Hi everyone!
I’ve had a lot of requests recently for exercises for the SI joint.
There are soo many things I want to say about this, but today, I figured we’d start with what I believe to be the most important place to start strengthening: a core muscle called the transverse abdominis.
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The transverse abdominis is the #1 most important muscle to strengthen to stabilize the sacroiliac joint. As you can see here, it wraps around the whole front of your torso. When you tighten it, it’s like tightening a corset.
A big part of my recovery was learning to consciously activate my TA at times when my SI joints were hurting, and I was having trouble making it from Point A to Point B. I’d think, “Oh wait– I have this amazing muscle that can help!” Then I would contract my TA, and it would almost feel as though someone or something was giving me a gentle hug in the front of my body, helping to hold me up.
Although this muscle is in the front of the body, it actually helps to support your whole spine. When it’s working, the difference is night and day.
The tricky thing about the TA is it’s not the most straightforward thing to learn to identify. As the guy in this video says above, it’s not like strengthening a muscle like the bicep, where you are looking to create a lot of force.
In the beginning, for most people, learning to identify the TA and contract it at all counts as “exercise.” Because it’s not so much about creating brute strength as it is becoming consciously aware of that muscle, and learning how to contract it when you really need it.
Technically, as part of the core, the TA is working on some level all of the time, without your conscious awareness. However, studies have shown that, in people with back pain, the relationship between the brain and the TA can be disrupted, and the TA tends to be weak. So training it has a lot to do with cuing your brain in to use this muscle again.
Below is an example of a physical therapist showing a patient how to contract the TA. You will see that, at the 45 second mark, there are two main instructions that he gives:
- To draw the belly button down to the spine.
- To gently rock the pelvis backward, “like you’re curling up your spine.” This is what’s known as a posterior pelvic tilt.
Technically, to contract the TA, all you really need to do is the first part, “belly button to spine.” This is what I focus on when I’m standing up right and walking around, and just need a little more support.
The second part, about the posterior pelvic tilt, ensures a stronger TA contraction. Having a very slight posterior pelvic tilt is a good way a really great way to help protect your lower back during certain exercises.
However, I know there are those of you out there who’ve been given the pelvic tilt alone as an exercise, and weren’t necessarily taught the first part about contracting the TA. It’s very, VERY important to get that TA contraction right, because it’s really the foundation of everything else you may go on to do.
Progressions
A very common way to start out strengthening the core is to do exercises such as the ones below. You start out lying on your back, only contracting the TA. Then, depending on your strength level, your PT will add in variations with leg movements, in order to increase the difficulty level and work different muscles (shown here at the 1:30 mark). You don’t have to do the exact variations in this video– your PT can work with you to determine how and when you should increase the difficulty level.
Often, when your core muscles are weak, your body will try to compensate by arching your back. This puts unhealthy stress on your lower back (I actually start to feel pain when I do it, which is a great way to know when I don’t have proper form!).
So, having this slight posterior pelvic tilt helps to get a fuller contraction out of the TA, and also ensures that you are protecting your spine.
Obviously, it will not be possible to have a posterior pelvic tilt during all of the exercises you do, but at times when it is possible (such as these lying down exercises), it makes all the difference.
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I know this is a complicated subject.
I know people are really excited to get information on SI joint exercises, so I really wanted to get something out to you.
In the long run, I wouldn’t expect you to be able to master TA contractions based on Youtube videos alone. I definitely recommend that you check in with a qualified physical therapist to make sure you’re engaging the right muscles.
Honestly, it took me a while to learn to contract the TA. I definitely did not get it on the first try, like the “patients” in these videos (who might actually be PT’s themselves). It’s somewhat of an art form, especially learning to contract it without also holding your breath.
But you can eventually get there. After all, it’s something your body is meant to do, and it’s a very powerful tool that’s there for you to use. You just have to trust that you can figure it out, and keep going. Once you feel it, you’ll know.
Top Photo Credit: Uwe Gille, via Wikipedia
My Sacroiliac Joint Saga 
i am still struggling to find a competent therapist .. and have still no clue to how to acitvate this one hell of a muscle
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Hi Rahima, I’m so sorry to hear you’re struggling like this. It really can be hard to find the right person to help you. I’ve been meaning to write a post with some general tips people can follow to try to find someone. In the meantime, you might be interested in this post from Sunlight in Winter (my more personal site) about what it took for me to finally find answers: https://sunlightinwinter.com/2017/11/30/chronic-illness/
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Hi Christy!
I know that great feeling.. doing some new”rough” exercises, and realizing you re making it through! Its so exciting! I have made some strides myself, too. ! And am very excited to be able to share with you my positive experiences.! Since April, i think, I have been able to walk my 2 miles a day with no issues and I walk on the back roads just outside my front door There are two good uphill climbs, too ( about 20%incline). So I know i can do trails that have nice flat paths like what i see in your pretty photos!
My next challenge recently was to get on a bike! … something i felt i could not do anymore. I decided to sell my Trek commuter bike with the downturned handlebars and it had a very narrow bike seat. I bought my next door neighbor s bike that had a cruiser type of seat which meant i would be sitting upright. Ill admit i was very nervous to just to get on the seat and to force push the pedals. I did a five minute ride on my street and returned home.. I got off quickly and expected to feel very wobbly and weak. That did not happen I was also pleased i was not getting any lower back pain either. . I tried it again the next day .. for 5 minutes only. . The 2nd time around my thighs were shaking a little. But that was all. ( i thought maybe my muscles were starting to “wake up” and i had no orher issues. . . I realize it was important to do this i slowly.. and to increase the time of riding just bit by bit….
Now I am now riding for 25 minutes and doing up a little bit of hill riding ( not the 20% incline!!). Just staying around on my block.( I feel like a kid doing just the neighborhood riding! ). My legs feel strong.. I am so excited to have made it this far!! (. And i have just turned 66! )
Next week on my one week vacation i plan to take my bike and ride on the bike path (or the rail trail ). And i will probably do 45 minutes? That is my next challenge and i hope ill do okay! … i try to ride everyday to keep this up!
Now I ll have to start thinking about what i will need to do when winter comes along Maybe get a bike frame of some sort and mount my bike on it? Ill have to google and see what is available out there…
I though, am a little scared because of my age… i hope i can stay strong and be okay through my 70 s and 80 s. ( Good gosh!! I am already thinking about this. ) There are plenty of things i need to improve on.. you mentioned the transverse abdominis. I probably should see a PT to help with this ….
Your suggestion to own a Sierra table is without a doubt got me on the road to feeling better about myself! I use it every daaaaay!!
Do you do planks? If you have a strong core, you should be able to do this?
When u went to RI to that center that excels in SIJD, did you go there with a problem or was it just to check it out ? Who did you see? I would love to visit. But it is a drive … ( i think and hour and half for me..)
Thanks for being here for all of us!
Laura
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Hi Laura, thanks so much for your update! It always makes me so happy to hear about your progress!!
I’m actually really impressed that you can bike so much– I personally would have been nervous about sitting on the seat for that long. But that’s really amazing that you can do it!
I actually don’t do planks as much for my core– I do the isometric TA contraction as well as some of the variations that you can add to it, to make it harder. It’s just personal preference, but I always try to pick the exercise that lets me work my muscles, while having the least impact on my SI joints. Stress to the ligaments can be cumulative so I like to be gentle on them as much as I can… so I can then go on that hike through the woods.
I went to Muldowney PT in Rhode Island because I needed help with another health issue that I have (mast cell activation syndrome). However, Kathleen (my PT there) ended up being able to explain and pinpoint all of these other issues I’d been having for a long time, related to having hypermobile joints (which I didn’t even know I had). I would highly, HIGHLY recommend them! The original PT who taught me the Muscle Energy Technique no longer sees patients, as she got promoted into management, so now Muldowney is my top recommendation for SI joints in the New England area. I would definitely go! It sounds like you are staying in alignment, but if it ever came up, there are also some adjustments they can teach to a friend or family member so you don’t have to drive back down there all the time.
Hope this helps 🙂
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Help!! My SI has been giving me problems the past two months. I can’t seem to get it to stay in place. I went to physio and they basically wrote me off so switched to chiro (I’ve been reading your blogs and see that maybe this isn’t the best idea??) it seems like it will go in place with manipulation and it slips out fairly quickly. I don’t get pain down my leg, I get it up my back (it feels like my multifidus is going to snap) I work out regularly and I felt like I was in decent shape. I was using a SI belt but it doesn’t seem to help.
I am getting super frustrated and discouraged with this. I expected it to be a quick fix but it just won’t stay in place 😦
Please send an response or email if possible.
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Thanks for the info.
Old school bodybuilders exercised the TVA this way to flatten the stomach/waist but also used it to strengthen the lower back. They called it the vacuum.
Some good info about here if interested: https://www.t-nation.com/training/the-best-exercise-for-a-smaller-waist/
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