Understanding and Managing Pelvic Girdle Pain During Pregnancy

Understanding and Managing Pelvic Girdle Pain During Pregnancy

Introduction

Welcoming a new life into the world is an extraordinary journey, but it often comes with its fair share of challenges. One challenge in particular that many expectant mothers face is Pelvic Girdle Pain (PGP). In this comprehensive guide, we’ll explore the intricacies of pelvic pain during pregnancy, from its definition to effective ways of managing and alleviating the discomfort it brings.

What is Pelvic Girdle Pain (PGP) and How Does it Feel?

Pelvic Girdle Pain, commonly known as PGP, is a medical condition among pregnant women that causes discomfort and pain in the pelvic area, particularly around the joints that connect the spine to the pelvis. 

If you’re wondering what is pelvic girdle pain, it’s essential to understand its symptoms and potential impact during pregnancy. 

The pelvic pain may vary from mild to severe and is often felt in the lower back, hips, and thighs. Understanding the nature of this pain is crucial for effectively addressing it during pregnancy.

Causes of Pelvic Girdle Pain During Pregnancy

Causes of Pelvic Girdle Pain During Pregnancy

Pregnancy is a remarkable journey, yet it brings challenges, including Pelvic Girdle Pain (PGP) for many expectant mothers. According to a study, approximately 1 in 5 pregnant women is estimated to experience some degree of Pelvic Girdle Pain (PGP).

To effectively manage this discomfort, it’s crucial to understand its causes. Let’s explore what contributes to the development of pelvic girdle pain during pregnancy.

Hormonal Changes

In pregnancy, hormonal shifts, especially in pregnant women, prompt an increase in relaxin, which loosens ligaments to prepare for childbirth. However, this flexibility can contribute to pain in pregnancy, causing pelvic discomfort and instability.

Increased Pressure on the Pelvic Area

As the baby grows, increased pressure on the pelvic area strains sacroiliac joints, contributing to pelvic girdle pain. Understanding the impact of the growing baby on the pelvic region, including pelvic floor muscles, is key to anticipating and managing this pressure.

Relaxation of Ligaments

During pregnancy, hormonal changes cause the necessary relaxation of pelvic ligaments for childbirth. However, this process can lead to an imbalance and instability in the pelvic joints, resulting in ligament pain.

Risk Factors that Contribute to Pelvic Girdle Pain During Pregnancy

Pelvic Girdle Pain (PGP) and/or Lower Back Pain (LBP) are estimated to affect around 50% of pregnant women, with severity ranging from 3.9% to 89.9%. Notably, 20% of expectant mothers may encounter PGP significant enough to necessitate medical assistance.

While pelvic girdle pain (PGP) is common in pregnancy, identifying risk factors is crucial for proactive pain management.

Recognizing these factors lays the foundation for targeted interventions to alleviate severe pain caused by PGP.

History of Back Pain: During weeks of pregnancy, individuals with a pre-existing history of back pain may be more prone to experiencing pelvic girdle pain.

Previous Pregnancies: Women with previous pregnancies may face an increased risk of sharp pains in the pelvic girdle in subsequent pregnancies.

Genetics: Genetic factors can be a factor to the likelihood of developing pelvic girdle pain. Understanding family history is crucial for proactive pain management during pregnancy.

Activities that May Increase Pelvic Girdle Pain

Pregnancy requires adjusting daily activities to align with changing dynamics. It’s crucial to be mindful of actions that may make pelvic girdle pain worse, ensuring a more comfortable and pain-free experience.

High-Impact Exercises

Engaging in high-impact exercises or activities that involve sudden, jarring movements can strain the pelvic joints, intensifying girdle pain. Consider low-impact alternatives for a gentler workout routine.

Prolonged Standing

Extended periods of standing can contribute to increased pressure on the pelvic region, potentially leading to symphysis pubis dysfunction. Taking breaks and incorporating sitting or gentle movements can alleviate this strain.

Lifting Heavy Objects

Lifting heavy objects, especially with poor body mechanics, can strain the lower back muscles and in the pelvic area, impacting the iliac crest and potentially increasing pain intensity. Opt for lighter loads or seek assistance when necessary.

Unsupportive Footwear

Wearing shoes without proper support can impact posture and exacerbate pelvic discomfort, especially in the pregnant population. Choosing footwear with adequate arch support can make a significant difference.

Sitting for Extended Periods

Prolonged sitting, especially in positions that strain the pelvis, can contribute to girdle pain, potentially leading to lumbar pain. Regular breaks, proper ergonomics, and supportive cushions can enhance sitting comfort.

How to Diagnose It

Activities that May Increase Pelvic Girdle Pain

Now, let’s delve into the specific steps and examinations involved in diagnosing Pelvic Girdle Pain to guide us toward a more detailed understanding of each aspect, including prognostic factors.

Symptom Assessment: A thorough evaluation of specific symptoms related to pelvic girdle pain, including clinical tests, provides initial insights into the condition, helping identify potential factors contributing to abdominal pain and pelvic pressure.

Medical History Review: Examining the patient’s medical history, including any previous occurrences of PGP or related issues, aids in understanding the context, particularly in addressing pregnancy-related low back pain.

Imaging Tests: In some cases, diagnostic imaging tests such as X-rays or MRIs may be conducted to visualize the pelvic region and identify any structural abnormalities, contributing to a comprehensive understanding of the clinical presentation.

Professional Examination: Physical examinations conducted by healthcare professionals play a crucial role in pinpointing areas of tenderness or instability, especially in the hip joints, contributing to an accurate diagnosis.

Treatment Options for PGP

Addressing PGP requires a multi-faceted approach. From conventional standard treatments to alternative therapies, a combination of strategies is often the key to effective pain relief.

Physical Therapy

Engaging in specific exercises under the guidance of a physical therapist, including manual therapy, can strengthen the pelvic muscles and alleviate pain, contributing to improved outcomes for vaginal deliveries.

Medication

Diagnostic tests may be conducted in some cases, and medication may be prescribed to manage musculoskeletal pain and inflammation. However, it’s important to discuss this with a healthcare provider.

Alternative Therapies

Exploring acupuncture or chiropractic care can provide additional relief for some pregnant women, promoting well-being during the postpartum period. It’s essential to discuss medication and physical activity with a healthcare provider for managing musculoskeletal pain.

Managing PGP at Home

Beyond professional help, practical steps can be taken at home to manage and reduce pelvic girdle pain. Research literature suggests that modifying activities and actively participating can be effective in treating pregnancy-related pelvic girdle pain.

Additional Tips to Reduce Pelvic Girdle Pain

Small changes, such as maintaining good posture, using supportive footwear, and practicing gentle exercises, including using a pelvic support belt, can minimize pelvic girdle pain. Additionally, it’s advisable to avoid heavy lifting to prevent strain on the pelvic region, especially during late pregnancy.

Who Can Help with Pelvic Girdle Pain?

Facing PGP doesn’t mean going through it alone. Various healthcare professionals, including obstetricians, physiotherapists, and chiropractors, can offer support. Seeking the proper assistance is crucial in managing and alleviating pelvic girdle pain, ensuring you don’t navigate this experience solo.

When to Seek Medical Help

While discomfort is expected in the pregnant population, especially in joints during pregnancy, certain signs indicate the need for immediate medical attention. Understanding when to seek help is vital for ensuring the well-being of both the mother and the baby.

Will Pelvic Girdle Pain Affect Labor and Birth?

Addressing concerns about how PGP might impact labor and birth is essential for expectant mothers. Exploring this aspect sheds light on what to expect during the crucial moments of childbirth.

Does Pelvic Girdle Pain Go Away After Birth?

Anticipating the future, many wonder if the discomfort of PGP will persist after giving birth. Understanding the postpartum scenario provides clarity on what to expect in the weeks and months following delivery.

Conclusion

In the intricate tapestry of pregnancy, pelvic girdle pain is a common thread. However, armed with knowledge and proactive measures, it is a struggle that can be managed effectively. By understanding the causes, seeking appropriate help, and making lifestyle adjustments, expectant mothers can navigate this phase with greater ease and comfort, including the incorporation of physical therapy during pregnancy.

For personalized guidance and expert support in incorporating physical therapy into your pregnancy journey, consider reaching out to Continuous Motion PT. Take the proactive step towards a more comfortable and pain-free pregnancy.

FAQs

Q1: What Does Pelvic Girdle Pain Feel Like?

A1: Pelvic girdle pain pregnancy is often described as a sharp, stabbing discomfort in the pelvic region, extending to the lower back and thighs. The intensity varies from person to person.

Q2: When Should I Be Concerned About Pelvic Pain During Pregnancy?

A2: If pelvic pain is severe, persistent, or accompanied by other worrisome symptoms, it’s crucial to seek immediate medical attention.

Q3: Does Bed Rest Help Pelvic Girdle Pain?

A3: While rest is essential, prolonged bed rest may not be the best solution. Consult with a healthcare provider to determine the most suitable approach for your situation.

Q4: Is Walking Bad for Pelvic Girdle Pain?

A3: Gentle and regular walking is generally beneficial for overall well-being. However, if walking exacerbates pain, consulting with a healthcare professional for personalized advice is advisable.

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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