What is Pelvic Girdle Pain? (PGP)

PGP is the medical name given to pre and post-natal pain in and or around the low back, pelvic joints (Sacro -iliac at the back and pubic symphysis at the front) side pelvis, side hip area, front groin and inner thigh. It can be severe and disabling, making even walking a major effort; or mild with episodes of pain or aching around the pelvis.

 

  • PGP is felt in pregnancy by up to 50% of women
  • It is in the back of the pelvis and/or over the side of the Hips
  • It can also be felt over the Pubic Symphysis bones at the front – This is called Pubic Symphysis Dysfunction (PSD)
  • It can start as early as 10 -12 weeks, but is often apparent at approximately 22weeks
  • It can be a persistent deep pain and is often worse after walking
  • You can wake up with PGP and have trouble getting comfortable lying on your side

 

What causes it?

  • During pregnancy the hormone Relaxin causes the strong ligaments surrounding the joints to soften and can have an effect on the stable ring shape of the pelvis
  • The muscles around the pelvis and hips may be tight or tighten up to support the ligaments and joints and contribute to the pain
  • An increase in the pregnant mother’s weight; excessive increase during pregnancy adds to the risk of developing problems.
  • Changes in centre of gravity as the baby grows out the front
  • Strenuous, repetitive or jarring type physical work and activity.
  • Previous injury or trauma.
  • Being overweight with an increased BMI.
  • The lie or position of the baby.
  • The overall quality of the mother’s connective tissue will have an impact on the stability of the pelvis.

 

What are the symptoms?

Types of pain that can be experienced;

    • Achy / sharp / burning / tender / acute / chronic.
    • The Intensity of pain can vary: from sudden severe intermittent pain to constant chronic disabling pain.

Location of pain;

  • In and around the pelvic girdle for example, sacroiliac joints, pubic symphysis joint, coccyx, one or both hip joints.
  • The pain can radiate from the pelvis up into the spinal column or down into the buttock and back of the leg.
  • Lower abdomen, groin and between the legs(perineum) and inner thigh

 

How do I avoid getting it?

  • There is no way of deciding WHO might suffer with PGP.
  • Keeping active, getting fit for your pregnancy and labour and seeking advice on types of exercise will all help.
  • Do exercise and classes designed specifically for Pregnancy.
  • See a Women’s Health Physio for advice on what exercise you can do …it’s individual!
  • Reduce or stop strenuous jarring activities /work

 

What can I do to stop it?

Avoid

  • Standing on one leg getting dressed / undressed.
  • Wide legs e.g. getting out of the car.
  • Stretches which cause strain around the pelvis and Hips
  • Exercise that causes pain
  • Exercise that over- stretches the low back and pelvis

Always try

  • To engage the right deep abdominal muscles to help support your baby and stabilise the pelvis
  • Do specific careful stretches for tight areas
  • Stand with good posture
  • Sit with good posture
  • Side lying sleeping -use pillows between the knees
  • Do not push through pain

PGP is something that CAN BE TREATED.

  • Do not accept that you have to suffer this as part of your pregnancy.
  • Talk to your GP, PT and get advice
  • Make sure you see a Women’s health Physio early, before the pain becomes established

 

A Women’s Health Physio will examine you to determine the cause of the pain and give effective treatment, advice and belt support if necessary.

This is something that can be treated successfully, with good return to function and exercise for most women.

 

Vanea Atwood

Women’s Health Physiotherapist

http://www.sportsfocusphysio.com.au/our-physios/vanea-atwood/

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