During pregnancy, the body produces a hormone called relaxin. Relaxin softens the ligaments in the pelvis and joints around it and lead to pelvic girdle pain (PGP). PGP can begin as early as the first trimester of pregnancy or as late as the last few days before giving birth. PGP can occur outside pregnancy but not as commonly.
Normally, when lying down, standing up or walking, the pelvis is in a locked stable position. But in pelvic girdle pain conditions, these activities are done with a less stable or unlocked pelvis- meaning too much movement. The result is irritated joints and pain which is called pregnancy discomfort. Pain can be felt at the lower back, or in front of the hip and groin or sometimes between genital and anus. Sometimes it is felt down on the buttocks or legs or in front of the thighs.
What can make the pain worse?
- Lying face up
- turning over in bed
- Standing from a sitting position
- dressing, eg standing on one leg
- getting in and out of the bath
- Sexual activities
- The pelvic joints moving unevenly or history of pelvic trauma
- A change in the activity of the muscles in the pelvis, hips, abdomen, back and pelvic floor
- Genetically hyper-mobility
- Positioning of the baby which put stress on the ligaments and joints
- Twin (or more) pregnancy
- Higher age of the mother during pregnancy
- Postural changes – your body is changing throughout pregnancy
- The growing baby
- Unstable pelvic joints under the influence of pregnancy hormones
- Changes in the center of gravity – your back with curve more to compensate for a heavy front
Signs and Symptoms:
- Swelling and/or inflammation over joint.
- Inability to stand on one leg or lifting the leg or pulling legs apart
- Pain in hips and restriction of hip movement and weight transferring through pelvis
- Giving away in Symphysis Pubis
- Clicking or grinding from pelvis or hips in movements
- Waddling or shuffling gait
Physiotherapy can help to reduce the pain. having a walking aid can help for severe cases of pain, even leaning on a pram while pushing another child can help.
Physio Savvy will apply these safe, non-invasive alternatives to help its patients suffering from PGP:
- Manual therapy to make sure the joints of your pelvis, hip and spine move normally
- Soft tissue release of any overly tight structures
- Exercises to strengthen pelvic floor, stomach, back and hip muscles
- Advice including positions for looking after the baby and lifting it, and positions for sex
- Advise for equipments such as crutches or pelvic support belts
- Pain relief, such as TENS, ultrasound, dry needling and heat
The most important is to recognise when you need help and to take it. After giving birth once your hormones settle down, PGP usually improves if you proceed with the right exercises and therapy.