Physiotherapy for Pelvic Pain During Pregnancy: Meaning, Symptoms, and Exercises

What Is Meant of Pelvic Pain in Pregnancy?

Pregnancy causes various changes in the body that most commonly cause pelvic pain in some individuals. The condition where pelvic pain occurs during pregnancy is said as pregnancy-related pelvic girdle pain. It is also known as symphysis pubis dysfunction. Pregnancy-related pelvic pain is caused when the pelvic joints get stiff or move unevenly in front or back of the pelvic floor when the pregnancy progresses.

How Does Pregnancy Impact the Pelvic Floor?

Pregnancy can impact the pelvic floor. The ligaments, muscles, and tissues in the pelvic floor support the pelvic organs, such as the uterus and bladder. The changes during pregnancy that affect the pelvic floor are as follows:

• During pregnancy, the change in hormonal level is common, leading to the relaxation of pelvic tissues and ligaments. These may influence the pelvic floor muscles.

• The growing baby puts pressure on the pelvic floor, leading to the weakening of the pelvic floor muscles.

• The pelvic floor muscles support the weight during pregnancy. Due to this, the muscle may get weakened.

• The increased blood flow in the pelvic region during pregnancy is essential for the growth and nutrition of the developing baby.

• Childbirth trauma may affect the strength of pelvic floor muscles.

What Are the Symptoms of Pelvic Pain During Pregnancy?

• Pelvic pain may be felt over the public bone in the center at the front, roughly at the hip level.

• The pain may also be felt across one side or both sides of the lower back.

• Pain may also occur between the vagina and the perineum.

• The pelvic pain may radiate to the thighs.

• In some cases, the person may hear a grinding or clicking sound around the pelvic area.

• The pregnancy-related pelvic pain gets worse on walking, sitting, climbing stairs, turning over the bed, standing while dressing in one leg, and moving the legs apart, like while getting out of a car.

What Are the Physiotherapy Exercises for Pelvic Pain During Pregnancy?

The physical therapist recommends exercises that help strengthen the pelvic and abdominal muscles that support the pelvic joints. These exercises may help relieve pelvic pain in pregnant women and reduce discomfort. The pelvic strengthening exercises help to ease the pain and make the pregnant women move around quickly. The physiotherapy exercises for pelvic pain during pregnancy are:

Pelvic Floor Squeezes:

The instructions are:

• The person should try to identify their internal pelvic muscles and squeeze their pelvic floor muscles by imagining the feeling of holding their urine.

• The person should sit comfortably on a firm chair, slowly try to squeeze their pelvic floor muscles in and up and hold the position for 10 seconds. Then the exercise can be repeated ten times.

• Then the person should pulse their pelvic floor muscles up and in, relax immediately, and repeat it ten times for three to five days.

Inner Thighs stretch:

This stretching exercise helps relieve hip muscle tension and ease pelvic pain. The instructions are:

• The person should sit on a chair with their feet flat on the floor. Then the person should move their feet as far apart as possible by bending their knees at 90 degrees.

• Then the person should place their hands on the inner thighs and press their knees further apart until they feel a comfortable stretch.

• Then the person should hold the position for 30 seconds.

• The exercise should be repeated three to five times daily.

Stability Exercises:

This exercise helps to strengthen the abdominal muscles as abdominal muscles play an important role in stabilizing the pelvic region. The instructions are:

• The person should sit in a comfortable position with a straight back.

• Then the person should place one hand on their stomach above their pelvis.

• Then the person should breathe in slowly through the nose, squeeze their stomach inward toward their spine, and exhale.

• The person should hold the squeeze for about 10 seconds and relax.

• This exercise should be repeated ten times.

Pelvic Tilts:

This exercise helps to loosen the stiff muscles of the back, which helps in relieving pelvic pain during pregnancy. The instructions are:

• The person should sit on the edge of the chair with a firm seat.

• Then the person should tilt their pelvis backward so that the person looks like he or she is sitting in a slumped forward position.

• Then the person should tilt their pelvis forward by arching their lower back.

• Then the person should repeat this rocking back-and-forth motion ten times.

• This exercise should be done for three to four days.

Kegel Exercises:

It is the most appropriate exercise to relieve pelvic pain. The instructions are:

• The person should lie on the floor with their back.

• Then the person should contract their abdominal muscles as if the person is stopping the urge to urinate.

• Then the person should hold the contraction for 10 seconds and repeat the exercise several times.

Side Stretches:

This stretching exercise helps to reduce pressure on either side of the pelvic floor muscles. The instructions are:

• The person should sit on a firm chair by placing their feet flat on the floor.

• Then the person should lift one arm straight toward the ceiling.

• Then the person should look away from the lifted arm and lean on that side.

• Then the person should arm the lifted arm over the head and feel the stretch at the lower part on the raised side.

• Then the person should hold the position for 10 seconds and repeat the exercise on the opposite arm.

• This exercise should be done three to five times a day.

Back Stretches:

This stretching exercise helps to move the pelvic joints and relieve pain caused by pressure on the pelvic floor muscles. The instructions are:

• The person should lean on the table so their back will parallel the floor.

• Then the person should rest their weight on the forearms and elbows.

• Then the person should slowly lean backward until they feel a stretch on the thighs and back.

• Then the person should hold the position for 10 seconds and return to the starting position.

• The person should swing their hips on both sides several times.

• This exercise can be repeated as many times as the person feels comfortable.

Conclusion:

Pregnancy-related pelvic girdle pain or symphysis pubis dysfunction is not a harmful condition. It is a painful condition. Physical therapists recommend exercises to reduce and ease pelvic pain. If any of their exercises cause pain, people are advised to stop them immediately. Exercise was found to be beneficial during and after pregnancy. So reaching out to a physical therapist may be beneficial. If the pain is not relieved or worsens after the exercises, it is best to consult an obstetrician to ease it and improve the quality of life.