Some women experience pelvic girdle pain (PGP) during pregnancy and this is, unfortunately, something which can simply not be avoided. Luckily, there are a number of steps you can take to remedy the discomfort which we will discuss shortly.
What is Pelvic Girdle Pain?
PGP in pregnancy typically manifests due to multiple symptoms which arise as a direct result of stiffness or misalignment (or both) in the pelvic sacroiliac joints, which are either experienced at the back or front of the pelvis.
Pelvic girdle pain can start as early as the first trimester – but some women also experience it as late as the final few days right before birth. During pregnancy, some women produce too much relaxin, which not only induce certain effects on the female reproductive system but also on how the pelvis generally functions.
When relaxin during pregnancy levels are balances, the ligaments in the pelvic region can relax; it also softens up and widens the cervix. But too much causes the pelvic bones and ligaments to relax too much, causing instability and increasing the likelihood of pelvic pain and, in some cases, injuries.
As it stands, most women experience an imbalance in their pregnancy hormones, particularly relaxin, which is often linked to pelvic girdle pain first trimester.
What Causes Pelvic Girdle Pain during Pregnancy?
The sacroiliac joints is a joint found between the sacrum and ilium bones in the pelvis which are all inter-connected by strong ligaments. The sacrum joint is responsible for supporting the spine, and in turn, is supported by the ilium bone on either side.
A sacroiliac joint dysfunction often causes PGP or SPD – symphysis pubis dysfuntion. SPD in pregnancy is caused by either too little movement around the pelvis and buttocks or too much movement. This is important to understand because sacroiliac joint dysfunction often leads to pelvic girdle pain in pregnancy.
Even though PGP is completely harmless in the sense that it does not affect the baby, it can cause serious discomfort – in some cases, severe pain – around the pelvic region and make everyday tasks like getting up and walking, or sitting down, extremely cumbersome.
This localised SI joint pain in the pelvis can radiate down to the thighs, with some women also reporting a clicking or grinding which they can hear and feel in their pelvic area.
The sacroiliac joint pain in pregnancy is mostly noticeable when you walk, go up the stairs, stand on one leg to get dressed or turn over the other side while in bed. You might also experience difficulty in moving your legs further apart – when you’re trying to get out of a car, for instance.
Symptoms of Pelvic Girdle Pain in Pregnancy
So what does pelvic girdle pain feel like? Different women tend to experience pelvic pain girdle symptoms differently, although these typically include:
- Pain felt directly at the front and centre of the pubic bone
- Pain that radiates across one/both sides of the lower back region
- Pain that is felt in the perineum (area between the vagina and anus)
According to a report, an estimated one in five pregnant women experience PGP in pregnancy, with symptoms ranging from moderate to severe.
Although it hasn’t been established yet so as to why pelvic pain affects certain women more during pregnancy, it is believed that PGP is linked to specific health issues such as an imbalance in pregnancy hormones, including too much relaxin production, the SI pelvic joints not moving in unison, the position or weight of the baby, or pre-existing damage to the pelvis.
Furthermore, the following factors might have a role to play in the onset of SPD pregnancy symptoms:
- Higher than normal BMI (body mass index)
- Smoking and drinking
- Too much emotional distress
- PGP experienced in a past pregnancy
- A pre-existing pelvic injury (from a fall, e.g.)
- A job that is physically taxing or too demanding
- A history of PGP and/or lower back pain
Exercise to Help pelvic Girdle Pain in Pregnancy
It’s important to know what helps pelvic girdle pain and, fortunately, there are treatments and techniques on hand which can help you manage the pain and undue discomfort. On many occasions, if you treat the SPD pregnancy symptoms at an early stage, they tend to disappear altogether.
There are a number of things you can do during SPD pregnancy such as pelvic girdle pain exercises. Even though it is best to see your general practitioner who will most likely refer you to a physiotherapist, you can try certain pelvic girdle pain relief exercises including yoga for pelvic pain girdle and exercises using a pelvic girdle pain exercise ball.
However, it’s important to know beforehand what exercises you should avoid in your pursuit of an active lifestyle, but more importantly, finding relief from PGP during pregnancy:
- Any kind of squatting exercises including lunges
- Breast stroke-style swimming
- Walking briskly or taking long strides
- Lifting heavy weights or doing exercises which place heavy loads on your hips (again, think lunges, squats, deadlifts, good mornings, etc.)
Pelvic floor exercises like pelvic tilts, kegels, cat stretches and hip bridges are great for stabilising the joints around the pelvic region while also promoting relaxation.
Mild stretching will certainly help the muscles around your quads, back and buttocks relax – key regions that are affected during SPD pregnancy – but you need to be careful. Gentle movements are the way to go and you should never aim for a range of motion that’s too full. In any case, don’t open your legs too wide.
An exercise ball or Swiss medicine ball will also help with pelvic girdle pain – just sit on the ball and use your buttocks to move around in gentle circular motions to engage the pelvic joints.
Many women have sworn by yoga for pelvic girdle pain – specific exercises that can relieve pain and discomfort in the sacroiliac joints, hips and lower back. The exercises below are highly effective at improving not only the functionality of your pelvic floor but also strengthening it and making it healthier, both during and after pregnancy:
- Simple seated forward fold
- Cat/cow pose
- Downward-facing dog
- Plank on knees
- Chaturanga on knees
How to Treat Pelvic Girdle Pain in Pregnancy
The best way to curb symptoms and cut down long-term discomfort as much as possible is to have an early diagnosis.
Other than the exercises recommended above and an active lifestyle, one of the best ways to treat pelvic girdle pain is to see a physiotherapist, who will gently press on or move the affected joint, so that it starts working normally again.
If you are experiencing any kind of pain whatsoever around your pelvic area, you should consult your doctor, midwife or obstetrician immediately. You might also ask someone from your maternity team to refer you to a physiotherapist who is specifically experienced in treating pelvic joint pain.
Although PGP problems do not go away completely until you’ve had child birth, treatment from an experienced physiotherapist can drastically improve symptoms during pregnancy.
Physiotherapy is one of the best ways to alleviate PGP pain, improve pelvic joint positioning and stability, and also improve overall pelvic muscle function. Your physiotherapy sessions might also include:
- Manual therapy which will help the joints around your pelvis hip and spine move along a normal groove
- Specific exercises in water
- Exercises that strengthen the stomach, back, pelvic floor and hip muscles
- Relief from labour pain using a TENS (Transcutaneous electrical nerve stimulation) machine which will, in turn, alleviate symptoms of pelvic girdle pain
Pregnancy physiotherapy can go a long way to alleviate PGP symptoms as can a TENS machine during pregnancy. Your physiotherapist might also prescribe muscle relaxants and pregnancy-safe pain relievers in case symptoms become severe.
A prenatal massage can also offer tremendous relief, although you need to make sure that your therapists holds a license and has the required certification in administering treatments to pregnant women.
Acupuncture has been gaining widespread popularity in helping pregnant women find all kinds of pregnancy-related relief, including that from pelvic pain.
Research has shown that a belly band has proven extremely helpful in alleviating PGP pain pregnancy. Since SI joint pain typically occurs during pregnancy as a result of elevated relaxin levels, which in turn cause the hip joints to become less stable – the sharp and excruciating pain in the lower back region can be minimised by using a pregnancy support belt or bump band.
Belly bands work to provide gentle and steady compression during everyday activities – helping to support the uterus and cut down discomfort that’s typically felt as you go about your daily activities.
Pregnancy support belts can also provide certain cues to your body so that it automatically reminds itself to observe proper posture. By supporting the torso and lower back, a maternity support belt prevents overextension of the lower back, while encouraging correct posture.
Wear your belly band for no more 2-3 hours at time to avoid overdependence. To further enhance the effects of a bump band, engage in exercises that directly strengthen the transverse abdominis region (your abs) such as pelvic tilts, glute raises and crunches.
It is best to consult your physician before using maternity belts as some women might not reap all the benefits due to pre-existing health conditions like irregular blood pressure or poor blood circulation.