During pregnancy, levels of the hormone relaxin drastically increase to help your soft tissues stretch, allowing plenty of room for your growing bub. However it can also have its downside – the joints in your pelvis can become excessively flexible, sometimes causing pain with movement. This pain is called Pelvic Girdle Pain (PGP), and 45% of all women will suffer from it with 25% continuing to experience it postpartum.
To understand what is going wrong and how we can help, let's take a closer look at the pelvis. It has three joints that are affected by PGP.
The pubic symphysis.
This joint sits at the front of your pelvis, down low where the pubic bones are joined together with cartilage and ligaments. This joint transfers the load of the trunk from your tailbone to your hips and acts as a shock absorber while you're walking.
The sacroiliac joints (SIJs)
Of which you have 2. They sit at the back of your pelvis, connecting your tailbone (sacrum) to the large curved pelvic bones (the iliums) with ligaments. These convert rotational forces generated by your lower limbs through your spine, stabilising you and also helping to absorb shocks.
During pregnancy, relaxin allows the ligaments of the pubic symphysis to stretch, letting the pelvic bones widen apart – a very important adaptation your body makes in preparation for delivery. However, this can cause pain on movements whenever your legs are wide apart such as when getting in and out of a car.
Relaxin also makes the SIJs more hypermobile, which can lead to a dull, aching pain near your tailbone (near the dimples) on one side or both. This may be particularly acute whenever your hips rotate and bear weight at the same time, such as when standing up from sitting, climbing stairs, or expended periods of walking. The pain may also feel like it is in your lower back, buttock, hip and thigh even though the SIJs are the real problem – we call this referred pain when it appears far from the true cause.
PGP is likely to worsen as the pregnancy progresses, but more than 70% of women whose symptoms started with their pregnancy are pain free by 2 months post delivery without the need of physiotherapy treatment. In the meantime, gentle core stability exercises such as those found in Pilates can help to stabilise your pelvic joints by increasing your postural muscle support – all helping to keep your bones in the right places! Exercises that gently engage the pelvic floor and deep abdominal muscles (as you have experienced in your Fix Program pregnancy classes) are particularly effective.
In the unfortunate (though fortunately rare) cases of severe PGP, hands-on physiotherapy treatment can offer relief and help correct the joints' positions. One of our Fix physios can also test to see if using a pelvic stability belt might ease your pain. These are designed to offer compression during painful movements to the lax pelvic joints. We are also great at giving advice on movements to avoid, practice of movements to adopt and exercises to limit your painful movements.
So please don't hesitate to let us know if you need further help with your PGP – there is a lot that physiotherapy can do to help you, like compression wear as seen below until you, your body and your bub are all settled.