Understand Pelvic Girdle Pain conditions that may be caused during pregnancy

9 November 2021

Generally, there are some common pregnancy-related conditions causing pregnancy symptoms are Pelvic Girdle Pain, Symphysis Pubis Dysfunction, Back pain, hip pain and many more. Uncertain of your condition? Visit us for an assessment and we will help you figure it out. 

  • Pelvic Girdle Pain (PGP)
  • Symphysis Pubis Dysfunction (SPD)
  • Lower Back Pain 
  • Hip Pain
Pelvic Girdle Pain conditions

Looking for Pelvic Girdle Pain relief options? 

Around 1 in 5 pregnant women experiences mild discomfort in the back or front of the pelvis during pregnancy. If you have symptoms that do not improve within a week or two or interfere with your normal day-to-day life, you may have PGP and should ask for help from your GP or physiotherapist. 

If you’ve tried various methods for PGP relief but can’t seem to find a lasting solution for your persistent pain – Core Concepts Singapore physiotherapy may have your answer. Compared to other types of solutions such as painkillers and home remedies that only offer temporary pain relief, Physiotherapy can provide you with a permanent solution. This is because we do not only treat the symptoms, but we also fix the underlying cause of your pain.

What is Pelvic Girdle Pain (PGP) Physiotherapy?

Pelvic Pain Location During Pregnancy

PGP Pain Area

PGP describes pain in the joints that make up your pelvic girdle; this includes the symphysis pubis at the front and/or the sacroiliac joints (SIJ) at the back. Therefore, the discomfort is often felt over the pubic bone at the front, below your tummy, or across one side of your pelvis/ lower back, or both sides.

About Transversus Abdominis Muscles

The abdominal muscles like the transversus abdominis muscles and lower abdominal muscles act like a corset to support the pelvis are generally stretched during pregnancy. This will affect the support of the pelvis. With posterior pelvic pain, the key rehabilitation is to strengthen the transversus abdominis and lower abdominal muscles, also the buttock muscles to improve the support of the pelvis.

Transverse Abdominis Anatomy

In the case of pubic symphysis pain,  the inner thigh muscles are called adductors to work very hard to compensate for the loss of support, sometimes on one side or both sides. Therefore, the treatment direction is to release the tight inner thigh muscles and train the supporting muscles around the pelvis like transversus abdominis and lower abdominal muscles, also the buttock muscles to better support the pelvis.

It is advisable to seek help from a physiotherapist or your obstetrician to strengthen specific muscles to better support the pelvis as every PGP is different in different individuals.

What causes Pelvic Girdle Pain and its symptoms?

PGP is common in pregnant ladies
  • PGP is common in pregnant ladies due to the hormone relaxin.
  • A change in the activity of the muscles of your tummy, pelvic girdle, hip and pelvic floor, which can lead to the pelvic girdle becoming less supportive and therefore painful
  • Relaxin helps the body to relax its soft tissue like muscles and ligaments to accommodate the growing fetus and to prepare for delivery.
  • The common symptoms of PGP are sharp,  stabbing pain, dull pain with change in position like turning in bed, sitting to standing, wearing pants, walking.

How is Pelvic Girdle Pain diagnosed?

PGP is usually diagnosed with a cluster of physical assessments done by physiotherapists or doctors. X-ray can be done to see if there is any physical abnormality of the pelvic girdle but it is not recommended on pregnant ladies.

There are a few tests that you can do at home to test for pelvic girdle pain, here are 2 simple tests that will determine if you have pelvic girdle pain.

1. For Pubic symphysis where pain is located at the pubic region.

  • Pulling a MAT
  • Modified Trendelenburg test

In standing position, imagine you are sliding a floor mat with your left foot inwards and outwards, and repeat the sequence on the right foot as well.

If you feel the same pain in the pubic region, you may be having Pubic Symphysis pain.

Test for pelvic girdle pain, Imaginary action of Pulling a Mat

In standing position, lift up your left hip to 90 degrees, and repeat on the right side. 

If you feel the same pain in the pubic region, you may be having Pubic Symphysis pain. 

Modified Trendelenburg test

2. For posterior pelvic pain where the pain is located at the back of the pelvis.

  • Posterior pelvic pain provocation test ( P4)
  • Bridging with the extension of one leg

Lying on your back, bend your left hip to 90 degrees and your right knee is straightened. Press your bent knee downwards towards your hip on the same side. Repeat on the opposite side.

If you feel the same pain in the pubic region, you may be having posterior pelvic pain.

Posterior pelvic pain provocation test (P4)

Lying on your back, bend your right knees and straighten your left knee. Lift your buttock up. Repeat on the sequence on the opposite side. 

If you feel the same pain in the pubic region, you may be having posterior pelvic pain.

Bridging with an extension of one leg

What are the risk factors of PGP?

If it is not managed well, there is a high likelihood that it will cause pain even after postpartum or with the next pregnancy.

Not all women have any identifiable risk factors, but for some, the following physical risks may apply: 

  • A history of previous low-back and pelvic girdle pain 
  • Previous injury to the pelvis 
  • More than one pregnancy 
  • A hard physical job or workload/awkward working conditions/poor working postures 
  • PGP in a previous pregnancy 
  • Increased body weight and body mass index before and/or by the end of pregnancy 
  • Increased mobility of other joints in the body

If you are experiencing PGP or think you might have other pregnancy-related conditions causing pregnancy pain, get in touch with our team of physiotherapists to book an appointment!