What is Pelvic Girdle Pain (PGP)?
Pelvic Girdle Pain is pain experienced anywhere in the pelvis. This can be at the front in the pubic symphysis joint (the condition actually was previously called Symphysis Pubis Dysfunction), the back, through the sacro-iliac joints, or the side in the hip joints.
What causes PGP?
PGP often occurs in pregnancy when the bones, joints and ligaments of the pelvis undergo significant changes. A hormone called relaxin is released during pregnancy, which has the effect of causing laxity in the body’s ligaments. This occurs not just in the pelvis, but the pelvis is often where our attention is focused because of it’s potential to cause pain and instability. The biomechanical changes which also occur are also part of the issue as there is increasing weight and additional requirements of the pelvis to support the uterus.
What are some of the symptoms of PGP?
- Pain in and around the pelvic girdle, hips, low back and/or down the legs
- Instability when walking, getting dressed, going up and down stairs etc
- Pain bending forward or twisting
- Pain rolling over in bed or after long sitting
- Pain during intercourse
What can help PGP?
Try doing the following:
- Keeping active with controlled exercises such as pregnancy pilates or yoga
- Wearing flat supported shoes
- Focusing on a tall posture while sitting and standing (see an osteopath if you need an assessment)
- Place a pillow between legs when sleeping
- In some cases, a pelvic belt or crutches may be used for support
- Long sitting >30 minutes
- High heels
- Heavy lifting
- Carrying uneven loads such as a shoulder bag or toddler on the hips
- Crossing legs on the floor or seated
What can osteopathy do to help?
Osteopaths are trained to assess the body holistically and will aim to improve restrictions in the spine, hips and lower limb to ease pain in the pelvis. It is also common that despite the ‘laxity’ of these ligaments, there can still be imbalances and restrictions through the pelvis, which can potentially lead to this pain.
An osteopath can identify any such imbalances and offer gentle treatment, or suggest strengthening exercises, specific stretches and ergonomic advice to assist in easing the pain.
A symmetrical and mobile pelvis offers a space for the baby to grow and develop without any restriction. It is ideal to see your practitioner early on, sometimes even before conception to encourage this.
The other aspect of PGP is using the muscles, which surround the pelvis to assist in supporting the body and ligamentous structures.
Doing clinical pilates is an excellent way to not only treat, but also prevent PGP from coming about.
Will PGP affect my birth plan?
There is no indication that PGP is associated with the incidence of labour intervention – this means that it does not mean you are more likely to have to be induced or have a caesarean. These choices are yours to make and should be discussed with your midwife or obstetrician.
How long does PGP last?
Most cases of pelvic girdle pain resolve after giving birth. The decrease in load on the pelvis is often enough to relieve the pain almost immediately. It is worth remembering that prevention is better than a cure and if you think you might have another baby that it would be worth resuming a strengthening/pilates programme and get some post-natal treatment also.