Pelvic Girdle Pain (PGP) During Pregnancy

Pelvic Girdle Pain (PGP) During Pregnancy

Pregnancy brings about significant changes in a woman’s body, leading to various physical and emotional transformations. It is estimated that up to 1 in 5 pregnant women experience pregnancy-related pelvic girdle pain (PGP) to some extent. Among these changes, Pelvic Girdle Pain (PGP), which refers to discomfort in the pelvic area, is a common and challenging pregnancy pain affecting up to 20% of pregnant women. Effectively managing pubic pain is crucial for a more comfortable pregnancy experience as it can significantly impact daily activities and overall quality of life. Therefore, it’s important to understand the causes, symptoms, and options for treatment.

Additionally, recognizing when pregnancy pain becomes severe and requires medical attention is also important. Understanding how the pelvic girdle joints are affected can help in managing this condition more effectively. This blog aims to explore these crucial aspects and provide guidance and support for those dealing with pelvic girdle pain during pregnancy.

Causes of Pelvic Girdle Pain During Pregnancy

PGP is a multifactorial condition with several contributing factors:

Hormonal Changes

During pregnancy, the body produces hormones such as relaxin, which help prepare the pelvis for childbirth by loosening ligaments and joints. While this is a necessary process, it can lead to instability and pain in the pubic bone and pelvic region.

Changes in Posture

As the pregnancy progresses, the growing uterus alters the woman’s posture, shifting her center of gravity forward. This change can put additional strain on the pelvic girdle joints, leading to discomfort and pain, especially in the hip joint.

Increased Weight

The natural weight gain during pregnancy adds extra pressure on the pelvis and lower back. This increased load can exacerbate pelvic girdle pain, particularly in women who gain weight rapidly or carry multiple babies.

Previous Pelvic Trauma

Women who have experienced pelvic injuries or previous trauma before pregnancy are at a higher risk of developing PGP. Earlier issues with the pelvis can be aggravated by the physical demands of pregnancy. Additionally, any history of unexplained weight loss should be reported to a healthcare provider as it might indicate underlying issues.

Symptoms of Pelvic Girdle Pain in Pregnancy

Symptoms of Pelvic Girdle Pain in Pregnancy

PGP manifests through a range of symptoms, including:

  • Pain in the pelvic area, lower back, hips, and thighs is often experienced as hip pain or a general discomfort in the lower body. This pain can be particularly noticeable during a single-leg stance or other weight-bearing activities.
  • Difficulty walking or standing for long periods
  • Pain during movements that involve the pelvis, such as getting in and out of a car or turning over in bed, which can become extreme pain in more severe cases
  • A clicking or grinding sensation in the pelvic area

Diagnosis and When to Seek Help

How is Pelvic Girdle Pain Diagnosed?

Diagnosis of PGP is primarily clinical, based on a thorough assessment of the patient’s symptoms and medical history. Healthcare providers may perform specific physical tests to identify pain triggers and assess the range of motion in the pelvic girdle joints.

When to Consult a Healthcare Provider

It is crucial to seek medical advice if you experience severe or persistent pelvic pain during pregnancy. Consulting a specialist pain service can provide targeted interventions for managing extreme pain effectively. Early intervention can prevent the condition from worsening and help manage symptoms effectively. Women who had PGP in a previous pregnancy should be particularly vigilant.

Pelvic Girdle Pain Treatment Options

Physiotherapy

Physiotherapy treatment is a cornerstone of PGP treatment. Manual therapy techniques used by a physiotherapist can be particularly effective in reducing pain and improving function, especially for those experiencing hip joint pain and other related discomforts. Wearing supportive shoes can also alleviate some of the strain on the pelvic girdle. A physiotherapist can guide you through exercises that strengthen the pelvic floor muscles, abdominal muscles, and lower back, improving stability and reducing pain.

Medications

In some cases, medications such as acetaminophen may be recommended as part of the standard treatment to manage pain. It is important to consult a healthcare provider before taking any medication during pregnancy.

Alternative Therapies

Alternative therapies, including acupuncture and chiropractic care, may provide pelvic pain relief for some women. These therapies should be performed by qualified practitioners experienced in treating pregnant women. Gynaecological physiotherapy can also be a beneficial adjunct therapy for managing PGP.

Pelvic Girdle Pain Exercises

Benefits of Exercise for PGP

Pelvic girdle pain exercises can significantly alleviate PGP by enhancing muscle strength, flexibility, and endurance. Regular physical activity helps maintain pelvic stability and reduces the risk of developing severe pain, offering effective options for treatment.

Recommended Exercises for PGP

Stretches for Pelvic Girdle Pain

Gentle stretching exercises can relieve tension in the pelvic area and improve mobility. Some effective stretches include:

  • Pelvic tilts: Help to strengthen the lower back and abdominal muscles.
  • Cat-cow stretch: Eases lower back tension and improves spinal flexibility.
  • Hip flexor stretch: Reduces tightness in the hip muscles.

Home Remedies and Self-Care Tips

Managing PGP at Home

Managing PGP involves a combination of self-care strategies:

  • Rest: Take regular breaks and avoid activities that exacerbate pain, such as carrying heavy shopping bags or using heavy vacuum cleaners.
  • Ice and Heat: Alternating between ice packs and heat pads can help reduce inflammation and pain.
  • Proper Support: Wearing a pelvic support belt can provide additional stability and relieve pressure on the pelvic joints.

Lifestyle Modifications to Reduce PGP

  • Maintain a Healthy Weight: Gaining weight gradually can help minimize pressure on the pelvic girdle. Wearing supportive shoes can further reduce the strain and help manage joint pain. Avoid lifting heavy weights to reduce the strain on your pelvis.
  • Practice Good Posture: Keep your back straight and avoid slouching to reduce strain on the pelvis.
  • Avoid Heavy Lifting: Minimize activities that involve lifting heavy objects or bending over frequently.

Impact of Pelvic Girdle Pain on Labour and Birth

Impact of Pelvic Girdle Pain on Labour and Birth

How PGP Affects Labour and Delivery

PGP can impact the birthing process by limiting mobility and making certain positions uncomfortable. However, with proper management, many women can still have a normal vaginal birth.

Tips for Managing PGP During Labour

  • Communicate with Your Birth Team: Inform your healthcare providers about your PGP so they can help you find comfortable positions during labor.
  • Use Supportive Equipment: Tools such as birthing balls or water immersion can alleviate pain and support mobility during labor, potentially making vaginal delivery more comfortable for women with PGP.

Postpartum Recovery and Future Pregnancies

Postpartum Care for Pelvic Girdle Pain

Postpartum recovery involves continuing exercises and self-care practices to strengthen the pelvic floor and surrounding muscles. Physical therapy may also be beneficial during this period.

Will PGP Affect Future Pregnancies?

Nearly 7 out of 10 people with PGP during pregnancy will experience it again in future pregnancies. It is especially important to monitor symptoms during late pregnancy and plan for any subsequent pregnancy accordingly. Therefore, it is important to address and manage the condition effectively during the current pregnancy to minimize future complications. This management can include developing a comprehensive birth plan to account for PGP.

Emotional Impact of Pelvic Girdle Pain

Coping with the Emotional Challenges of PGP

Living with PGP can be emotionally taxing, leading to stress, anxiety, and feelings of helplessness. Seeking support from healthcare providers, family, and friends is essential. Counselling or joining support groups can also provide emotional relief and improve mental health.

Why Choose Continuous Motion Physical Therapy?

Our Expertise in Treating Pelvic Girdle Pain

At Continuous Motion Physical Therapy, we specialize in managing PGP through personalized treatment plans tailored to each woman’s unique needs. Our experienced therapists use evidence-based practices to ensure effective and safe care.

Contact Us for a Consultation

If you are experiencing pelvic girdle pain during pregnancy, contact us today for a comprehensive assessment and customized treatment plan to help you enjoy a more comfortable and active pregnancy.

FAQs About Pelvic Girdle Pain Pregnancy

What does pelvic girdle pain feel like?

PGP typically feels like a deep, aching pain in the pelvic area, lower back, hips, or thighs. It may be accompanied by a clicking or grinding sensation.

When to worry about pelvic pain in pregnancy?

Seek medical advice if the pain is severe, persistent, or interferes with your daily activities. Early intervention is crucial for effective management.

At what stage of pregnancy does pelvic girdle pain start?

PGP can start at any stage of pregnancy, but it is more common during the second and third trimesters as the body undergoes significant physical changes.

Pelvic Girdle Pain (PGP), including Symphysis Pubis Dysfunction (SPD), affects up to 20% of pregnant women, highlighting the prevalence and impact of this condition during pregnancy. It’s crucial to recognize the importance of addressing previous trauma and unexplained weight loss to ensure effective management. While many manage their symptoms effectively with self-care, a significant portion may experience severe pain requiring medical intervention. If you are experiencing PGP, do not hesitate to seek help. Proper management can lead to a more comfortable pregnancy and a smoother postpartum recovery.

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Dr. Cameron Moore

PT, DPT, FAAOMPT, CSCS, Dip. Osteopractic

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Dr. Peyton Oules, PT, DPT Cert. DN

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Dr. Peyton Oules, physical therapist, is a Brewster, Washington native who grew up as a small-town athlete. During her high school sports career, she suffered from two ACL injuries which led her to pursue a career in physical therapy. 

She began her studies by earning her Bachelor of Science in Exercise Science, Pre-PT at Eastern Washington University.  During her undergraduate studies, she spent much of her time playing volleyball and coaching at the high school level.  Dr. Oules continued her education to earn her Doctorate in Physical Therapy from Franklin Pierce University in Goodyear, Arizona.While in school, Dr. Oules became Certified in both Dry Needling and Myofascial Cupping.

Part of her clinical training included international travel to Sydney, Australia where she expanded her orthopedic skill set and had the opportunity to provide treatment for the athletes from the 2023 World Underwater Hockey Championships.

During her doctorate level studies, Dr. Oules learned the importance in making movement a lifestyle. She has a passion for sharing this knowledge with the community and getting her clients back to the activities they love.

Outside of the clinic Dr. Oules enjoys CrossFit®, hiking, traveling, and spending time outdoors with her dog, Rue. Some of her favorite adventures to date include hiking parts of the Grand Canyon and running across the Sydney Harbour Bridge during the Sydney 10k!

Dr. Peyton Oules’ Credentials:
•           Physical Therapist (PT)
•           Doctor of Physical Therapy (DPT)
•           Certified Dry Needling (Cert. DN)

Dr. Khristian McGinley, PT, DPT Cert. DN

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Dr. Khristian McGinley, physical therapist, grew up here in Phoenix, as a competitive softball player with a longtime passion for health and wellness. After sustaining an elbow injury in high school and attending PT herself, she knew that she wanted to pursue a career helping people recover from injuries and getting back to doing what they love. She eventually received her B.S in Nutritional Sciences from the University of Arizona in 2013, then earned her Doctorate in Physical Therapy from Franklin Pierce University in 2017.

Dr. McGinley began her career with a passion in pediatrics and orthopedics, undergoing coursework to treat diagnoses such as torticollis, developmental delay, and toe walking. She also became certified in Dry Needling in 2017, and since then has been additionally trained in Dry Needling for Pelvic Rehabilitation. After the challenging birth of her first child, she developed a passion for treating the pregnant and postpartum population. She became specialty training in Pelvic Floor Rehabilitation in 2021 and since then has focused her practice on helping moms achieve pain free pregnancy, peaceful childbirth, and complete postpartum recovery. She specializes in diagnoses such as urinary incontinence, diastases recti, pelvic organ prolapse, and pelvic pain.

Outside of the clinic, Dr. McGinley enjoys hiking, running, camping, weight lifting, and playing slow pitch softball. She loves spending as much time as she can outside with her husband and two children.

Dr. Khristian McGinley’s Credentials:

  • ​Physical Therapist (PT)
  • Doctor of Physical Therapy (DPT)
  • Certified Dry Needling (Cert. DN)
  • Specialty-trained in Pelvic Floor Therapy

Dr. Meredith Wall, PT, DPT FAFS, Cert. DN

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Dr. Meredith Wall, physical therapist, grew up as a competitive athlete in basketball, gymnastics, soccer and volleyball. After sustaining an ankle injury and going to rehab as a young athlete, she instantly fell in love with learning about sports injuries and rehabilitation. This led her to major in Exercises Science at Grand Valley State University. After she graduated in 2010, she immediately pursued physical therapy to ultimately achieve her lifelong goals of becoming a physical therapist. She earned a Doctorate in Physical Therapy from Grand Valley State University in 2013, graduating as a member of the Phi Kappa Phi Honor Society recognizing individuals with outstanding GPA in a college graduate program.

Dr. Wall continued her educational pathway through the Gray Institute receiving a fellowship in Applied Functional Science (FAFS). A FAFS is only obtained by a select number of practitioners, who deliver optimal care through the diagnosis and treatment of functional human movement. She also became Certified in Dry Needling (Cert. DN) in 2017, is trained in the McKenzie Method to treat spinal pain, and most recently has become specialized in Pelvic Floor Rehabilitation. This specialty area allows her to treat women across the lifespan dealing with incontinence, diastasis recti, pelvic pain, and pain during or after pregnancy.

Dr. Wall’s special interests include diagnosing and treating active patients across the lifespan to help them return to optimal function. In her spare time, she enjoys Crossfit®, running, coaching youth sports, and traveling with her husband and three sons.

Dr. Meredith Wall’s Credentials:

  • ​Physical Therapist (PT)
  • Doctor of Physical Therapy (DPT)
  • Fellow of Applied Functional Science (FAFS)
  • Certified Dry Needling (Cert. DN)
  • Specialty-trained in Pelvic Floor Therapy

Dr. Cameron Moore, PT, DPT, FAAOMPT, CSCS, Dip. Osteopractic

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Dr. Cameron Moore, physical therapist and co-owner, has always been very active with sports and activities starting with competitive motocross racing up to a semi-professional level and being a scholarship athlete in track and field competing at the division 1 level in college at Eastern Washington University in the triple jump. Cameron became interested in the profession of physical therapy after having knee surgery in high school and seeing the inter-workings of the profession. He pursued his bachelors degree in Exercise Science before moving to Phoenix to earn his Doctor of Physical Therapy (DPT) from Franklin Pierce University.

He then began specialization courses for spinal manipulation (Spinal Manipulation Institute) and dry needling (Dry Needling Institute). This lead Cameron in to becoming a Fellow of the American Academy of Manual Physical Therapist (FAAOMPT) through the American Academy of Manipulative Therapy (AAMT) and earned a Diploma of Osteopractic®, a distinction and training that only a small percentage of physical therapist have completed.

Dr. Moore continues to be very involved with motocross riding, Crossfit®, Olympic weight lifting, running and an overall active lifestyle with his Wife (Michelle) and their Vizsla (Parker).

Dr. Cameron Moore’s Credentials

  • Doctor of Physical Therapy (DPT)
  • Certified in Dry Needling (Cert DN)
  • Certified in Spinal Manipulation (Cert SMT)
  • Certified Strength and Conditioning Specialist (CSCS)
  • Diploma in Osteopractic® (Dip Osteopractic)
  • Fellow Of The American Academy Of Manual Physical Therapist (FAAOMPT)
  • American Academy of Manipulative Therapy Fellow (AAMT)
  • Crossfit® Level 1 Certified (CF-L1)
  • Crossfit® Mobility Certified
  • USA Track and Field Level 1 Coach

Dr. Michelle Moore, PT, DPT FAAOMPT, Dip. Osteopractic

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Dr. Michelle Moore, physical therapist and co-owner, grew up as a competitive gymnast and developed a passion for healthy living from a young age. Her collegiate studies in Health Education at the University of Wisconsin-La Crosse and athletic background influenced her to combine her passions and pursue a career in physical therapy. She earned a Doctorate in Physical Therapy from Franklin Pierce University in 2013.

Dr. Moore continued her educational pathway through the American Academy of Manipulative Therapy where she earned her Diploma Osteopractic® (Dip. Osteopractic) and became Certified in Dry Needling (Cert. DN), and Spinal Manipulative Therapy (Cert. SMT). From 2016-2017 Dr. Moore completed the rigorous coursework to become a Fellow of the American Academy of Orthopedic Manual Physical Therapy (FAAOMPT), a distinction held by only a fraction of the profession.

Dr. Moore’s special interests include treating active individuals and returning them to the activities that they love. In her spare time she enjoys Crossfit®, Olympic Weightlifting, mountain biking, hiking, and traveling with her husband, Cameron, and dog, Parker.

Dr. Michelle Moore’s Credentials:

  • ​Physical Therapist (PT)
  • Doctor of Physical Therapy (DPT)
  • Fellow of American Academy of Orthopedic Manual Physical Therapists (FAAOMPT)
  • Diploma in Osteopractic® (Dip. Osteopractic)
  • Certified Dry Needling (Cert. DN)
  • Certified Spinal Manipulative Therapy (Cert. SMT)
  • Crossfit® Mobility Certified