Pelvic Girdle Pain- what is it and what can I do about it?!
Pelvic girdle pain (PGP) is defined as pain in the posterior joints of the pelvis or in the anterior pubic bone that comes on during pregnancy. It is estimated that up to 50% of women will have experienced some PGP by the time they are 20 weeks pregnant, with that number rising to up to 70% by the third trimester. PGP can have major effects on women, impacting their function at work, at home and in caring for other children.
What causes PGP?
A number of factors contribute to PGP. Studies have shown that hormonal changes during pregnancy can change the degree of movement in the sacroiliac joints of the pelvis, sometimes leading to asymmetry in the joints. The growing baby often changes how a woman carries herself in standing and walking, which can put additional stress on the joints. Add to that the increasing pressure as baby gets bigger, and it is a recipe for sore and irritated muscles and joints.
It is important to note that symptoms of PGP do NOT mean that your pelvis is unstable. The sacroiliac joint remains one of the most inherently stable structures during pregnancy. As discussed above, an asymmetry between the joints and the contribution of pregnancy related changes all contribute to the presentation.
What can I do about it?
There are many ways to treat PGP, and every presentation will have different contributing factors. Your physiotherapist will complete a thorough assessment to help you identify the causes of pain, and then prescribe a treatment plan.
Treatment can involve:
- manual therapy to relieve sore muscles or joints
- exercises to strengthen supporting muscles around the pelvis
- stretches to relieve tight muscles
- application of heat or cold
- support garments for compressive support
- advice on load management and activity modification
Pelvic girdle pain is most commonly aggravated in positions where one leg is supporting the weight of the body (as opposed to two legs). So some simple ways to help with PGP include:
- sitting down for lower body dressing
- swinging both legs out of the car before standing up
- rolling over in bed with your knees bent and legs together
- wear low heeled or no heeled shoes
- wear shoes with some arch support
Where to now?
The fantastic news is that there are many treatments available for PGP and our physiotherapists at Seasons of Life have a lot of experience dealing with this condition. We would love to help you control the pain, and help you to be as active as you would like to be.
Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuga B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Euro Spine J. 2008;17(6)794-819.
Clinton SC, Newell A, Downey PA, Ferreira K. Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health from the section on women’s health and the orthopaedic section of the American Physical Therapy Association. J Womens Health Phys Therap. 2017;41(2):102-25
Damen L et al. Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints. Acta Obstet Gynecol Scand. 2001; 80(11):1019-102