You may experience occasional aches in your pelvic region during pregnancy and this is common due to the hormonal changes taking place and the secretion of relaxin, whose job is to soften and widen the joints preparing your body to deliver the baby.
However, with some women pelvic pain can sometimes mean symphysis publis dysfunction (SPD) or Diastasis Symphysis Pubis in it’s more severe form, which is a pelvic joint pain. So it’s essential to monitor the pain and symptoms, which I’ll tell you about further on.
The pelvis is four separate bones joined at the front by the Symphysis pubis. There’s a normal gap of 4-5mm between the two pubic points. During pregnancy, the gap widens by another 2-3mm, as the hormone, relaxin is secreted to allow the pelvis in preparation to aid the baby to pass down the birth canal.
With some women excessive amounts of the hormone or where the pelvis is out of alignment can cause the gap to stretch too far, resulting in pain and discomfort. When this happens there may be pain or swelling over the joint. This can happen at any stage of pregnancy or after the birth – most commonly it is during the second trimester. In severe cases, some women can be incapacitated by the pain and need crutches during later stages of pregnancy.
Symptoms for SPD include:
- Pain in your pubic area and groin.
- Pain in the inside and down the thighs.
- Lower back and hip pain (as the whole pelvis is under strain).
- Pain when you walk, step, go up and down stairs or get out of bed.
- A clicking sound that you can hear.
- A feeling that your bones are grinding together.
- Difficulty and pain when you try and open your legs.
If you experience any of these symptoms, it’s vital to get this checked with your doctor or midwife. If SPD is confirmed you’ll be referred to an obstetric physiotherapist, who can prescribe exercises for you.
Prior to the birth ensure you tell your midwife so they can help find a position that is comfortable to you.
- Avoid activities which take the legs apart and also bring them together as these can cause pain. Squatting, Lunging, stepping, walking, yoga, breast stroke can produce pain.
- Avoid activities on one leg.
The good news is there are exercises you can do to remain strong and fit. I have trained pregnant clients with SPD and by working closely with the client and their physiotherapist the condition has not got worse.
Exercises you can do:
- Squat with feet and legs together – like a ski squat would avoid the legs being apart.
- Core exercises (avoid lying on your back after the thirteen to fourteen weeks), side planks and knee planks
- Pelvic tilts – addressing posture
- Standing wall press-ups (legs together)
- Lateral Raises and upright rows with resistance bands – sat on a chair or fitness ball with the feet together (second trimester)
- Pelvic Floor exercises
!Stop any of these exercises immediately if they do cause you pain and get your condition and pain checked out again!