Pelvic Girdle Pain is a generic term to describe pain in the pelvis. It is common to see this term used when talking about women who are pregnant.
If we talk first about pelvic girdle pain during pregnancy. To read about other conditions related to Pelvic Pain that are not pregnancy related please click here and for any pelvic pain or prostatitis related to men, please click here
When a women is pregnant, the hormone relaxin is secreted to allow ligaments to soften and enable the sacoiliac bones to move. The body is preparing for the growing baby and the eventual delivery. For the baby to enter and exit from the birth canal the pelvis must move and as the baby grows the natural weight of the baby moves the pelvis. During birth there is additional movement and the bones rotate to allow the baby to exit. This phenomenal process is largely pain free. It is the ONLY time the pelvis moves under normal circumstances. There can be trauma caused to the pelvic girdle. However, the bones rarely move.
The sacroiliac joint (SIJ) is composed of 3 main bones: Sacrum and 2 iliac bones. To the front of the pelvic is the symphysis pubis and during pregnancy women can suffer from symphysis pubis dysfunction (SPD). PGP and SPD are often used interchangeably when referring to pain in the pelvis. Pain during pregnancy is common and rarely anything related to the progress of your pregnancy. PGP and SPD is very common. Should you be feeling pain in the lower abdomen and your baby is moving we would still recommend an examination by your GP and Midwife before seeing a physiotherapy specialist.
Keeping the muscles strong and active during pregnancy is essential. The muscles are key to maintaining a strong pelvic supportive ring drawing in the pelvic bones and compensating for the slight loss in pelvic ring stability. Pain causes the muscles to spasm and inhibit. Movement is therefore painful, uncoordinated and patients become incapacitated.
We find that women present with specific features when asking for help with PGP:
- Pain at the front of the pelvis (Lower abdomen and under the baby bump)
- Pain in the inner thighs and up into the pelvis and sometimes genitalia
- Pain in the lower back
- Pain in the SIJ themselves
- Pain in the buttocks
- Pain inside the pelvis
Pain is often felt with:
- Rolling in bed
- Sit to stand
- Sudden movements
- Walking and weight bearing through the legs
What can a physiotherapist or sports therapist do to help?
- Use gentle pain releiving manipulation
- Apply a supportive belt
- Use massage techniques
- Use exercise therapy to engage the pelvic muscles.
- Teach and evaluate the pelvic floor muscles and reduce the liklihood of continence problems.
Physiotherapy techniques are among the safest to use during pregnancy and physiotherapists are certified to look after pregnant women. Massage is especially helpful for these patients