Your pelvis is not falling apart...debunking the myths around pregnancy pelvic pain
by Carrie Seow, women's health physio
Pregnancy-related pelvic girdle pain (PRPGP) is a term that some women are all too familiar with. It can present in many different ways and impact your pregnant life when you sleep, change positions in bed, walk, climb stairs, get in or out of the car, get dressed or put on your shoes and socks. All those everyday tasks you previously never gave a second thought to may have become painful and difficult to do. It can be felt at the front of your pubic region, or across your tailbone and buttocks. It is often blamed on the lower back, but often is not.
MYTH: "My unstable pelvis is causing my pelvic girdle pain."
Recent research from Prof. Sinead Dufour of McMaster University in Canada has noted that this concept of “pelvic instability” is unsubstantiated. Your pelvis is not falling apart! Rather, advanced pain science indicates that the pelvis is more sensitive during pregnancy. This sensitivity is increased by a range of lifestyle factors including the changing posture and load through the pelvis when pregnant, the differing ways in which you move with a belly bump, stress, sleep, and even gut health.
MYTH: :"I should just rest and avoid doing too much for the remainder of the pregnancy."
Initial rest may be helpful to minimize a flare up of pain, however, we don’t want you to stay in this state! Exercise is the best medicine for pain. You may have heard the “motion is lotion” phrase. More importantly, you need to be strong in the hips, legs and upper body so that your body can carry you through the rest of the pregnancy. Yes, there may be some types of exercise which are not suitable for you during your pregnancy due to the nature of PRPGP but as clinicians we can help design appropriate and safe exercise programs to help you get stronger, which in turn help reduce your symptoms.
"But what if I can’t even get back to exercise because I’m in too much pain!"
You may need some physio treatment by way of manual (yes, massage and ‘muscle love’!) and exercise therapy to help reduce the sensitivity of your back, hips and legs before gradually increasing your exercise load. For those with more severe symptoms, there are support garments available (e.g. pelvic belts, belly belts, SRC pregnancy shorts) that are available to help support your body in pregnancy to allow you to exercise rather than stopping all exercise. Your physio will retrain the better way of movement control and muscle activation around your pelvis to support and reduce the sensitivity, and all while keeping within those pain levels .
"How can I do all those everyday tasks such as sleeping, walking, sitting, putting on clothes and shoes without as much pain?"
It’s realistic to assume that you may need to change the way you do certain things when you’re pregnant. We can give you some ergonomic strategies to avoid irritating the sensitive structures in your body during activities of daily living. For starters, rather than balancing on 1 leg, try putting your pants, shoes and socks on while sitting down on a chair.
Catching and managing PRPGP early in pregnancy will help you the most!
Remember, it’s best to start dealing with PRPGP in the early stages rather than waiting until it gets really bad! Book an appointment for a thorough assessment and chat with your physio about the best management path for your pain. This could be manual therapy, home based exercise, or our pregnancy specific Pilates and group classes. Contact us for a chat.
References: Dufour, S. (2018) ‘Pregnancy-related Pelvic Girdle Pain: Embrace the Evidence and Move beyond Biomechanics’