Disclaimer: This program provides general guidelines for managing SI joint impingement. Severe or chronic conditions, or cases involving neurological symptoms, may require specialized care. Always consult your healthcare provider before starting a rehab program.
Week 1-2: Acute Phase (Pain Management and Protection)
Goals: Reduce pain and inflammation, restore initial mobility, and avoid aggravating activities.
Rest and Activity Modification:
Avoid prolonged standing, bending, twisting, or heavy lifting.
Use a supportive SI belt if recommended for stabilization.
Pain Management:
Ice Therapy: Apply ice to the lower back or SI joint for 15-20 minutes every 2-3 hours to reduce inflammation.
Heat Therapy: Use heat packs after 48-72 hours for muscle relaxation.
Gentle Mobility Exercises:
Pelvic Tilts: Lie on your back, gently tilt your pelvis forward and backward. Perform 10-12 reps, 2-3 sets.
Knee-to-Chest Stretch: Bring one knee at a time toward your chest. Hold for 15-20 seconds, 2-3 sets per leg.
Cat-Cow Stretch: On hands and knees, alternate arching and rounding your back. Perform 10-12 reps, 2-3 sets.
Chiropractic Care:
Gentle mobilizations and adjustments to correct SI joint alignment and reduce compensatory strain.
Week 3-4: Subacute Phase (Restore Mobility and Build Stability)
Goals: Improve SI joint mobility, strengthen surrounding muscles, and address imbalances.
Stretching (Hold for 15-30 seconds, 2-3 sets):
Hip Flexor Stretch: Kneel on one knee, push the opposite hip forward.
Piriformis Stretch: Cross one leg over the other while lying on your back, pulling the legs toward your chest.
Hamstring Stretch: Extend one leg on a low surface and lean forward gently.
Strengthening Exercises:
Glute Bridges: Lie on your back, knees bent, and lift your hips toward the ceiling. Perform 10-12 reps, 2-3 sets.
Side-Lying Clamshells: Use a resistance band if tolerated. Perform 10-15 reps per leg, 2-3 sets.
Bird Dog: On hands and knees, extend opposite arm and leg. Perform 10-12 reps per side, 2-3 sets.
Core Stability:
Plank (Modified): Hold a forearm plank for 10-20 seconds, gradually increasing as tolerated. Perform 2-3 sets.
Dead Bug Exercise: Lie on your back, alternate extending opposite arm and leg. Perform 10-12 reps, 2-3 sets.
SI Joint Mobility:
Seated Pelvic Rocks: Sit on a stability ball or firm surface, gently tilt your pelvis forward and backward. Perform 10-15 reps, 2 sets.
Week 5-6: Advanced Phase (Strength and Functional Recovery)
Goals: Build strength and dynamic stability, improve functional movements, and return to activity.
Dynamic Strengthening:
Lunges (Modified Depth): Perform shallow lunges to minimize SI joint stress. Perform 8-12 reps per leg, 2-3 sets.
Step-Ups: Step onto a low surface, focusing on engaging glutes. Perform 8-12 reps per leg, 2-3 sets.
Side-Stepping with Resistance Band: Perform 10-12 steps in each direction, 2-3 sets.
Proprioception and Balance Training:
Single-Leg Balance: Stand on one leg for 15-20 seconds, gradually increasing duration. Perform 2-3 sets per leg.
Balance Board Exercises: Use a balance board for stability drills. Perform for 1-2 minutes, 2-3 sets.
Functional Training:
Incorporate hip hinges, squats, and other daily movement patterns while maintaining a neutral spine.
Gradually reintroduce low-impact activities like walking or cycling.
Advanced Core Stability:
Side Planks: Hold for 10-20 seconds per side, 2-3 sets.
Swiss Ball Rollouts: Engage the core while rolling a stability ball forward. Perform 10-12 reps, 2 sets. Chiropractic Care and Shockwave Therapy
Chiropractic Care: Routine adjustments can correct misalignments in the SI joint, lumbar spine, and pelvis, reducing compensatory stress and promoting optimal biomechanics.
Shockwave Therapy: Shockwave therapy improves blood flow, reduces inflammation, and stimulates tissue repair in the SI joint and surrounding muscles, especially in chronic or stubborn cases (Chen et al., 2019).
Evidence-Based Sources
Chiropractic and Manual Therapy:
Cusi, M., et al. (2013). "The Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Diagnosis, and Management." Journal of Orthopaedic & Sports Physical Therapy. https://pubmed.ncbi.nlm.nih.gov/23818324/
Strengthening and Proprioception:
Fryer, G., & Morris, T. (2018). "Interventions for Treating Sacroiliac Joint Pain: A Systematic Review." Manual Therapy. https://pubmed.ncbi.nlm.nih.gov/30201281/
Shockwave Therapy:
Chen, P., et al. (2019). "Effectiveness of Extracorporeal Shockwave Therapy for Musculoskeletal Conditions." Medicine (Baltimore). https://pubmed.ncbi.nlm.nih.gov/31560493/