Do SI Joint "Release" Exercises Actually Work?

Videos with millions of views on how to self-release your SI joint, or safely pop it back into place are everywhere right now. There is real utility to relief exercises and I recommend some for other aspects of back pain myself. The problem is that relief exercises are just that, relief, not a treatment and rehab plan.

TLDR

• Your SI joint can't go out of place, because it barely moves even when it hurts.
• Relief from a release move is real, just short term, and it isn't realigning your SI joint.
• Plenty of pain labelled sacroiliac is referred from other regions of the back like the thoracolumbar junction (the transition point between the thoracic and lumbar regions of the spine).
• There’s no accepted consensus for how to treat SI pain, but soft tissue work on the glutes, strengthening the muscles that surround the joint, and addressing thoracolumbar mobility are good starting points.

The moves I'm talking about

The moves I mean: the knee-drop off the edge of the bed, the lying leg-raise variations, and the foam roller wedged under your sacrum (one video literally uses a soup can rolled in a towel). If you want to see the genre at full scale, this one has over three million views. The moves themselves are mostly fine. But any claims that you need to mobilize your SI joint should be met with skepticism. More below.

What your SI joint actually is

Your sacrum is the flat triangular bone at the base of your spine, just above your tailbone. Your pelvic bones sit either side of it, and where they meet you get the sacroiliac joints, roughly underneath where lower back dimples would be. You can see the whole arrangement in the image below - the sacrum is the orange piece in the middle.

The SI joints aren’t built to move. They are synovial joints with joint capsules, but they’re highly fibrous and capable of only a few degrees of rotation and only millimeters of potential motion. They’re built to transfer load between the legs/hips and the spine, not to permit lots of motion. Some of the thickest ligaments in the body strap it together, and your glutes squeeze it tighter when they contract. Stability and limited motion are the goals for this joint.

So when someone claims that your pain is from a “locked up” SI joint, they may be confusing the purpose of the joint. Now, to be fair, many people claim that self-release exercises have helped them tremendously. That doesn’t mean that they’re wrong or that they’re experiencing a placebo effect. Relief exercises that introduce motion and muscular activity to regions of the body that have been inactive due to avoidance can have a real benefit. Relaxing muscles that compress the joint, and activating those that don’t can give temporary relief.

In fact, since the function of the SI joints is to be stable and transfer load, I would argue that it is more likely that pain would manifest from instability in the joint, not a lack of mobility.

It might not even be your SI joint

A systematic review this year gathered 43 randomized trials of conservative care for SI joint pain and checked how each one decided the pain was sacroiliac [1]. Over 95% did minimal or no screening of the thoracolumbar spine, the part of your back just above the pelvis. That matters, because pain from those segments refers down into the buttock and back of the pelvis, exactly where people point when they say their SI is out. The dorsal rami (fancy term for the beginning of nerve roots that exit out of the spinal cord) of the lower thoracic and upper lumbar regions innervate tissues in the low back right near the location of the SI joints. This means that we can feel pain in the SI region and it might not be caused by anything local to those joints. So a decent chunk of what gets called SI joint pain could be coming from above it.

The only near-certain answer is an anesthetic injection into the SI joint under imaging (not something you're doing at home). If the pain doesn’t subside, then it is likely referred pain from above. And again, more serious interventions should only be considered after conservative treatment options have been exhausted.

Pregnancy is the real exception. Pelvic girdle pain affects close to half of pregnant women and SI motion does genuinely increase, with roughly 8 to 10% of mothers still in pain one to two years after birth [2].

So what can you do?

A well-structured rehab plan can cover all of your bases regardless of whether your pain is local to the joints, or referred from elsewhere. But you might be thinking “isn’t it a waste of effort to complete a program that addresses more than my immediate pain source?”. No. You get one body and it’s nice when everything is working. Besides, strength is never a weakness.

A 2025 review of 38 studies covering 2,666 people found the same order for SI joint pain rehab everywhere: conservative care first (exercise-based physio, activity changes, anti-inflammatories), then injections, then radiofrequency treatment of the nerves, with fusion surgery reserved for people who fail everything else [3]. That review is honest that the evidence is limited and inconsistent, with no agreed guidelines yet.

So the plan below is the conservative first line, built the way I'd build it.

1. Foam roll the glute region. Sit on a foam roller or a ball, one side at a time, and hunt around the glute and piriformis (a small deep muscle running from your sacrum out to your hip).
2. Mobilize the lower thoracic region gently. Perform gentle cat cows and open book stretches with your knees lifted a little higher than 90 degrees (targets thoracic region more).
3. Build the muscles around the hips for greater stability, not mobility. Glute bridges at home, hip thrusts in the gym. 2-3 sets, 2-3 times per week. Your glutes compress that joint when they fire, so this is the most direct thing you can do. Adductor and abductor exercises are also a good idea. Try out Copenhagen Planks and Side Plank Clamshells for this at home.
4. Add anti-movement core work. Dead bugs and side planks, or the full McGill Big 3. Back in August I wrote about the core working like a cylinder, and the floor of that cylinder is your pelvis. You're teaching the trunk to stay stable while the legs move.
5. Loaded hinges. Seated good mornings to start, bodyweight hip hinges once those feel easy. 2-3 sets of 8-12, 2-3 times per week.

As always, have a great weekend.

Best,

Mitch

Want to know which back pain pattern matches you? Take my free 2-minute quiz and find out.

References

[1] Schumacher et al., 2025 — 10.1080/10669817.2025.2539783. Screening of the thoracolumbar spine in randomized controlled trials of conservative treatment for sacroiliac joint pain: a systematic review. Journal of Manual & Manipulative Therapy, 34(2), 118-127.

[2] Fiani et al., 2021 — 10.7759/cureus.18619. Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women. Cureus, 13(10), e18619.

[3] Migliorini et al., 2025 — 10.1007/s00590-025-04308-2. Management of sacroiliac joint pain: a systematic review. European Journal of Orthopaedic Surgery & Traumatology, 35(1), 208.

Disclaimer: this content is educational only and does not constitute medical advice. See a practitioner if you suspect serious spinal trauma from a fall or accident, or if you experience any of the following red flag symptoms: loss of bowel or bladder control, numbness in the groin or saddle area, rapidly worsening leg weakness, back pain with fever or feeling generally unwell, or unexplained weight loss with back pain.