Dealing With SI Joint Pain Part 2: Effective Exercises For Sacroiliac Joint Pain Relief During Pregnancy.
The sacroiliac (SI) joint can be a major source of pain and discomfort during pregnancy. As the body undergoes various changes to accommodate the growing baby, extra strain is placed on the SI joint connecting the sacrum and ilium bones. The loosening of ligaments along with the added weight on the pelvis can lead to inflammation and irritation. While SI joint pain can be limiting for an expectant mother, there are safe and effective exercises that can provide relief.
This article will outline beneficial exercises tailored to pregnancy that can help stabilize the SI joint, strengthen surrounding muscles, and increase mobility without overexerting the body. The key is modifying traditional exercises to accommodate a pregnant woman's changed centre of gravity and avoid high-impact movements. With proper guidance, an exercise regimen can be developed that reduces SI joint pain and prepares the body for the demands of labor and delivery.
Safe exercises during pregnancy
Diaphragmatic Breathing
Starting Position:
Visualization: Picture the diaphragm as a dome-shaped muscle separating the chest (ribcage) from the abdomen, even though it's not physically felt.
Awareness: Stand or sit upright and place a scarf or band around the lower ribcage, gently pulling both ends to draw attention to the diaphragmatic area.
Inhalation
Focus: Direct your attention to the back and sides of the ribcage where the lungs are situated.
Breathing In: Inhale through your nose, visualizing your lungs expanding like slowly inflating balloons, feeling the scarf tighten.
Avoid Force: Do not force inhalation; it should be natural.
Diaphragm Action: Simultaneously, the diaphragm descends into the abdominal region, expanding the ribcage outward.
Exhalation
Expelling Air: Exhale through your mouth, sensing air gently leaving from the depths of your lungs.
Diaphragm Rising: Feel your diaphragm rising as you engage your deep abdominal muscles, gradually closing the ribcage.
Avoid Tension: Refrain from puffing cheeks or pursing lips to prevent tension in the neck, jaw, and face.
Benefits: Diaphragmatic breathing enhances breath control and posture, facilitating ease of movement and overall well-being.
Pelvic Elevator Exercise
Starting Position
Sit upright on a chair with your feet planted on the floor, either hip-width apart or with inner thighs touching.
Distribute your weight evenly on both sitting bones and maintain a neutral, elongated spine.
Preparation
Take deep breaths, expanding your ribcage, and elongate your spine.
Exhale while imagining closing elevator doors and ascending to the first floor.
Initiate the lift by contracting from the back passage (as if holding back gas) and gradually shift this sensation forward toward the pubic bone (as if preventing urine release).
Continue to gently engage these muscles.
Inhale, maintaining the elevator on the first floor with closed doors.
Second Level:
Exhale as you rise to the second floor, slightly intensifying the pelvic floor engagement.
Inhale and hold the elevator at the second floor.
Third Level:
Exhale as you reach the third floor, engaging the pelvic floor muscles a bit more, without excessive tension.
Inhale while keeping the elevator on the third floor.
Descending:
Exhale gradually, lowering the elevator one floor at a time until reaching the ground floor.
Open the doors slowly, releasing the pelvic floor with control.
Repetition: Repeat this cycle up to five times.
Guidance:
Avoid forceful or overly tight contractions; maintain a gentle engagement.
Keep the buttock muscles relaxed, ensuring the pelvis remains steady.
Maintain an open chest and relaxed shoulders, preventing neck tension.
Continuously breathe; refrain from holding your breath throughout the exercise.
Benefits: Enhances pelvic floor awareness, control, and strength.
Pelvic Tilts and Circles on a Birth Ball
Sit on a birth ball with knees at a 90-degree angle and feet flat on the floor.
Place hands on knees and gently roll your back backward, creating a "C" shape with your belly.
Roll your belly forward to create another "C" shape with your back.
Repeat pelvic tilts 10 times for relief and movement in the pelvis.
Seated Ball Squeeze: Feet Parallel
Sit on a birth ball with knees at a 90-degree angle, feet flat and parallel on the floor.
Place a mini ball between your knees.
Coordinate your breath with the movement; inhale to prepare and exhale as you lift the pelvic floor while squeezing the knees together and the ball.
Hold for 5-10 seconds.
Inhale to release.
Repeat 5-10 times.
If you lack a ball, a small pillow or rolled-up towel can be used.
Seated Ball Squeeze: Hip Shift
Sit on a birth ball with knees at a 90-degree angle, feet flat and parallel.
Place a mini ball between your knees.
Shift one knee forward and the opposite hip backward.
Coordinate your breath; inhale to prepare and exhale as you lift the pelvic floor, squeezing the knees and ball while maintaining this position.
Hold for 5-10 seconds.
Inhale to release.
Repeat 5-10 times.
Switch sides; shift the opposite knee forward and the other hip backward.
90-90 Banded Ankle Rotations
Lie down on your side in a 90-90 position; knees forward in line with your hips and feet in line with your knees.
Position the back of your thighs against a box.
Place a resistance band around your ankles and yoga block between your knees.
Push the top leg's hamstring into the box.
Perform a slight posterior pelvic tilt.
Slowly turn your toes down, leading with your heel toward the ceiling.
Stay within your active range of hip internal rotation.
Repeat 10 reps each leg.
Focus on maintaining a slight posterior pelvic tilt throughout.
Feel the forward fibers of your glute muscles working.
Control the movement and maintain controlled breathing.
Ensure your head, ribs, and hips stay stacked in alignment.
Kneeling Squats
Kneel on a soft surface like a yoga mat or cushion. Your knees should be hip-width apart.
Sit your hips back and down until your glutes touch your heels. Keep your back straight, core engaged, and chest lifted.
Sit back until buttocks touch heels
Engage your core and squeeze glutes to extend hips upwards
Hold top position for 2 seconds
Slowly and with control return to starting position
Breathe in as you lower down, breathe out as you drive up.
Repeat 8-10 times.
Bird Dog
Get on your hands and knees on the floor or a yoga mat. Your wrists should be under your shoulders and your knees under your hips.
Engage your core and draw your shoulder blades down your back
Raise one leg straight back, simultaneously raise opposite arm straight forward
Keep core and shoulders engaged
Hold for 3 seconds.
Return to start and switch sides
Repeat 6-8 times per side.
Modified Side Plank
Begin lying on your side, support yourself up on your forearm and bend your knees together.
Engage your core and draw your shoulder blades down your back
Keep your shoulders stacked vertically and your neck neutral.
Raise your hips up off the floor by squeezing your glutes and obliques. Your body should form one straight line form knee to crown of the head.
Make sure to keep your hips lifted high, do not let them drop down. Maintain engagement.
Hold this side plank position for 20-30 seconds, continuing to breathe normally.
Slowly return hips to floor and switch sides, repeating on the other side
Banded Squat Hold
Stand with feet hip-width apart, toes facing forward. Place a resistance band around your knees.
Inhale as you initiate the movement by sending your hips back while keeping your chest lifted.
Exhale as you lower down into the squat position, sitting your hips back and down until your thighs are parallel to the floor.
Engage your core to keep your back straight. Press your knees outward into the band to activate your glutes and inner thighs.
Hold this bottom squat position for 30 seconds, continuing to breathe deeply. Maintain engagement of the core and glutes. Do not allow knees to cave inward.
Inhale and exhale for 30 seconds as you hold the bottom of the squat. Keep chest lifted.
To stand up, inhale and drive through your heels, straightening legs while keeping tension on the band. Maintain a neutral spine.
Exhale as you reach the top standing position.
Repeat for 2-3 sets of 30 second hold. Focus on proper form and activation of muscles.
Hip Hinge Movement:
Stand with feet shoulder-width apart, knees slightly bent. Breathe into your belly and engage your core muscles.
Initiate the movement by pushing your hips back as if closing a door behind you with your butt. Keep your spine long and neutral - don't round your back.
As you hinge forward at the hips, bend your knees slightly but keep your legs relatively straight. Do not let your knees collapse inward.
Keep the crown of your head, neck and spine in one line as you continue hinging forward from your hip joints.
Lower down until you feel a stretch in your hamstrings. Do not round your spine - go only as far as you can while maintaining a flat back.
Drive through your heels to return to standing.
Make sure you are hinging from your hips rather than bending at your lower back. Maintain a neutral spine throughout.
Start with no weight and focus on form. Progress to holding weights such as a kettlebell or dumbbell to increase challenge.
Breathe in as you hinge down, breathe out as you squeeze your glutes and return to standing. Perform slowly and controlled.
Repeat for 2-3 sets of 10-12 reps, keeping proper form.
Resistance Band Lat Pulldown
Secure a resistance band above your head to a sturdy anchor point. Grip the handles or ends of the band with a slightly wider than shoulder-width grip.
Sit or stand tall with a neutral spine. Retract your shoulder blades down and back. Engage your core.
Inhale and initiate the movement by pulling the band down toward your chest in a controlled motion. Focus on drawing your shoulder blades together as you pull.
Exhale at the bottom as your hands approach your chest. Do not round or arch your lower back.
Inhale and slowly return your arms back overhead to the starting position by straightening your arms. Maintain control throughout.
Repeat for 2-3 sets of 10-12 reps, keeping proper form. Draw your shoulder blades down and back on each rep.
Keep your shoulders down and control the movement on both the pulling and releasing phases.
Though SI joint pain is common during pregnancy, it does not have to prevent staying active. With doctor approval, choosing the right low-impact exercises can provide significant relief by keeping the joints mobile and surrounding muscles engaged. While being careful to avoid overstretching or high-impact activities, moves like pelvic tilts, resisted band work, and modified yoga can strengthen and stabilize without placing undue strain. Along with other lifestyle measures, a targeted prenatal exercise routine can help manage SI joint pain for a more comfortable pregnancy. Most importantly, new mothers should listen to their bodies, seek professional guidance, and work within their current capabilities. With the proper modifications, exercise can be tremendously beneficial for alleviating SI joint discomfort during this transformative time.
The key is staying active while honouring your body's changes and limitations during pregnancy. Seeking professional guidance can help develop the perfect exercise plan for your SI joint pain.