As your little human grows inside your belly, many women are struck with the undesirable experience of pelvic pain in pregnancy. For those who have gone through this, you know it can feel like you have no control over what is happening to your body & as a result, feel completely helpless. Especially when you’ve been fit & healthy all your life and now you’ve got this pain that you didn’t even know was a thing in pregnancy!
Well, I am going to shed some light on your pain & reassure you that you do have control. Pelvic pain in pregnancy is incredibly common with up to 76.4% of women recorded to experience it. Even so, it is not ‘normal’ & can be reduced by you taking the following steps.
14 Ways You Can Reduce Pelvic Pain In Pregnancy:
1. Understand Your Pregnant Body.
During pregnancy it has been shown that there is a reduction in core muscle strength. This along with abdominal stretching, increased weight & a shift in centre of gravity, causes other muscles to overcompensate i.e. the glutes (butt muscles) & back muscles.
To make space for your growing bubs & to help prepare your body for childbirth, the body releases a hormone called relaxin. As the name suggests, relaxin relaxes the ligaments in your body. As a result, the joints & muscles of your pelvis & lower back can stiffen/tighten in attempt to increase stability. This is a protective response of the body, but this tension can end up leading to more pain.
Understanding this can help to explain why you are feeling this pain in pregnancy & give you reassurance that there is a reason for it. The good news is that in 93% of cases pelvic pain disappears within 3 months post birth. Hallelujah I hear you say! So hang in there, because this is not going to be a forever issue for you.
2. Activity Modification.
There are so many ways you can take control & help your pelvic pain in pregnancy. Avoiding aggravating activities might sound obvious but many women continue to do what aggravates their pain thinking there is no other way. Ensuring you keep your pelvis & hips level during all activties can be achieved by the following:
- Avoid movements that create shearing through the pelvis like stairs, standing on one leg & the cross trainer.
- If you have to take the stairs, do one step at a time.
- Avoid lifting & carrying heavy items.
- Avoid carrying a toddler on one hip as much as you can.
- Sit down & let your toddler climb onto you.
- Sit down to put your pants & underpants on.
- Sit in your car by lowering your bum onto the seat first then lifting your legs in carefully. You can sit on a plastic bag to make this swivel easier.
- Keep your knees together when you are rolling in bed.
- To get out of bed, roll onto your side, drop your legs over the edge of the bed & push yourself up to sitting using your arms.
- Avoid twisting your body, instead move your feet.
- Avoid vacuuming (yay!).
- Walk with smaller steps if your pain is severe.
- Lying on your back during sex may aggravate your pain so try other positions like lying on your side.
Pain = inflammation. To help settle this, promote healing & therefore improve our pain we need to ensure we have adequate rest. This might mean having a lie down after work or getting help looking after your toddler so you can rest.
Getting adequate sleep is also essential as your body heals during sleep & rest.
4. Manual Therapy.
See a Women’s Health Physiotherapist who treats pelvic pain in pregnancy ASAP! Women’s Health Physio’s like myself can make a huge difference to your pain. I have helped hundreds of women with mild to severe pelvic pain by using techniques to reduce tension through joints & muscles around their pelvis. Dry needling the glute muscles is an incredibly effective technique.
b& stert E5. SRC Pregnancy Shorts.
I am a big advocate for SRC pregnancy shorts (or leggings) as I have seen them help countless women with pelvic pain in pregnancy. They provide the right amount of compression to stabilise the pelvis without deactivating the muscles. They are comfortable & can be worn under your clothes; whereas some braces can be cumbersome & dig in. The SRC pregnancy shorts also provide support for the pelvic floor & legs, which braces do not. The Australian Physiotherapy Association endorses the use of SRC shorts.
As your baby grows, your posture becomes more lordotic, which means the arch in your lower back increases to compensate for the increased abdominal weight. This change in posture can place extra strain on your lower back & cause pelvic pain in pregnancy.
Learning how to stand with a neutral pelvis can help alleviate some pressure on your lower back & improve your pain. Focus on gently tucking under your tailbone, drawing your pubic bone upwards. Lengthen your spine from this position & gently draw your shoulder blades back together.
7. Pelvic Floor Exercises.
Pelvic floor exercises can help to increase stability around the pelvis. Making sure you do this correctly is key. Read more about the pelvic floor & download your FREE Pelvic Floor Guide here.
8. Strengthening & Stretching Exercises.
Regular exercises to both strengthen & stretch your hips, pelvis & lower back can both prevent & improve pelvic pain in pregnancy. My Pregnancy Exercises E-book will teach you all the exercises you need to know!
Pilates run by a Physiotherapist is a safe way to exercise with pelvic pain in pregnancy, as the Physio can modify the exercises for you. Pilates can help stabilise the pelvis & spine, which can in turn improve pain. Generally exercises that involve standing on one leg or single leg extensions should be avoided.
10. Safe General Exercise.
Exercise within your pain limits & avoid any exercise that aggravates your pain. This might mean modifying the duration or the way you exercise. Here are some recommendations:
- Avoid shearing movements such as the stepper machine or the cross trainer or exercises that involve standing on one leg.
- If walking for long periods is a trigger then do shorter walks more often e.g. go for a 10 minute walk before work, after work & in your lunch break, rather than 30 minutes straight.
- Swim freestyle or backstroke, avoid breastroke legs. Swim with a pool buoy between your legs if kicking is aggravating.
- Walk fowards & backwards in the pool or calm ocean.
- Aqua aerobics.
- Light weights in a standing or seated position.
- Modified Pilates or Yoga – see above.
- Stationary-seated bike may be ok for you.
To find out what other general exercise is safe in pregnancy click here.
11. Spikey Ball Release.
The spikey ball will be your best friend! It’s a simple, cheap way to release the muscles around your pelvis, especially the glutes (butt muscles). Use the spikey ball against a wall or the ground, pushing into it with your body weight. Roll it around on your butt muscles (like a massage) to release the muscles. Even if your pain is one sided or at the front of your pelvis, use the spikey ball on both glutes every 1-2 days. There are no 2 ways about it, the spikey ball hurts! But you will be thanking me later 😉
12. Sleeping Positions.
Finding a comfortable position when you have pelvic pain in pregnancy can be tough. Here are some tips that might help you:
- Keep your pelvis/hips in a neutral position by placing a pillow between your legs when lying on your side.
- Lie quarter turned to your left by placing a pillow under the right side of your pelvis/back. You can also use a pregnancy wedge pillow to achieve this.
- Use a wedge under your belly to support it when on your side.
- A pregnancy body pillow may help you feel supported & comfortable.
13. Reduce Stress.
Psychological stress can negatively impact pain & muscle tension. As a result, it’s important for you to find ways to manage you stress levels or anticipation of birth/postpartum. Making self-care a priority & including relaxation into your day or week is a must. You could also try speaking to a trusted friend or practitioner. Read these 2 blogs for inspiration on reducing stress:
14. Ongoing Management.
Ongoing self-management is essential to reduce pelvic pain in pregnancy & maintain these improvements. We need to take control of what we can & help ourselves as much as possible rather than relying on a “quick fix”, as unfortunately this rarely exists.
Ongoing manual therapy with your Women’s Health Physio during your pregnancy is recommended as maintenance. To find a WH Physio in your area click here.
The unknowns that accompany pregnancy can be a scary. Throw in pain to this scenario & it can add a whole lot of worry & feelings of helplessness. This is why understanding your body & empowering yourself with knowledge is where your energy needs to go.
Know that you can control the actions you take. You can improve your pain & quality of life during pregnancy by implementing the above 14 strategies. What helped you manage your pelvic pain in pregnancy? Share it in the comments below.
Kanakaris NK et al (2011) Pregnancy-related pelvic girdle pain: an update. BMC Medicine 9:15.
Verstraete EH et al (2013) Pelvic girdle pain during or after pregnancy: a review of recent evidence and a clinical care path proposal. ObGyn 5:33-43.