Pelvic Pain During Early Pregnancy
It kind of goes without saying that there are some very clear anatomical changes that happen during pregnancy. Along with these changes, some people may experience pregnancy related pelvic girdle pain.
This term is the umbrella term for any pain around the pelvis and hips. It can show up as pubic symphysis pain, SIJ pain, lightening crotch or round ligament pain.
But why do some people have pelvic pain during early pregnancy when the growth hasn’t been that big?
Let’s dive in.
Pregnancy related pelvic girdle pain
There’s a lot of myths to debunk when it comes to pelvic pain in pregnancy. A lot of times, people are cautioned that the mechanical changes to the body are the reason for your pain. And while that seems to make reasonable sense, the correlation between these changes is NOT showing up in the research.
Normal changes that don’t correlate to pelvic pain intensity are as follows:
The pelvic floor and abdominal wall
More length and stretch happen with an increase in the load of the ever changing size and weight of the uterus, including the placenta.
Posture
Hips may widen for some, the tilt of the pelvis adjusts to the new front load, and rib cage position can flare up to make more space for the belly
Relaxin hormone
This hormone has taken a lot of the blame. Some people say that it’s the cause of the pelvic pain, theorizing that with this hormone circulating, and causing ligaments to be lax and more loose, it causes the pelvic bones to also be unstable.
This is not true.
I will say it again, just to make sure you read that right. Relaxin does not cause the pelvic bones to be unstable.
The correlation between relaxin and an “unstable” pelvis just doesn’t exist. It’s so important to remember that your pelvis is completely stable during pregnancy.
Why do I have pain then? Why do I feel so unstable?
First off, you’re not imagining this symptom. The body can be pretty incredible on how it responds to change and sometimes, people can have the feeling of instability or twisted or locked up pelvis.
The muscles around this area can sometimes actually demonstrate tension around the pelvis and give the “look” of a change in pelvic position.
But we have to remember that it’s kind of an optical illusion. Muscles are influencing how things appear and move and the bones themselves have not changed in their stability.
Hormone levels can also increase tissue sensitivity in some people. When we have a higher sensitivity, we can have an increased feeling of instability and be more sensitive to pain.
So what can I do to help my pelvic pain during early pregnancy?
Believe it or not, but the beliefs of why you are having pain have a BIG impact on whether or not you manage it well.
“The strongest predictor of resolution of pregnancy related pelvic girdle pain is having the belief that it will go away” [1]
What that means is you have to stop your brain from going down the rabbit hole.
Having pain in early pregnancy does not mean you will suffer for the remainder of your 9 months. And I’ve seen this firsthand in the clinic!
Anecdoctally, I’ve seen many pregnant athletes frustrated with such an early onset of pain in their pregnancy but once they “pop” or grow for a few more weeks, their pain is gone and doesn’t return.
If you are struggling with pain early on, try not to worry that this is your new normal for the rest of pregnancy.
Remind yourself that your pelvis is not unstable. That your body’s growth is a new sensation for your nervous system and pressures around the pelvis, low back and pubic symphysis feel different.
Movement is safe
Exercise during pregnancy benefits have been proven time and time again and it’s no different with pregnancy related pelvic girdle pain.
Finding a routine and rhythm of exercise is a great way to manage pain. It may seem like an uphill battle to figure out what feels good. Visiting a prenatal pelvic health physiotherapist can be extremely helpful in figuring out what your body can tolerate.
And no, you don’t need to keep your legs together and your core tight all the live long day. This can increase tension all around the pelvic girdle which can increase your sensitivity to pain.
It is pretty normal for your body to head that way… tension can be a reaction to pain. But learning ways to move without bracing aggressively can actually help reduce your pain.
Other ways to help with pelvic pain
Work on improving sleep quality
Stress management
Manual therapy from a qualified practitioner or external belt supports to provide your nervous system a new sensory experience that can help reduce pain
Prenatal physiotherapy for education around movement and exercise
In Conclusion
Regardless of how the symptoms show up, remember that these pelvic structural changes and posture changes are a normal and necessary part of pregnancy. Your body is safe and doing what it needs to do.
However, you do not just need to suffer through your pregnancy hoping that the pain goes away once you deliver your baby.
Working with a pelvic health physiotherapist can help to manage your pain, help you reframe your beliefs and provide guidance on exercise and movement so that you can be as comfortable as possible through your pregnancy.
At HerSport Physio, we are incredibly passionate about helping athletes stay active through pregnancy and are thrilled to work with many athletes of all abilities. If you are experiencing any pregnancy related symptoms, we are here to help!
Want to learn more pelvic health things? Check out The Ultimate Pelvic Health Guide for Athletes
[1] Pulsifer J et al Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain. Br J Sports Med. 2022 Nov;56(22):1262-1265. doi: 10.1136/bjsports-2022-105724. Epub 2022 Aug 10. PMID: 35948414.