Firstly – Yes! It Will Get Better!
Pelvic pain in pregnancy is a common symptom affecting up to 80% of women.
This can start as pain in one or more of the three pelvic joints: your left or right sacroiliac joints (at the back of the pelvis) or your pubic sympysis (at the front of the pelvis).
The pain can be localised to this spot or can also be felt in the back, buttock, groin or leg.
Often, pelvic pain can affect:
• Walking (especially up stairs)
• Rolling in bed
• Getting dressed
• Sexual activity
• And lots of other day to day functions!
Having pelvic pain can be a big concern, if can cause so much bother to so many things which can be really overwhelming!
There are many different causes of pelvic pain.
Often with lots of different factors, all acting together, including:
• Hormonal changes: these increase the flexibility of your joints and cause more movement than usual through your whole body. Your pelvis needs to widen to allow your baby to move through in delivery, so this change is really important to help you prepare for birth. The side effects mean that your pelvis is more mobile which can put extra strain on the joints causing irritation and pain.
• Posture: your body changes to accommodate your growing baby, this means that more of your weight is in the front (from your breasts and baby). This changes how your muscles have to work and can increase pressure through different parts of the pelvis. Weight gain is a normal part of pregnancy, which also impacts your posture and can put more strain on your pelvic joints.
• Exercise: this is a balance in pregnancy – high impact exercise can aggravate pelvic pain and too little exercise can cause pain due to inactivity and muscle weakness. It is recommended that throughout your pregnancy you continue exercising to prevent pain from starting or if you have pain already, prevent it from worsening. Many women stop exercising when they start getting pain – it is best to keep exercising but you might need to change the type of exercise (such as less running or walking and start pilates, swimming or aqua exercises). If in doubt, talk to your Dr or Physio.
• Pelvic floor muscles: your pelvic floor muscles are very important pelvic support. If they are weak then they are not able to support your pelvis and the increased weight from your baby. They also may be too tight, causing more strain on the pelvis! It can be hard to spot the difference yourself, bladder leakage can be a sign your pelvic floor is not working well.
• Other factors: previous pelvic or back pain, stress (at home, work) or other muscle tightness.
So, what can be done? Generally, most women find their pain will disappear after birth – within 3 months 90% are back to normal. Until this point, keeping your pain levels reduced for the remainder of your pregnancy and reducing it quickly after your delivery is key so you are able to keep up with the activities you enjoy without the pain stopping you and enjoy the time with your new baby.
Treatment can include:
• Massage – releasing tight muscles
• Specific exercise – strengthening your pelvic support muscles
• Pelvic floor training – either strengthening weak muscles or relaxation of tight muscles
• Pelvic support – pelvic support belts or support shorts are helpful to take the load are reduce pain as your body continues to change through the pregnancy. Different types are available depending on the type of pelvic pain you have and what daily activities are affected.
• Posture support and training – correct postures for sitting, standing, work
So it is great to know that normally this pain will gradually ease off – Physiotherapy treatment is very effective to reduce the intensity of pain and help get you back to your normal self faster.
If you feel you may need treatment, please do not hesitate to book an appointment with one of our Women’s Health Physio’s.
Jane Rothe, myPhysioSA Senior Women’s Health Physiotherapist