10 Pain Relief Exercises For Pelvic Girdle Pain

Pelvic Girdle Pain (PGP)

Pelvic girdle pain can be treated safely at any stage during pregnancy (or after birth) and as soon as symptoms arise.

What’s pelvic girdle pain

Pelvic girdle is ring-like shape structure that is located in lower part of the trunk. It connects trunk with the lower limbs.

Pelvic girdle consist of two bones (hipbones) connected in front at pubic symphysis and in the back by the sacrum. Each of them is build by 3 bones; illium, ishium and pubic.

Pelvis is the largest bone in human body and it is symmetrical. Pelvis bones are harder than the skull.

The size and shape of pelvis bone have huge impact on how a woman looks.

Pelvis girdle function

• transfer weight from upper body (trunk) to lower body, especially during movements
• provides attachments to many muscles and ligaments
• protects pelvic and abdominal organs
• connects upper and lower body
• contains and support urinary track
• contains and support internal sexual organs

Pelvis is body’s centre of gravity and while in standing, gravity falls through pelvis and then transmitted via the pelvis to the thighbones, knees and feet.

Changes during pregnancy

During pregnancy pelvic girdle is changing as an effect of musculoskeletal changes and sometimes during pregnancy those changes are not going the way they should.

Symptoms of pelvic girdle disfunction

– Stabbing pain (in pelvic girdle)

– Deep pain

– Dull pain (in lower back)

– Pain in pelvic area

– Painful intercourse

– Referred pain to back, buttocks, tight or/ and abdomen

– Clicking sound in pelvic joints

– Bladder dysfunction (incontinence)

– Waddling gait

– Low back pain

– Pain across lower back area

– Pain between your vagina and anus (perineum)

– Problems walking

Pain location

– Pain is located around pelvic girdle

– It can radiate from pelvis to spine (especially lumbar part) or down to the buttocks, sometimes down the leg (back of it)

– Pain can be felt in abdomen area and perineal area

Painful activities

• standing on one leg
• getting dressed or undressed
• lifting one leg at a time (especially walking up and down stairs)
• getting in and out of the car
• getting in and out of the bath
• bending forward
• rolling to the side in the bed
• standing up and sitting down
• intercourse

Pelvic girdle treatment

Manual therapy for pelvic girdle

It is a clinical approach and you should get in touch with physiotherapist for a session or to be shown by one how to perform proper and safe mysofascial release. Manual therapy will:

– Modulate pain

– Increase range of motion

– Reduce tissue inflammation

– Help to relax

– Improve stability

In pelvic floor girdle, a series of strengthening exercises will be suggested by your physiotherapist, however it is good to be able to release built up tension on your own. Here are some exercises which might help you with that. Always remember to consult your physio or a doctor before starting any exercises.

Pelvic girdle exercises

1. Pelvic floor strengthening exercises

Kegel exercises – also known as pelvic floor exercises.

– Stopping urine flow

While in a toilet and passing urine, try to stop the flow of urine midway through emptying your bladder. Remember this is not an exercises but the way of finding pelvic floor muscles.

–  Use your imagination
Instead of sitting on the toilet and trying to find pelvic floor muscles use you imagination:

• squeeze muscles around vagina and suck upward
• squeeze muscles as you were trying to stop passing wind

Pelvic tilt –   in the first trimester you can perform this exercise on your back. In the second and third, perform it while sitting on the chair, exercise ball or in all four position.

Option 1

–   Lie down on your back, legs bend with feet flat on the ground. Keep your legs hip distance apart.

–   Keep your back on the floor while you are lift your hips to raise buttocks about an inch of the ground. Keep this position for 5-10 seconds and come back to start position. Repeat 5-10 times

Option 2   Standing pelvic tilt

– Stand with your back and buttocks against the wall. Knees soft, legs hip distance apart, toes pointing forward.

– Pull your belly in toward your spine as if you were trying to press every inch of your back to the wall.

– Hold for few seconds and release

– Repeat 5-10 times

Option 3 on all fours

– Position: on your all fours. Hands shoulder width-apart, legs hips distance apart. Keep back straight (as a tabletop), head in neutral position.

– Let your bump sink down and then tuck your tailbone under and get your belly in.

2. Abdominal strengthening exercises (stability exercises)

• Abdominal hollowing on all fours

3. Back and glutes strengthening exercise

Glutes bridge (high and low)

• For low glutes bridge lie on the floor, legs hip distance apart, feet flat and knees bend.
• Lift buttocks and hips of the ground as high as you feel comfortable. Either hold in top positions for up to 10 seconds or perform a series of 10 single butt lifts in a row.
• For higher option sit on the floor, knees bend, legs hips distance apart
• Place hands under shoulders with hands pointing to side. Lift hips to knee level
• Perform 2-3 series of 10-15 lifts

Moderation 1

– to make it harder, bring your heels to each other with toes pointing outwards. The rest is as above.

Moderation 2

– The same exercise but keep your legs straight in front.

Cat stretch

4. Hip strengthening exercises

– isometric glutes contractions.

5. Water based exercises

– not a breast stroke.

6. Pelvic girdle stretches

• Stand behind the chair or table so you could hold to something. Make sure the table it’s not too high so when your hands are resting on the top it, your back remains straight.
• Legs hip distance apart, hands resting on table or chair.
• Lift your tailbone up as if you would try to press it against the ceiling.
• At the same time keep your back flat and try to shift your weight into heels so your toes are super light on the ground.
• Now shift your weight gently from left to right in slow pace.

Tight hip flexors stretches with side bend

7. Hips circles on exercise ball (sitting positions)

–    Sit on an exercise ball with your legs wide apart (wider than hips). Make sure your hips are higher than your knees. Place hands on the top of your knees.

–    Roll your pelvis around in circles. As you are rolling, imagine your tailbone is a stick or a pole stuck in that exercise ball. Roll around it.

–    Go few times to the right and then circle to the left

8. Hips circles
   

• On the back, knees bend hands on the top of knees, legs hips distance.
• Using hands help rolling circles outside and then inside.

9. Small ball glutes trigger point massage (in standing against the wall) and in sitting position

–    Use spiky massage ball. Stand against the wall and placed ball between wall and your buttock. Start with right one and then you will move to left one.

–    Circle around whole buttock trying to find more tense spot. When you find it gentle hold ball over that place and wait few second before circling around again. Find that tender spot again and lean against it.

–    If that spot is really sore start circling really close to it without putting direct pressure against it. Once tension is released a little, try pressing against it.

10. Cross trainer as it is supporting your weight and it’s easier to walk

Every woman is different and different exercises will work for each of them.

What to avoid

• Standing on one leg
• Aerobic exercises that involve leg abduction and adduction
• Swimming breaststroke
• Lifting or pushing heavy objects
• Avoid squats
• Avoid lunges
• Avoid side raises
• Long stride walks

What to do- suggestions

• Avoid too many trips down and up stairs. Plan ahead so you could minimalize amount of times you have to do it
• Avoid bending and lifting
• Have changing stations (nappies, powder, wipes) up stairs and down stairs
• Keep snacks and drinks upstairs with you so you don’t have to go to the kitchen
• If the pain is in front use ice pack or packs of frozen peas
• If the pain is in the buttock area have apply warm shower on that painful spot