The Top 3 SI Dysfunction Exercises

Your sacroiliac (SI) joints lie between the sacrum, the triangular-shaped bone at the base of the spine, and the ilium, or pelvic bone. These joints have limited motion, are surrounded by strong ligaments, and function as shock absorbers for the spine. One or both of these joints can become inflamed and unstable, resulting in pain and possible limited mobility. Use the exercises suggested by Cawley Physical Therapy to recover from SI joint dysfunction.

Human SI joint with dysfunction.

Symptoms of SI Joint Dysfunction

When the SI joint is out of balance, pain can often be felt in the lower back or hip. The pain can be felt on one or both sides of the body and radiate into the groin and down the back of the leg. Pain can increase upon the activity that puts pressure on these joints, such as when rising from a seated position, walking up a hill, sitting or walking for extended periods, and twisting or bending. 

Other disorders that may be mistaken for SI joint dysfunction include hip disorders, lumbar disc herniation, or a pinched nerve. Though anyone can experience the symptoms of SI of joint dysfunction, it commonly occurs in young and middle-aged women.

Causes of SI Joint Dysfunction

The causes of SI joint dysfunction can originate from a number of everyday or unique occurrences. They can happen during pregnancy when changing hormones cause ligaments to relax, leading to hypermobility. It can result from the cartilage degeneration that lies between the two bones and ultimately leads to osteoarthritis.

Sitting or standing for long periods with inappropriate back support can place undue stress on this joint. It can also be the direct result of a fall or overexertion injury.

Conservative Treatment and SI Dysfunction Exercises

Conservative treatment should always be considered before medical intervention, such as injections or surgery. A physical therapist will design an individual treatment approach depending on the cause of the joint pain. It can include manual therapy to correct misalignment, soft tissue, and joint mobilization to improve mobility and stabilization, flexibility, and strengthening exercises. 

The following exercises are designed to provide stabilization and increase the strength of the pelvic, glutes, and core muscles. Stop immediately if you experience increased pain, and check with your physical therapist before initiating an exercise program. If the joint is experiencing hypomobility, manual physical therapy must be performed before exercise to correct the underlying disorder.

Perform the following exercises on a comfortable surface, such as a yoga mat. Soreness is not uncommon and should subside with rest. Your physical therapist may recommend applying intermittent ice and moist heat for 15 minutes each before and after exercising. Always warm up before exercising by walking or bicycling for 5 to 10 minutes. Focus on keeping your core muscles contracted as you perform these exercises.

1. Ball Squeezes in Supine Position

Lay on your back with your knees bent to 90 degrees. Place a ball between the knees and squeeze for three to five seconds. Relax and repeat 10 to 15 times for one to two sets. This strengthens the adductors, the muscles on the inside of the thighs, as well as the glutes.

A woman squeezing an exercise ball with her knees.

2. Clam Shell Exercises in Supine Position

Lay on your back with your knees bent to 45 degrees. Place a Theraband or other elastic exercise band around your legs above your knees. Keeping your feet together, slowly open and close your knees. Repeat two sets of 15 repetitions. This exercise is designed to help reduce pain by strengthening the hip, glute, and thigh muscles and stabilizing the pelvic muscles.

A man doing clam shell exercises while in the supine position.

3. Simultaneous Alternating Hip Flexion and Hip Extension Isometrics

Isometric exercises involve extended muscle contractions in which specific muscle groups remain contracted for a specific time. These types of exercises limit potential joint injury. This standing exercise will require a chair or exercise bar for balance. Lift one leg to 90 degrees at the hip and knee. Your thigh will be parallel to the floor. Hold for 10 to 30 seconds. Slowly lift that same leg back behind you, keeping it as straight as possible. 

At this point, you will need to bend slightly at the waist. Try to get your leg parallel to the ground and hold for another 10 to 30 seconds. Perform with the other leg. Repeat two to three times and remember to breathe. This exercise strengthens your hamstrings, quadriceps, glutes, and lower back.

A woman doing hip exercises while laying on her back.

Learn SI Dysfunction Exercises at Cawley Physical Therapy

Call or email Cawley Physical Therapy for any questions you may have or to schedule a free 30-minute discovery visit with one of our doctors of physical therapy. We treat orthopedic-related conditions and will create an individualized rehabilitation plan tailored to your problem. You can also visit our YouTube channel for more information, call 570-208-2787 or email us at