07-17-19 - Pelvic Health, Physical Therapy
This content was updated for accuracy and relevance on 02/01/22
Pregnancy is a beautiful thing, but it can also take a toll on a woman’s body. Many women experience discomfort, and sometimes pain, during pregnancy due to the pressure a growing baby puts on your bladder, low back, hips, pelvis, and pelvic floor. Pelvic pain and incontinence are common conditions that can happen at any stage of life but it’s not normal, and you don’t have to suffer in silence. Don’t ignore your pelvic floor muscle pain with pregnancy, especially when you are trying to stay healthy and protect another human.
Generalized pelvic pain or pressure during pregnancy can present in many different forms. Symphysis pubis dysfunction (SPD) or pregnancy-related pelvic girdle pain (PGP) are common and can be treated with Physical Therapy to help improve functional mobility and pain management. These uncomfortable symptoms can be caused by the stiffness of your pelvic joints or the symphysis pubis may become stretchy and unstable due to a rise in pregnancy hormones. Unfortunately, a lot of women experience pressure in the pelvic region during pregnancy due to a number of different reasons. The joints also can move unevenly at either the back or front of your pelvic bone. During pregnancy, a woman’s center of gravity and body mass are changing, so any muscle weakness or joint instability can lead to chronic pain. If you are experiencing chronic pelvic pain while pregnant, read on.
Symptoms of Pelvic Pain During Pregnancy
You may experience chronic pelvic pain at different stages of pregnancy or due to different conditions:
- First trimester: accommodation pain due to your expanding uterus is a reason for lower pelvic pain symptoms during early pregnancy.
- Second trimester: round ligament pain that starts in your side as the ligaments that go from the top of the uterus down to the groin stretches is a common cause of pelvic and groin pain during pregnancy in the second trimester.
- Third trimester: Pelvic discomfort and groin pain during pregnancy in the third trimester is also very common in women. Pressure from your baby’s weight putting pressure on the nerves that run from your vagina into your legs
Other symptoms to be aware of
Always be sure to communicate your symptoms to your healthcare provider, so they are aware of your situation. There are also other symptoms you need to look out for that may indicate a more serious problem:
If you experience any of the symptoms below along with your pelvic pain, you should seek medical care right away.
- Vaginal bleeding
- Burning sensation while urinating
Diastasis recti occur when your abdominal muscles separate during pregnancy. This can cause pelvic pain pregnancy symptoms similar to SPD. In addition, an ovarian cyst can grow larger during pregnancy and cause persistent abdominal pain. Urinary tract infections and constipation may also cause pelvic pressure during pregnancy. They are common conditions that can be treated with antibiotics, iron supplements, eating fiber-rich foods, staying hydrated, and using a stool softener.
Pelvic floor pain during pregnancy can make it hard to get around or do daily activities. You may feel pubic symphysis pain:
- At the front or center of your pubic bone, level with your hips
- On one or both sides of your lower back
- In your perineum, the area between your vagina and anus
- When you spread your thighs
- You may feel a clicking or grinding in the pelvic area
The pelvic pressure or severe pain can come and go and get worse when you:
- Walk, bend and twist to lift, or push heavy objects
- Climb up and downstairs
- Stand on one leg
- Turn over in bed
- Move your legs apart or try to get out of a car
Pelvic Floor Therapy Can Help
Physiotherapy and physical therapy help to relieve or ease pain, improve mobility, strengthen and improve pelvic joint position and stability. Physical therapy and specialized pelvic floor therapy during and after pregnancy can help decrease low back pain and post-delivery bladder problems. As movement specialists, PTs are medical professionals trained to identify and address the source of chronic pain within the pelvic region. A physical therapist can educate expecting moms about safe exercise and body mechanics, including how to lift, stand, and carry other children while pregnant. These techniques can help with muscle pain relief and management.
- Manual therapy to help joint alignment and your pelvis, hips, and spine move normally
- Exercises to support your pelvic floor, stomach, back, and hip muscles
- Addressing pain triggers such as posture, flexibility, or nerve involvement
- Education on lifestyle changes for pain relief in pelvic muscles
- Water-based exercises
- Advice on positions for sleeping, sex and labor and birth
- Pelvic support belt or crutches
- Rest when necessary and use safe over-the-counter pain relievers with your doctor’s permission
It’s important to stay active and do gentle exercise during pregnancy in order to support your pelvic area. It’s also important to recognize your pain limits and avoid activities that make the severe pain worse. You may have to call on your partner and family and friends to help with housework, especially if you have to climb stairs to do laundry or make dinner and care for other young children.
- Move your bedroom to the first floor
- Wear flat, supportive shoes
- Sit down to get dressed
- Take a warm bath or shower and let the water hit your back
- Get a prenatal or lymphatic massage
- Try gentle exercises such as walking, prenatal yoga, or pelvic tilts
- Keep your knees together when getting out of the car or turning over in bed
- Sleep on your side with a pillow between your legs
- Take the stairs one at a time, or go upstairs backward on your bottom
- Avoid bending and twisting to lift or carrying a baby on one hip
- Limit sitting or standing for long periods, crossing your legs, or sitting twisted
- Minimize lifting or carrying heavy shopping bags, vacuuming or pushing heavy objects such as a supermarket cart to reduce pain in the pelvic region
Addressing Pelvic Pain
Pelvic discomfort or hip pain is not something to tough out or dismiss because you are pregnant. And physical therapy is not just for post-birth recovery; it can be a valuable part of prenatal care, especially if you need to strengthen your pelvic muscles.
Specialized pelvic floor rehab can help your pregnancy and delivery go smooth and relatively pain-free or restore strength and address postpartum pain. Ivy Rehab has a wide network of clinics with professional physical therapists who can treat a variety of Pelvic Floor Dysfunction (PFD) related to pregnancy, delivery, trauma such as a fall or car accident, surgery, obesity. Pelvic floor physical therapy can improve other pelvic conditions including endometriosis, interstitial cystitis, or prolapse.
Article Reviewed by Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA
Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA is a practicing physical therapist and a partner and Director of Clinical Services at Ivy Rehab Network. Deur isboard certified as a geriatric clinical specialist and certified exercise expert for aging adults with more than 35 years of clinical experience. She is certified as an aquatic and oncology rehabilitation specialistandservesas adjunct faculty at Central Michigan University and Grand Valley State University.
The medical information contained herein is provided as an information resource only, and does not substitute professional medical advice or consultation with healthcare professionals. This information is not intended to be patient education, does not create any patient-provider relationship, and should not be used as a substitute for professional diagnosis, treatment or medical advice. Please consult with your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition. If you think you have a medical emergency, call your doctor or 911 immediately. IvyRehab Network, Inc. disclaims any and all responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained herein.
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