“Ouch!, Ow! and Eeek! What is this fresh hell that pregnancy has delivered upon me?” Having made it through morning sickness (hopefully), and arrived somewhere between 2nd trimester and giving birth, suddenly you’re getting very achey . All around the hips and lower back. Sometimes it travels down your thighs and, yikes, is that a red-hot poker right up your nethers when you least expect it? You may even feel some crunching or grinding in your hip joints when moving.
If this is all sounding a little familiar, you could be experiencing Pelvic Girdle Pain. (“Girdle?” “GIRDLE?” Could they make pregnancy ailments sound any less sexy if they tried?)
Pelvic Girdle Pain (PGP for short) is very common in pregnancy. It can start as early as a few weeks in, or crop up just as labour is on the horizon. It can be mild and a bit achy at the end of a day of over-doing-it, or it can be so debilitating women are left on crutches for the duration of their pregnancy, and struggling to find comfortable positions for birth.
You may also hear the term Symphis Pubis Dysfunction. Which is sort of the same thing (actually, that term more relates to the red-hot-poker sensation that shoots right up the hoo-ha, aka the Symphis Pubis, the bit right at the front. But now we use the term Pelvic Girdle Pain as an umbrella term for all the achy-hip-and-pelvis-related discomfort).
So why is this a thing and what can you do about it?
Well, the good new is that PGP causes no harm to the baby and your little one will remain oblivious to all this that is going on. The bad news is there is no magic cure (except for having the baby, which may be a little way off).
When you become pregnant, you start to produce hormones that help to relax the ligaments, pelvis and cervix (called relaxin, not surprisingly). It’s obvious that this hormone and it’s resulting ‘stretchiness’ will help you to accommodate the baby and help with the birth.
However, as your pelvis is not one complete circle, but actually made up of three sections jointed together, some of the new space between the joints can start to cause problems. PGP is a result of your hip and pelvic joints moving unevenly. Potentially the joints move too close to each other, too far away or just out of sync. You can feel this in the muscular support network around your pelvis or even in the joints of the pelvis and pubis itself.
As I’ve said, there isn’t a magic cure (more often than not, this condition goes immediately or very soon after baby is born. Only lingering in a very small handful of women). However, many women may find a visit to a qualified physiotherapist helpful (only downside is if you’re accessing this on the NHS the waiting list might be longer than the remainder of your pregnancy). And some women achieve some respite from wearing a pelvic support belt.
Otherwise, here are my top tips for reducing the effects of PGP:
Avoid activities that make it worse. This sounds obvious, but sometimes the pain doesn’t come until AFTER the activity. For example a long walk might feel fine, but sit down for a cuppa and then try to get up and you may find you’re stuck to the chair!
Take smaller steps. Great big yomping strides might feel like you’re keeping fit, but this will destabilise your pelvis and move your hip joints more than they can accommodate. Littler strides and slowing your pace should help.
Don’t stand on one leg. Err, I’m not sure why you would stand on one leg for very long unless you’re a flamingo, but think about sitting down to put tights, socks and shoes on. Try to stand straight instead of leaning on one hip if you’re stopping for a chat. Unless you ARE a flamingo, then I’m not sure what to suggest….
A lady on has one leg! Anyone who’s been to a Swiss Finishing School (not me, obvs) will know that a lady leaves the car with her ankles and knees pressed together. So should pregnant ladies with PGP. Also turning over in bed, sitting at your desk, swimming and generally anything involving your legs, try to keep your knees together.
Talking of knees together, it is recommended that you should have sex in the all 4’s position. Don’t shoot the messenger…
Don’t carry your handbag, baby or shopping on one side/hip. If you’re going to carry anything whilst you’re taking small steps and being a ladeee, make sure you’re evenly balanced.
Upstairs/Downstairs. If going up and down stairs is particularly painful, or you suspect it might be exacerbating the symptoms, try coming down on your bottom instead. And going up just one step/one foot at a time. Or better yet, get someone else to fetch and carry up those stairs!
Visit a really good Pregnancy-specific yoga teacher or PT to help keep your pelvic floor strong and responsive and provide gentle and appropriate exercises to help strengthen your back, hips and glutes. IF they can’t make adaptions in a general class or don’t know what you’re talking about, then you need to walk away (very slowly and with small steps, of course!).
Wear flat, comfy and supportive shoes. Sorry, high heels are out for now.
Finally, and this is a good one, the Pelvic Obstetric and Gynealogical Physiotherapy Network (phew, that’s a long title) recommend NOT VACUUMING. Hurrah!!
My last little tippet would be for the birth itself. If it really hurts to squat or widen your legs you will need to let those caring for you at your birth know. The easiest way to do this is to take a piece of string the length you are able to have your knees apart (measure it before hand). Hand the piece of string to your midwife and tell her that you cannot widen your knees any further due to PGP.
And, of course, it goes without saying that any pain should be reported to your midwife or GP at your next appointment. Even earlier if it has come on suddenly or your pain is unmanageable.