SI Joint Pain During Pregnancy: What Causes It, and What Can You Do to Help?

Understanding the SI Joint and Why It Hurts During Pregnancy

Mommas, if you've been experiencing nagging lower back pain, a sharp pinch near the back of your hips, or discomfort when walking, climbing stairs, or rolling over in bed, your sacroiliac (SI) joint might be the culprit. SI joint pain is incredibly common during pregnancy, but the good news is that there’s a lot we can do to manage and prevent it!

What is the Sacroiliac Joint (SI Joint)?

The SI joint connects the sacrum (the triangular bone at the base of your spine) to the ilium (the large bones on either side of your pelvis). It’s held together by strong ligaments and plays a crucial role in absorbing shock and stabilizing your pelvis.

During pregnancy, hormonal changes—especially increases in estrogen and relaxin—cause these ligaments to loosen, making the SI joint more mobile. This increased laxity, combined with postural shifts like externally rotated hips, a wider stance, and increased lumbar lordosis (a deeper curve in your lower back), can put excessive pressure on the sacrum and lead to SI joint pain.

To add to this, as your belly grows, your deep core, pelvic floor, and paraspinal muscles are often in less-than-optimal positions to support the SI joint as they once did, which can contribute to instability and discomfort.

Common Symptoms of SI Joint Pain During Pregnancy

If you’re dealing with SI joint pain, you might experience:

• Lower back pain, often on one side
• Pain radiating to the hips, buttocks, or groin
• A sharp, stabbing sensation when changing positions
• Pain when walking or climbing stairs
• A feeling of instability in the pelvis
• Increased pain when getting in and out of a car or rolling over in bed

Risk Factors for SI Joint Pain

Certain factors make some Moms more prone to SI joint pain, including:

• Previous trauma to the back or pelvis
• Multiple pregnancies
• A history of sacroiliitis (inflammation of the SI joint)
• Carrying a higher-weight pregnancy

If you have any of these risk factors, it’s extra important to focus on strengthening and stabilizing your pelvis throughout pregnancy.

Exercises to Help Reduce SI Joint Pain

The key to alleviating SI joint pain is improving stability and balance through targeted exercises. Here are a few strategies to help:

1. "Resetting" the SI Joint

While it takes a significant amount of force to truly “reset” a joint, using opposing muscle contractions can help relieve immediate discomfort. Try this:

• Lying Down Position: Lie on your back with knees bent and feet flat. Lift one knee and press it into your palm while simultaneously pressing your opposite foot into the ground (without lifting your hips). Hold for 6 seconds, repeat 3 times, then place a pillow between your knees and squeeze for 6 seconds. Repeat on the other side if needed.
• Sitting Position: While seated, lift one knee into your hand and press while also pushing the opposite foot into the ground as if preparing to stand. Hold for 6 seconds, repeat 3 times, then place a pillow or fists between your knees and squeeze for 6 seconds.

See if this provides relief—if it does, repeat as needed!

2. Bird Dog

This classic core and stability exercise strengthens the muscles that support your SI joint.

• Start on all fours, engaging your deep core and pelvic floor (think pulling your belly button toward your spine and lightly engaging as if stopping urine and gas).
• Exhale as you extend your opposite arm and leg, maintaining stability in your pelvis and back.
• If you feel wobbly, modify by keeping your toes and fingers on the ground instead of fully lifting.

3. Banded Bridges

Glute strength is crucial for pelvic stability. Adding a resistance band can further activate the outer hip muscles.

• Place a resistance band above your knees and lie on your back with feet hip-width apart.
• Lightly press outward on the band while engaging your deep core and pelvic floor.
• Exhale and lift your hips, hold for 5 seconds, then lower slowly.

4. Backward Lunge with Row

Once you can tolerate more movement, single-leg exercises help improve hip and core stability.

• Hold a resistance band in the same hand as the leg that’s stepping back.
• As you step into a reverse lunge, row the band back by squeezing your shoulder blade down and back and bringing elbow to your side.
• Return to standing and repeat.

5. Adductor Rock Backs

Pregnancy can lead to tight inner thigh muscles (adductors), which contribute to pelvic imbalances.

• Get on all fours and extend one leg out to the side.
• Slightly arch your lower back and shift your hips back until you feel a stretch in the inner thigh.
• Hold for a few breaths or gently rock back and forth.

Additional Support for SI Joint Pain

In addition to exercise, external supports and lifestyle modifications can help manage SI joint pain:

• Pelvic Support Belts: These belts can provide external compression and stability to the SI joint, reducing pain and discomfort: Belt Option
• Postural Awareness: Be mindful of your alignment—avoid excessive arching in your lower back and keep your weight evenly distributed when standing.
• Avoid Prolonged Positions: Sitting or standing for long periods can worsen pain, so take frequent movement breaks.

You Have Options!

Mama, SI joint pain is common in pregnancy, but that doesn’t mean you have to suffer! Focusing on core and pelvic stability, making small daily modifications, and utilizing external supports can make a world of difference. If you find that your pain isn’t improving, seeing a pelvic floor physical therapist can provide a personalized plan to help you feel stronger and more comfortable throughout your pregnancy journey.

You’ve got this, Mama! Keep moving, keep breathing, and know that your body is doing something incredible.