One of the topics people ask me about most frequently is my exercise routine for SI joint dysfunction. However, before I go into specific exercises, I wanted to take a moment to try to shift your thinking on what strengthening means for SI joint dysfunction.
What a lot of people get wrong is thinking there are certain exercises that they have to do, no matter what.
This idea often comes from working with a PT or other healthcare professional who tells you that there’s only “one” way to do things, and that you’ll never get better unless you push through a certain number of reps, no matter how much it hurts.
I encountered this idea myself, when I was first starting out. Yet, being told to do exercises that were painful never worked for me– and now, I know that it doesn’t work for my clients, either.
Here’s a better way to think about it: which muscle GROUPS are you activating?
The key to stabilizing your SI joints is to build up your strength in the muscles that surround the joint. However, the end result you’re looking for is an increase in strength.
For any muscle in the body, there is more than one way to get there. You don’t have to do things that are painful.
So before we talk about specific exercises, I like to talk about muscle GROUPS.
#1 The Core/Transverse Abdominis muscle
What we know about core strengthening has changed a lot in the past decade or so. When I was a high school runner, my coaches had us doing crunches and sit-ups.
Now we know that those exercises are actually not the best way to strengthen your core, because they don’t focus on the very most important muscle to core stability, the transverse abdominis.
The transverse abdominis is deeper than all of the other core muscles, and when it contracts, it acts like a “corset” to support your trunk.
Exercises to strengthen the TA actually don’t involve crunches. Instead, contracting the TA is more of an “inward” motion. It will almost feel as though you are sucking in your belly button, as though you’re trying to squeeze into a pair of tight pants.
I personally think the easiest position to start learning how to do this is when you’re lying flat on your back. Then you maintain this “sucking in” while you perform other motions that challenge your body– but only you’re sure you’re contracting it correctly.
Here is a video that gives you an idea of what it’s like to learn how to strengthen the TA. As you’ll see, it’s a lot more about learning to identify the muscle and control it, than it is about brute strength.
The TA is also activated quite easily and effortlessly by pool exercises that force you to stabilize your trunk and legs in the water– but you do have to know how to contract it, in order to make sure you’re doing it right. More on this later.
Update: I wrote another post focusing exclusively on the TA– you can read about it here!
#2. The Muscles in the Back of the Hip (Hip Extensors, Abductors, and External Rotators)
Did you know there are actually several different muscles that make up the glutes?
The term “glutes” actually refers to several different muscles which perform slightly different functions: the hip extensors, abductors, and external rotators..
Rather than giving you an oversimplification, I want to walk you guys through the thought process that really helped me in my own recovery. I started to take much more control over my own situation once I began to understand things on a more technical level.
That’s why I’m giving you the official names for these muscle groups, which are all located in the back of the hip/SI joint.
One of the reasons why the SI joint is so difficult to treat is that there are no muscles that directly act on it.
Other joints in the body have one or two major muscles that directly cross them, so rehab can be more straightforward.
For the SI joint, things are a little more complicated because it isn’t a joint where major motion is supposed to occur. Instead, it’s meant to transfer forces as part of a larger overall force transfer system. That’s why there aren’t any muscles that specifically act on it, compared to the muscles acting on the joints in your arms and legs.
That’s why it’s a bit more complex to identify which muscles to strengthen. However, these muscles in the back of the hip, such as the gluteus maximus and gluteus medius, are *super* helpful.
For me, strengthening these muscles made a big difference in healing my recurring posterior rotation. Weaker muscles are more likely to get tired easily, tense up, and then, in my case, pull that hip bone backwards. Once I managed to get stronger, they had a lot more endurance, and stopped constantly pulling me into that posterior rotation.
There are multiple ways to strengthen these muscles.
The key is to find the ways to target these muscles, so that your brain is sending a signal to those muscle fibers… without causing any pain and stressing out the joint. (We talk more about this in my coaching program!).
#3 Muscles of the Lower Back (Spinal Stabilizers)
Similar to the muscles in the back of the hip, the low back muscles are another “next best thing” to actually being able to strengthen a muscle that directly crosses the SI joint.
These muscle work hand in hand, along with the muscles in the back of the hip, to strengthen that whole part of your body.
Two major sets of muscles here:
And the Multifidus:
Both the erector spine and the multifidus attach along the vertebrae and help to stabilize your low back and maintain good posture.
They are really deep inside the body, however, and aren’t the easiest muscles to visualize. Luckily, you don’t need to be thinking about them consciously to strengthen them.
Instead, when you do proper core activations with the correct breathing and posture, these spinal stabilizers are recruited as well– all the more reason to invest in a good core routine.
Learning to re-frame my thinking on strengthening was a key part of my recovery.
I went from thinking I had to push through certain exercises, to realizing I could modify anything I needed to. That’s when I started strengthening in a way that was actually gentle on my ligaments.
If you’d like to learn how to strengthen in a way that actually helps you heal, rather than causing setbacks, you’ll love my coaching program! Click here for more info.
What do you guys think?
Has anyone ever told you to push through a list of exercises that are painful? How does the idea of targeting muscle groups instead sit with you?
Let me know in the comments below!