Pregnancy-Related Pelvic Girdle Pain

Have you started to notice pain at the front or back of your pelvis during pregnancy?

Maybe in particular when you are:

• spending long periods sitting or on your feet
• getting in and out of the car or bed
• completing activities requiring standing on one leg, such as getting dressed
• walking or climbing stairs
• moving legs apart, or crossing them
• rolling in bed

These symptoms could potentially be pregnancy related pelvic girdle pain.

Pregnancy related pelvic girdle pain (PGP) can be defined as pain across the pelvis, from the top of your iliac crest (the bones just below your waist), to the gluteal fold (where your bottom meets your leg) AND/OR in the pubic symphysis (the joint front and centre of your pelvis) during pregnancy, birth or directly after birth. For some people, this pain can radiate down the back of their thigh too.

Pregnancy hormones lead to changes in our bodies to help create a good environment for our baby to grow and to prepare our bodies for birth, this includes our pelvis. As a part of this, our pelvic joints increase their flexibility (just a little) and are move sensitive. Our pelvis remain strong and stable, but the muscles and structures around these joints can respond in different ways to these changes.

Sometimes…

• our bodies adapt to these changes with no noticeable physical symptoms
• our bodies go into overload, overcompensating for these changes, leading to pain from too much compression around the joints
• our bodies don't make enough adjustments to these changes, leading to pain from a lack of support

PGP symptoms can be experienced when our bodies go into overload OR when our bodies don't make enough adjustments. In this way, two people may experience similar PGP symptoms, but have very different reasons for this pain occurring.

Aside from this, there are lots of other factors that can play a role in whether a person develops PGP. This may include mental health, sleep, inflammation, sedentary behaviours, social situations and past history of back or pelvic pain.

See A Pregnancy/Women's Health Physiotherapist

If you are experiencing PGP symptoms, even if mild, it is important to get this assessed by a women's health/pelvic health physiotherapist. As mentioned above, although PGP may present similarly, the factors contributing to the pain (and therefore how the condition is managed) can greatly vary from person to person. A thorough individualised assessment and treatment plan will most likely give you the best outcomes.

A physiotherapy treatment plan can help to eliminate or reduce symptoms. It is worth keeping in mind that if your symptoms do resolve, you may still have flare ups during periods of greater pregnancy growth (often approximately around the 20 week mark and 28-30 weeks). If your symptoms do not fully resolve prior to birth, be reassured that for most people symptoms resolve by 3 months post birth, if not before.

Keep Moving

If you have developed PGP, sometimes staying active can feel challenging, so aim to keep moving in ways that you can comfortably, as guided by your physiotherapist.

Continuing to exercise appropriately in pregnancy:

• has many health benefits to birthing parents and their babies (if there are no medical complications preventing this).
• is recommended as a part of PGP treatment and may reduce PGP symptoms.
• may help reduce the risk of developing PGP if you are not already experiencing symptoms.

Prior to seeing your physio, some strategies that may help you to keep moving are listed here. These are a basic starting point, your physio will guide you to more specific advice and treatment for your individual circumstances. If any strategies are aggravating your symptoms, discontinue and speak with your physiotherapist.

Physio-led exercise classes, pool based exercise or seated stationary cycling can be good options to stay active, as they are generally less likely to stir up pain.

Yes!

If you are looking for ways to stay active while experiencing PGP, Babes on Board is a great option. Classes are designed and led by physiotherapists who are experienced in exercise in pregnancy, creating workouts that are appropriate and modifiable for people experiencing PGP.

If you are happy for us to do so, we can work in collaboration with your 1:1 physiotherapist aiming to improve your symptoms whilst keeping you active.

1. You don't need to put up with PGP. It's common, but a women's health/pelvic health physiotherapist can help improve your symptoms. These symptoms are likely to resolve in the early months after your baby is born, if not before.
2. There are ways to stay active whilst experiencing PGP! You may need to modify some activities to avoid stirring up pain. Speak with your physiotherapist to know what's best for you.
3. Despite how you may feel, your pelvis remains strong and stable whilst adapting to pregnancy and preparing your body for birth and beyond.