My PGP Pregnancy Action Plan to Reduce Pain from Pelvic Girdle Pain

I knew Pelvic Girdle Pain well after suffering for around 20 weeks in my second pregnancy so when I started to get twinges around my pelvis, groin and lower back from 11 weeks in my last pregnancy I was worried. I wanted to do everything I could to stop it getting as bad as the time before so I created an action plan to reduce the impact of PGP. Through proactive action, taking extra care and the knowledge I gained from severe PGP experienced before I managed to limit the pain from this common pregnancy ailment

Pregnant me pointing at my pelvic region to show where I get PGP pain in pregnancy.
PGP can cause a lot of pain in pregnancy around the pelvic region

How To Manage and Reduce Pelvic Girdle Pain in Pregnancy


What is Pelvic Girdle Pain (PGP)? 


Pelvic Girdle Pain used to be called SPD (symphasis pubis dysfunction) but PGP refers to pain experienced across a larger area. It's basically pain around the pelvic region including: lower back, hips, groin and pelvic area. It's caused by the uneven movement of the pelvic bones although it's not understood why some women get it and others don't.

Can Treatment Help Pelvic Girdle Pain?


Yes, but the effectiveness varies between individuals in part due to how early treatment is started. For some people PGP will go away, some will manage to stop it getting worse and for others the pain will progressively get worse until birth. The pain for most people will go away soon after birth.

My Action Plan To Tackle Pelvic Girdle Pain


The plan I created to limit the impact and pain of PGP in my last pregnancy was based around treatment, preventing aggravating the PGP and strengthening my core muscles to better support my pelvic region. The first time I had PGP I ended up in a lot of pain and it took some time to recover after birth. After following this PGP plan in my last pregnancy it was less severe and more manageable.

Physiotherapy/ Osteopathy


I’ve heard people say that Physiotherapy has had little impact on their PGP and I suspect this is a combination of not being seen soon enough, there being too few specially trained Women’s Health physiotherapists and exercises not being completed adequately. While Physio might not make PGP go away manual therapy and exercises to strengthen the core muscles should help limit the deterioration.

The first time I experienced PGP in pregnancy I had regular physiotherapy before and after birth. It took a long time to get a referral the second time round (I discovered that my health Trust now encourage self referrals) so  I wasn't able to see someone in the NHS as early as I would like. I strongly recommend finding out how to get a referral as soon as you start feeling pain in the pelvic region. I used the exercises I was given previously 2 to 3 times a day to strengthen my body and maintain a range of movement. 

An alternative option is to have private treatment and after investigating private practitioners locally the most highly recommended person for PGP is an Osteopath with a special interest in Women's Health. The specialist knowledge appears to be of more importance than the field they work in so ask for recommendations where you live.

Pelvic Floor Exercises


Kegal or pelvic floor exercises can help reduce the groin pain often experienced with PGP. As they also stop you peeing yourself when you sneeze they are pretty essential anyway (I don’t think women in their first pregnancy realise just how big an issue this is). 

I have previously reviewed a free app from Tena Lights, but I now prefer Squeezy which is a paid for app supported by the NHS. I like how customisable this app is. I set it for 3 repetitions a day and despite it reminding me multiple times I still only managed 2 sets most days. Better than none...

The most important thing about pelvic floor exercises (after actually doing them) is doing them correctly so it’s worth refreshing yourself on this and a midwife might be able to help if you are unsure.

Following Advice


There is too much useful advice about how to prevent antagonising PGP to include in the post so I have included some links at the bottom of this post. The most useful advice I got from my Physio was to not push myself. Continuing to do something which hurts will only make the pain worse and cause more damage so it's not worth it. I really cut back on any movement which caused pain early on in my last pregnancy and I think it made a huge difference. Ask people to do things for you where ever possible.

The other advice is mostly focused around keeping your knees together, trying to stay balanced (eg avoiding standing on one leg which is really difficult given you will inevitably need to walk and use stairs etc), keeping your pelvis straight (eg sit properly and with your knees lower than your bottom) and don’t lift anything heavy.

There are tricks to help with this like using a back pack instead of a shoulder bag, wearing flat shoes instead of heels, sitting down to dry yourself/ get dressed and taking one step at a time (rather than alternate steps) if you can’t avoid stairs, but it's well worth reading the Practical Suggestions from the Pelvic Partnership.

My favourite new gadget to prevent aggravating pain is this reaching aid. It allows me to pick up small items from the floor without having to bend over. Given how often I drop things and how little tidying up my children do it is super helpful (Affiliate Link).


Acupuncture 


I was dubious about acupuncture until I used it as a last resort to help with my migraines and it worked. There is scientific evidence that it can help relieve certain types of pain and it's even available on the NHS for PGP in some areas. I had it regularly when experiencing PGP and it's definitely worth trying. 

Swimming 


In my last pregnancy I wasn't really fit enough for most exercise and too much walking aggravates the PGP so I started to go swimming regularly. The water soothed my painful body and provided it with support while allowing me to exercise strengthening my core.

I adapted my strokes for PGP including doing front crawl legs instead of breast stroke ones. If the pain is really bad try holding a float between your thighs and just move your legs from the knees down.

Pregnancy Yoga/ Pilates


Through all my pregnancies I have experienced various aches as well as PGP and I have found pregnancy yoga a great way to stretch out my body. My favourite DVD by Tara Lee (affiliate link) is available on Amazon, the updated version is also available on Amazon Prime video. What I like about this DVD is she tells you about the modifications you need to do for PGP.

In my last pregnancy I went to a weekly Pregnancy Pilates class and this made a huge difference to me so it is well worth the investment. I tried a few different teachers to find one which worked for me (they often offer a weeks free trial). The teacher I saw for most of my pregnancy was brilliant and gave everyone little adaptions to help support the most painful areas. It also helped being in a class where other women were experiencing similar issues to me so I didn't feel alone. 

Using A Support Band


Lots of people with PGP advocate support bands. When your bump is big they can definitely help spread the weight providing some relief, but the leading Women’s Health team I worked with several years ago didn’t recommend them for their patients. My understanding is that by using the band you are actually weakening the muscles which can make the pain worse when the band isn’t being worn. This makes sense to me, but their use is still widely recommended by health professionals. If you are already in severe pain then it might be worth using it for short periods alongside exercises for strengthening your core.

Where to go to get more information about Pelvic Girdle Pain


More information about Pelvic Girdle Pain including the causes and treatments are available from the NHS Pelvic Pain in Pregnancy, the Pelvic Girdle Pain and Pregnancy factsheet from RCOG and there is a huge amount of information from the Pelvic Partnership charity website.

Title text on an image of a pregnant woman
An action plan to prevent and reduce pelvic girdle pain in pregnancy

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