SI joint pain. It can be especially rough in pregnancy, making you (even more) uncomfortable as you try to stay active.
How can we prevent those symptoms of pain in the back part of the pelvis from increasing during pregnancy (and beyond!)? Read on to find my top 5 solutions for SI joint pain in pregnancy.
Where are the SI joints?
SI joint = sacroiliac joint.
These are the joints where your sacrum (more generally, think of your upper tailbone) inserts into the actual hip bones (ilium).
You might be able to feel these joints on yourself. If you put your thumbs onto the back part of the pelvis and then feel for a bony prominence, you might feel the outline of two circles. Let your thumbs fall under those circles and this is where the SI joints are.
The SI joints are very strong joints with thick ligaments and connective tissues supporting it.
In pregnancy we can have a lot of hormonal fluctuations causing this connective tissue be less stable and can cause pain to flare up in those areas.
This makes it incredibly important to keep our strength training up so we can increase the stability to counter that instability that is happening in the pelvis.
Solution #1: Walking or Weights?
I often hear the comment from my pregnant mama’s that leisurely walking does not feel so good on the SI joints.
It is common to have longer bouts of walking increase or ramp up the pain in the SI joints.
Here’s my advice: walking in pregnancy is absolutely wonderful. We want to keep walking as often as we can, but I will say that a sound strength training program can often be less irritating on the SI joints.
Me at 37ish weeks doing a strength training workout in our unfinished basement – it doesn’t need to be fancy or an equipment filled gym!
Notice how you’re feeling. If you go for a longer walk and the SI joint pain is building up during and/or after, let’s back off on the time spent walking in one bout.
Personally, towards the end of pregnancy I really reduced the amount of time per walk, yet kept strength training 3-days per week because that’s what felt best on my body.
If strength training feels better than walking, don’t feel bad that you’re not doing long enough walks. If walking is ramping up your symptoms, a shorter duration is probably best for now, while keeping your strength training workouts in.
Solution #2: Stack Your Joints From Head To Toes
We need to be sure that our alignment is well-stacked. Meaning? Get your ribcage to sit overtop of your hip bones.
What I mean by this, is that we’re not allowing ourselves to get into a bum tucked under position, where the upper body also tends to shifting backwards.
Of course this bum tucking is extremely typical as the posture starts to change in pregnancy, but do you best to ensure that your bum is staying behind you.
Instead of your bum slumping in front of your body, keep your bum behind your body.
The photo on the RIGHT is more optimal positioning. My bum is untucked – see that gentle arch in my low back?
That is going to be way comfier for your sacrum, low back, and it’s going to allow your glutes to help out in supporting your pelvis.
I really want you to watch this position in LIFE and exercise, too.
SOLUTION #3: Use Your Booty.
The difference between using the glutes to help you stand up in a squat, versus squeezing the bum really hard and going back into that bum tucked position at the top position.
I explain how to keep your bum UNTUCKED in this video:
I’m squeezing the glutes to stand, but I’m just coming to standing tall while making sure the bum still stays behind me at the top of the movement.
Really pay attention to this in your glute bridges, hip thrusts, deadlift and squat positioning. Do squeeze the glutes to stand, but don’t overdo it to cause yourself extra stress onto the pelvis and the low back by over extending through the hips.
You will still use the glutes strongly by standing to the top and keeping a ‘neutral’ pelvis position.
SOLUTION #4: Even More Booty (Use Mini Bands).
Mini bands are one of my fave fitness tools for helping the glutes do their thing. Extra fave-y of mine for use in pregnancy and postpartum (and they’re inexpensive + take up no space).
With my To Pregnancy & Beyond clients we use mini bands for lots of different exercise to help our glutes work strongly.
Mini bands are a small, circular loop of flat resistance band that you’re going to put on either just under the knees, or just above the knees as well. I think it’s easier to put them under the knees in later pregnancy because #beautifulbellies.
Pretty sure my pregnancy experience could be summed up in one phrase: ‘compression socks and mini bands’, ha!
We can use the mini bands to help the glutes do more work, yet not stress the body further by needing to pile on extra weight to make the exercise harder.
Let me set the scene. You have a goblet squat in your program, but you think it might be irritating the SI joints.
Option 1: Ditch the weight and go straight to using a mini band.
Option 2: Keep the weighted, but add a mini band in, and see if that extra effort from the glutes helps to reduce your symptoms.
Add the mini band on in lots of different lower body exercises.
• Glute Bridges
• Hip Thrusts
• Side Lying Leg Raises
SOLUTION #5: Exhale On Exertion.
Use your exhale breath well in exercise. Use your exhale breath to help support and to help create more stability in your core and pelvic floor.
There are 2 types of breathing patterns I have my moms who are working out in pregnancy play with.
Let’s keep on the squat theme:
1). As I go down into my squat, I’m inhaling. As I go to stand up from my squat, I’m going to start my exhale breath.
As I stand up from the squat, I’m exhaling.
2). If might feel better to exhale all the way down and up in your squat, then take an inhale at the top of the squat, and go into your next rep.
Way down and up in the squat = exhale, exhale, exhale, exhale.
Top of the squat: Inhale.
Either option is fine. See what feels best for the hips!
BONUS: Women’s health/pelvic floor physio’s and gentle chiropractic care can be incredibly are helpful as well in alleviating symptoms.
I want you to practice stacking your body, strengthening your glutes, and using your breath to help your core stability in these exercises.