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.
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.
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.
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.
The truth is, however, that I honestly wouldn’t expect you to be able to master TA contractions based on Youtube videos alone.
I really, really recommend that you work with a qualified physical therapist. I honestly think that’s the only way to go.
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