Biking With SI Joint Problems
By
Aubrey Bailey, PT, DPT, CF-L1
Updated on July 31, 2025
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You might not think much about your sacroiliac (SI) joints — until they hurt. Sacroiliac joint dysfunction is a literal pain in the butt. SI joint exercises can help, but road or trail biking could make your pain worse.
Recognizing SI Joint Problems
SI joint dysfunction — a condition that affects the joint where the sacrum, the lowest part of your spine, and pelvis attach — doesn't just cause pain in the buttocks. According to one research review, SI joint dysfunction is the main underlying cause of low back pain in 15 to 30 percent of patients.
Before exercising, see your doctor for an accurate diagnosis if you suspect you have sacroiliac joint dysfunction or you have low back pain that interferes with your daily activities. Some activities, such as running or biking, could make your symptoms worse.
Biking and SI Joint Pain
While biking is an excellent exercise for boosting heart and lung health, it isn't without its drawbacks. Low back pain is a common overuse injury among cyclists. Riding a bike puts your low back and pelvis in a flexed position for prolonged periods. This position also puts your core muscles in a position that compromises their effectiveness, putting you at further risk of injury.
Take frequent breaks while biking to help with sacroiliac joint pain relief. When stopped, stand up straight, with one hand resting on a stable surface. Grab one ankle behind you with the other hand, gently pulling it toward your glutes. Keep your spine in neutral alignment, and hold for 15 to 30 seconds on each side to stretch your quadriceps.
A poorly fitting bike or improper biking posture can also contribute to low back and sacroiliac joint pain — a seat that is tilted too high causes your spine to flex even farther. Position your seat so that your knee has a slight bend in it at the bottom of your pedal stroke.
If you continue to have SI pain but want to keep your legs conditioned for cycling, consider training with a recumbent bike. This exercise machine’s supportive seat reduces stress on the lower back and minimizes the impact on hip joints.
How to Get Sacroiliac Joint Pain Relief
Taking a break from cycling while your SI joint heals can be a bummer. The good news is, there are several things you can do at home to help with sacroiliac joint pain relief. Home treatment can include applying heat or ice, taking pain medications and anti-inflammatories, resting, and doing strengthening exercises and stretches.
Apply ice for 10 to 15 minutes every 2 to 3 hours to decrease pain immediately following any aggravating activity, such as biking. This will numb your skin, lessening pain, as well as constrict your blood vessels, helping to decrease inflammation. For achy muscles when you have chronic SI dysfunction, try applying heat or taking a warm bath. This will open your blood vessels to increase circulation and relax tight muscles around your SI joint.
Medical interventions are also used to treat sacroiliac joint inflammation. Oral pain relievers, steroid injections, SI belt use, physical therapy (including manual joint manipulation), massage, and acupuncture are all treatments for this condition.
Other treatments include radiofrequency ablation, in which heat temporarily destroys nerves to reduce pain. Platelet rich plasma or prolotherapy (natural irritant) injections are both used to induce tissue healing, as are biologics like stem cell therapy. Joint fusion surgery is also an option in rare cases that don’t respond to other treatments.
SI joint exercises, including strengthening activities and stretches, can also help relieve SI joint pain. Stop exercising if your pain increases, and consult a physical therapist for an individualized exercise program.
SI Joint Exercises for Strengthening
SI joint exercises include strengthening muscles in your core, glutes, pelvic floor, and hips, as well as stretching muscles that attach to your pelvis. Perform strengthening exercises in sets of 10 to 15 repetitions, holding each rep for 5 to 10 seconds each. Stretches should be held for 15 to 30 seconds on each side.
Move 1: Kegels
Strengthen your pelvic floor — deep muscles that attach to your pelvis and the base of your spine — with Kegel exercises.
- Sit, stand, or lie on your back.
- Tighten your pelvic floor as if you are stopping the flow of urine and preventing the release of gas, taking care not to engage your glutes, thighs, or other muscles.
- Hold for 8 seconds, then relax for 8 seconds. Complete 8 more reps of the hold-relax cycle.
Move 2: Pelvic Tilt
The pelvic tilt strengthens deep abdominal muscles that help support your SI joint.
- Lie on your back with your knees bent and feet on the floor.
- Tighten your abs and flatten your low back into the ground with a slight upward tilt of the pelvis, as if you are pulling your belly button to your spine.
- Hold for 5 to 10 seconds, then relax. Repeat 10 to 15 times.
Move 3: Clamshells
Clamshells strengthen the gluteus medius muscles, which are important for stabilizing the pelvis in a standing position.
- Lie on your side with your hips, knees, and ankles stacked on top of each other, resting your head on your arm or in your hand.
- Bend your knees at a 90-degree angle.
- Keeping your feet together and your bottom leg on the floor, lift your top knee up toward the ceiling. Hold for two to three seconds, then lower back down. Repeat 10 to 15 times. You should feel muscles on the outside of your buttocks tighten during this movement.
- Repeat on the other side.
Move 4: Knee to Chest Stretch
The knee to chest exercise gently stretches the SI joint, lower back, and glutes.
- Lie on your back with your legs bent, feet on the ground.
- Lift one knee up toward your chest while keeping the other foot flat on the floor.
- Place your hands behind your knee and gently pull your thigh closer to your chest.
- Hole for 15 to 30 seconds when you feel a stretch in your lower back and glutes.
- Repeat on the opposite side.
Never stretch to the point of pain.
Move 5: Piriformis Stretch
The piriformis muscle attaches to the sacrum bone, which is part of the SI joint.
- Lie on your back with your legs straight.
- Lift one leg and bend your knee. Gently pull your knee to the opposite side with your opposite hand.
- Gently press down on your knee until you feel a stretch in your buttock and hip; hold for 15 to 30 seconds.
- Repeat on the other side.
The Takeaway
- Sacroiliac (SI) joint dysfunction, a condition that’s responsible for low back pain about 15 to 30 percent of the time, can be difficult to live with, but there are simple exercises that can alleviate some of its symptoms.
- Low back pain, including SI joint dysfunction-related pain, is a common overuse injury in cyclists that can be prevented by making sure that your bike fits and you’re maintaining a proper spinal position while riding.
- While rest is crucial, there are a variety treatments for SI joint dysfunction, such as home remedies like ice and heat, physical therapy, medication, regenerative treatments, and, in severe cases, surgery.
- If you’re experiencing hip or low back pain related to cycling, talk to your doctor about a diagnosis and treatment options.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Sacroiliitis. Mayo Clinic. February 22, 2024.
- Moore C. Sacroiliac Joint Pain: Best Exercises & Stretches for Relief. Continuous Motion Physical Therapy. October 31, 2024.
- Szadek K et al. Sacroiliac Joint Pain. Pain Practice. December 28, 2023.
- Health Benefits of Cycling and Do’s and Don’ts. Cleveland Clinic. June 6, 2022.
- Kreuger L. 5 Common Cycling Injuries and How to Avoid Them. Hospital for Special Surgery. September 20, 2023.
- Patti A et al. Effects of Cycling on Spine: A Case–Control Study Using a 3D Scanning Method. Sports. November 15, 2023.
- Cyclist’s Back. Physiopedia.
- Sacroiliac Joint Pain. Mass General Brigham.
- Dennis A. The 3 Most Common Cycling Injuries. Ace Sports Clinic.
- Bike Fit. Physiopedia.
- Sidelined by Hip Pain? Here's How You Can Still Get Exercise. Spine and Orthopedic Center of New Mexico.
- Discover the Health Benefits of Recumbent Bicycles: A Physiotherapist’s Guide. Brentwood Physio.
- Diagnosing and Treating Sacroiliac Joint Dysfunction. Weill Cornell Medicine. September 2023.
- Sports Medicine: Sacroiliac (SI) Joint Dysfunction. Nationwide Children’s Hospital. 2021.
- Injury: Do I Use Ice or Heat? Boys Town National Research Hospital.
- Ice vs. Heat: Which Is Better for Your Pain? Cleveland Clinic. February 5, 2025.
- Aranke M et al. Invasive and Conservative Interventions for the Treatment of Sacroiliac Joint Pain: A Review of Recent Literature. Orthopedic Reviews. May 31, 2022.
- Pelvic Floor Muscles. Cleveland Clinic. April 13, 2022.
- Why You Should Be Doing the Clamshell Exercise Regularly. International Sports Sciences Association. August 3, 2022.
- Chang C et al. Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle. StatPearls. November 13, 2023.
- Chang C et al. Sacroiliac Pain: Exercises. Kaiser Permanente. July 31, 2024.
Meet Our Experts
Scott Haak, PT, DPT, MTC, CSCS
Medical Reviewer
Scott Haak, PT, DPT, has been a member of the Mayo Clinic staff since 2000. Dr. Haak serves as faculty for the Sports Medicine Fellowship program at Mayo Clinic Florida. He is certified by the NSCA (National Strength and Conditioning Association) as a CSCS (Certified Strength and Conditioning Specialist), is a Certified USA Weightlifting Coach and Certified USA Football Coach, and possesses a MTC (Manual Therapy Certification) from the University of St. Augustine for Health Sciences.
Haak is an exercise enthusiast and enjoys running, weightlifting, and sports performance training. He is the president and director of coaching of a youth tackle football organization, JDL Providence Football, and currently coaches high school football and weight lifting.
