Sacroiliac joint pain: exercises to avoid and what to do instead

Your sacroiliac (SI) joints sit where the lower spine meets the pelvis, one on each side.^[1] When they hurt, the pain is usually in the lower back and buttocks, and it can spread into the hips or thighs.^[1][2]

If you’re looking for a list of exercises to avoid with sacroiliac joint pain, none of the health services or reviews we checked gives a fixed list of banned moves. One review notes that no single treatment has been shown to work reliably for SI joint pain.^[3] What the sources do name are activities that tend to bring the pain on. The usual advice is to ease off those, stay active and get a plan from a physical therapist.^[3][4][5]

What SI joint pain is, and why some movements hurt

Each SI joint links the sacrum, the triangle-shaped bone at the base of your spine, to the ilium, the top part of your pelvis. You use these joints every time you move or shift your hips.^[2] They can become painful after an injury such as a fall or a car accident, with arthritis, during pregnancy, or from not moving enough, which can leave the muscles around the joint tight.^[1]

Certain positions and movements tend to set the pain off. Cleveland Clinic says the pain of sacroiliitis, an inflamed SI joint, can get worse when you turn or rotate your hips, or after you’ve sat or stood in one position for a long time.^[2] For more on causes and how doctors diagnose it, see our guide to what sacroiliac joint pain is.

Activities that can make SI joint pain worse

These are the activities that health services and a review of nonsurgical SI joint care name as ones that can bring on or worsen the pain. Use the list to spot your own triggers.

• Running. Mayo Clinic lists it, and the review names it among the activities that provoke SI joint pain.^[1][3]
• Climbing stairs. Mayo Clinic lists stair climbing. For pelvic pain in pregnancy, the NHS advises against going up and down stairs too often.^[1][7]
• Single-leg movements. The review names single-leg activities.^[3] In pregnancy, standing on one leg, such as when you’re getting dressed, can make pelvic pain worse.^[7]
• Twisting. Twisting activities are on the review’s list, and turning or rotating your hips can worsen sacroiliitis pain.^[2][3]
• Long spells of sitting, standing or walking. Doing any of these for a long time can make the pain worse.^[1][2]
• Heavy lifting and twisting your back. For a new bout of low back pain, MedlinePlus advises against activities that involve heavy lifting or twisting your back for the first 6 weeks after the pain starts.^[6] Sacroiliitis itself can make bending and lifting hard.^[1]
• Sleeping on the painful side. Mayo Clinic lists this too.^[1] Our guide to how to sleep with sacroiliac joint pain covers positions in more detail.

Ease off, don’t stop

The review recommends relative rest: cutting back on the activities that provoke the pain, not giving up all activity. It says this can speed recovery.^[3] Go back to the sports and exercise that set off your symptoms once you’re pain-free without medicine, and build up with care, because monitoring your return can help prevent another injury.^[3]

What about crunches, lunges, bridges and clamshells?

Many websites list moves such as crunches, deep lunges, bridges, clamshells and deep hamstring stretches as ones to avoid. None of the Mayo Clinic, Cleveland Clinic, NHS or MedlinePlus pages, or the SI joint reviews we read, rates these specific moves either way. That doesn’t mean they’re safe for you.

What the reviews describe are types of exercise, not named moves. Physical therapy for SI joint pain commonly includes exercises to strengthen the core, gluteal (buttock) and pelvic floor muscles, and stretches for the lower back, hamstrings and hip flexors.^[5] Muscles often found to be weak in people with SI joint pain include the gluteus medius and gluteus maximus, the lower abdominals and the hamstrings. People differ a lot in which muscles are tight or weak, so treatment plans are built for the individual.^[3] Our guide to SI joint exercises and stretches describes 7 gentle moves, including a hip bridge, and the source behind each one.

Stretching needs extra care in pregnancy: aggressive stretching can make symptoms worse when pregnancy has loosened the joints, so get pregnancy exercises from a physical therapist.^[3] For any back exercise, the NHS advice is to stop if your pain gets worse and see a doctor.^[4]

What to do instead

These steps come from general back pain advice and the SI joint reviews. A physical therapist can tailor them to you.^[3][4]

Stay active

Bed rest isn’t recommended for low back pain. MedlinePlus advises cutting back on activity only for the first couple of days, then slowly returning to your usual activities.^[6] The NHS says to stay active, try to carry on with your daily activities, and avoid staying in bed for long periods.^[4]

Choose gentler activity

Walking, swimming, yoga and pilates may help ease back pain, according to the NHS.^[4] For a new bout of low back pain, MedlinePlus suggests starting light aerobic activity, such as walking, riding a stationary bike or swimming, after 2 to 3 weeks.^[6] Walking appears on both lists, though: Mayo Clinic says walking for a long time can make sacroiliitis pain worse.^[1] If longer walks bring on your pain, ask a physical therapist how much walking suits you.

Get a plan from a physical therapist

Physical therapy is the most common treatment for sacroiliitis. A physical therapist gives you stretches and exercises to strengthen the muscles around your SI joints, which takes pressure off the joints and helps keep them stable.^[2] A home exercise program is recommended to keep the gains and, the authors hope, to help stop the pain coming back.^[3]

Starting stretching and strengthening exercises too soon after an injury can make your pain worse, and a physical therapist can tell you when to begin and how to do them.^[6] The research is thin: a 2017 systematic review found that physical therapy, including exercise, manipulation and kinesio tape, can reduce pain and disability from SI joint dysfunction, but the studies were small and of low to average quality.^[8] For general back strengthening, see our guide to core exercises for back pain.

Ice, heat and painkillers

The NHS suggests an ice pack, or a bag of frozen peas wrapped in a towel, to reduce pain and swelling, and a heat pack wrapped in a towel to relieve stiffness or muscle spasms.^[4] Anti-inflammatories such as ibuprofen may help, but they aren’t suitable for everyone, so check with a pharmacist or doctor if you’re unsure.^[4] Cleveland Clinic advises not taking them for more than 10 days in a row without talking to your doctor.^[2] If you’re pregnant, ask your midwife or doctor before taking an anti-inflammatory, because these drugs have been linked to pregnancy complications.^[9]

Lifting, standing and long drives

MedlinePlus lifting tips to protect your back: get help if a load is too heavy or awkward, bend at your knees rather than your waist, hold the object close to your body, and don’t twist while you bend, lift or carry. It also suggests avoiding standing for long periods and, on long drives, stopping to walk around every hour.^[6] Our guide to proper lifting has more.

During and after pregnancy

The SI joints loosen and stretch for childbirth, and the extra weight and change in how you walk during pregnancy can stress them.^[1] Pregnancy-related pelvic girdle pain (PGP) affects up to 1 in 5 pregnant women to some degree. It isn’t harmful to your baby, but it can be painful and make it hard to get around. It can be worse when you walk, go up or down stairs, stand on one leg, turn over in bed or move your legs apart, such as when getting out of a car.^[7]

The NHS suggests these steps:^[7]

• Stay active, but avoid doing things that make the pain worse, and rest when you can.
• Put equal weight on each leg when you stand, and sit down to get dressed or undressed.
• Put a pillow between your legs in bed, and keep your knees together when getting in and out of a car.
• Avoid sitting or standing for long periods, going up and down stairs too often, and lifting heavy things such as grocery bags.

Call your midwife or doctor if it’s hard to move around, it hurts to get out of a car or turn over in bed, or stairs are painful. A physical therapist may give you exercises for your pelvic floor, stomach, back and hip muscles, and sometimes a pelvic support belt or crutches.^[7] Avoid aggressive stretching: it can make symptoms worse when pregnancy has loosened the joints.^[3] Sacroiliitis linked to pregnancy usually lasts only while you’re pregnant.^[2] If pain continues after the birth, individually tailored, supervised physical therapy is reported to work better than general back or pelvic pain therapy.^[9]

Treatments a doctor may suggest

A doctor will examine your back, hips and legs, and may ask you to do some movements or press around the joint to see what triggers the pain. Tell them which activities make it worse. Imaging such as an X-ray, CT scan or MRI can show the joints, and blood tests can help rule out an infection or other causes of inflammation.^[2]

Alongside physical therapy, Cleveland Clinic lists other treatments a doctor may suggest: prescription muscle relaxers, a corticosteroid injection into the joint, or, less often, radiofrequency ablation to stop nerves in the joint sending pain signals. Surgery to fuse the joint is rare and is considered when other treatments haven’t helped. You may also be referred to a rheumatologist, a specialist in inflammatory diseases.^[2] Read more about SI joint injections and SI joint fusion.

Common questions

Is SI joint pain the same as sacroiliitis?

You can have pain in or near an SI joint without having sacroiliitis, which is inflammation of the joint that a doctor diagnoses.^[2] Arthritis is the main cause of sacroiliitis, including ankylosing spondylitis, a type of arthritis that affects the spine.^[1][2]

Can an SI belt help?

Reviews say SI belts or braces may reduce stress on the joint and pain, though research hasn’t shown who is most likely to benefit.^[3][5] Belts are often worn for walking and standing, and they need to sit in the right place on the pelvis, and fitting them takes care.^[3] A physical therapist or doctor can check the fit.

How long does SI joint pain last?

It varies. SI joint pain often fluctuates, flaring with certain daily activities, sports or exercise.^[3] If inflammatory arthritis is the cause, the joint damage may be permanent, but most people with sacroiliitis can treat the cause with medicine and manage their symptoms with physical therapy.^[2]

Does losing weight help?

It may. A 2025 review lists keeping your body weight down, along with avoiding activities that aggravate your symptoms, as lifestyle changes that might reduce stress on the joint and pain.^[5] Being overweight is also one of the things that may make pelvic girdle pain in pregnancy more likely.^[7]

Sources

1. Mayo Clinic. Sacroiliitis: Symptoms and causes. August 11, 2026.
2. Cleveland Clinic. Sacroiliitis. Last updated August 23, 2023.
3. Prather H, Bonnette M, Hunt D. Nonoperative treatment options for patients with sacroiliac joint pain. Int J Spine Surg. 2020;14(Suppl 1):S35-S40.
4. NHS. Back pain. Page last reviewed March 5, 2026.
5. Migliorini F, Lucenti L, Bardazzi T, Bell A, Cocconi F, Maffulli N. Management of sacroiliac joint pain: current concepts. Eur J Orthop Surg Traumatol. 2025;35(1):208.
6. MedlinePlus. Low back pain – acute. Review date June 27, 2026.
7. NHS. Pelvic pain in pregnancy. Page last reviewed December 12, 2022.
8. Al-Subahi M, Alayat M, Alshehri MA, et al. The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. J Phys Ther Sci. 2017;29(9):1689-1694.
9. Kanakaris NK, Roberts CS, Giannoudis PV. Pregnancy-related pelvic girdle pain: an update. BMC Med. 2011;9:15.