Throughout pregnancy, many women will experience some form of Pelvic Girdle Pain (PGP). Knowing how to relieve pelvic girdle pain during pregnancy is vital to ensure women still have a good pregnancy experience and one that allows them to continue their normal daily activities for as long as possible.
PGP during pregnancy is a relatively common condition affecting approximately half of all pregnant women. For 25-30% of pregnant women, the condition can become quite severe. This blog will introduce the topic of pelvic girdle pain and allow you to develop a better understanding of what causes it, what the symptoms are and how you can work with a Barefoot Physiotherapist to relieve your pelvic girdle pain and comfortably adapt to your body’s changes.
What is Pelvic Girdle Pain?
Pelvic Girdle Pain (PGP) is classified as pain felt either at the front of the pelvis over the pubic joint, pain at the back of the pelvis near the sacroiliac joint or pain on one or both sides of the pelvis. PGP which relates to the pubic symphysis joint can also refer pain into the inner thigh (adductors), groin, vaginal or lower abdominal region. Approximately 90% of woman recover from PGP within 12 months of having a baby, however, up to 10% of women have continued PGP pain up to 2 years post birth.
What Causes Pelvic Girdle Pain During Pregnancy?
To determine how to relieve PGP in Pregnancy, your Physiotherapist will need to assess your pelvis and the related muscles in the region. PGP can have multiple causes stemming from both ligaments and muscles. During pregnancy your body undergoes multiple changes including:
- The increasing weight of the baby on your pelvic floor muscles
- Your centre of gravity pushing forward as your baby and stomach grows which challenged your balance and adds increased load to your back.
- Hormonal changes: Relaxin is one of the hormones responsible for an increase in ligament laxity, as it alters the collagen structure of your connective tissues (which composes ligaments). Ligaments help to control your joint movement and support your pelvic floor muscles.
- The pelvic joints usually have very small amounts of movement when you are not pregnant. However, as this increases during pregnancy your pelvis requires your muscles to help control and stabilise the pelvis. Therefore, if your muscles aren’t doing their job correctly this can increase the strain on the ligaments/ joint which can result in inflammation and pain.
- Finally, as your abdominal muscles stretch throughout pregnancy and the weight of the baby bears down on the pelvic floor, it is more difficult for muscles to tighten and support the pelvis. This can also contribute to poor control of the joints and therefore increased pain.
Practical Tips: How to Help Pelvic Girdle Pain
There are numerous effective Physiotherapy techniques utilised for relief for pelvic girdle pain in pregnancy.
Some things you may want to try at home are
1- Icepack. A soft icepack over the area of pain can be relieving. Icepack can be applied over the painful joints around the pelvis for approximately 20 minutes at a time. It is recommended you then rest for at least 40 minutes before reapplying ice as needed. Ice can help settle your pain and relieve the inflammation at the joint.
2- Heat. Some people find heat to be more calming and relieving than ice. A wheatbag warmed up (not burning hot!) applied over the back or hips may be relieving. This also applies to a warm shower or bath.
3- Focussing on bilateral stance activities. Ok that sounds technical but it is about having weight evenly distributed through the joints as opposed to time spent on one leg. So try not to ‘hang off one leg’ when you’re standing. Take shorter steps. Sit with both feet on the floor.
4- Pillow between your knees when you’re lying down. And having that pillow in between when you roll over.
5- SIJ belt. Now this will usually need to be fitted by a Physiotherapist but if you don’t have access to one this is definitely worth a try. The simple test you could do at home to determine if you think an SIJ support belt may work for you is to get someone to compress on either sides of your hips (at the widest point) while you are standing. If you get relief or it ‘feels easier’ this would subjectively indicate it is worth trying an SIJ belt. Now make sure to get the measurement correctly (for size) and wear it as instructed (always lower down than you think). We stock and recommend the Serola SIJ belt. Again we recommend you are fitted and taught to wear/use by a physio.
6 – Tubigrip. Again this is usually a thing a Physiotherapist would determine if worthwhile using. And again we know not everyone has access. Doubled over Size L or M Tubigrip can have enough compression do give some good feedback to brain for support around tummy and hips. It’s likely you would source this at a Physio but potentially a pharmacy may stock it. You’ll need 90cm at least. Pull up as single layer then fold back on itself so that it covers from the bra line down across the hips.
7- Taking it easy. You may need to reduce your activity if you are getting PGP. If you see a Physio they will be able to help determine how long to do this for (to calm the body down) before reintroducing activity and strengthening as appropriate.
If you are in Brisbane please book in so we can take care of you. If you are not feel free to reach out to us and we will happily talk you through care over the phone or help you choose a physio local to you. We really are passionate about helping people get the best care for them.
How To Relieve Pelvic Girdle Pain During Pregnancy with Pelvic Floor Exercises
Pelvic floor muscles act to support the weight of your growing baby. As your baby increases in weight, the load on these muscles increases and it can cause a slight stretch to the muscles. Correct pelvic floor and lower abdominal muscle activation, strength and length are vital to a happily functioning pelvic girdle. For example, if pelvic floor muscles become weak that can cause other muscles such as the adductors to pick up the slack and tighten, which in turn pulls on the pubic symphysis joint. In addition, dysfunction of lower abdominals, glutes and hamstrings can all negatively impact the pelvic girdle. Therefore, it is essential for your Physiotherapist to thoroughly assess your individual symptoms and determine what muscles need to be treated either through manual therapy or exercise.
Your Physiotherapy exercises may include, but is not limited to the following:
- Increase correct breathing patterns
- Lower abdominal strengthening
- Glute and Hamstring strengthening
- Pelvic floor strengthening
- Gentle adductor strengthening
- Muscle releases
- In addition, the use of a support belt for your pelvic girdle pain might also help.
Relief For Pelvic Girdle Pain with Physiotherapy
It is recommended to work with a trusted health care professional, such as a Physiotherapist to help determine how to relieve pelvic girdle pain during pregnancy. Booking an appointment with a Barefoot Physiotherapist will allow us to thoroughly assess your situation, determine where your discomfort is coming from and then work together to determine your best treatment plan for both in the clinic and at home. Your Physiotherapist will show you how to help pelvic girdle pain by creating a multimodal treatment plan. You can expect your treatment to include: hands on techniques to relieve pain, advice around how to move without aggravating your symptoms and exercises to help keep you moving well.
Whilst majority of women report a decrease in pelvic girdle pain symptoms after giving birth, it is still important for women to return to their full strength and mobility without pain as soon as it is safe to do so. Physiotherapy can help women adjust to motherhood and implement strategies and exercises to help their bodies adapt to the new load of raising a child.
Book In with Barefoot to for PGP Management Today
If this sounds like the type of Physiotherapy you are searching for, please don’t hesitate to reach out. If you or someone else you know needs relief for Pelvic Girdle Pain in pregnancy or is experiencing other pain or discomfort associated with pregnancy, we can help assess and determine your best course of treatment. Barefoot Physiotherapy provide leading pregnancy physiotherapy, pelvic floor physio and women’s physiotherapy services in Brisbane. Book in with Barefoot Physiotherapy today by calling us on 1300 842 850 or using the book online link on our website.