My guess is that if you currently are experiencing or have experienced pelvic girdle pain during pregnancy, that is why you are here! You are not alone! The prevalence of pregnancy related pelvic girdle pain (PPGP) and back pain has been reported to be as high as 50%.
PPGP is pain experienced through the low back and pelvis that might radiate into the posterior (back) of the thigh. It's an issue where the structures of the pelvis become more sensitized. They can become more sensitized for many reasons, including: fear, previous trauma, or existing inflammatory issues.
What are the risk factors for PPGP and risk factors for the pain persisting longer than weeks or months??
Lack of job satisfaction
Smoking (inflammation)
Previous trauma (birth trauma)
High BMI (inflammation)
Lack of expectation for improvement
Dr. Sinead Dufour has done some amazing research on pelvic girdle pain in pregnancy & I'm going to share some of her recommendations below!
What exercises are best for PPGP??
Novel (new), Free-Flowing Movements have been shown to be beneficial for those experiencing PPGP. So, think of activities like gentle yoga, dancing, or other exercises where you can incorporate mindfulness and integrate breathing techniques!
Why do I feel better in the morning typically??
This is very common with PPGP because of what Dr. Sinead Dufour refers to as the energy system and threat response. When your energy is depleted and you have no gas left in the tank (think at the end of a long day), the alarm goes off to protect you and remind you to rest and refuel!
When your energy is depleted, you are going to have a heightened threat response, and thus likely experience an increase in your symptoms/pain.
The pelvis and low back and other structures affected will most likely be least sensitized in the morning when your energy is full!
How can I decrease my pain during transitional movements??
Movements like going from sit-to-stand or getting in and out of bed can cause pain when someone is experiencing pelvic girdle pain.
It can be helpful to switch up the way you are doing a certain movement to send different inputs to your nervous system and help decrease the threat response with that movement.
To transition from sitting to lying down, you want to inhale as you lie down onto your side with knees bent. Once you are on your side, you will straighten the bottom leg and open the top leg very wide with your foot flat. Inhale and shift through your foot to come onto your back.
To transition from lying down to sitting, you want to straighten the leg of the side you are rolling towards. Open up the far leg very wide with your foot flat on the bed or floor. Push through your foot to roll onto your side keeping the knee wide as you push. Once you are on your side, you can bend the knees and bring them up to your chest, & inhale to sit up.
Check out this video to see this technique for getting in and out of bed in action!
Movement is Medicine!
As I said above, research has found that novel, free-flowing movements have been shown to be beneficial for those experiencing pelvic girdle pain in pregnancy. It's important to continue to stay active in ways that feel good in your body!
In addition to the techniques above, I've found it beneficial to perform workouts that include strengthening the anterior oblique sling of muscles (obliques and adductors) and posterior oblique sling of muscles (lats and glutes). These muscles are important to strengthen the core and muscles that surround the hips and pelvis. Here are a couple of my favorite exercises that I've found beneficial for my patients with PPGP:
Cross Body Pull Down with Adductor Squeeze -- Anterior Oblique Sling
Tall Kneeling Wood Chop with Adductors -- Anterior Oblique Sling
Single leg bridge + Opposite arm pull down -- Posterior Oblique Sling
I hope you found this information helpful! If your provider or doctor tries to tell you that your back pain or pelvic pain isn't going to get better because you're pregnant and just to "wait until the baby comes," please advocate for yourself! Seek out help from your local physical therapist because there is a lot we can do to help decrease your pain and symptoms during pregnancy.
If you have any questions for me or would like more information on how we can work together, please feel free to send me an email at restore.physicaltherapy614@gmail.com !
Kaitlin Hartley, PT, DPT, PPCES