You expect the pregnancy back aches that come with carrying an extra passenger. And swollen feet seem par for the course. But pain in your pelvis when you walk or try to put on a pair of leggings — that might come as a little bit of a surprise. It has a name: pelvic girdle pain (PGP). And it affects about one in five pregnant women. Fairly common? Yes. But common does not make it normal. You don’t just have to grit your teeth through the discomfort of pelvic girdle pain until you deliver your baby. Here, learn more about pregnancy-related pelvic girdle pain — and find out how to get pain relief with exercises and tips from our Hinge Health physical therapists.

What Is Pelvic Girdle Pain?

First, a quick anatomy lesson: The pelvic girdle is the bowl-shaped ring of bones at the base of your spine. It’s made up of three parts: the sacrum (or triangular bone in your lower back), which sits in the middle; the coccyx (tailbone) is below the sacrum; and the hip bones flank each side and meet in the front. The pelvic girdle is supported by strong ligaments and muscles, including your pelvic floor muscles. Any type of pain in or around your pelvic bones and joints falls under the term pelvic girdle pain (PGP) — from a stabbing sensation in the pelvic joint at the front of your pelvis (called the symphysis pubis) to a dull ache in your lower back that can radiate through the fold of your buttocks and into your hips and thighs.

When the pain stems from your symphysis pubis, it’s also known as pubic symphysis dysfunction (PSD). When it involves the sacroiliac joints — which connect the sacrum to the hip bones — it may be referred to as sacroiliac (SI) joint pain.

Symptoms of Pelvic Girdle Pain

Pelvic girdle pain may be constant or come and go. For some, the pain may be mild; for others, it’s severe enough to disrupt your daily routine. With PGP, you may feel:  

• Pain in the front or back of your pelvis, which can be shooting or steady

• Pain that radiates to the lower back, buttocks, hips or thighs

• Clicking or grinding in the pelvic area

• Pain after sitting for prolonged periods of time

•  Pain that is made worse with movement, such as while walking, going up or down stairs, standing on one leg (e.g., getting dressed), parting your legs as you get in and out of bed or in and out of the car, or during sexual intercourse

Causes of Pelvic Girdle Pain

Pelvic girdle pain is most common during pregnancy and after delivery. Many factors contribute to pelvic girdle pain in pregnancy. The combination of a growing baby and the pregnancy hormone relaxin can impact your joints and body mechanics. As a result, the pelvic girdle and surrounding muscles and ligaments may become less stable, leading to pain. Your increasingly heavy belly bump can also shift your center of gravity in the second and third trimesters, changing the way you sit or stand and putting extra strain on your pelvis.

Risk factors for pelvic girdle pain in pregnancy and postpartum include:  

• A history of pelvic or lower back pain

• Previous pelvic or lower back injury or trauma

• Multiple pregnancies

• Pelvic girdle pain with a previous pregnancy

• Hypermobility disorders

• Overweight or high body mass index (BMI)

• A physically demanding job

• Overly tired or stressed

Pelvic girdle pain is often related to pregnancy. But it can affect anyone and may be due to other factors, like muscle issues, injuries, arthritis, and more. 

Pelvic Girdle Pain in Labor and Delivery

Pelvic girdle pain will not cause any harm to your baby. And most women experiencing pelvic girdle pain in pregnancy can deliver vaginally. “But pelvic girdle pain symptoms may worsen during labor, which can make delivery more difficult,” explains Gwen Smith, PT, DPT, a Hinge Health physical therapist.

Your obstetrician or physical therapist can suggest labor and birth positions that may be more comfortable or help ease pelvic girdle pain during delivery.

Pelvic Girdle Pain: A Hinge Health Perspective

At Hinge Health, we believe movement is medicine, and that’s definitely true when it comes to healthy expectant moms and babies. Regular prenatal exercise offers a long list of benefits, from helping ease low back pain to improving sleep and boosting energy. It’s important to stay active even with pelvic girdle pain, while avoiding movements that can aggravate pain. 

“Exercise can help ease pelvic girdle pain, but you might feel like you’re in too much pain to start moving,” says Dr. Smith. “That’s where a physical therapist (PT) can help.” PTs can help you identify positions and activities that make your symptoms worse and provide tips and small adjustments to your daily routine to ease pelvic girdle pain. They can also suggest exercises to strengthen pelvic muscles and improve stability to help reduce pain during pregnancy and labor.

Ways to Manage Pelvic Girdle Pain

There are many ways to ease pelvic girdle pain. A pelvic floor physical therapist can offer lifestyle tips and strategies to help manage your discomfort and reduce symptoms, such as:

Modify everyday activities that aggravate your pain.

• Stand with your weight evenly distributed on both legs instead of cocking your hip to one side. This can help keep your pelvis in a neutral position, reducing stress on joints and muscles. Break up long periods of standing with sitting breaks.  

• Sit with both feet flat on the floor and your knees bent no higher than your hips. Avoid crossing your legs, which can strain your pelvis.

• Shorten your stride when you walk (take smaller steps).

• Take stairs one at a time (leading with your strongest leg) or go sideways.

• To get out of a car, pivot your hips toward the door and keep your legs together before standing up

•  When getting dressed, sit on a chair or the bed to avoid standing on one leg.

Engage deep core muscles when changing positions. Tightening your core muscles before transitioning from one position to another (e.g., standing up from a chair or rolling over in bed) can help support your pelvis and ease PGP pain. Rethink your sleep position. Sleeping on your side is often most comfortable, especially later in pregnancy. Add a pillow between your knees to support your hips and pelvis, or a full-length body pillow for extra support.

Consider a pregnancy support belt. Unlike belly bands (which support your belly), pelvic support belts fit more snugly and are positioned further down around your hips to support your joints, which can help ease pelvic girdle pain. They work best under clothing, but can be worn on top of clothing if they irritate your skin.

A pelvic floor physical therapist can recommend specific exercises to address your pelvic girdle pain by strengthening surrounding muscles to better support your joints and stabilize your pelvis. The moves above, recommended by Hinge Health physical therapists, are a great place to start. The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Practice Deep Breathing

“This is one of the most underrated exercises for pregnant women,” says Dr. Smith. “You can do it in a seated position — or try it on your hands and knees. In this position, your spine stays in neutral, which can relieve pressure on the low back, pelvis, and rib cage. Let your belly lower toward the floor as you inhale and move back up toward your spine as you exhale. Diaphragmatic (or deep belly) breathing also helps you coordinate your breath with your pelvic floor and engage your core, which can help stabilize your pelvis and reduce pelvic girdle pain during daily activity.” 

How Hinge Health Can Help You

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. NHS. (2022, December). Pelvic pain in pregnancy. Nhs.uk. https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/pelvic-pain/

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