You might not think much about your sacroiliac (SI) joints — that is, until they hurt. Sacroiliac joint inflammation is a literal pain in the butt. SI joint exercises can help, but biking could make your pain worse.
About SI Joint Problems
SI joint dysfunction — a condition that affects the joint where your sacrum and pelvis attach — doesn't just cause pain in the buttocks. According to a study published in the January/February 2019 issue of Pain Physician, SI joint dysfunction is the main underlying cause of low back pain in 15 to 40 percent of patients.
Prior to exercising, see your doctor for an accurate diagnosis if you suspect you have sacroiliac joint inflammation or you have low back pain that interferes with your daily activities. Some activities, such as running or biking, could make your symptoms worse.
Read more: Exercises to Strengthen the Sacroiliac Joint
Biking and SI Joint Pain
While biking is an excellent exercise for boosting heart and lung health, it isn't without its drawbacks. According to Brookhaven National Laboratory, low back pain is a common overuse injury among cyclists. Riding a bike puts your low back, sacrum and pelvis in a flexed position for prolonged periods of time. This position also allows your core muscles to relax, putting your SI joint at further risk of injury.
Take frequent breaks while biking to help with sacroiliac joint pain relief. When stopped, stand up straight and gently bend your lower spine backward, holding for 10 seconds. Repeat two to three times.
A poorly fitting bike or improper biking posture can also contribute to low back and sacroiliac joint inflammation — a seat that is too high causes your spine to flex even farther. Position your seat so that your knee has a slight bend in it at the bottom of your pedal stroke.
If you continue to have SI pain but want to keep your legs conditioned for cycling, consider training with a recumbent bike, as demonstrated at ExRx.net. This exercise machine allows you to sit up straight, reducing the amount of strain on your SI joint and low back.
Sacroiliac Joint Pain Relief
Taking a break from cycling while your SI joint heals can be a bummer. The good news is, there are several things you can do at home to help with sacroiliac joint pain relief. According to Weill Cornell Brain and Spine Center, home treatment can include applying heat or ice, taking over-the-counter pain medications and anti-inflammatories, resting from aggravating activities, and performing strengthening exercises and stretches.
Apply ice for 10 to 15 minutes at a time to decrease pain immediately following any aggravating activity, such as biking. This will constrict your blood vessels, helping to decrease inflammation. For achy pain that occurs hours after an activity, apply heat or take a warm bath. This will open up your blood vessels to increase circulation and relax tight muscles around your SI joint.
Medical interventions are also used to treat sacroiliac joint inflammation. Oral steroid medication and pain relievers, steroid injections, SI belt use, physical therapy, massage and acupuncture are all treatments for this condition. SI join release and manipulation for SI joint realignment can also be performed by qualified healthcare professionals.
SI joint exercises, including strengthening activities and stretches, can help relieve SI joint pain. Stop exercising if your pain increases, and consult a physical therapist for an individualized exercise program.
SI Joint Exercises
SI joint exercises include strengthening muscles in your core, pelvic floor and hips, as well as stretching muscles that attach to your pelvis. Perform strengthening exercises in sets of 10 repetitions, working up to three sets in a row. Stretches should be held for at least 20 to 30 seconds, and repeated three times.
Move 1: Kegels
Strengthen your pelvic floor — deep muscles that attach to your pelvis and the base of your spine — with Kegel exercises.
- Sit up straight with your thigh muscles relaxed.
- Tighten your pelvic floor as if you are stopping the flow of urine and preventing the release of gas.
- Hold for five seconds, then relax. Work up to a 10-second hold as strength improves.
Move 2: Pelvic Tilt
The pelvic tilt, or abdominal draw in exercise, strengthens deep abdominal muscles that help support your SI joint.
- Lie on your back with your knees bent and feet on the floor. If this increases your SI joint pain, move your feet farther away from your buttocks.
- Place your hands on your hips.
- Tighten your abs and flatten your low back into the ground, as if you are pulling your belly button to your spine. The muscles under your fingertips should tighten.
- Hold for two to three seconds, then relax.
Move 3: Clamshells
Clamshells strengthen the gluteus medius muscles, which are important for stabilizing the pelvis in a standing position. Standing on one leg more than the other can lead to SI joint problems and cause an imbalance in the strength of your right and left gluteus medius muscles.
- Lie on your side with your legs stacked on top of each other.
- Bend your knees and pull them halfway up toward your torso — your thighs should form a 45-degree angle with your trunk.
- Keeping your feet together, lift your top knee up toward the ceiling. Hold for two to three seconds, then lower back down. You should feel muscles on the outside of your buttocks tighten during this movement.
- Repeat on the other side.
Move 4: Knee to Chest Stretch
The knee to chest exercise gently stretches the SI joint on the same side of your pelvis.
- Lie on your back with your legs straight.
- Lift one knee up toward your chest.
- Place your hands behind your knee and gently pull your thigh closer to your abdomen.
- Stop when you feel a pulling sensation along your SI joint.
- Repeat on the opposite side.
Do not stretch to the point of pain — this can increase your sacroiliac joint inflammation.
Move 5: Piriformis Stretch
The piriformis muscle attaches to the sacrum bone, which is part of the SI joint.
- Sit up tall in a chair.
- Cross your right ankle over your left thigh, forming a "number 4."
- Gently press down on your right knee until you feel a stretch in the right side of your buttocks.
- Repeat on the other side.
Advance this exercise by performing it while lying on your back. Increase the intensity of the stretch by lifting your left foot off the ground as you press your right knee away from you.
- Pain Physician: "Effectiveness of Exercise Therapy and Manipulation on Sacroiliac Joint Dysfunction: A Randomized Controlled Trial"
- Brookhaven National Laboratory: "Common Overuse Injuries Attributed to Cycling and Ways to Minimize These Injuries"
- ExRx.net: "Recumbent Cycle"
- Weill Cornell Brain and Spine Center: "Sacroiliac Joint Dysfunction"
- Princeton University Athletic Medicine: "Lumbar/Core Strength and Stability Exercises"
- Princeton University Athletic Medicine: "Pelvic Stabilization, Lateral Hip and Gluteal Strengthening Program"