How to Exercise with Pelvic Girdle Pain in Pregnancy

Pelvic girdle pain in pregnancy happens to many women (it’s been estimated 1 in 5 pregnant women experience it (1)). A combination of Relaxin hormone that makes everything looser and a widening in the hips to allow baby to grow makes the pelvis a vulnerable part of the body in pregnancy. When the hip joints move out of alignment it can cause pain to the joint and the related tendons/muscles. The pain can range from uncomfortable ache to sharp, stabbing pains in your pubic bone.

I have worked with several clients who feel they are at a loss of how to exercise with this pain. Walking can make it worse and even certain lifting exercises hurt. But don’t give up! You can stay active. In fact as long as you aren’t making your pain worse I encourage you to! Studies show that exercise can help people effectively manage pain better and stay mentally/emotionally more healthy (2)! I am going to give you some tips here on what you can try for your own exercise regime that won’t cause more pain and may even help diminish the pain you have.

What are a few common types of Pelvic Girdle Pain? (these are the ones I commonly see with clients although there are more)

  1. Symphysis Pubis Dysfunction: the joint in the very front of the pelvis is inflamed from moving slightly or being pulled while joints are more lax in pregnancy.
  2. Pubis Symphysis Diastasis: the joint in the very front of the pelvis separates to some degree. Causes extra mobility in the hips and different painful sensations in the pelvis.
  3. One-sided Sacroiliac Syndrome /Double Sided Sacroiliac Syndrome: The joints in the back of the pelvic bone are inflamed and somewhat mobile. Moving too much can cause pain in the joint and all throughout the hips, back, legs.
  4. Hypermobility: when the joints in the body are more mobile than usual. This can be genetic, due to different hormonal changes (or extra Relaxin hormone in the body), and can be contributed to by a lack of strength in the stabilizing muscles around a joint.

What Exercises are Recommended for Pelvic Girdle Pain?

Biking for cardio

**As always, check with your doctor before starting any exercise regime. This information is not meant to diagnose or treat any condition. It is tips and ideas on how to help you stay healthy and active in pregnancy. Each pregnancy is different and needs to addressed individually. If you are experiencing pelvic pain in pregnancy it is important to let your healthcare provider know.**

  1. Biking in a seated or recumbent bike (not a spin bike): Stay seated, keep the seat high/far back enough to allow full extension of the leg, don’t rock the hips while biking (which may mean monitoring how much resistance you use).
  2. Walking on stable surfaces for limited amounts of time.
  3. Light strength training in stances where both feet are on the ground or while seated. Even better if the hips are square and feet are next to each other.
  4. Circuit machine strength training where the pelvis and back are supported.
  5. Foam rolling the legs in positions where the legs are together. If stretching is causing more pain to the pelvis try rolling gently.

Ways to manage PGP in daily life movements:

  1. Stand with hips square. Don’t tilt one pelvis and rest on one leg.
  2. Rest the pelvis with lying and seated positions throughout the day.
  3. Keep light movement throughout your day. Don’t sit for extended periods without a position change.
  4. Sit with hips above knees. Choose supportive surfaces rather than fluffy couches, etc. Don’t cross your legs while seated.
  5. Sit down to dress.
  6. Place a pillow between the knees while sleeping to keep the hips square.
  7. Try not to perform activities where one leg is off the ground for extended periods.
  8. Use a stabilizing belt (SI belt) for support during movements and/or exercise.
Belts that stabilize the pelvis and help manage PGP

References:

1. Pelvic Girdle Pain and Pregnancy.  Royal College of Obstetricians and Gynaecologists. June 2015.https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-pelvic-girdle-pain-and-pregnancy.pdf

2. Reynolds, Gretchen. How exercise helps us tolerate pain. The New York Times. August 13, 2014.

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