A Pain in the Bum - Pelvic Girdle Pain

Pelvic girdle pain (PGP), sometimes known as Symphysis Pubis Dysfunction (SPD) or SI Joint Pain - can be felt in the back, bum, legs and front of pelvis.

It’s a common problem in pregnancy – 20% of pregnant women get it, although it can be as much as 50%.  But remember common does not mean normal - so you don't have to just put up with it! The good news is that it does tend to clear up after pregnancy – only 7-8% women still have a problem postnatally.  But how you deal with it in pregnancy will have a bearing on your recovery There are various risk factors for the condition including:

• pelvic girdle pain in previous pregnancy
• gaining excessive weight during pregnancy
• lack of core strength
• poor posture
• pelvic misalignment or history of trauma to the pelvis
• hypermobility, connective tissue disorders or laxity in the joints
• expecting a large baby or multiples
• baby's position

There is also a range in the severity of pain felt and different activities can affect differently - some movements may cause no pain in some women but be excruciating for others.  For instance, the classic going up stairs was not a problem for me but turning over in bed was always painful. The general rule of thumb is - if it hurts, don't do it!  There is no benefit in pushing through the pain and you're more likely to make it worse.

Here are a few ideas to try which may help out with day to day activities:

• Walking - take smaller steps and go slower.  Be aware that if you have a small child or a dog pulling on you that will also exacerbate it.  Otherwise walking is a great exercise and should be continued as much as possible
• Sitting - don't cross your legs - either at the ankles or the knees.  Sit upright and with both feet on the floor - an upright chair or birthing ball is helpful rather than the sofa.  Click here to go to my YouTube channel where there are videos instructions on sitting, standing up and getting up from the floor or bed.  Using the Knack on movement will also help.
• In bed - turning over is usually the issue.  Keep a pillow between your knees then squeeze your knees, perform the Knack and try to keep your hips stacked as you roll.  This can be aided by having a duvet under the bottom sheet.  Also reducing friction to turning can help - using silk sheets, a snoozle slide sheet or if you're desperate, a bin bag!
• In the car  - getting in and out is a challenge.  Think 1950s and keep your legs still and swivel round!  You don't want the knees to move inwards past hip width, so again a pillow between the knees (or a yoga block) and squeeze and perform the Knack as you swivel.  A plastic bag on the chair can help.  Also when in the car try sitting on a rolled up towel so that your hips are more in line with your knees.
• Avoid one legged positions - sit down to get dressed and walk upstairs by bringing the second leg up to meet the first before you take the next step.  Think of stepping upwards with each step rather than forwards.  You may also want to avoid carrying things upstairs.  If you need to get down to the floor try to use a squat position and onto all fours instead of a lunge.
• Avoid wide legged positions - anything wider than hip width apart will either cause pain or risk pulling the pubic bones further apart.  This also applies to your birthing position - safest position is actually on your side.
• Avoid heavy lifting and pushing - this means vacuuming and shopping trolleys are not good idea.  Time to get help where possible.
• Work on your posture and try to keep your pelvis in alignment - get a referral to see a women's health physiotherapist or a chiropractor for an assessment.  They will be able to give you manual therapy and may advise a support belt to help.
• Exercise - it's important to keep moving if possible.  Gentle walking and swimming are good - but avoid breaststroke legs. Pelvic floor and deep abdominal exercises are essential - my pregnancy Pilates classes are ideal for this.  Other key exercises we do are those that work on keeping the pelvis both stable and mobile.  Try to practice these at home regularly.

Also, make sure it's written in your notes - mine wasn't and I ended up in stirrups with a forceps delivery.  I was kept in that position a long time after birth too and this made my postnatal recovery from PGP much harder.

For more information the best website to use is www.pelvicpartnership.org.uk - loads of information there.

If you need any more help feel free to contact me and remember I can always teach you exercises in class that you can use at home.