Pregnancy related Pelvic Girdle Pain (PGP)
What is PGP?
Pelvic girdle pain is not uncommon during pregnancy. However it is NOT a ‘normal’ side effect of pregnancy that women should just put up with. There are plenty of management methods that can help to ease the symptoms and help a woman to keep active and enjoy her pregnancy.
Why does it occur?
There are both mechanical (muscles / joints / movement), and chemical (hormones) changes that occur during pregnancy, and both will affect PGP. Muscles such as the gluteus maximus and gluteus medius are put under increasing strain, trying to cope with the increased load of a growing baby and a changing pelvis. Often, when they are not strong enough to cope with this increasing load they will struggle to support the pelvis and this can be a cause of pain. The abdominals (Rectus Abdominus) will separate, the diaphragm is pushed upwards and the pelvic floor muscles are under greater stress in order to make space for your growing baby. While these changes are necessary to accommodate your baby during pregnancy, they are also factors which can cause PGP. Specific exercises to address these changes, build strength, improve your breath pattern (this has a massive effect on the diaphragm, pelvic floor and abdominal pressures) can all be extremely effective at reducing PGP.
There are chemical and hormonal changes that are unavoidable during pregnancy. The hormone ‘relaxin’ is often blamed for musculoskeletal pain during pregnancy, but in fact evidence shows there is no link between relaxin production and joint ‘instability’ or ‘laxity.’ We do know that pain is exacerbated by the stress hormone ‘cortisol’ and fear can drive up the nervous system response, sometimes causing a greater painful reaction in the brain despite there being no ‘damage’ in local tissue. It is really important not to add to or cause an increased production of cortisol by expecting women to put up with this pain and discomfort during pregnancy or making them fearful of movement. Educating women about what to expect during pregnancy, how to manage symptoms and reassuring them that movement is helpful and not damaging can make a huge difference to their experience of pregnancy. Keeping well hydrated, finding stress management techniques and trying to establish a good sleeping pattern are all ways in which we can minimise the effects of cortisol and reduce pain.
What can you do?
Often women are told PGP will disappear after they have given birth, and while this can be true in some cases, due to a number of factors other women find that their symptoms persist after having their baby.
How can a physiotherapist help with this condition?
Education, advice and support
Create individual strength and mobility programmes to address your specific pain and your personal goals
Provide treatment to local tissues to reduce pain
Fit and measure belts and use taping techniques to provide support to a painful area and enable normal movement
Reduce stress on the nervous system
Assess and monitor posture, function and stability throughout your pregnancy
Prepare your body for the birthing process and for looking after your baby when they arrive
If you are experiencing this pain after giving birth a physiotherapist can assess you and work with you to recover and restore normal function