Healing a Broken Sacrum? Try These Physical Therapy Exercises

Sacrum fractures are uncommon, according to the American Academy of Orthopaedic Surgeons. But because of their location within the pelvis near major blood vessels and organs, they may cause extensive bleeding and other injuries that require immediate treatment. Depending on the severity of the injury, sacral fractures might respond to nonsurgical treatment, or they may require reconstructive procedures.

Your sacrum is located at the bottom of your spinal column, just below your lower back and above your coccyx, or tailbone, according to Kaiser Permanente. It’s composed of several vertebrae fused together. Along with the rest of the bones in the pelvis, it protects the nerves, blood vessels, and organs in the area, which include the bladder, bowels, and reproductive organs.

A fracture, or break, in these bones can be a painful injury. It can require weeks or months of icing the area, using pain medication, and staying off your feet to heal — even if it doesn't require surgery. You may be prescribed mobility aids like crutches or a walker to help you get around until your bones are healed enough to bear weight.

Your doctor will also refer you to physical therapy (PT) to help ensure that you regain a normal range of motion and to strengthen the muscles that stabilize your pelvis, according to Physiopedia. Check with your doctor or physical therapist to determine whether you’re ready to start PT and to confirm which exercises are appropriate for your injury.

Pelvic Lift

According to the Nicholas Institute of Sports Medicine and Athletic Trauma, the pelvic lift (sometimes called a bridge or a glute bridge) can help strengthen the muscles supporting your pelvis.

To start, lie on your back on a flat surface. Bend your knees, keeping the soles of your feet flat. Cross your arms over your chest and keep your knees together. Use your core muscles (the abdominals and back muscles) to tilt your hips upward, pushing your low back flat onto the floor. Slowly lift your buttocks off the floor as far as you can without straining. Your entire torso, from your shoulders to your knees, should be straight and in alignment. Hold this position for about five seconds, then lower your spine and hips back to the floor, using a slow and controlled motion.

Make sure that you’re breathing steadily throughout the exercise — exhale on the upward movement, inhale on the release. The number of repetitions and sets you’ll do will vary based on your injury; your physical therapist will specify where to start. Research indicates that many PT programs recommend 10 repetitions per set, with a goal of completing three sets. Rest between each set. If any exercise causes pain, stop immediately and discuss the issue with your physical therapist or physician.

Straight Leg Raise

To strengthen your pelvic floor (the muscles that help stabilize your core and hold your internal organs in place), the National Association for Continence recommends straight leg raises.

To begin, lie on your back on a flat surface, with one foot flat, knee bent, and the other leg straight and long; place your arms by your sides. Tighten your abdominal muscles and lift your straight leg upward while keeping your bent leg stable. Hold for a second, then return your leg to its starting position using a slow, controlled motion. Exhale on the upward motion; inhale as you release down. Do an equal number of reps and sets on each leg.

Back Extension

To strengthen the back muscles that support your pelvis, the Nicholas Institute of Sports Medicine and Athletic Trauma recommends back extension exercises.

Lie on your stomach on a flat surface, with your feet together and your arms at your sides, palms touching the sides of your thighs. Lift your head and shoulders off the floor as far as you can without pain. Hold this position for 15 to 30 seconds, then lower your head and shoulders to the floor. Don’t tense your shoulder muscles, and remember to exhale on the upward motion and inhale on the release. Rest between reps; repeat until you’ve completed the number of reps and sets recommended by your physical therapist.

Lying Hip Extension

To help stabilize your pelvis, the Nicholas Institute of Sports Medicine and Athletic Trauma recommends lying hip extensions.

Lie on your stomach on a flat surface, with your legs stretched behind you and your arms stretched in front of you. Bend one knee 90 degrees, with the sole of your foot parallel to the ceiling. Your head and upper body should stay on the ground. Slowly lift the sole of your foot toward the ceiling; your thigh should come about six inches off the surface you’re on. Make sure that both hip bones stay flat on the surface as you move your leg. Slowly lower your thigh back to the starting position. Make sure to breathe: Exhale on the upward motion, inhale as you come down. Repeat for an equal number of reps on each leg until you’ve completed the number of reps and sets recommended by your physical therapist.