SI joint pain in pregnancy, sacral pain, or sacrum pain – whatever you want to call it, is no joke. I see women come into the clinic who can barely walk or turn over in bed because of it. And usually they think it’s their hip hurting them. But when they actually show me where their pain is, it ain’t their hip or their low back. It’s the pesky SI joint.
What is the SI joint
The sacroiliac or SI joint is along the back of the pelvis. It’s where the two sides of the pelvis come together and connect with the sacrum. There are a lot of strong ligaments that help support this joint, as well as muscles that attach near it.
Some people get pain on both sides of their SI joint, while others only get pain on one side. Occasionally women will complain of direct sacrum pain, but usually it’s to the side of the sacrum itself.
Why SI joint pain in pregnancy
There are a lot of different factors for SI joint pain. Interestingly, some of them have nothing to do with the SI joint itself, but factors related to emotions of previous experiences.
For one-sided SI joint pain in pregnancy risk factors include:
- Habitually standing on one side more than the other
- Increased stress
- Poor prior birth experience
- Previous low back pain
- Back trauma
- History of salpingitis (inflammation of the fallopian tubes)
Risk factors for double-sided SI joint pain in pregnancy:
- Prior low back pain
- Pelvic or low back trauma
- Multiple pregnancies
- Poor relationship with spouse
- Decreased job satisfaction
Reading these lists might provoke some questions in you (or they did to me the first time I read them!) about how pain and experience are related. But we’ll leave it at the fact that if our body is stressed mentally or emotionally, it can be expressed physically. This is why I’m pretty big on learning breathing patterns to help decrease the stress you’re experiencing.
At the end of the day, I find that most of my mamas have SI pain in pregnancy because of some imbalance in their system.
How to get relief from SI join pain in pregnancy
1) Seek out a PT, massage therapist, chiropractor
These people can help provide some relief and help you while you strengthen and balance.
Here are the places I go to look when someone reaches out to me asking for recommendations:
Or schedule a free consultation to see if I can help point you in the right direction
2) Change how you normally move
If you do nothing else, change the way you rest and do your normal daily tasks. We sit so very much so changing the way you do this is the number one thing I’d recommend.
Stop sacral sitting
Sitting on your sacrum can increase SI or sacral pain, not to mention tailbone pain. So if you’re slumped back, move that belly forward. One way to think about this, is imagining a flashlight in the belly button. You want the flashlight to be shining straight out or down towards the ground instead of up towards the ceiling. ⠀
Uncross your legs
Because SI pain in pregnancy often happens because of imbalance, crossing your legs while sitting (or standing!) can contribute. I had one patient who noticed she often stood with one leg crossed over the other. When she stopped doing this it made a difference in her pain.
Switch up your carry
So often women always carry things on the same side of their body. Start to notice, “Do I always carry my purse on this side? Do I always hold my toddler on this hip?” Changing what side is always bearing that extra weight can make a big difference.
This is often when women feel their SI pain the most. Keeping everything lined up while you sleep can help.
- Try putting a pillow between the knees AND the ankles. Often times, women forget the ankles and it can make a big difference.
- Put a pillow under your bump to keep it from pulling you over. Or m ake a little “nest” to rest your belly in
- When getting in and out of bed, try and roll over as a unit and bring both legs up and down off the bed at the same time. We call this “log-rolling.”
These exercises are great for allowing the sacrum to move with more balance from side to side, and with more stability overall.
- Squats – another winner for improving strength in the back of the body, squats are also super wonderful for preparing for birth.
- Band pull apart – helps strengthen the muscles so important for lifting and carrying like we talked about above
- Deadlift – one of my all-time favorite exercises. So good for helping strengthen the back of the body, as well as create healthy length.
- Bridge or hip thrust – great for improving strength on the back side of the body, as well as the core. Some women feel uncomfortable with their head below their hips, so if that’s you, a hip thrust will likely feel better.
- Cat/cow – feels so good! And great for getting the pelvis to move. If your belly feel uncomfortable on all fours, try rocking your pelvis back and forth in sitting or laying down.
- Quadruped hip EXT – I like this because you get to work on hip stability on the leg that’s down, as well as strength on the leg that’s moving. If uncomfortable in quadruped, move to standing and slide the leg back.
- Sidelying hip abduction- wonderful for helping with the glute and hip rotators. The clamshell is a classic exercise I find most women tolerate well throughout pregnancy. Just make sure you’re moving from the hip and not the low back.
- Piriformis stretch – another great one for loosening up the too tight muscles that cause some of the sacral pain in pregnancy.
- ITB stretch – you can perform this in side-lying letting the leg hang off in front of you (you might want someone in front of you to support you ) or with a strap. Whatever feels good to you. Helps with the balance of the sacrum and pelvis.
- Diaphragmatic breathing – learning to open up the chest and relax throughout the body. This helps address the stress component of SI pain we touched on above.
4) Use supports
SI belts and/or taping can help with the pain. For SI pain in pregnancy, the one most often recommended is the Serola Belt. But make sure you buy the right size and wear it correctly 😉 One way to know if this might help you – does it feel good when something squeezes your hips together? That’s basically what this does. So if it hurts when you squeeze your hips together, this probably isn’t for you.
Taping can also be of use for some women. I love to teach people how to tape themselves (or their loved one) using some basic techniques. Then they can reapply as needed. (And this is something we could totally do over a video chat, so hit me up if you’re interested).
But like I tell my patients, these solutions are only a band-aid. They can help relieve pain in many women, but it won’t fix the underlying cause of the pain.
SI joint pain in pregnancy: final thoughts
If you’re experiencing pain in pregnancy, you don’t have to live with it. There is so much that can be done for SI pain, but also hip pain, low back pain, carpal tunnel, sciatica, and shoulder pain to name a few.
Movement is definitely important, but having a plan allowing you to feel good while you move is key. So ask for help, sister. You might as well start now. Asking for help is one of the most important things we can do as women. It builds community and takes some of the burden off our shoulders.
Use the resources I outlined above to find someone near you, or go to contact tab at the top of this website to set up a free 15 min consultation to get you on the path to where you want to be.
So tell me, would you like a video to help you do these exercises?