Pregnancy Related Pelvic Girdle Pain

What is Pelvic Girdle Pain?

Pelvic girdle pain (PGP) is the term commonly used to describe pelvic instability. It includes both sacroiliac joint instability and public symphysis dysfunction. You may feel pain in the front or back of the pelvis, buttocks, groin, or into one or both legs. There is a big variation in the severity of PGP.

In most cases, PGP can be well managed with the guidance of your physiotherapist and an exercise program. However, for some women the pain can become very severe requiring the use of crutches or even a wheelchair. For this reason, I always recommend acting quickly if you notice discomfort or pain by arranging an appointment with your physiotherapist. That way, we can reduce the likelihood of your symptoms worsening.

Aggravating factors may include:

  • Prolonged or fast walking

  • Climbing stairs

  • Standing on one leg- eg: Getting dressed

  • Getting in or out of the car

  • Turning over in bed

  • Lying on your side

  • Deep squats or lunges

  • Moving from sitting to standing

  • High Impact exercise

What causes PGP?

There are many factors which contribute to development of PGP during pregnancy, many which are out of your control. These include:

  • Hormonal changes which soften the ligaments that support the pelvis

  • Increased size of the baby stretches the pelvic floor, abdominal and core muscles

  • The position of your baby

  • Changes to your posture

You may also be at increased risk of developing PGP if there is a history of previous low back or pelvic pain, previous pregnancies or a family history of PGP. 

How can my physiotherapist help?

Your physiotherapist will thoroughly assess your condition and make recommendations specific to you. Usually this will include manual therapy, education and advice, and formulation of an exercise program to strengthen muscles supporting the pelvis. Participating in pregnancy and postnatal Pilates classes are a great way to prevent and manage PGP during and after pregnancy.

Tips for managing PGP

  • Avoid pushing through pain

  • Taking smaller steps and going shorter distances when walking

  • Use of a compression garment or a pelvic belt

  • Use of a wheelchair or crutches in severe cases

  • Keep your knees together when

    • rolling in bed

    • getting in and out of bed

    • getting in and out of the car

  • Avoiding aggravating factors above

  • Use of a spikey ball for self-trigger point release