PGP (Pelvic Girdle Pain)
Information in this section has been provided by Moira Clark, an experienced, specialist prenatal/pregnancy and postnatal Pilates and exercise instructor.
What is Pelvic Girdle Pain (PGP)?
PGP is pain in the pelvic area, commonly at the joint at the front where the legs meet, or at the back of the pelvis at the base of the spine. There may also be pain in the low back, radiating down the inside of the thighs or back of the legs. There may be difficulty walking, sitting or standing for extended periods, climbing stairs or turning over in bed.
Symptoms can range from very mild to very severe mobility problems. Some women experience pain very early in pregnancy; others will have problems in the later stages. There is a tendency for problems to be more pronounced and start earlier in subsequent pregnancies, however appropriate treatment strategies, especially if started early, can substantially help with symptom management.
PGP is common in pregnancy, but not normal, affecting around 1 in 5 pregnant women. Of these women a significant number will continue to have problems post birth.
Symphysis Pubis Dysfunction (SPD) is a much less common, separate condition.
Who is at risk of PGP in pregnancy?
Sometimes there is no identifiable cause however women may be more at risk if they have:
- A high degree of joint flexibility
- Had PGP in a previous pregnancy
- A history of low back pain or pelvic trauma
- Body weight above normal range
- Awkward working conditions/heavy workload.
How can you help yourself?
If you have no pain:
- Keep exercising (walking is the best choice) in good posture. Activities involving impact, twisting, rapid movement, excessive range (such as some Pilates or Yoga moves and swimming breaststroke) or uncontrolled lifting may stress the pelvis beyond coping point.
- Keep weight within normal range
- A pregnancy specific programme of exercises for posture and pelvic stabilisation will complement other activities and reduce risk
- Do Pelvic Floor exercises
If you have pain:
- Pace yourself in daily activities with as little pain as possible. Avoid the cycle of pain/rest/pain.
- Get as much help as you can especially with tasks involving bending and lifting.
- Ask for a referral to a physiotherapist with experience in treating pelvic conditions in pregnancy.
- A successful treatment strategy should include specific exercises to improve posture and pelvic stability, prescribed by an experienced pregnancy specialist.
- Do Pelvic Floor exercises
For further information see www.acpwh.org.uk leaflet Pregnancy related Pelvic Girdle Pain.
What about after my baby is born and future pregnancies?
After the birth of your baby the pain may disappear, or it may persist, sometimes for a considerable period of time.
Between pregnancies is an ideal time to focus on strengthening the muscles that surround the pelvis to help regain stability and provide a strong foundation for a future pregnancy. Consult a specialist physiotherapist or qualified pregnancy/postnatal exercise instructor; check that your chosen professional has experience with this type of work.
Remember that if you have had PGP in one pregnancy you are more at risk for future pregnancies. Do not think that the problem is no longer present because the pain has gone.
Pelvic Floor exercises will help.