PELVIC GIRDLE PAIN IN PREGNANCY
Pelvic Girdle Pain is a common condition that affects up to 80% of pregnant and postpartum women. Previously also known as Symphysis Pubis Dysfunction (SPD), but this term indicated that only the symphysis pubis is affected, when in fact this is not usually the case. Pelvic Girdle Pain can be experienced in different areas around the pelvic ring, including the thighs and hips – the sacroiliac joints at the back and the symphysis pubis at the front.
If you’re experiencing any pelvic pain we recommend you speak to your healthcare provider as soon as it comes up so you can start working with a specialist. Quite often you can start creating good habits which break the pain cycle and address the issues before they get worse. Read on to find out more about the causes and some ways you might be able to help.
WHAT ARE THE SYMPTOMS OF PELVIC GIRDLE PAIN?
The pain can be manageable or severe, with some expectant mums needing to use a wheelchair. Symptoms include but are not limited to:
- Pain deep in the pubic area and groin (between the vagina and anus)
- It can be brought on by some types of activity, such as walking, climbing stairs and turning over in bed. Even standing up can be tricky
- You may also have pain across your lower back
- You might have a grinding or clicking sensation in your pubic area
- The pain can be made worse by parting your legs or by leaning on one leg.
As well as physically causing pain it can also really take a toll emotionally, and on many pregnant women’s quality of life. Unfortunately there is a lot of misinformation around and quite often expectant mothers are told that their pelvis is just unstable, pain is normal, there is not much they can do about it and it will go away after birth, which is just not true. One study showed that although 71% of pregnant women told their healthcare professionals about experiencing PGP, and only 25% received any treatment. So why does Pelvic Girdle pain occur and what can you do to help alleviate your symptoms?
WHY DO SOME WOMEN EXPERIENCE PELVIC GIRDLE PAIN?
There is no denying that the biomechanical changes that occur in pregnancy play a major role in women developing Pelvic Girdle Pain. As the pregnancy progresses body weight changes and the front of the body becomes overloaded with not only the growing bump, but growing boobs and amniotic fluid too.
These changes cause the centre of gravity to shift and a musculoskeletal imbalance develops. The functioning of the glutes, abdominals and pelvic floor muscles physically changes. Quite often the pelvic floor muscles become overactive. In fact over 90% of women with back pain have an overactive pelvic floor – it compensates for the weaker glute medius, maximus and the abdominals which are all on a stretch.
However, the causes are not just biomechanical changes nor are they hormonal. Poor old relaxin usually gets the blame for this, however the latest research shows there is no correlation between the levels of relaxin and the severity of Pelvic Girdle Pain. That being said, the tissues do become more sensitive, and that sensitivity is driven by oestrogen and progesterone.
Latest research has shown that one of the main drivers are psychosocial; these could be previous trauma, constipation (which is commonly linked to lower back pain and is also common in pregnancy), gut dysbiosis, lack of sleep and stress. Stress and anxiety is a biggy and cortisol can be a big driver of PGP.
Research has shown that the pelvic floor muscles are super sensitive to what goes on in our brain. Think of them as the guardians of the body – going into fight or flight when they sense something is wrong.
So when we get stressed or panic our pelvic floor muscles tighten even more which can lead to more pain.
We then see this continuous cycle of pain, anxiety is created around certain movements that cause pain, more cortisol is released, the pelvic floor muscles tighten even more, causing more pain.
BUT WHAT CAN YOU DO TO EASE THE PAIN?
We’ve identified that your pelvis is stable and strong, but the muscles just might be on high alert. We need to calm the central nervous system to allow confidence in movement, rebalancing the autonomic system. Then we can address the muscle imbalance with exercise – the magic bullet in this equation.
- Identify what movements cause you pain and find a work around.
For example if it’s getting out of bed, try tying a Theraband around your thighs and pressing out as you stand up. This will help the glutes to switch on and support the movements.
If it’s getting up – do the movement differently, try standing with one foot in front of the other. Stand up on the exhale and try not to push down onto your pelvic floor.
The POGP have made a great booklet on managing pain which is free to download – check them out here.
- Once you’ve desensitized the muscles and rebalanced the autonomic nervous system you can then start to address the muscle imbalance and postural changes that happen in pregnancy.
- Work to strengthen the glute max and glute med.
- Look at your breathing patterns – are you breathing efficiently?
- Work on your deep core muscles – those transverse abdominal muscles that wrap around like a corset, hugging your baby in and supporting your pelvis.
- Keep mobile in your thoracic spine to assist with breathing, movement and postural changes.
- Opening up through the chest and shoulders and releasing through the deep neck muscles. Pregnancy massage is great for this 🙂
- Strengthening the back of the body.
- Make sure you’re wearing a good supportive bra!
- If a belt helps you get out of pain then brilliant, however this should be accompanied by an exercise program to keep you out of pain.
A WORD FROM OUR WOMEN’S HEALTH EXPERT SARAH PARKER:
“Don’t struggle along in pain when you’re pregnant even if it’s early days or right towards the end. Just because you’re a woman doesn’t mean you deserve to have pain and that it’s expected when you’re pregnant. Please seek help from a physio as there is always something that can be done to make your journey a more comfortable one.” www.sarahparkerphysio.com
If you want to know anymore or want to discuss how we can help you throughout your pregnancy please get in touch. We want you to trust your body and your pelvis.
Mama you’ve got this.
Lettie, Founder of Planet Mama x