Pelvic Girdle Pain (PGP) is a common condition characterised by pain in the joints of the pelvis, which is especially prevalent during pregnancy. This discomfort can significantly impact daily activities and quality of life. As physiotherapists, we specialise in understanding and treating musculoskeletal conditions like PGP, helping individuals regain function and reduce pain.
Understanding the Pelvic Girdle
The pelvic girdle is a ring of bones connecting the spine to the lower limbs. It comprises three main joints:
- Sacroiliac Joints (SIJ): Two joints located at the back of the pelvis, where the sacrum meets the ilium.
- Pubic Symphysis: The joint at the front of the pelvis, where the two pubic bones meet.
- Coccyx: The tailbone, located at the very bottom of the spine.
Pain in any of these areas can contribute to PGP.
During pregnancy, hormonal changes lead to increased elasticity and relaxation of the pelvic ligaments, which can result in:
Instability: The joints of the pelvis become more mobile, leading to less stability during movement and weight-bearing activities.
Pain: The combination of instability and misalignment can cause strain on muscles and ligaments, resulting in pain in various areas of the pelvis, including the pubic bone, groin, lower back, and hips.
Assessment of Pelvic Girdle Pain
A thorough assessment is crucial for effective management of PGP. This typically involves:
1. Subjective History: Gathering information about the onset, nature, and aggravating/relieving factors of the pain. We'll discuss your daily activities, pregnancy history (if applicable), and any previous injuries.
2. Postural Assessment: Observing your standing and sitting posture to identify any imbalances.
3. Movement Analysis: Assessing your walking, squatting, and other functional movements to pinpoint pain triggers.
4. Palpation: Gently feeling the pelvic bones and surrounding muscles to identify tender areas.
5. Special Tests: Performing specific orthopaedic tests to evaluate the stability and mobility of the SIJ, pubic symphysis, and coccyx. This helps us differentiate between joint dysfunction and muscle imbalances.
6. Muscle Strength and Length Testing: Assessing the strength of core muscles (e.g., transversus abdominis, pelvic floor) and the flexibility of surrounding muscles (e.g., hip flexors, hamstrings).
Physiotherapy Treatment for Pelvic Girdle Pain
Our approach to treating PGP is holistic and tailored to your individual needs. Treatment strategies often include:
Manual Therapy: Hands-on techniques to restore proper joint movement and reduce muscle tension. This might involve gentle mobilisations to the sacroiliac joints, pubic symphysis, or coccyx.
Therapeutic Exercise: A targeted exercise program to strengthen weak muscles (especially core and pelvic floor muscles) and stretch tight muscles. This helps to stabilise the pelvis and improve overall function. Examples include:
- Pelvic Floor Exercises: To improve stability and support.
- Core Strengthening: Exercises like bridging and modified planks to engage deep abdominal muscles.
- Gluteal Strengthening: To improve hip stability.
- Stretching: For muscles like the piriformis and hip flexors that can contribute to pelvic pain.
Education and Advice: Providing you with an understanding of your condition, pain management strategies, and ergonomic advice for daily activities to prevent aggravation of symptoms. This might include recommendations on sleeping positions, sitting postures, and lifting techniques. Advising on how to modify activities that aggravate your pain while maintaining an active lifestyle.
External braces and supports: Such as pelvic girdle belts. We stock a range of options and brands including Belly Band and GRDL belts. Our Physiotherapists will recommend an option that is right for you.
Written by: Caitlyn Smith, Physiotherapist
*Please note these blog posts are for information purposes ONLY. This may not apply to your specific situation, so please seek advice from a qualified health professional.