Our bodies go through a multitude of changes throughout pregnancy and sometimes, that can lead to aches and pains. It may be hard to figure out where the pain is stemming from and how to fix it. If you are having some discomfort in your hips/buttocks, it may be from your sacroiliac (SI) joint. Here are some ways to find out if you’re having SI joint pain and how you can relieve it. 

What Causes SI Joint Pain During Pregnancy?

SI Joint pain during pregnancy can be caused by an increase in relaxin and having poor posture pushing the joint out of alignment. Let’s talk about what each of these are and how it happens. 

  1. Relaxin: Relaxin is a hormone in our bodies while pregnant that relaxes your ligaments to widen your pelvis in preparation for birth. This is helpful during birth but throughout pregnancy this can cause our bodies to be out of alignment more easily and create instability. 
  2. Anterior Pelvic Tilt: With the increase in weight centering our bellies, it tends to throw our center of gravity off causing our pelvis to tilt forward. This causes stress on our transverse abdominals (inner ab muscles) and causes them to weaken and not protect the pelvis properly. This is why continuing to exercise your core muscles safely during pregnancy is so beneficial for us. 

Symptoms of SI Joint Pain

If you are feeling pain in your backside on one or both sides of your pelvis, it may be related to your SI joint. It could be a dull aching pain or a sharp shooting pain that radiates down your leg and can be difficult for you to get comfortable when standing or sitting.  Movements that can make the pain worse are walking, climbing stairs, getting in and out the car or bed. If you are having these symptoms it is best to speak with your doctor or a pelvic floor physical therapist for an accurate diagnosis. 

How Do You Relieve SI Joint Pain While Pregnant?

During pregnancy, you can help relieve SI joint pain by working with a physical therapist, chiropractor, improving your posture, and strengthening the muscles around your pelvis. The best option is to find a physical therapist to properly diagnose and provide a treatment plan for your pain. 

Chiropractors may also be able to alleviate pain but without fixing our posture and strengthening the muscles around our pelvis, it can lead to constant chiropractic visits and short term relief. If neither of those are an option, you can work on improving your posture and strengthening your core, glute and back muscles.

Things you can do to not exacerbate the pain are avoiding crossing your legs or sitting in an uneven manner. You want to be sitting straight onto your sit bones. While sleeping, try putting a pillow between your legs and avoid having one leg higher than the other. 

When getting out of bed, roll to your side, bring your legs down on the side of the bed together while helping your upper body up with your arms – try not to get out of bed one leg at a time. And while exercising, avoid single leg movements such as lunges, step-ups, etc. 

How Do You Strengthen Your SI Joint When Pregnant?

You can strengthen your SI joints by exercising your back, glutes and core. The muscles that need to be focused on specifically are the transverse abdominals/pelvic floor, glutes, and latissimus dorsi (back muscles). It is commonly found that one side of your lats is weak while the opposite glute is weak. Exercising those muscles will help them get stronger and create a more stable pelvis.

Testing For Imbalances

To determine which glute is weak, try to stand up from a chair or box on one leg. You will notice that it is increasingly difficult to stand up on one leg versus the other. Whichever leg is harder will have a weak glute. 

Once knowing your weak glute you can assume the opposite lat is weak. However, to be sure you can test them by holding your arms straight up in a Y position. Then, have a partner stand behind you and try to push your hand down. You should be able to hold the position without your arm falling. If not, that is the side in which your lat is weak. These will be the muscles you need to get stronger to alleviate your SI joint pain. 

Core Strengthening Exercises for SI joint pain

Diaphragmatic Breathing:

  • Begin sitting on a chair with your feet on the floor, knees at 90°, and sitting up straight.
  • Put one hand on your chest and one hand on your stomach so you can feel the movement of your breath.
  • Inhale through your nose, expanding your stomach and your chest while relaxing your pelvic floor.
  • Exhale through your mouth, bringing your stomach in towards your spine and lifting your pelvic floor up and in. Audibly make a shh or hiss sound to help expel all the air and activate your pelvic floor. 
  • To feel if your pelvic floor is activating, put your index and middle fingers just inside your hip bones and feel a gentle activation of your muscles. 
  • Repeat for 10 breaths or 2 minutes. 

Check out my post with a whole list of core strengthening exercises that are safe during pregnancy and postpartum!  

Glute Strengthening Exercises for SI joint pain

Staggered Glute Bridge:

  • Begin on your back with your knees hip-width apart and bent 90°. Have one leg slightly closer to your body with less weight on it. You want to focus the weight on the other leg(your weaker leg). 
  • Using the one leg, lift your hips off the ground until your knees, hips, and shoulders form a straight line. 
  • Hold that position for 3 seconds while squeezing your glutes before coming back down.
  • Repeat for 15 reps. 

Bridge Heel Slide:

  • Begin on your back with your knees hip-width apart and bent 90°. Under your feet you will need a pair of sliders, paper plates, or you can use socks on a hardwood floor.
  • Lift your hips off the ground until your knees, hips, and shoulders form a straight line. 
  • Slowly bring one heel away from your body as far as you can and slowly bring it back to 90°.
  • Repeat for 15 reps on the weak glute.

Clamshells:

  • Begin lying on your dominant glute side with your arm stretched out and your head resting on it. Your knees are bent 45° and stacked. 
  • While keeping your feet together, raise your top knee as high as you can without shifting your hips and keeping your other leg on the floor. 
  • Repeat for 15 reps on the weak glute.

Back Strengthening Exercises for SI joint pain

Single arm lat pulldowns:

  • Tie a resistance band to a stable structure above your head and either sit or kneel on the floor. If that’s not available, you can tie it on the wall/object and perform this movement while leaning over or lying on the floor.
  • Grab the resistance band with your arm(weak side), bring your shoulder blades down and back, pulling the band until it reaches about chest level. Remember to activate your core to avoid coning. Hold the position for 3 seconds squeezing your back muscles.
  • Return your arm to the starting position and repeat for 15 reps. 

Bent Rows:

  • Begin with your strong arm on a bench or box and your leg bent 90° on the bench as well, keeping your back straight and parallel to the floor. 
  • With a dumbbell in the opposite hand, lift the weight towards your body, driving the elbows behind your body until the dumbbell is in line with your torso. Avoid shrugging your shoulders by keeping them back and down.
  • Hold for 3 seconds and squeeze your back muscles before lowering back down to the starting position. 
  • Repeat for 15 reps. 

Wall Plank:

  • Begin facing a wall with your feet a few inches away from it, hip-width apart. 
  • Put your forearms on the wall shoulder-width apart, keeping your arms perpendicular to your shoulders. 
  • Keep a neutral spine, engage your core by pulling your stomach towards your spine, and breathe normally.
  • If this seems too easy, you can walk your feet out a little further from the wall with your arms in the same position. 
  • Hold this position for 30 seconds or however long you can hold it.

Pregnancy is hard enough, you don’t need to be dealing with pain from your SI joint. Whether you seek out help from a physical therapist or implement some strengthening exercises, you can get relief for your aches and pains. Let me know if you tried any of these exercises and which helped you the most!

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