Pelvic instability: Causes, symptoms, and exercises for relief

Your pelvis is naturally stable — supported by the shape of its joints, strong ligaments, and surrounding muscles like your glutes (butt muscles), core, thighs, and lower back. These systems work together to keep your pelvis feeling secure and moving well. When they're not coordinating as effectively as they could, it can lead to what's often described as pelvic instability.

Pelvic instability can feel uncomfortable, affecting everyday movements like walking, standing on one leg, or going from sit to stand. But improving your strength and coordination through targeted movements can help your pelvis feel more stable, which can boost your confidence during daily activities. 

Ahead, learn what pelvic instability is, what may contribute to it, and how simple strategies such as targeted exercises recommended by Hinge Health physical therapists can help.

What is pelvic instability? 

Pelvic instability refers to changes in how the joints of your pelvis move and are supported. The pelvic girdle — which includes the sacroiliac (SI) joints and pubic symphysis — is designed to have a small amount of movement. But when the systems that support those joints — including ligaments, joint structures, and surrounding muscles — aren't working together as well, the area may feel less stable. Muscular imbalance is one of the most common reasons this happens, and it responds well to exercise.

“Many muscles attach to the pelvic region, so if they aren’t contributing to its stability, people can experience pain with certain movements,” says Julia Guseva, PT, DPT, a Hinge Health physical therapist.

Causes of pelvic instability 

Pelvic instability can develop for a variety of reasons — often related to how your muscles, joints, and nervous system are working together to support movement. It’s rarely caused by just one factor. Instead, it’s usually a combination of changes in strength, coordination, load, and daily demands on your body. While pelvic instability is especially common during pregnancy, it can happen to anyone. Some of the most common contributors include:

• Pregnancy and hormonal changes. During pregnancy, your body releases hormones that increase joint mobility to prepare for childbirth. This can temporarily affect how your pelvis moves and feels. At the same time, the growing baby shifts your center of mass, which can change posture and how forces move through your body. "The changes in center of mass as the baby grows can change your posture," says Dr. Guseva — which may ask your pelvic muscles to work differently to keep the area feeling stable.

• Postpartum recovery. After childbirth, your body needs time to recover — your abdominal and pelvic floor muscles stretched and worked hard during pregnancy and delivery. These muscles may not coordinate as well right away, which can make the pelvis feel less supported. 

• Core and pelvic floor muscle imbalances. Stability isn’t just about strength — it’s about how well muscles work together. If certain muscles (like your deep core or pelvic floor) aren’t contributing as much as they could or they aren’t engaging at the right time, other muscles (like your lower back or hips) pick up the slack. Over time, this can lead to fatigue, muscle tension, or a sense of instability in your pelvis.

• Previous injury or trauma. Injuries to the pelvis, hips, or lower back — such as falls, fractures, or muscle strains — can affect the ligaments, joints, and muscles that work together to stabilize the area. Even after tissues heal, your body may continue to move differently, which can affect pelvic stability, Dr. Guseva says.

• Repetitive or increased physical demands. Jumping into new activities too quickly or repeating the same movements (like running, lifting, or prolonged standing) can overload the muscles that support your pelvis. When these muscles get fatigued, they may not provide the same level of support, which can contribute to discomfort or instability.

Symptoms of pelvic instability 

Pelvic instability symptoms can vary depending on what’s contributing to the issue and how your body is moving and adapting. Some people notice mild discomfort, while others may feel more limited during certain activities. Common signs of pelvic instability include: 

• Pain in the pelvis, lower back, groin, or inner thigh

• Difficulty balancing or standing on one leg

• Discomfort when getting up from sitting, walking, or rolling over in bed

• “Start-up pain” — stiffness or pain when you first begin moving after sitting or resting

• Sensations like clicking or popping in the pelvic area — with or without pain (these aren’t always harmful, but can feel unsettling)

• A feeling that your pelvis is “shifting,” giving way, or not fully supported during movement

How movement can help pelvic instability 

While pelvic instability can feel uncomfortable or unsettling, remember that your pelvis is designed to move and often responds well to exercise therapy. 

Rather than trying to “lock” the pelvis back in place, the goal is to improve how your muscles work together to support and control movement. Strengthening key muscle groups — including your core, lower back, glutes, thighs, and pelvic floor — helps create a more stable and coordinated system. “Exercises for pelvic stability focus on improving strength and coordination of these muscles,” says Dr. Guseva.

Movement also helps in other important ways: it increases blood flow, reduces muscle tension, and helps your body gradually build tolerance to everyday activities like walking, standing, and transitioning between positions. Over time, this can reduce pain and improve your confidence in how your body moves.

Together, these exercises strengthen the deep core, glutes, and pelvic floor muscles that support pelvic stability. They also improve coordination between these muscle groups, helping your pelvis feel more supported and your movements feel more controlled and comfortable over time.

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.

Treatments for pelvic instability 

Feeling like your pelvis is unstable is not just uncomfortable — it's also unsettling. But there’s so much you can do at home to improve stability over time. Some effective, at-home treatments for pelvic instability include: 

• Try physical therapy and targeted exercises. Targeted exercises, like the ones above, can help strengthen key supporting muscles around your pelvis. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Start with postpartum-friendly exercises. If you're recovering from childbirth, rebuilding strength and coordination gradually can help your pelvis feel more supported. "Restoring strength in those muscles can create more support for the pelvis," says Dr. Guseva. A physical therapist can help you find the right starting point.

• Take movement snacks throughout the day. If you sit for long periods, take regular movement snacks, such as a quick walk or stretching session to reduce stiffness and keep your supporting muscles engaged.

• Apply heat or ice. Either therapy may help you feel better. Cold therapy can help reduce swelling and numb pain receptors. Heat, on the other hand, can help boost blood flow and break up stiffness or muscle tension. Consider alternating between using an ice pack and a heating pad as needed, or stick to the method that works best for you.

• Take over-the-counter (OTC) medication as needed. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have pelvic pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Try using supports. While strength training is key to improving support and stability in the pelvic region, in some cases (like pregnancy) using additional measures can be helpful in managing discomfort. “Many pregnant people like to wear compression belts, which help create greater support and stability in the pelvis as the muscles adapt to accommodate the growing baby and shifting body positioning,” says Dr. Guseva.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for pelvic instability relief, such as massage, acupuncture, or chiropractic care.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain from pelvic instability. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable. Enso is not indicated for use during pregnancy, but it can be supportive postpartum. 

How to prevent pelvic instability 

Pelvic instability often comes down to how well your muscles work together to support your hips and core. Building strength, improving coordination, and being mindful of how you move can all help your pelvis feel more supported.

• Build core and pelvic floor strength. Targeted strengthening exercises — including physical therapy — help support the muscles around your pelvis so they can better stabilize the area. If you’re pregnant or planning to become pregnant, prioritizing core and pelvic floor strength can be especially helpful.

• Practice good movement mechanics. How you move throughout the day plays a big role in pelvic support. “Your Hinge Health physical therapist (PT) can teach you good movement mechanics to prevent discomfort and keep your pelvic muscles strong,” says Dr. Guseva.

• Gradually increase activity levels. Avoid sudden spikes in activity. Ease into new routines and give your body time to adapt. Some discomfort can be normal, but sharp or worsening pain is a sign to scale back and adjust.

• Stay physically active. Regular movement helps keep your muscles strong and responsive. Choose activities you enjoy — like walking, swimming, biking, or strength training — so you’re more likely to stay consistent.

When to see a doctor

Pelvic instability often improves with targeted exercises and physical therapy. But if your pelvic pain is severe, getting worse, or causing significant difficulty with daily activities, see a healthcare provider. It's also a good idea to get care if you have:

• Numbness, tingling, or weakness in your legs or genital region

• Loss of bladder or bowel control

• Pain that begins suddenly after a fall or injury

• Severe pelvic pain during pregnancy (always consult your prenatal care provider)

Living with pelvic instability 

Pelvic instability isn’t permanent. How long it takes to improve pelvic instability can vary depending on what’s contributing to it. For example, pregnancy-related pelvic instability often improves after childbirth, though it may take several weeks to months of consistent exercise and supportive strategies.

In general, most people notice gradual improvement with regular movement and targeted exercise. The pelvis is adaptable, and building strength and coordination over time can help reduce discomfort and improve how supported you feel during daily activities. Ongoing strengthening and movement strategies can also play an important role in maintaining long-term pelvic health.

PT tip: Breathe to activate your muscles

How you breathe during movement can make a difference. When you’re lifting, rolling in bed, or changing positions, try to exhale during the effort. “Studies show exerting effort on the exhale helps generate more muscle strength and force, which can help engage stabilizer muscles in the pelvis during activities like squatting, rolling in bed, bending, and lifting,” says Dr. Guseva.

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

1. Dydyk, A. M., & Gupta, N. (2020). Chronic Pelvic Pain. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554585/

2. Stover, M. D., Edelstein, A. I., & Matta, J. M. (2017). Chronic Anterior Pelvic Instability. Journal of the American Academy of Orthopaedic Surgeons, 25(7), 509–517. doi:10.5435/jaaos-d-15-00338

3. Dubey, L., Karthikbabu, S., & Mohan, D. (2018). Effects of Pelvic Stability Training on Movement Control, Hip Muscles Strength, Walking Speed and Daily Activities after Stroke: A Randomized Controlled Trial. Annals of Neurosciences, 25(2), 80–89. doi:10.1159/000486273

4. Ali, A., Andrzejowski, P., Kanakaris, N. K., & Giannoudis, P. V. (2020). Pelvic Girdle Pain, Hypermobility Spectrum Disorder and Hypermobility-Type Ehlers-Danlos Syndrome: A Narrative Literature Review. Journal of Clinical Medicine, 9(12), 3992. doi:10.3390/jcm9123992