Pregnancy is a time anticipated with positive expectations of joy and a time to relax and take care of themselves. However, for some, unexpected pains and aches make this journey troublesome. One such discomfort is pelvic girdle pain or PGP or pregnancy-related pelvic girdle pain or PPGP. PGP is a common difficulty as 1 out of 5 antenatal mothers experience it during their pregnancy. PGP is often described as a symptom-related syndrome and can have different presentations for individuals. The clinical manifestations of this syndrome refer to a musculoskeletal type of persistent pain localized at the anterior and/or posterior aspect of the pelvic ring. The symptoms may begin either during the first trimester of pregnancy, during labour or even during the postpartum period.
PGP limits daily activities and working ability and thus decreases the health-related quality of life. Imagine experiencing pain in the pelvic region while side-turning in bed or getting out of bed. Pain in the groin region while getting dressed for the lower half of their body, walking, standing on one leg or climbing up and down steps. All these or one among these can be a presentation for PGP.
Pregnant women who experience such pain are always keen to find out the reason for the pain. The cause can be multifactorial but in a maximum number of cases, the reason is mechanical, which can be because of changes in the posture that may happen because of exaggerated lumbar curvature or the pelvic joint misalignment that may occur in pregnancy or during the labour process.
Another reason can be hormonal changes in pregnancy, because of the laxity in the ligaments in the pelvic region that happens because of the relaxing hormone, this laxity of ligaments can cause uneven movements and these movements can create sharp pain.
PGP can also be because of past history of backache because of misalignment of the spine/pelvic joint or excessive weight gain in pregnancy. All of these together also can cause pelvic girdle pain.
How Physiotherapy may help with PGP?
Physiotherapy helps in preventing as well as treating pelvic girdle pain
Women with PGP are worried to have normal delivery as they fear that the pain may be more excruciating for them and they will not be able to have a normal birthing experience, however, with certain interventions, pelvic pain can be eased out during labour.
Pelvic pain usually subsides gradually after the delivery process, however, in some cases, it may persist. During a normal delivery, the pelvic floor muscles stretch, if there is any trauma from the labour and delivery process, muscles may go into spasms that can elicit pain. Complications such as a perineal tear, infection and prolonged healing may worsen the pain.
Pelvic floor therapy is the term used for postnatal pelvic pain, in this therapy evaluation is done first that may include external and internal examination. After the assessment, if the pelvic floor muscles are tense/tight relaxation techniques are suggested for patients, if the muscles are weak, strengthening exercise are programmed accordingly.
Diastasis recti or abdominal separation can also attribute to pelvic pain, diastasis recti are also assessed by physiotherapists and core strengthening exercises are included as an exercise regime.
Post birth, one must keep themselves active as pain permits. One must obtain a comfortable supported seated position for breastfeeding.
Though, pelvic girdle pain may be considered common in pregnancy but must not be considered normal. This pain does not cause any harm to the growing foetus, but it is difficult and inconvenient for the pregnant lady as it causes excruciating pain with basic everyday activities. One must visit an OBG-GYN Physiotherapist for treatment as such pains are completely curable and make the journey from pregnancy to motherhood pain-free.
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For pelvic girdle pain during pregnancy, a physiotherapist will use a combination of exercises and manual therapy to help you manage pain and improve mobility. They will correct your posture, teach you specific exercises to strengthen your core and pelvic floor muscles, and even advise you on how to move or bend. They may even suggest the use of belts or crutches to support your movement.
The role of a physiotherapist in pelvic pain is to identify the exact location of the pain, which could be radiating pain to other areas. They will next use a combination of exercises and therapy to help mobilise your joints and improve movement. They will also check and correct your posture and movement wherever necessary, to prevent such pain from recurring.
Maintaining good posture while sitting, standing, and moving, gentle exercises such as walking and swimming, and using hot and ice packs can help relieve pelvic girdle pain. Practice relaxation techniques and poses to stretch and release the stiffness causing the pain. Consult a doctor and take prescribed painkillers if necessary.
Yes, exercises can help alleviate and manage girdle pain to a great extent. The use of belts, crutches, or manual therapy by a professionally qualified physiotherapist can help reduce the pain gradually and even prevent it from recurring.
