Managing Sacroiliac Joint Instability with Reformer Pilates

Sacroiliac joint (SIJ) instability may cause pelvic pain, lower back discomfort, and difficulty with movement. General exercises may help, but without proper guidance, general exercise often does not address the root issue: joint control.

As a Physiotherapist, I’ve seen how Reformer Pilates can be a targeted exercise tool for both prenatal and postnatal mummies, to improve pelvic stability and joint control for people with SIJ pain.

Why Reformer Pilates Offers Something More?

While general exercise is beneficial, some individuals with SIJ pain may still:

• Notice discomfort during daily movements or prolonged standing

• Struggle with a sense of pelvic imbalance or reduced control

• Find that traditional core exercises alone don’t fully address their symptoms

Reformer Pilates adds a structured, low-impact option that targets pelvic stability through controlled resistance, precise alignment, and focused muscle engagement, making it a valuable tool alongside other forms of exercise.

What Does the Sacroiliac Joint Do?

The SI joints connect pelvis to spine and:

• Transfer weight between upper body and legs

• Provide stability for movement

• Absorb shocks

Healthy SIJ’s require proper alignment, controlled movement, and balanced muscle activation.

SIJ Dysfunction in Pregnancy: What Causes It?

Pregnancy may often worsen SIJ pain due to:

• Hormonal changes: Increased levels of relaxin and progesterone during pregnancy lead to greater ligamentous laxity, which facilitates pelvic adaptability for childbirth.

• Enhanced joint mobility: The sacroiliac joints and pubic symphysis exhibit increased physiological mobility to accommodate pelvic widening.

• Biomechanical shifts: As the fetus grows, changes in posture and lumbar curvature alter load distribution, increasing mechanical stress across the SI joints.

• Muscle demands: The pelvic stabilising muscles must adapt to altered biomechanics, which can lead to muscular fatigue or altered activation patterns.

• Asymmetrical loading: Variations in weight bearing and movement patterns during pregnancy may result in uneven forces across the pelvic joints.

Symptoms: pain near the tailbone or lower back, worsening with standing or walking, feeling of instability, difficulty moving in bed or climbing stairs.

Managing SIJ pain in pregnancy improves comfort and prepares the body for labour.

How Reformer Pilates Helps?

The Reformer Pilates machine uses springs, pulleys, and a sliding carriage to:

• Provide controlled resistance tailored to your stability

• Enable precise positioning for pelvic alignment

• Activate pelvic stabilising muscles safely

This makes it ideal for retraining pelvic control and improving SIJ stability.

How Physiotherapist Adjust the Reformer?

Physiotherapists customise:

• Adjust spring tension to support your current joint mobility

• Set foot bar height and carriage range to encourage optimal pelvic alignment

• Incorporate wedges or props to assist balanced positioningGuide activation of core and pelvic floor muscles for improved coordination

• Progress exercises thoughtfully, emphasising precise and controlled movement

When It May Not Be Suitable?

• Placenta Previa after 26 weeks

• Preterm labor or history of preterm labor

• Preeclampsia or pregnancy-induced hypertension

• Incompetent cervix or cerclage

• Vaginal bleeding or ruptured membranes

• Severe anemia

Always consult a Physiotherapist before starting a Reformer Exercise Program.

Final Takeaway

SIJ instability requires more than generic workouts. We recommend:

✔️ A Physiotherapy Professional assessment

✔️ Personalised machine adjustments

✔️ Focus on pelvic alignment and control

You can reduce pain and restore function.

Book a consultation and Reformer Pilates Session with our Women’s Health Physiotherapists - who are trained Physiotherapists and have years of experience in Reformer Pilates and managing SIJ pain. 

Cheers

Danielle, Claire and Xan at Physiomatters

Contact Information

Email: hello@physiomatters.com.sg

Phone: +65 9352 9067

Address: 360 Orchard Road #10-07 International Building, 238869