A doctor, chiropractor, or physical therapist could recommend therapeutic stretches along with exercises as part of a sacroiliitis or sacroiliac joint pain treatment plan. Sacroiliitis refers to inflammation in one or both of the sacroiliac joints. This could be caused by:

• Pregnancy
• Injury
• Infection
• Arthritis
• Ankylosing spondylitis

Sacroiliac joint pain is a symptom related to sacroiliac joint dysfunction. The symptoms of sacroiliitis and sacroiliac joint pain can be felt in the lower back, buttocks, hips, and legs. These symptoms can be similar to sciatica and can mimic other lower back disorders.   Some of the stretches and exercises included are common for treatment plans for various low back conditions/problems. Talk with a chiropractor or doctor to get their recommendation prior to starting any exercise or stretching program.

Stretches

Piriformis stretch

The piriformis muscle extends over the hip and can aggravate the sacroiliac joint when it becomes tight. To help stretch the muscle:

• Lie on back with knees bent
• Feet flat on the floor
• Slowly raise the right leg
• Bring the right knee toward chest
• Gently pull the leg in until there is a comfortable stretch in the buttock
• Exhale during the stretch movement
• Hold the stretch for 30 seconds
• Lower leg
• Repeat on the left leg
• Repeat each side 3 times daily, as needed

The stretch helps the muscle fibers to lengthen/elongate and relax.  

Trunk rotation

Trunk rotation increases flexibility in the low back and hips. This can help relieve pressure on the sacroiliac joints. To do this stretch:

• Lie on back with knees bent
• Feet flat on the floor
• With knees together
• Slowly rotate to one side
• Feet, hips, and back should stay on the floor
• Hold 3-5 seconds
• Move knees to the opposite side
• Repeat 5-10 times on each side

Bridge

This is a stretch that strengthens the muscles in the lower back, buttocks, and hips.

• Lie on back with arms at side
• Knees should be bent, and feet flat on the floor
• Slowly raise hips while squeezing buttocks and hamstrings
• Hold raised position for 5 seconds
• Repeat 10 times

Water Therapy and Yoga Exercises

Aquatics and yoga are a gentle and natural form of exercise that is recommended for staying active. Talk to a doctor before starting any exercise program. Aquatic therapy, known now as hydrotherapy/water therapy, is one of the gentlest forms of exercise and is highly effective. Exercising in water creates an almost weightless environment without gravity. Hydrotherapy uses the resistance from the water to improve strength and flexibility without straining the muscles. Regular exercise can cause pain by placing added pressure on the sacroiliac joints. Water therapy conditions the spine and hip muscles without generating muscle stress. Another option for individuals with back pain is yoga. The following poses are recommended and beneficial for the sacroiliac joints:

Child’s pose

This pose stretches the hips and thighs and is a great yoga pose for beginners.  

Cobra

Cobra pose can help strengthen and stabilize the sacroiliac joints.

• Lie flat on the stomach
• Hands beneath the shoulders
• Slowly push up as far as the arms extend
• Bring upper body off the ground
• Keep the pelvis and legs on the floor
• When extended, be sure low back and buttocks are relaxed
• Hold for 15 to 30 seconds
• Gently lower to the floor

Triangle pose

Triangle pose helps to strengthen the sacroiliac joints and makes them less susceptible to pain. However, this pose involves twisting, so make sure to do this pose only when the joints are stable and pain-free.  

Before stretching and exercise

Before starting any stretching or exercise program, check with a doctor or chiropractor, if the joints are able then the stretching/exercise could begin right away. However, in most cases, a doctor will refer the patient to a physical therapist or chiropractor to create a customized exercise and stretching plan. The therapist will show exactly what activities will strengthen the joints and how to do them properly and safely. These movements can help condition the spinal and abdominal muscles. This can help prevent future episodes of back pain. If an individual just had surgery for sacroiliac joint pain, the surgeon more than likely prescribed a customized rehabilitation stretching/exercise program. Follow instructions, and get the surgeon’s approval before engaging in anything outside of the plan.

Staying fit safely

When dealing with sacroiliac joint dysfunction or sacroiliitis, physical activity may need to be redefined after treatment. As regular exercise could mean strenuous activity and could do more damage. Exercises like heavy weightlifting, contact sports, and intense biking could place excessive pressure on the joints. A doctor or chiropractor will offer the best stretching and exercises for every individual. Physical activity combined with gentle stretching and conditioning exercises can effectively reduce low back and hip pain. Talk to a doctor, chiropractor, or physical therapist about incorporating healthy exercise into a daily regimen. For some, the workout might not feel like there’s anything going on, but the effects on the pain will be.

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