Painful SI Joints when I do Core Strengthening Exercises

(Norah)

I suffered from a severe sacrioiliac joint sprain six months ago after changing my horse saddle to a broader one which also set me in a different position from what I was used to.

I seemed to be improving at 3 months when I went back to work as a teacher and it came back with a vengeance. I am now in a lot of pain mostly the right hand joint but the pain can fluctuate from one side to the other.

My physio has given me core stability exercises the simplest ones but I feel when I make the stretches it stresses the joints which become even more sore and inflamed. I am seeing another physio who has confirmed my fears that I have loose ligaments not restricted movement.

I feel as if I have lost my elasticity and my suspension.

Is Pilates right for me? I am very slim and agile and am so upset at not being able to exercise anymore. I am no longer working, riding, or even walking the dog!

I would value your opinion as I am at my wits end as to how to help myself get mobile again.

My joints even hurt in bed and I cant sleep and I find it difficult to sit for long or bend and the tip of my coocyx gets inflamed as well when the sacrioiliac are inflamed!

Regards Norah

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Jennifer's Response:

Hi Norah and thank you for your question and putting your confidence in me. I'm sorry for your condition and especially the pain it is causing.

I addressed another question similar to yours a few months ago about lax ligaments and hypermobility issues in the si joints. This person also had a mis-aligned pelvis, which contributed to the pain.

See this article as a question on this same page.

There are several references to exercises and working in neutral spine, not a flat back posture, which can overstretch the lower back and si joints.

If it's painful for you to do the exercises lying or sitting you may want to try them in a kneeling position with something as simple as just doing breath work with abdominal contractions on the exhale.

I would also recommend doing prone lying exercises such as single leg extensions, swimming, single leg kicks (adding a lower leg circle to this one to work on strengthening the si joint).


Position yourself in a prone lying and kneeling position such as is shown on this lower back exercise page and begin by just engaging the abdominals as instructed then add some of the arm and leg movements later when you are strong enough.

I think these prone and kneeling exercises are your best bet until you can get out of pain.

Check out my newly revised Pilates Ebook here to see descriptions and pictures of these and more.

Lax Ligaments/Hypermobility Issues in the SI Joint

by Belinda
(Oregon)

I have lax ligaments and am hypermobile in general and have continuing problems with my joints being too loose.

My left sacroiliac joint in particular is constantly painful.

On your exercises for sacroiliac joint pain you say "Do not do SI exercises in poor pelvic alignment."

How can you tell if you are out of alignment and how do you correct it?

You mention the Pilates ebook. Would it be better to get the beginner DVD or the ebook?

Any info on whether Pilates would help this problem would be appreciated. There are many mentions of joints that are too tight but mine are too loose!

Thanks for your time.


Jennifer's Response:

Hi Belinda and thank you for your question.

Women do have a tendency for loose ligaments in the hip and pelvic floor muscles, especially after pregnancy.

It is recommended to do strengthening exercises in a smaller range of motion, in other words don't work the leg as far as it can go in any direction to address this hypermobility issue.

First - Dynamic (fast) and end of range movements, as well as forward bending are contraindicated (should be avoided until the joints are less painful and balanced).

For instance the Pilates Leg Circles should not be done through a full range of motion.

Second- You should learn how to find neutral spine to balance out your Pelvic Floor muscles.

This page has a good explanation of how to balance the muscle of the SI joint and some exercises that can begin to get you out of pain.

The exercises are very fundamental and focus on stabilizing the pelvis.


The Pilates Bridges are a great exercise to develop glute maximus and medium muscles to improve pelvic and hip stability. I would recommend bridges for you only after you have less pain and more balance.


There is a chance the bridge may not work for you. Symptoms vary from person to person so discontinue if it hurts.


The butterfly stretch on this page can help with some of the hypo and hyper mobility.

Focus on stabilizing the left side and allow the right leg to drop, then squeeze the right leg back to the center keeping both buttocks anchored to the floor.

This exercise can be done in a side lying position such as the clam which is very effective as well, as long as you keep the pelvis still.

Find the clam here.

This exercise and more of these are detailed in the Pilates ebook. It has over 30 exercises and modifications with 3 progressions as you increase your strength.

I feel like the ebook has more options and modifications on exercises to help your condition than the dvd.

But ultimately you choose the best way for you to exercise whether it's reading or watching and hearing a workout.


Try out some of this and, if you have a chance find a certified Pilates Equipment Instructor in your area. The spring tension on the equipment is amazing at realigning the body.

Find certified Studio's and Instructor's in your area by going here.