15. SI Joint Pain in Pregnancy

Pregnancy can come with a lot of aches and pains, a major one being SI Joint Pain. 

The SI Joints (sacroiliac joints) sit at the back of the pelvis and many expectant moms are told this is just "a part of pregnancy"....

But in this episode, Meg breaks down:

- what the role of the SI Joints are

- what causes SI Joint pain in pregnancy

- prevention strategies to reduce SI Joint pain

- management strategies is pain is already occuring 

For more support in your pregnancy, check out Meg's 1:1 Prenatal Fitness coaching HERE. 

To sign up for Meg's FREE Strong in Pregnancy class happening on April 2, 2025 click here! 

Disclaimer: This podcast is intended for educational purposes only and not to diagnose or treat any conditions. Before beginning any type of fitness or nutrition program, it is your responsibility to consult with a medical professional.

Connect with us! 

• Instagram @vibrantlyyoupodcast
• Meg's Instagram @vibrantmamawellness
• Caitlin's Instagram @wholesomehuntressnutrition

Transcript

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SPEAKER_02 0:00

Oftentimes, providers will tell people, like, oh, this is just a normal part of pregnancy. It'll go away when pregnancy ends. And that can just be really defeating because especially if you're someone who's, you know, at the beginning of your second trimester and you're already experiencing this, you're like, what do you mean I have to deal with this for six more months?

SPEAKER_01 0:21

Welcome to the Vibrantly You podcast. We're your hosts, Megan Martnow. Caitlin Cipriano. In this podcast, we talk about fitness and nutrition on your motherhood journey. Whether you're trying to conceive, pregnant, postpartum, or beyond, you're welcome here.

SPEAKER_02 0:36

Nothing is off limits, and our goal is to support you in this important season of life so that you can feel vibrantly you. As a reminder, this information is not medical advice. Please see the show notes for more details.

SPEAKER_00 0:49

Welcome back to the Vibrantly You podcast. Today we're going to be talking all about SI joint pain in pregnancy, which is unfortunately something both Meg and I have personally experienced and is very common in both pregnancy and postpartum populations. So, first things first, Meg, let's talk about exactly what SI joint pain is, because sometimes this can get confused with low back pain.

SPEAKER_02 1:15

Yes, so SI joint pain is the sacroiliac joint, which is on the back of your pelvis, and you have two of them. So there's one on either side of your spine where the ilium meets the sacrum. And so this is like technically low back, but it's like low. But sometimes people just can't differentiate the two because even if your pain is originating from this joint, it can travel, right? So it can like travel up your back. You might not know that this is what you're experiencing. But typically, if you're having SI joint pain, it's usually just felt on one side, or one side is worse than the other. It can be chronic and dull, something that you're always kind of experiencing. And it can also be sharp and shooting, coming in at, you know, either random times or even consistently with certain movements and things like that. And sometimes it can even radiate down the leg. So sometimes it can even be confused with sciatica.

SPEAKER_00 2:16

Yeah, it's very involved in a lot of day-to-day movements. And I know for me personally and my experience, it also impacts my glutes significantly. So I deal with a lot of glute tightness. And it will sometimes, like you mentioned, like shoot down through my leg when it's been really bad. And it just can be really debilitating.

SPEAKER_02 2:44

It can absolutely. It can be something that is really frustrating. It's lumped into pelvic girdle pain, which a lot of people experience in pregnancy. So typically the other thing that people experience is SPD, which is the front of the pelvis, and we'll do a whole separate episode on that. But oftentimes, providers will tell people, like, oh, this is just a normal part of pregnancy. It'll go away when pregnancy ends. And that can just be really defeating because especially if you're someone who's, you know, at the beginning of your second trimester and you're already experiencing this, you're like, what do you mean I have to deal with this for six more months? That can feel horrible. That was me. Like my pelvic pain started at 18 weeks with my second pregnancy, and thankfully I knew what to do. But for people that don't, that is horrible. So there are things that we can do, which is good.

SPEAKER_00 3:40

I think it is helpful to know that you can't see improvement here because, like you, this is something that's been ongoing and it doesn't just like magic itself away once you're done having a pregnancy. These are, you know, these are joints, and there's a lot of uh, yes, there's a lot of stress that gets placed on them because things shift when you're pregnant, but a lot of it too is like you talk about the way that like we move and our alignment and uh how our body stabilizes things, and so that means that there's things that you can also do to improve it.

SPEAKER_02 4:27

Absolutely. So let's talk about what causes this pain. So the purpose of the SI joints are to help resist an anterior pelvic till, which is when you're kind of sticking your butt or your tailbone out. So basically, it's trying to help keep your pelvis neutral, but also their joints. So we do want to see some movement there, especially when you're walking, like the pelvis is meant to move. But in pregnancy, more stress is placed on these joints due to, you guessed it, an anterior pelvic tilt, which happens due to a weak core and also just the weight of the belly pulling forward, which naturally pulls that pelvis into an anterior pelvic tilt. Other things are hormonal changes like relaxing. And I feel like relaxing gets a lot of attention in pregnancy for this reason, but it does cause some laxity, which is what we want, but we typically don't want that until closer to birth when we want things to loosen up and move. Sometimes this can happen earlier on in pregnancy and it can cause some hypermobile joints. But typically, this is like if you are already someone who is hypermobile. So it's not just gonna be for everyone where like you're eight weeks pregnant and suddenly everything is just like super mobile. Like that's probably not gonna happen. But if you're someone who's more prone to being hypermobile, then this can happen. And then also increased body weight. So obviously, you're gaining weight as your pregnancy progresses. This is going to increase pressure on the pelvis. And yeah, just like that overall postural thing, changes in your center of gravity, like all of these things impact the pelvis.

SPEAKER_00 6:13

Do you also feel like there is an impact on like when we talk about the 360 breathing a lot in our like core canister, that pressure system? Do you feel like there is a role or impact there when it comes to this like pelvic stability and SI joint, how it moves on a day-to-day basis?

SPEAKER_02 6:37

Yes, because the 360 breathing impacts multiple things. So it's impacting your diaphragm, your transverse abdominis, which is the deep core muscles that's wrapping all the way around your torso. So that's kind of like, yes, it's your abs, but it's wrapping all the way around to the back. It's also the multifidus, which are muscles in your back along the spine, and pelvic floor. Do I say that already? The pelvic floor muscles. So if your breathing technique is a little off, all of those muscles are going to be impacted and they're all connected to your pelvis. So that is actually a big prevention and management strategy is really mastering that 360 breathing. Because again, if you're like breathing a little funky, say it's impacting your pelvic floor muscles, and those muscles tighten up. If your pelvic floor muscles are tight, that's going to start to pull on the pelvis and it can pull on those joints. So it is really important to remember that everything is connected. I've just been thinking about that a lot.

SPEAKER_00 7:42

Personally, and how I just feel like that probably was the start of that cascade of issues for myself. Is just even going back to my first pregnancy, I didn't know I get an idea how to quote unquote improperly breathe, like breathe and do that. And now I do, but I feel like if I had known that back then, it may not have quite gotten to this point.

SPEAKER_02 8:12

Yeah. Well, and that's why I talk about 360 breathing, like ad nauseum. Like people are probably like, oh my gosh, this girl needs to shut up about 360 breathing, but it's so important. And I think it's also important to bring up the fact that it's like if you are like, you know, you have a day where you're sick or something, you know, and your your breathing is off. Like that's not the problem. It's repeated patterns over time and like us getting stuck, and I'm actually gonna talk about this a little later, but when we get stuck in these like repeated patterns that are not optimal over time, like months and months or years and years, that's when these problems crop up. So sometimes I do feel like people get a little afraid because they're like, oh my gosh, if I'm not breathing perfectly here, like everything's gonna go wrong. And it's not, it's just like we want to do our best as often as we can because everything adds up, you know.

SPEAKER_00 9:05

Absolutely. And I think that is such a good, big foundational piece, and then you can again stack these other things that you mentioned on top of it. Yes.

SPEAKER_02 9:20

Yes. So if we're talking about prevention strategies, so just like a little caveat like we can't always prevent this, sometimes it just happens. However, putting in place these prevention strategies are always gonna help and not hurt. So things that you can do if you're earlier on in your pregnancy and you want to try to prevent this as pregnancy progresses is really focusing on a stacked alignment. So that's going to look like keeping your rib cage stacked over your pelvis, trying to make sure that that pelvis is staying neutral, not coming into that anterior pelvic tilt where your, you know, tailbone is sticking out, but also trying to not tuck the pelvis under either. Because sometimes people can get stuck in that pattern where they're like clenching the glutes and the pelvis is tucked under. So just Caitlin's raising her hand. So just trying to keep that pelvis nice and neutral, but also stacking the rib cage over too, because we can also come into a rib flare situation where you're like sticking your rib cage out. So then if you have the combination of sticking out that rib cage and then your butt sticking out, like not great for your breathing, like we were just talking about, but that's going to put a lot of stress on your pelvis. So trying to stay stacked and neutral as often as you can. Again, this is I don't want you to walk around like a robot and never moving, but just the more you can bring attention to it and try to stay stacked, the better off you'll be. The second thing for prevention is having strong core functioning and glutes. Like I know you just mentioned Caitlin, like it affects your glutes when you have that SI joint pain. So having a strong core, I know we did an episode on abs in pregnancy. So I'll link that below if you want to learn like what are some good ab exercises for pregnancy. And then strengthening those glutes, because these are both involved in stabilization for the pelvis and just helps reduce excess movement in those joints. And then the last thing, prevention-wise, is just at the first sign of discomfort. So, say you're doing an exercise and you're doing some reverse lunges and you notice a little twinge in that SI joint pain. Do not power through. Do not be like, okay, it's fine. No pain, no gain. No, if you are noticing that it's starting to bother you, stop with the single leg exercises and maybe, you know, look at these strategies that I'm gonna talk about next if it's already occurring, or seek out a pelvic floor PT, seek out someone who specializes in prenatal exercise. Like, don't just try to power through and be like, it'll be fine, because it probably will get worse. I'm not gonna lie.

SPEAKER_00 11:51

I was gonna say, listen to your body if it is uncomfortable. Like Meg said, don't power through. I can tell you from experience that it just prolongs things improving and can make your just like your day-to-day symptoms worse as well.

SPEAKER_02 12:10

Yeah. So if you're already experiencing this, here are some management strategies that you can implement and hopefully this will help reduce some pain. You probably won't get to the point where it's like completely eliminated. You might though. It's definitely possible. But at the at the very least, it will help reduce the symptoms, which is what we're always trying to aim for. So it's gonna be those same tips that I just mentioned. So focusing on that stacked alignment, rib cage over pelvis, strengthening your core and glutes to help with the stabilization. And then you are going to avoid single leg exercises. So this includes things like lunges, step-ups, single leg deadlifts, anything where you're putting the majority of the weight on one leg, you're going to stop doing those. And I know that can feel frustrating, especially if you are someone who has been really active and you know, you like going to the gym, you like working out. It can feel like you are um, you know, being restricted in your movement. But I don't want you to think of it as a restriction or something that you can't do. Like this is a management strategy. We're trying to reduce pain and discomfort so that you can get through the rest of your pregnancy with more ease and enjoy it and not be in pain. Another thing you're gonna want to avoid is deep single leg stretches. So that could be, you know, like a seated hamstring stretch where you have like one leg out and like sitting on the ground and you're stretching that one hamstring. So try to avoid things like that. And then I know I mentioned this a little bit before, but habitual postures. So these are the type of movement patterns that you are habitual with. You're doing them all the time, repeated over time, because these can influence SI joint pain. So these are gonna be things. Some of these things you might even be like, what how's this connected? Forward head positioning. So a lot of us do this because also we're like looking at phones or hunched over at a desk. So trying to like like put your finger on your chin and try to like press it back. Like give yourself a double chin. Try to bring that head back because this is all part of the stacked alignment. We want ears over shoulders. So trying to do that as much as you can with your head, that's going to just help overall posture. Jaw clenching. This is something I'm very guilty of. I feel like a lot of us are. But your jaw is directly connected to your pelvic floor. So most likely if you're clenching your jaw, you're also clenching your pelvic floor. So just something to be aware of. If you notice that you're clenching, try to release that jaw, also bring awareness to the pelvic floor. Try to release that as well. Shallow breathing, so like we mentioned before, just like those not so great breathing patterns can have a big impact. So try to focus on that 360 breathing. Glute clenching. So this does happen when we tuck the pelvis under. So trying to just bring awareness to your glutes. I feel like an activity where people notice this the most is washing dishes for whatever reason. Whenever people are washing dishes, they always notice that pelvis is tucked under and they're clenching the glutes. So trying to just bring awareness there, like literally shake it out, like shake your butt, let those muscles go. Rib flare, like I mentioned before, shifting to one side. So if you're someone when you're standing, again, even like washing dishes, if you kind of like shift onto one hip, you know, and like shift to one side, a lot of your weight is on that one foot. You're gonna want to stop doing that and try to evenly distribute weight on both feet when you're standing. Also standing on the insides or outsides of your feet. A lot of us do this too without realizing it, just like rolling onto the outsides of our feet or having them come inward. So trying to just again have balanced weight on the feet. And then, like I mentioned before, the anterior pelvic tilts, being aware of that. Also crossing your legs. So this is going to be not like crossing your legs at the ankles, but like if you're taking one, you know, knee and bringing it up over the other knee, that kind of thing, because that's going to pull the pelvis out of alignment and really stress those joints. And then I had already mentioned the single leg movements in terms of exercise, but even thinking about as you're going through your day-to-day, what are some single leg movements, movements that you're doing? So if you're getting dressed and say you're putting your pants on when you're standing up and you like stand on one leg to put your pants on, avoid that. Instead, sit down on the edge of your bed and put your pants on. So thinking about things like that, even like getting out of the car rather than like swinging one leg out, starting to stand, pull the other leg out. Instead, think of yourself like a mermaid. And, you know, your legs are attached and swing them both out of the car, plant both feet on the ground, stand up. So just bringing more awareness to that. And sometimes going up and down stairs can be a challenge for people. Even just turning sideways. I know it sounds silly and looks silly, but just turning sideways and going up your stairs sideways can help because it's not bringing that pelvis in that like forward and back motion. Instead, we're just kind of like a crab, you know, going sideways up the stairs. So those are some lifestyle things that can be really helpful. Did you, Caitlyn, ever find that those, like just implementing those helped with your SI joint pain?

SPEAKER_00 17:22

Yeah, and I would say for me, my most significant SI joint pain is actually in the postpartum period in comparison to pregnancy. Yes, I I absolutely had discomfort with it then. But I just like you said, there's little strategies throughout the day that made it much easier to manage. Uh, like you said, just really paying attention to positioning. I had to really bring awareness and especially like washing dishes for whatever reason, just really had glute clenching during that. So I had to really just pay attention and be mindful there. But yeah, sitting on the bed to put like pants on was huge, and just paying attention to these little things did make a difference in how I could manage the discomfort.

SPEAKER_02 18:22

Yeah, and I'm glad that you mentioned that it was a problem postpartum too, because again, I think when people have this during pregnancy and they go to their provider, and their provider's like, oh, it'll go away once you give birth. Like, yeah, for some people that does happen, and we love that for them. But for a lot of people like you, it actually gets worse postpartum. And even for me, actually, I didn't really have a whole lot of SI joint pain during pregnancy. For me, it was more of the SPD, but then postpartum, I had SI joint pain. I was like, what's going on here? This is new. And this can happen, especially if you're lactating. Cause again, we still have that hormonal stuff going on. And if you are someone who's more prone to being hypermobile like me, that can also be an issue postpartum. So the same strategies would apply in pregnancy postpartum. But this is why it's important if you are experiencing it during pregnancy. Don't just be like, okay, I'm gonna rest, I'm gonna wait it out, it'll go away. Because it might not. And I would hate for it to get worse for you postpartum. So it's like the sooner that you can start implementing these things, the better off you're gonna be. And if you are one of those lucky people where it goes away postpartum, then great. You know, like this is only gonna help you. So I would definitely be implementing these things as much as you can. And then I would also just say if things are really not improving, like you're implementing all these things and you're not really noticing a difference, you can also consider a pelvic support belt. So this is something that you wear that it wraps around the pelvis and it's like pulled tightly. So it's like an actual physical support to the pelvis to provide stability. So when we're trying to strengthen different muscle groups, we're trying to, you know, increase some stability there, but this will actually give you like physical support and kind of hold things together. And then if that's not helping either, go see a pelvic floor physical therapist. Like, do not prolong this. They are fantastic people. I always recommend a pelvic PT over a chiropractor for pelvic pain. Now, chiropractors can be really helpful, but again, this is like a stability issue where you want to have muscles getting stronger to aid and support. And this is just not what chiropractors provide, right? Like they're giving you a little more like immediate relief. But if you want like long-term lasting results, I definitely recommend seeing APT. And you could see both in combination, like that would be fantastic, but don't like just go to a chiropractor and not also work on strengthening because that's what's really going to help you long term.

SPEAKER_00 21:06

Yeah, absolutely. I think both are I I use both, and I think they both have um really good value. And but I agree with you. I think both personally, like I had more success in improving pain with working with a physical therapist on those strengthening imbalances, I should say. Yeah.

SPEAKER_02 21:38

Yeah. And I would say even like the pelvic floor PTs that I've talked to, like they do recommend Cairo work as well. But I think doing them in combination is gonna get you the best results. And if you only can pick one, go with the pelvic floor PT. That's my recommendation.

SPEAKER_00 21:53

Yeah, I would agree. Alrighty, we hope that you enjoyed this week's episode. Please don't forget MAG is hosting a free strong in pregnancy class on Wednesday, April 2nd. So please be sure to sign up for that in the show notes. It's going to have information on exercising safely in pregnancy, followed by a workout that is safe for all trimesters. If you're currently experiencing SI joint pain and want personalized programming to feel better and strengthen your body, be sure to check out Meg's one on one prenatal coaching and we will talk to you next week.