Pregnancy Related Pelvic Girdle Pain

Pregnancy-related Pelvic Girdle Pain (or PRPGP) is an umbrella term for pain around the pelvis/hips at any stage during pregnancy.

What is Pregnancy Related Pelvic Girdle Pain (PRPGP)?

PRPGP can be discomfort at the back of the pelvic (the sacroiliac joint, abbreviated as SIJ), the front of the pelvis (the pubic symphysis), the sides of the pelvis or in the inner thigh/groin area. This discomfort could occur or worsen with activity such as walking, bending, and rolling over in bed. It can occur at any stage during pregnancy, and the location of your pain may change as your pregnancy progresses.

Why does PRPGP Occur?

Traditionally, the hormone relaxin was blamed for PRPGP as it was thought to make the joints in the pelvis too mobile during pregnancy, but more recent research shows no link between relaxin and pain. Instead, PRPGP is more likely related to the increased load on your muscles and joints. As your baby grows, the demands on your body, and especially your pelvis, change. Your growing bump changes your posture, which can change the way your muscles work – your muscles may become tight, weak or overworked (or a combination!).

PRPGP is a common complaint (up to 50-84% of pregnant women) which is often written off as one of those things you have to put up with during pregnancy, but this is not true! There are lots of things you can do to help manage discomfort around your pelvis. The good news is that most people see their symptoms disappear after the baby is born, but please don’t wait till then to get relief.

The recommendations below are general tips - if you haven’t already, we strongly advise seeing a pelvic health physiotherapist for individualised assessment and advice.

Who is most likely to get PRPGP?

There are some risk factors to developing PRPGP.
These include:
·       Previous pelvis or lower back pain
·       History of trauma to the back or pelvis
·       Previous pregnancies
·       Physically demanding work
·       Increased body mass index
·       Emotional distress
·       Smoking

How can I manage PRPGP?

Address unhappy joints and muscular tightness/weakness — Physiotherapists can assess your muscles and joints to work out what is contributing to your pain. Once the contributing factors are identified these can be addressed with manual therapy (if appropriate) and by prescribing specifically tailored exercise prescription. Commonly, we see the glutes, hip flexors and groin muscles may become tight and/or weak, and the hip abductors often require additional strengthening. Check out these videos for pregnancy-safe stretches and strengthening exercises.

Pelvic support – support belts or garments can give a sense of stability around the pelvis and reduce pain. The Pelvic Studio stocks a variety of belts and SRC pregnancy shorts/tights.

Modifying aggravating activities — e.g.

If standing on one leg gives you pain, then sit down to get dressed and avoid stairs if possible.

If fast walking gives you pain, take smaller steps and walk more slowly

If your symptoms come on after 30 minutes of sitting, try to change position more regularly

Being aware of posture – the growing weight and size of the belly can affect the way you stand, which can in turn make certain muscles tight or weak. Especially if you spend long periods standing, try to stand with your ribs sitting directly over your hips, and avoid hyper-extending your knees.

Is it safe to keep exercising?

Yes, it’s safe and beneficial to stay active. Staying strong and mobile may in fact help your symptoms - research shows that people with PRPGP who exercise regularly have fewer days with pain, and fewer days off work. And of course, engaging the pelvic floor and core with physical activity is key during pregnancy (and beyond!).

You may need to make some modifications to avoid pain eg avoiding single leg activities, reducing the weight or duration of exercise, or even trying exercise in a pool to take some of the load off your pelvis. Talk to your physiotherapist if you are unsure of which exercises may be suitable for you.

The Pelvic Studio run small group pregnancy exercise classes. The physiotherapists leading the classes are experts at adapting exercises to suit your needs.