Pregnancy Related Pelvic Girdle Pain

Recent research suggests 50% of pregnant women will incur pregnancy related pelvic girdle pain (PPP). PPP consists of pain within and around the pelvis which can include the lower back, the hip region and pubic region. The pain may persist after pregnancy in some women and can lead to severe disability during pregnancy. Some women can require crutches for walking in severe cases.

The most frequent reported area of pain in women with PPP is over the sacro-iliac joint (joint between the sacrum or tail bone and pelvis) the gluteal region or pubic symphysis (front of pelvis). Leg pain is uncommon but can occur in the back of the thigh. Patients often describe a ‘sharp’ ‘catching’ pain in the buttock or leg.

Current evidence from the literature shows that women with PPP have altered muscle function in the lower back muscles and hip muscles. These muscles can become weak or overactive in an attempt to cope with the extra load going through the pelvis as the pregnancy progresses.

Walking, prolonged standing and single leg activities such as going up steps or putting on pants are commonly reported as aggravating activities. These activities result in load being transferred through the pelvis causing pain.

Risk factors for developing PPP include:

Strenuous work
Previous low back pain
Previous PPP during or after pregnancy

Treatment involves a specific and individualised stabilisation program. This re-trains the weak or overactive muscles around the pelvis and normalises load transfer across the pelvis and lower back.

Pelvic belts are often used during pregnancy to aid the above mentioned process and can be very useful as the pregnancy progresses to control pain while weight bearing.

Clinical Pilates has been proven to be an effective form of low impact exercise in managing ongoing PPP in the longer term. Clinical Pilates is individualised with emphasis on movement awareness and muscle retraining and is a great way to build abdominal and gluteal strength.

A pelvic floor muscle assessment may be recommended by your treating therapist to identify whether these muscles are contributing to your symptoms and to ensure that they are working effectively during your exercise program.

Physica staff have additional training in diagnosing and treating PPP. We will identify your specific impairments and devise a management plan to return you to optimal health and functioning.