Pregnancy is a fascinating process that allows for the development of another human being, but if you’re currently pregnant, you might have realized that it’s not so simple for the body to adjust to the physiological changes associated with pregnancy. Starting from the second or third trimester, it’s common for pregnant women to experience pain in the lower back, buttocks, or pubic symphysis. These symptoms are grouped under the medical term « pelvic girdle pain » (PGP).
Pelvic girdle pain is a particularly debilitating condition that negatively impacts day-to-day activities such as walking, standing and sitting. It can even affect sleep quality by triggering pain during rolling movements in bed. Pelvic girdle pain is a frustrating condition that affects 30-55% of pregnant women, but it can be managed if appropriately diagnosed by a healthcare professional.
The causes of PGP are multifactorial and include biomechanical, hormonal, genetic, metabolic, and traumatic factors. Pregnancy generates postural changes that increase the load on the lumbar spine and pelvis. With the developing uterus, the centre of gravity changes and the lumbar spine subsequently changes its alignment. During this time, the musculature has to adapt to ensure that the weight of the trunk is sill effectively transferred through the pelvis and the legs. If muscles fail to stabilise the pelvis, it can lead to PGP symptoms. In fact, a study conducted by De Groot et al. (2008) showed that patients with PGP had reduced lumbopelvic muscle strength and endurance. Although biomechanics play a key role in the development of PGP, other factors need to be considered. Having multiple pregnancies, a high BMI, a physically demanding profession, or experiencing emotional distress can all be predisposing factors of PGP.
Once a diagnosis of PGP is made by a qualified healthcare professional (e.g.GP, Osteopath or Physiotherapist), the pain can be managed in various ways. Start by identifying aggravating activities and develop strategies to avoid them. Pregnant women often tell me that putting their shoes on whilst standing, walking up the stairs, or standing for long periods of time at a museum exacerbates their symptoms. To reduce the stress on your lower back and pelvis, you could sit down to put your shoes on, avoid stairs by taking lifts, reduce squatting movements, etc. Alongside these lifestyle changes, it’s important to practice exercises specific to your muscular imbalances. An Osteopathy assessment can help you understand the areas of your body that are compensating for the growth of your baby. Through the analysis of your musculoskeletal system, an Osteopath can inform you on the areas that need to be strengthened and on the exercises that will help you with your recovery. Exercises usually aim to strengthen the gluteal and adductor muscles whilst reducing the activity of lumbar spine musculature. It’s important to start this work before the delivery of your baby and to continue afterwards as symptoms can linger for a few months postpartum. Lastly, you can improve your symptoms by wearing a flexible pregnancy belt. This helps to deload the lower back muscles in activities that are particularly challenging.
In summary, pelvic girdle pain is a debilitating condition that commonly affects pregnant women. Even though pregnant women might believe that there are no solutions to this common problem, there are many ways of reducing pelvic girdle pains. These are some of the strategies we’ve discussed:
- Getting an assessment with an Osteopath or Physiotherapist
- Changing some of the day-to-day activities that might exacerbate your symptoms - Practicing exercises that promote gluteal and adductor strength
- Practicing exercises that reduce the muscle activation of postural muscles
- Finding a flexible maternity belt
If you’re experiencing pelvic girdle pain, don’t hesitate to speak to a healthcare professional that can guide you through your recovery.
