Pregnancy-Related Pelvic Girdle Pain (PGP)
Pelvic girdle pain (PGP) is a common pregnancy-related issue that is often dismissed as “normal”, leaving many to feel discouraged as they try to navigate their health and movement with debilitating pain.
According to the Royal College of Obstetricians and Gynaecologists, PGP is pain at the front or back of the pelvis that can also affect the hips or thighs, often involving the sacroiliac joints or the symphysis pubis joint. Those who experience PGP may find everyday activities like getting in and out of bed, walking, or even sitting for extended periods challenging.
Below are some updated facts about pelvic girdle pain.
About 45% of pregnant women and 25% of postpartum women experience PGP.
There is very little evidence that Relaxin, the pregnancy hormone, causes pelvic girdle pain
Widening of the symphysis pubis is a normal part of pregnancy (as long as it doesn’t exceed 9.5mm) and is not necessarily the contributor of pain
Emotional distress (like anxiety or depression) predicts ongoing PGP disability.
Fear of movement is linked to increased pain and disability.
The sacroiliac joints (SIJ) do NOT displace during pregnancy. This myth has been debunked by current valid studies.
As you can see, PGP is common but NOT normal, and several factors contribute to it. This is where pelvic floor physiotherapy can help. By evaluating your posture, movement patterns, daily activities, psychological factors, and pelvic floor function, a physiotherapist can identify the root cause of your pain and develop a personalized treatment plan. Early intervention can reduce pain, prepare your body for birth, and lower the risk of continued PGP postpartum.
The most important takeaway: don’t be afraid of the pain. Movement is essential, and avoiding it can make the problem—and the pain—worse.
References
1- Bjelland, E., Stuge, B., Engdahl, B., & Eberhard-Gran, M. (2012). The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study. BJOG: An International Journal of Obstetrics & Gynaecology, 120(1), 32–40.
2- Fredriksen EH, Moland KM, Sundby J. “Listen to your body”. A qualitative text analysis of internet discussions related to pregnancy health and pelvic girdle pain in pregnancy. Patient Educ Couns. 2008;73(2):294–299.
3- Mens JMA, Pool-Goudzwaard A, Stam HJ. Mobility of the pelvic joints in pregnancy-related lumbopelvic pain: a systematic review. Obstet Gynecol Surv. 2009;64(3):200–208.
4- Sutton, C., Nono, L., Johnston, R. G., & Thomson, O. P. (2013). The effects of experience on the inter-reliability of osteopaths to detect changes in posterior superior iliac spine levels using a hidden heel wedge. Journal of Bodywork and Movement Therapies, 17(2), 143–150.
5- Symphysis pubis dysfunction: a practical approach to management’ published in The Obstetrician & Gynaecologist (2006;8:153–8)
6- Verstraete EH, Vanderstraeten G, Parewijck W. Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal. Facts Views Vis Obgyn. 2013;5(1):33–43.
7- Wu, W. H., Meijer, O. G., Uegaki, K., Mens, J. M. A., van Dieën, J. H., Wuisman, P. I. J. M., & Östgaard, H. C. (2004). Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. European Spine Journal, 13(7), 575–589.