on a pillow on the floor and kneel on it. Lift the other knee up 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:

side-lying-quad-stretch
  • 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:

seated-hip-external-rotation-stretch
  • 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 gently press your knee down toward the floor.
  • 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 have been some studies looking at the effectiveness of massage on pelvic pain and the results haven’t been 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.

Final Words On Pelvic Pain In Pregnancy

So those are all the things you can do to try and get some posterior pelvic pain relief.

Now I want to hear from you.

What have you tried to get SI joint pain relief?

Comment below and let me know!

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brittany-robles

Brittany N Robles, MD, MPH, CPT

Brittany N Robles is a full-time OBGYN, a NASM certified personal trainer, and health & fitness expert. She holds a Masters 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.

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