Pelvic girdle pain is a common condition during and post-pregnancy. It is also known as:
- Symphysis Pubis Dysfunction (SPD)
- Pelvic Girdle Relaxation
- Osteitis Pubis
- twisted hips
What Happens to the Pelvic Muscles During Pregnancy?
“Pregnancy hormones prepare the body for pregnancy and birth,” says Dominic Howson, Director of Tonicity, a health and beauty clinic specialising in pelvic health.
This increases the laxity of the ligaments and muscles stabilising the pelvic joints. "The two pelvic bones are able to move more, which can lead to instability, the joints becoming stuck and in pain. This most commonly occurs where the two halves meet at the front of the pelvis, or pubic symphysis, or at the back, where they meet at each side of the sacrum, at the sacro-iliac joints.”
Symptoms of Pelvic Girdle Pain
Symptoms of pelvic girdle pain include the following and can range from mild to severe. They can occur during pregnancy, childbirth or afterwards and include:
- pain at the front or rear of the pelvis – it can affect any pelvic joint anywhere
- pain during general activities such as walking, stairs, in bed, getting dressed, housework
- feeling physically and mentally exhausted. It is hard to explain the pain to others because it’s not obvious or visible.
Treatment for Pelvic Girdle Pain
Treatment uses hands-on techniques to realign the joints and release muscle tightness. “A women’s health physiotherapist will be able to assess the pelvis for increased movement or a ‘stuck’ joint and help to address this, teaching specific exercises to help increase muscle stability, address imbalance and advise on posture to ease back and pelvic pain,” says Dominic Howson. “They can also advise on delivery positions and measure the range of movement a woman is able to achieve without pain when opening her legs so that during delivery this is not surpassed.”
Pelvic Exercises to Do at Home
Tonicity recommends the following general exercises to improve pelvic stability: inner range pelvic tilting, hip abductor strengthening (the clam), and pelvic floor exercises. Ask a physiotherapist to demonstrate and monitor the exercises to check performance and number for an individual:
- Pelvic Tilting Exercise: Lie on your back with your knees bent. Squeeze your abdominal muscles and tilt your pelvis so your lower back flattens against the floor. Hold for three seconds. Relax back to half way between the fully tilted position and normal lying (neutral) position. Hold for three seconds, and repeat the pelvic tilt. Aim to do 10 pelvic tilts.
- The Clam: Lie on your side with your knees bent. Check your hips, knees and ankles are stacked on top of each other. Squeeze your abdominal muscles and lift your top knee slowly. Make sure your ankles remain touching throughout. Hold for three seconds. Lower your knee slowly. Repeat 10 times on each side.
- Pelvic floor exercises: Sit on a chair. Close your front passage as if to stop yourself passing urine and at the same time, close your back passage as if to stop yourself passing wind. You should feel a lift inside, away from the seat of the chair. Practise 10 quick, one-second squeezes and some holds of up to 10 seconds each.
Self-help Tips and Complementary Therapies
TENS machines, available from pharmacies, can also help to relieve pain by encouraging the body to produce its own natural painkillers (endorphins) to block pain signals to the brain.
Complementary therapies can be helpful in treating and managing pelvic pain during and post-pregnancy. Try acupuncture, reiki, meditation, reflexology and deep tissue or aromatherapy massage. Pilates helps to strengthen the core body and improve posture, relieving back and pelvic pain.
The following tips can also help reduce day-to-day pain and over-exerting the pelvis:
- Keep the knees together when getting in and out of a car. Put a plastic bag on the car seat to help the body to move as one when turning in the seat.
- At work, set any swivel chairs so they don’t spin.
- Avoid standing on one leg – sit down to dress and keep the knees together as much as possible when turning or getting in and out of bed.
Pelvic Support Belts
"A support belt can help to give more stability around the ‘loosened’ joints of the pelvis, where the ligaments and muscles are weaker, decreasing the extra movement at the joints and reducing the pain," says Dominic Howson. “This enables the mother to move more easily and carry out more of her normal activities." Whether the physiotherapist opts for a support belt, tubigrip or elastic band it must be fitted correctly to ensure it is in the correct position, and appropriate guidance of use given.
“Support belts shouldn’t be worn when sitting down, as they can increase the risk of stillbirth. In addition to the belt, exercises also need to be performed to strengthen the main muscle groups."
Pelvic pain during pregnancy needs to be investigated and treated promptly to avoid further health problems. Don’t put up with pain as part and parcel of being pregnant, as a trained physiotherapist can easily rectify a pelvic joint problem. If pelvic girdle pain is diagnosed, the birth plan needs to take it into account to make the labour as pain-free and easy as possible.
Resources:
The Association of Chartered Physiotherapists in Women’s Health: Find a physiotherapist
The Pilates Foundation: pilatesfoundation.com
Nicci Talbot - Nicci Talbot is a journalist and author specialising in sex, health & wellbeing. She edits Rude Magazine, an online resource for better ...
Join the Conversation