Pelvic girdle pain in pregnancy: causes, symptoms, treatments, and exercises
Learn about pelvic girdle pain in pregnancy (PGP) causes, symptoms, and treatment options, including PT-recommended exercises for pain relief.
Table des matières
Key Takeaways:
1. Pelvic girdle pain during pregnancy is often caused by hormonal changes, a growing belly, and extra strain on pelvic joints and muscles.
2. Gentle movement and small activity adjustments can help ease discomfort and support your pelvis as your body changes.
3. Simple stretches and strengthening exercises can help relieve pelvic girdle pain and improve stability (see videos below).
Hinge Health offers virtual physical therapy and more to help you manage pelvic pain. Learn more.
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.
Reviewed by our clinical and medical experts
Gwen Smith, PT, DPT
Tamara Grisales, MD
Kandis Daroski, PT, DPT
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
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.
It can be tough when you feel like you’re in too much pain to start moving. But gentle exercise can make a big difference in your pelvic girdle pain.
Treatments for 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.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
Exercises for pelvic girdle pain
Want expert care? Check if you're covered for our free program →- Seated Hip Adduction
- Seated Pelvic Tilt
- Cat Cow
- Figure Four Stretch
- Bridge
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 joint or muscle pain that makes it hard to move, 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.
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References
Gutke, A., Sundfeldt, K., & De Baets, L. (2021). Lifestyle and Chronic Pain in the Pelvis: State of the Art and Future Directions. Journal of Clinical Medicine, 10(22), 5397. doi:10.3390/jcm10225397
NHS. (2022, December). Pelvic pain in pregnancy. Nhs.uk. https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/pelvic-pain/
Simonds, A. H., Abraham, K., & Spitznagle, T. (2022). Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population. Journal of Women’s Health Physical Therapy, 46(1), E1–E38. doi:10.1097/jwh.0000000000000236
Sward, L. B., Manning, N., Murchison, A. B., Ghahremani, T., McCaulley, J., & Magann, E. F. (2023). Pelvic Girdle Pain in Pregnancy: A Review. Obstetrical & Gynecological Survey, 78(6), 349–357. doi:10.1097/ogx.0000000000001140
Symphysis Pubis Dysfunction: Causes, Symptoms & Treatment. (2021, November 30). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22122-symphysis-pubis-dysfunction
Verstraete, E. H., Vanderstraeten, G., & Parewijck, W. (2013). Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal. Facts, Views & Vision in ObGyn, 5(1), 33–43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987347/
Walters, C., West, S., & Nippita, T. A. (2018). Pelvic girdle pain in pregnancy. Australian Journal of General Practice, 47(7), 439–443. doi:10.31128/ajgp-01-18-4467
Wobser, A. M., & Wobser, R. W. (2020). Anatomy, Abdomen and Pelvis, Bones (Ilium, Ischium, and Pubis). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519524/