SI joint pain treatment in Manchester
Find out if your SI joint is really the problem, settle the pain and build a pelvis that copes with running, lifting and everyday life.
SI joint pain physio in Manchester city centre
Reviewed by Nick Chatziviltsos, PgDip, HCPC-registered physiotherapist (PH114351), November 2026
At a glance
Who gets it: runners, lifters, people after a fall onto the buttock, and women during or after pregnancy.
Main symptom: one-sided pain over the dimple at the back of the pelvis, worse on stairs, rolling in bed or standing on one leg.
What helps most: strength and gradual loading. Your SI joint isn't "out" and doesn't need putting back.
Sessions: many people need 4 to 6. Pregnancy-related pain often needs support through to birth and beyond.
Avoid: repeated "realignment" sessions, and stopping all exercise.
Get checked: back and buttock pain with morning stiffness over 30 minutes, especially if you're under 40: ask your GP about inflammatory back pain.
If you've been told your pelvis is "out of place", here's the reassuring news. Your sacroiliac (SI) joints are some of the most stable joints in your body. They move only a few millimetres, and they don't slip out and need putting back.
What does happen is that the joint and the strong ligaments around it become irritated and sensitive. That can make stairs, getting out of the car, turning in bed or running surprisingly painful. It settles well with the right plan.
At our clinic inside F45 NQ on Piccadilly, we see SI joint pain in runners, lifters, footballers and new mums. It's often mistaken for lower back pain, sciatica or a hip problem. This page explains how we tell them apart.
🛠️ How we treat SI joint pain
Every SI joint plan at Athos Physio follows the same three steps. What changes is what we find at each one.
Step 1. Find the root cause of your SI joint pain
There's no single test that proves pain is coming from the SI joint. So the first job is to rule other things in or out. In your first 60-minute session we work out three things:
What's irritated: the SI joint and its ligaments, or the lower back, hip or a nerve referring pain into the same spot.
What's overloading it: one-sided loading such as kicking or a split stance, a jump in running, a fall onto your bottom, or pregnancy and the months after birth.
What's keeping it sensitive: weak glutes and trunk muscles, guarding and bracing, poor sleep, or worry that something is out of line.
We show you what's going on with a 3D anatomy model on a tablet. You'll see where the joint sits, how little it moves and why strength, not realignment, is the fix.
Step 2. Treat what's driving it
Calm the pain. Joint mobilisation for the lower back and pelvis, soft tissue work and IASTM on tight glutes, hip flexors and lower back muscles.
Reduce the overload. We change the movements that aggravate it this week, such as shorter strides, taking stairs one at a time, or getting out of the car with your knees together.
Find the exercises that help. Gentle glute and deep trunk work often eases SI joint pain within days. We test which ones help you.
Adjust your training. Single-leg and split-stance exercises, running and kicking are modified for now, not stopped.
Treat the areas around it. Stiff hips and a stiff lower back push more load through the SI joints. We work on those too.
Step 3. Build a pelvis that lasts
SI joint pain often eases with rest, then returns as soon as you run or lift again. Step 3 builds the strength to stop that cycle:
Progressive strength work for the glutes, adductors, trunk and legs. Typical exercises include glute bridges, side planks, Copenhagen planks, Pallof presses, hip thrusts, step-ups and single-leg Romanian deadlifts.
Single-leg control. Your SI joints work hardest when you stand on one leg. We build that from split squats to step-downs, hops and bounds.
Rehab on the gym floor. Being inside F45 NQ means we can load your lifts, test single-leg strength and coach technique under real conditions.
Practise what caused it. Running, kicking, lunging, carrying a baby or a long day on your feet.
A flare-up plan. Which exercises to use in the first 48 hours if your pelvis niggles again, and how to adjust your training.
We finish when you can run, lift and climb stairs with confidence, not just when the pain has gone.
Want to know whether it's really your SI joint? Your first 60-minute session tests it properly and starts treatment the same day. Book your assessment →
🔍 What is SI joint pain?
You have two sacroiliac joints, one on each side, where the base of your spine (the sacrum) meets the pelvis. You can usually find them under the two dimples at the bottom of your back. They pass load between your spine and legs every time you walk, run or lift.
The joints are held together by some of the strongest ligaments in the body. SI joint pain is when the joint, those ligaments or the tissue around them become sensitive. The European guidelines on pelvic girdle pain describe it as pain between the top of the pelvis and the buttock crease, near the SI joints.
Types of SI joint pain we treat
Mechanical SI joint pain: irritated joint and ligaments, usually from overload. One-sided pain over the dimple, worse on stairs and standing on one leg.
Pregnancy-related pelvic girdle pain: hormone changes and extra load on the pelvis. Pain at the back or front of the pelvis, worse walking, turning in bed or parting the legs.
After birth: ongoing sensitivity and reduced strength after pregnancy. Pain that hasn't eased in the months after birth. See prenatal and postnatal physiotherapy.
After a fall: a jarring injury, such as landing on your bottom or missing a step. Pain that started suddenly after the incident.
Inflammatory (sacroiliitis): inflammation of the joint, for example in ankylosing spondylitis. Stiffness in the morning, worse with rest, better with exercise, often under 40. See your GP.
Working out which of these you have shapes the plan. Inflammatory pain, for example, needs a GP and often a rheumatologist alongside physio.
⚠️ SI joint pain symptoms
Most SI joint pain shows a mix of these:
Pain low at the back of the pelvis, usually on one side, over the dimple
Pain spreading into the buttock, groin or back of the thigh, usually not below the knee
Pain standing on one leg, climbing stairs or getting dressed
Pain getting in and out of the car, or rolling over in bed
Pain getting up after sitting, which eases once you get going
Pain running, hopping, lunging or kicking
A feeling that the pelvis is "stuck" or "giving way"
Many people can point to the spot with one finger. That's a useful clue, although it isn't proof on its own.
Is it your SI joint, your lower back or your hip?
These areas share nerves, so pain overlaps. Here's how they usually differ:
Pain across the lower back, worse bending or sitting, better walking: more often the lower back. See lower back pain.
Pain below the knee, with tingling or numbness: points to an irritated nerve. See sciatica.
Pain in the groin or front of the hip, worse putting on socks or squatting deep: often the hip itself. See hip pain.
Pain at the front of the pelvis over the pubic bone, in pregnancy: part of pelvic girdle pain. See our pregnancy pelvic pain page.
One-sided pain over the dimple, worse on stairs and single-leg standing: likely the SI joint. That's this page.
🔍 What causes SI joint pain?
The SI joint gets sore when the load through the pelvis gets ahead of what the muscles around it can support. One-sided loading is a common thread.
Common triggers we see in Manchester
A jump in running. A new marathon block, more hills or a return after time off, especially with weak glutes.
One-sided sports. Football, rugby and golf all load one side of the pelvis more than the other.
Split-stance and single-leg training. Lots of lunges, Bulgarian split squats or step-ups added quickly to an F45 programme.
Pregnancy and after birth. Hormone changes loosen the ligaments, and the pelvis takes extra load.
A fall or jolt. Landing on your bottom, missing a step or stepping off a kerb awkwardly.
Long periods of standing or sitting. Especially standing with your weight on one leg.
Myths about SI joint pain
Your SI joint isn't "out". A click during treatment doesn't mean it went back in. Pelvic asymmetry is common in people without pain and doesn't need correcting. Strength and gradual loading are what make the difference.
🧪 How we assess SI joint pain
Your first session lasts 60 minutes. The European guidelines say SI joint pain should only be diagnosed after lower back causes are ruled out, using several tests together. Here's what happens:
Your story (10 to 15 minutes). Where exactly it hurts, what started it, what eases and aggravates it, and your training, work, pregnancy history and sleep.
Safety and inflammatory screen. We check for the warning signs below, including the pattern of morning stiffness that suggests inflammatory back pain.
Lower back assessment. Repeated movements, the straight leg raise and a neurological check, so we know whether your back is the real source.
Hip assessment. Hip movement and strength, plus the FADIR and FABER (Patrick's) tests, to rule hip problems in or out.
SI joint provocation tests. The distraction, compression, thigh thrust and sacral thrust tests, and Gaenslen's test. Pain with several of these makes the SI joint much more likely.
Load transfer tests. The active straight leg raise test, standing on one leg and a single-leg squat show how well your pelvis handles load.
Your diagnosis and plan. In plain English: what's irritated, why now, what to do and avoid this week, and how many sessions we expect you to need.
You'll leave with treatment already started, the first two or three exercises of your custom rehab plan, and a clear plan for the next few weeks. If anything suggests an inflammatory condition or you need a scan, we'll tell you and write to your GP.
🛠️ SI joint pain treatment at Athos Physio
Every plan moves through four phases. How fast you move depends on how your pelvis responds, not on the calendar.
Settle (weeks 0 to 2). Ease pain and calm the aggravating movements. Joint mobilisation, soft tissue work and IASTM; activity changes for stairs, car and bed; glute bridges and gentle trunk work.
Restore (weeks 2 to 4). Comfortable walking, stairs and single-leg standing. Hip and lower back mobility; side planks, dead bugs, side-lying hip work; walking targets.
Strengthen (weeks 4 to 8). Build glute, adductor and trunk strength. Hip thrusts, Copenhagen planks, split squats, step-ups, single-leg Romanian deadlifts, suitcase carries.
Return and prevent (week 8 onwards). Full running, sport and training. Hops, bounds, change of direction, a graded running plan, a long-term gym plan and a flare-up plan.
Hands-on treatment helps most in the first phase. It eases pain and makes it easier to move, but it works best alongside exercise.
Your home programme is usually 3 to 5 exercises taking about 15 minutes a day, reviewed each session. Many people need 4 to 6 sessions. Pregnancy-related pain usually needs support through to birth and beyond.
What actually works for SI joint pain?
The main guidance comes from the European guidelines for pelvic girdle pain, which cover SI joint pain. The NHS gives practical advice for pregnancy-related pelvic pain. Research on SI joint pain is less complete than for lower back pain, so we treat recommendations with care.
What's supported: diagnosing it only after lower back causes are ruled out, using several tests rather than one; individualised exercise, rather than one set programme for everyone; for pregnancy-related pain, physio with exercises for the trunk, back, hips and pelvic floor, and help such as crutches or a support belt if needed; after birth, clear information and reassurance, plus specific exercises for control and stability.
Weaker evidence or not supported: pelvic support belts on their own (they may help some people short term, but evidence is limited); the idea that the joint needs "putting back in"; long-term rest or avoiding exercise.
That's why most of your time with us goes on building strength and control. Hands-on treatment eases pain early on. If pain doesn't settle with good rehab, your GP may refer you to a specialist to discuss other options.
⏱️ How long does SI joint pain take to heal?
These are typical ranges we see. Your own timeline depends on how long you've had it, your training and how consistently you do the plan.
Mechanical SI joint pain: much better in 4 to 8 weeks; back to full activity or sport in 2 to 3 months
After a fall: much better in 4 to 8 weeks; back to full activity in 2 to 4 months
Runners and one-sided sport: much better in 4 to 8 weeks; back to full sport in 2 to 3 months, with a graded running plan
Pregnancy-related pelvic girdle pain: managed through pregnancy, and NHS advice says it often doesn't fully go until after birth; usually back to full activity in the months after birth
After birth: 6 to 12 weeks of rehab; back to full activity in 3 to 6 months
"Back to full activity" means running, sport or your normal gym sessions, not just pain-free walking. That last step is where most people stop too early, and it's the step that protects you from the next flare-up.
✅ Managing SI joint pain day to day
Around the house and at work
Get in and out of the car with your knees together. Sit down first, then swing both legs in.
Take stairs one at a time, leading with the less painful leg going up.
Stand with your weight on both feet, rather than hanging on one hip.
If you sit all day, stand up every 30 to 45 minutes and walk for a minute.
If you run or train
Shorten your stride and add a few more steps per minute. That reduces load through the pelvis.
Swap long runs for shorter, flatter ones for a couple of weeks.
Reduce split-stance and single-leg work for now. Use double-leg versions such as hip thrusts and goblet squats.
Use a 0 to 10 pain rule. Up to 3 out of 10 during exercise is usually fine, as long as it's settled by the next morning.
Self-help in the first few days
Keep moving with short, frequent walks
Sleep on your side with a pillow between your knees, or on your back with a pillow under them
Roll over in bed with your knees together
Use heat on tight glute and lower back muscles
Is my SI joint out of place?
No. Studies of SI joint movement show it moves only a few millimetres, even in people with pain. Feeling "out" is a real sensation, but it comes from sensitive tissue and guarded muscles, not a joint out of line.
Hands-on treatment can ease pain quickly, and sometimes there's a click. That's gas in the joint, not a bone going back into place. The relief is real, but it's usually short-lived without strength work.
So you don't need repeated sessions to keep "realigning" your pelvis. You need a clear diagnosis and a plan that makes your pelvis strong enough for what you do.
Related conditions
Lower back pain: an ache or catch across the low back that changes with movement
Sciatica: pain, tingling or numbness that travels below the knee
Trochanteric bursitis (GTPS): pain on the outside of the hip, worse lying on that side
Pregnancy and postnatal physio: pelvic and back pain during and after pregnancy
❓ SI joint pain FAQs
🚨 Physio, GP or A&E?
Most SI joint pain is safe to manage with a physio. A small number of symptoms need a doctor first, and a few need help straight away.
Book a physio (no GP referral needed): one-sided pain at the back of the pelvis that changes with movement; pain that hasn't eased after 2 to 3 weeks, or keeps coming back with running.
See your GP: pelvic pain in pregnancy that makes it hard to move, turn in bed or use stairs (tell your midwife or GP, and book a pregnancy physio assessment); back or buttock pain and stiffness that's worse in the morning and with rest, better with exercise, and started before about 40, which can be a sign of inflammatory back pain; pain that wakes you at night, unexplained weight loss, or a history of cancer.
Call your GP urgently or 111: pelvic or back pain with a high temperature or feeling generally unwell; pain after a fall, especially if you're older or have osteoporosis (go to A&E if you can't put weight through your leg).
Call 999 or go to A&E now: numbness around your genitals or bottom, trouble peeing, loss of bladder or bowel control, or weakness in both legs. Don't drive yourself.
Pelvic pain in pregnancy with bleeding, a high temperature or anything else that worries you needs a call to your midwife or maternity unit, not a physio.
Not sure whether you need a physio or a GP? Book a free 15-minute call and we'll tell you honestly, or ring us on 07475 433300. Book a free call →
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SI joint pain is usually one-sided, over the dimple at the back of the pelvis, and worse on stairs or standing on one leg. A physio can confirm it with a group of specific tests.
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Not really. The SI joint is very stable and moves only a few millimetres. Pain comes from irritation and sensitivity, which responds well to exercise.
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Yes. Individualised exercise is the main recommended treatment for SI joint and pelvic girdle pain, with hands-on treatment to ease pain early on.
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On your side with a pillow between your knees, or on your back with a pillow under your knees.
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Usually yes. Take shorter strides at first. If walking aggravates it, we'll adjust your plan.
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Yes, especially after a sudden increase in training or with weak glutes. We can help you get back to running comfortably with a graded plan.
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A pelvic support belt can help some people short term, especially in pregnancy. The evidence is limited, so we use it alongside exercise rather than instead of it.
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Sitting for a long time, especially with your legs crossed or weight on one side, loads the joint unevenly. Changing position often and standing up regularly helps.
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Sometimes. Pain and stiffness that's worse in the morning and with rest, and better with exercise, can be a sign of an inflammatory condition. We screen for this and will refer you to your GP if needed.
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No. You can book directly with us. If you're claiming on health insurance, check with your insurer first, as some ask for a GP referral.
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Your first 60-minute assessment and treatment is £95. Follow-up sessions are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. See our price list for all fees.
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Yes. Book a free 15-minute consultation and we'll tell you honestly whether physio is the right next step for your pelvis.
📍 Book SI joint pain physio in Manchester city centre
Athos Physio is inside F45 NQ, 77 Piccadilly, Manchester M1 2BU, a two-minute walk from Piccadilly station and Piccadilly Gardens. We're open 7am to 8pm, Monday to Friday, so you can come in before or after work.
Your first appointment is a 60-minute assessment and treatment (£95). Follow-ups are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. We work with Bupa, WPA, Vitality and Aviva, and you can see all our fees on the price list.
Pregnant, or just had a baby? We also offer home physio visits and online physiotherapy. Not sure physio is right for you? Book a free 15-minute call and we'll talk it through.
Call or WhatsApp 07475 433300, or book online.
Other services: Physiotherapy and active rehab · Sports massage · Pregnancy and postnatal physio · Home visits · Online physio
Written by Nick Chatziviltsos, physiotherapist and founder of Athos Physio, BSc (Hons) Physiotherapy, HCPC registered. Last reviewed: November 2026.
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Athos Physio is a full-service physiotherapy clinic
We offer injury rehabilitation, post-surgery functional strengthening, deep tissue massage and pain relief, and strength training expertise. We support you in becoming pain-free so that you can achieve a limitless life experience. If you want to speak with us before booking a session you reach out via WhatsApp, call us or email us.
We are based in Manchester city centre a couple of minutes walk from Piccadilly train station and Piccadilly Gardens Square