Pelvic Girdle Pain (PGP) & Pregnancy
Pregnancy can be a real pain in the hips, back, and butt…literally! If you’re experiencing this just know you’re not alone. In fact, Approximately 45% of women experience Pelvic Girdle pain; SI Joint Pain and Pubic Bone pain (aka lightning crotch..yup it feels like that) during pregnancy. We are going to unpack all things pelvic girdle pain in pregnancy this month and leave you with some tips to help.
*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1181256/
What is Pelvic Girdle Pain and how is SI Joint Pain Related?
Pelvic girdle pain (PGP) in pregnancy can arise from the 3 main joints of the pelvis and the muscles, ligaments and nerves associated with them.
Pelvic Girdle Pain can come from:
The right SI joint pain (SIJ) or
The left SI joint pain (SIJ) and
From the front of the pelvis which is called the pubic symphysis (PS). When only the pubic symphysis is involved, the pelvic girdle pain is sometimes referred to as Symphysis Pubis Dysfunction (SPD).
There are 2 sacroiliac joints (SIJ) at the back of the pelvis. Your sacroiliac joint is where your two hip bones (ilia) meet your tailbone region (sacrum) — which explain the name sacroiliac joint…anatomists did a fantastic job naming this joint in the body way back when.
The SI joint is a very strong joint structure and it has thick ligaments that support it. It’s also very jagged like a jigsaw puzzle. Because of these features, the SI joint is usually very stable. But when you’re pregnant, that’s not the case. Let’s dive into why that is.
Why do my SI joints Hurt When I’m Pregnant?
There are a few reasons why pregnant women tend to experience SI joint pain. It can start pretty early in pregnancy – typically in the first trimester and progressing as your belly grows.
SI joint pain during pregnancy is caused by several factors that mostly have to do with the structure of your spine and how it changes during pregnancy.
Normal weight gain that comes with pregnancy puts stress (load) on your spinal joints, especially the SI joints and joints of your lower back.
Your center of gravity shifts forward, which in turn, puts increased load and pressure on your SI joints, low back spinal joints, and even your hips.
The way you walk and move also changes to accommodate for your pregnancy, which causes compressive forces in your hips to change.
But usually the biggest culprit of SI joint pain is probably the hormone Relaxin.
This pregnancy hormone is a necessary hormone during pregnancy as it allows your joints to loosen and expand in order to accommodate a growing baby. However, this causes “looser” joints that don’t have as much support as they had before. In the meantime, that means your pelvis is less stable, which can compromise your SI joint and cause some serious aches and pains.
Lastly, a lot of research suggests that if you’ve had lower back pain before your pregnancy, it can double the chances that you’ll have low back pain during pregnancy. Sorry to be such a drag guys, just giving you all the facts.
Symptoms of Pelvic Girdle Pain:
Symptoms of pelvic girdle pain in pregnancy can be a combination of the following:
The pregnancy waddle / shuffling gait
Struggle to place weight on one leg
Struggling to climb stairs
Turning in bed causing pain and sleeplessness due to hip pain
Sciatic type pain travelling down your leg
Pain with long periods of sitting or standing
Difficulty transitioning from sitting to standing
Pelvic floor muscle weakness
PGP can vary in sensation, but typically individuals experience lateral hip soreness and pain. It is possible for the pain pattern to shift day to day or week to week, where it may be just one sided, or it alternates, or the pain is only felt at the front or the pain is only at the back of the pelvis. This again is usually because of instability and body changes during pregnancy.
Pain stemming from your SI joint can present as localized “butt” pain, numbness and/or tingling that can start in your butt and radiate down the back of your thigh. It can be very intense for some, but for others it might be more of a dull, constant ache. Women that experience this pain typically have a decreased tolerance to standing, walking or sitting. They constantly feel the need to change positions and find it hard to get comfortable. During walking, some individuals feel a “catching” or “clicking” of the hip.
Pregnancy pelvic girdle pain can occur early in the first trimester or at any time during the second and third trimesters.
How To Reduce PGP and SIJ Pain
1. STEP ONE: GET SOME HELP
First, you need to correct the alignment of the pelvis and or SI joint and make sure your low back is moving well. To do this, you will need help. Your SI Joint is complicated and not one you can fix on your own. Ahem, this is me telling you to go see a good chiropractor.
A chiropractor for pregnancy related conditions (like yours truly) is a valuable resource for knowledge and treatment. Your OB or midwife might have everything under control, but sometimes they might not have a lot of treatment options for your SI joint pain. This is where a chiropractor can come in handy. Chiropractic adjustments can help keep your SI joints positioned, and chiropractic adjustments can give you a great deal of pain relief.
Certain research has even shown that almost 75% of women undergoing chiropractic manipulation during pregnancy report significant pain reduction and clinically significant improvements in disability.
STEP TWO: FIX THE INSTABILITY
The root of pelvic girdle pain and/or SI joint pain is instability. This means that strength training is a must. During pregnancy, your core — which consists of your abdominals, pelvic floor, diaphragm and back muscles — becomes compromised. You should focus on waking these muscles back up as soon as you can, especially if you’re starting to feel pain.
Strengthening exercises that target core activation, SI joints and other joints of the lower back, pelvis, and hips can create more stability in the area. Relaxin is going to do what Relaxin does, which is create laxity. There’s nothing we can do about that, and your body needs that to accommodate your baby. We can combat the hypermobility with strengthening exercises such as these.
If you don’t know what to do, think about working with a competent trainer and or physical therapist who REALLY understands pregnancy. Here in Bedford, Renegade Movement and Performance ARE those people.
Moderate intensity aerobic exercise can also help relieve back pain and help with a healthy pregnancy. In addition to musculoskeletal benefits, ongoing exercise during pregnancy decreases one’s risk of excessive weight gain, pre-eclampsia, gestational diabetes, and pre-term birth, while improving self-image and pain tolerance.
Invest in a maternity support belt. A maternity support belt (like one’s made by Serola) is designed to relieve pressure from your SI joint. You can wear one whenever you’re walking or doing other light activities. These can be God-sent for expecting mothers with intense SIJ pain.
Lastly, just know that most of the time (not to be a complete bummer,) pelvic girdle pain does not correct itself after your baby arrives. On top of everything, trauma from labor and delivery can also cause SI joint pain postpartum. This is just more of a reason to make sure you have a good “squad” of competent providers to help you through pregnancy and postpartum.
