Pregnancy Related Pelvic Girdle Pain (PGP)

Summary

This video, presented by pelvic health physiotherapists from North Bristol NHS Trust, focuses on understanding and managing pregnancy-related pelvic girdle pain. It explains the common causes and symptoms of pelvic pain during pregnancy and reassures viewers about the strength and stability of the pelvis. The video offers practical tips on posture, sleep positions, and gentle exercises, emphasizing the importance of staying active and managing mental well-being. Additionally, it covers pain relief methods, including the use of heat, massage, and support belts, and encourages seeking professional advice if needed.

Takeaways

• 👶 Pregnancy-related pelvic girdle pain is common, affecting around 1 in 5 women, and involves discomfort in the lower back, pelvis, hips, pubic bone, groins, or inner thighs.
• 💪 The pelvis is a strong and stable structure, and pelvic girdle pain during pregnancy does not indicate any damage.
• 📉 Factors that can contribute to pelvic girdle pain include previous back pain, overweight before pregnancy, and increased sensitivity to pain during pregnancy.
• 🧘‍♀️ Posture management is key to coping with pelvic girdle pain. Regularly changing positions, using cushions for support, and adopting comfortable rest positions can help.
• 🛏️ Sleeping on your side, especially the left side, is recommended in the third trimester to reduce the risk of stillbirth, and using extra pillows can improve comfort.
• 🧘‍♂️ Simple exercises like rocking the pelvis and stretching can help relieve pain. These can be done on a gym ball or while on hands and knees.
• 🌡️ Heat or cold therapy, massages, and the use of a pregnancy support belt can provide relief from pelvic girdle pain.
• 💊 Paracetamol is usually safe for pain management, but consult a GP if stronger pain relief is needed.
• 🚶‍♀️ Maintaining moderate physical activity, about 150 minutes per week, is important despite the pain. Light exercises like pelvic floor exercises are beneficial.
• 🧠 Managing mental well-being through relaxation, mindfulness, or yoga can help reduce anxiety and stress, which can exacerbate pelvic girdle pain.

Q & A

What is the term used to describe aches and pains around the middle during pregnancy?

The term used is 'pregnancy-related pelvic girdle pain'.

What are some common areas where one might experience pain during pregnancy?

Common areas include the lower back, back of the pelvis, buttocks, sides of the hips, pubic bone, groins, or inner thighs.

How common is it for women to experience pelvic girdle pain during pregnancy?

It is quite common, with around one in five women struggling with pain that really bothers them.

What is the general outcome for most women after giving birth in relation to pelvic girdle pain?

For most women, the pelvic girdle pain improves quickly after giving birth.

What factors might make a woman more likely to experience pelvic girdle pain during pregnancy?

Factors include having back pain before pregnancy, having pelvic girdle pain in a previous pregnancy, or starting the pregnancy being overweight.

How do hormones during pregnancy affect the body in relation to pelvic girdle pain?

Hormones make tissues a bit more stretchy and joints a bit more mobile, but research hasn't demonstrated a direct link between joint mobility and the amount of pelvic pain.

What is one of the significant changes in sensitivity during pregnancy that may contribute to pelvic girdle pain?

Sensitivity to pain increases in pregnancy, which may be a bigger factor in experiencing pain.

What are some non-physical factors that can contribute to pelvic girdle pain?

Depression, stress, anxiety, and lack of sleep can contribute to pelvic girdle pain.

What is a recommended strategy for managing posture during pregnancy to help with pelvic girdle pain?

Changing position regularly, not sitting for too long without breaks, and using support such as a rolled-up towel or a gym ball can help manage posture.

What is the recommended sleeping position during pregnancy to reduce the risk of stillbirth?

Sleeping on the side, preferably the left side, is recommended to reduce the risk of stillbirth.

What are some simple exercises that can be done at any stage of pregnancy to help with pelvic girdle pain?

Simple exercises include moving in a box shape on hands and knees, tightening the pelvic floor and tummy muscles, and balance exercises with arms and legs.

What can be used as a tool to help with pelvic girdle pain during pregnancy?

A gym ball or pregnancy ball can be used to perform exercises that help with pelvic girdle pain.

What is the recommended approach to exercise during pregnancy in relation to pelvic girdle pain?

Aim for 150 minutes of moderate activity each week, stay hydrated, avoid heat, listen to your body, and take breaks when needed.

What should be done if a woman is struggling with pelvic girdle pain and the self-help strategies are not enough?

If self-help strategies are not enough, it's important to talk to a GP or other health professional about pain relief and possibly being referred to pelvic health physiotherapy.

Outlines

00:00

🤰 Understanding Pregnancy-Related Pelvic Girdle Pain

In this video, Becca, a specialist pelvic health physiotherapist from North Bristol NHS Trust, introduces the topic of pregnancy-related pelvic girdle pain. Alongside colleagues Sophie and Jen, Becca aims to educate viewers about this common condition affecting one in five pregnant women. Pelvic girdle pain can manifest as aches in the lower back, pelvis, buttocks, hips, pubic bone, and thighs, impacting daily activities like walking and climbing stairs. Fortunately, this pain is usually temporary, improving after childbirth for most women. Although it can persist beyond the postnatal period for some, it's reassuring to know that the pelvis is strong and stable, with no evidence suggesting the pain indicates any damage. Various factors, including previous back pain, pelvic pain in a prior pregnancy, or starting pregnancy overweight, can increase the likelihood of experiencing pelvic girdle pain. Hormonal changes may also contribute, although research hasn't confirmed a direct link between joint mobility and pain levels. Increased pain sensitivity, stress, anxiety, and lack of sleep can exacerbate discomfort. The video promises to explore strategies for managing pelvic girdle pain during pregnancy.

05:01

🧘 Posture and Positioning Tips for Managing Pain

The video provides strategies for coping with pelvic girdle pain, emphasizing the importance of maintaining good posture as the body changes during pregnancy. It reassures viewers that poor posture will not harm the pelvis and advises changing positions regularly to avoid discomfort from prolonged sitting. Tips include using a rolled-up towel for back support at a desk or in a car and rocking the pelvis while sitting. Using a gym ball can keep one active and alleviate discomfort. Various resting positions, such as lying on one's side or kneeling, can help relieve pressure on the back. Sleeping on the side is recommended during the third trimester to reduce the risk of stillbirth, with specific advice to use extra pillows for comfort. Additionally, the video suggests gentle stretches to alleviate pain, reminding viewers that pregnancy will not harm their pelvis. It advises pacing oneself to balance activities, managing expectations, and accepting help to prevent overexertion, which can exacerbate pain.

10:03

🧘‍♀️ Exercises and Mental Well-being

This section highlights the importance of mental well-being and offers exercises to alleviate pelvic girdle pain. Stress, anxiety, and depression can worsen pain perception, so the video recommends mindfulness, relaxation, and yoga to enhance mental health. Fitness routines can relieve stress, and the video introduces safe exercises during pregnancy. Applying heat or cold packs may provide relief, and massage from a partner can help ease tension. For severe pain, consulting a GP about painkillers is advised. Exercise is vital, with 150 minutes of moderate activity weekly suggested, complemented by pelvic floor exercises. The video introduces simple exercises, recommending seeking medical advice if needed. The first exercise involves making a box shape on hands and knees, alternating between hollowing and rounding the back. Small movements are encouraged initially, increasing as comfort allows. Practicing these exercises may prepare for active labor, improving pain management.

15:05

💪 Strengthening Exercises and Coping Strategies

The final section demonstrates strengthening exercises and coping strategies for pelvic girdle pain. Beginning with balance exercises, viewers are guided to maintain a flat back, tighten abdominal muscles, and engage the pelvic floor, repeating up to ten times. Advanced exercises include raising arms or legs while maintaining balance. Sitting on a gym ball is recommended, starting with gentle rocking motions, and progressing to hip circles. For added challenge, alternating arms and legs can be raised. Consistency in practicing these exercises can increase endurance and improve pain management. For severe or persistent pain, consultation with healthcare professionals is advised, and a referral to pelvic health physiotherapy may be beneficial. The video concludes by encouraging viewers to seek further advice and thanking them for watching.

Keywords

💡Pelvic Girdle Pain

Pelvic Girdle Pain (PGP) is a term used to describe aches and pains around the pelvic region during pregnancy. This includes discomfort in areas such as the lower back, buttocks, hips, pubic bone, groin, and inner thighs. The video emphasizes that PGP is common and can make daily activities like walking and rolling over in bed challenging.

💡Posture

Posture refers to the position in which someone holds their body while standing, sitting, or lying down. Maintaining good posture during pregnancy can help manage pelvic girdle pain. The video suggests changing positions regularly and using support like rolled-up towels to alleviate discomfort.

💡Hormones

Hormones in pregnancy can make tissues more stretchy and joints more mobile, which can contribute to pelvic girdle pain. However, the video clarifies that there is no direct link between joint mobility and pain levels, and factors like increased pain sensitivity play a more significant role.

💡Pain Management

Pain management involves various strategies to cope with discomfort during pregnancy. The video provides several tips, such as using heat or cold packs, massage, pregnancy support belts, and taking painkillers like paracetamol if necessary. These methods aim to make the pain more manageable and improve daily functioning.

💡Mental Well-being

Mental well-being encompasses the psychological state of being comfortable, healthy, or happy. The video highlights the importance of addressing stress, anxiety, and depression during pregnancy, as these factors can exacerbate pelvic girdle pain. Techniques like relaxation, breathing exercises, mindfulness, and yoga are recommended.

💡Exercise

Exercise is any bodily activity that enhances or maintains physical fitness and overall health. The video suggests staying active during pregnancy to manage pelvic girdle pain, recommending exercises like pelvic tilts, gentle movements on a gym ball, and pelvic floor exercises, which can help strengthen muscles and alleviate pain.

💡Pelvic Floor Exercises

Pelvic floor exercises involve strengthening the muscles that support the pelvic organs. The video underscores their importance in managing pelvic girdle pain and maintaining overall pelvic health. These exercises help stabilize the pelvis and can be practiced throughout pregnancy.

💡Support

Support refers to both physical and emotional assistance. The video advises using physical supports like cushions, rolled-up towels, and pregnancy pillows to alleviate pain. Additionally, it encourages seeking help from friends, family, and healthcare professionals for emotional support and practical assistance.

💡Sleep

Sleep is essential for overall health and well-being. The video advises pregnant women to sleep on their side, particularly the left side, to reduce the risk of stillbirth and manage pelvic girdle pain. It also suggests using extra pillows and padding to enhance comfort while sleeping.

💡Pacing

Pacing involves balancing activity and rest to manage pain effectively. The video recommends planning daily activities to avoid overexertion and taking breaks when necessary. This strategy helps pregnant women maintain a balance between staying active and preventing pain flare-ups.

Highlights

Pelvic girdle pain is common during pregnancy, affecting around one in five women.

Pelvic girdle pain can make daily activities like walking or climbing stairs difficult.

Most women experience a quick improvement in pelvic girdle pain after giving birth.

Pelvic girdle pain is not a sign of damage to the pelvis, which is a strong and stable structure.

Factors contributing to pelvic girdle pain include previous back pain, overweight status, and pregnancy hormones.

Increased sensitivity to pain during pregnancy may contribute more to pelvic girdle pain than joint mobility.

Depression, stress, anxiety, and lack of sleep can exacerbate pelvic girdle pain.

Maintaining good posture and changing positions regularly can help manage pelvic girdle pain.

Using a rolled-up towel for back support and sitting on a gym ball can provide comfort.

Sleeping on the side, especially the left side, can reduce the risk of stillbirth and pelvic girdle pain.

Pacing oneself and balancing activities can be a useful strategy for managing aches and pains during pregnancy.

Stress management through relaxation, breathing exercises, mindfulness, or yoga can help reduce pelvic pain.

Heat application, such as using a hot water bottle, can provide relief for pelvic girdle pain.

A pregnancy support belt may help manage pain, especially for those with physically demanding jobs.

Paracetamol is generally safe for pain relief during pregnancy, but stronger painkillers may be considered if needed.

Staying active and doing pelvic floor exercises are important for managing pelvic girdle pain.

Simple exercises, such as those demonstrated on the video, can be done at any stage of pregnancy to ease pelvic pain.

Using a gym ball for exercises can help with pelvic girdle pain and is beneficial for an active labor.

If pelvic girdle pain persists or interferes with daily activities, it's important to consult a GP or health professional.

Transcripts

foreign

[Music]

pregnancy-related pelvic girdle pain I'm

Becca one of the specialist pelvic

Health physiotherapists working at North

Bristol NHS trust my colleagues Sophie

and Jen will join me in this video where

we aim to improve your understanding of

pelvic girdle pain and teach you some

strategies for coping with it during

your pregnancy

so we use the term pregnancy-related

pelvic girdle pain as an umbrella term

to describe aches and pains around your

middle during pregnancy here you can see

the different places you might feel pain

in your lower back the back of your

pelvis or buttocks sides of your hips

pubic bone at the front groins or inner

thighs

so it's pretty common to experience

pelvic girdle pain during pregnancy and

around one in five women will struggle

with pain that really bothers them

this can mean that you might find it

difficult to do things like walking

going up and down the stairs rolling

over in bed or even getting in and out

of the car

the good news is that it is pregnancy

related

which means that it improves quickly

after giving birth for most mums

for around one in ten women the pain can

take a little longer to settle down and

might carry on past the initial

postnatal period

the really reassuring thing that we want

you to know is that your pelvis is a

strong and stable structure and there's

no evidence that the pain that you're

experiencing is a sign of any damage

there are lots of factors that can

contribute to pelvic girdle pain and we

know that you are a bit more likely to

get it if you've had things like back

pain before your pregnancy if you have

pelvic girdle pain in a previous

pregnancy or if you start your pregnancy

being overweight

you may have heard about hormones in

pregnancy making your tissues a bit more

stretchy and the joints a bit more

mobile

this is true however it's important to

know that the research hasn't actually

demonstrated a link between how mobile

joints are and how much pelvic pain you

have

we do know that our sensitivity to pain

increases in pregnancy and this may

actually be a bigger factor in why we

are more likely to get some pain

other factors include depression stress

anxiety lack of sleep and all of these

things might reduce your ability to be

able to cope with the pain

luckily there are lots of little things

we can do to help you cope better and

make the pain feel more manageable and

these are things we're going to run

through next

looking after your posture as your body

changes during pregnancy can be really

helpful

don't worry about a bad posture doing

any harm it won't remember your pelvis

is strong and stable and pregnancy won't

harm it

the best strategy is to change your

position regularly this means not

sitting at your desk or on the sofa for

too long without taking breaks to get up

and move around

when you do need to stay in one position

for a bit longer we have some tips to

keep you feeling more comfortable

at your desk or in the car try using a

rolled up towel to support the small of

your back and in between your brakes you

can move in the chair by rocking your

pelvis forward and back lots of women

find sitting on a gym ball helps them

stay comfortable too it's great for

keeping you gently active and you can

keep yourself moving on it little and

often which tends to help

on the sofa some extra cushions behind

you can give you more support but try to

mix it up a bit and find other comfy

rest positions too

you could lie on your side on the sofa

or kneel on the floor leaning on your

coffee table or gym ball instead

these positions take the weight of baby

away from your low back which may be a

relief for some people

they're good practice positions if

you're hoping to have an active labor

and might help your baby into an optimal

position for delivery

in your third trimester when you sleep

at night or if you go for a nap during

the day remember that it's best to sleep

on your side

this is because sleeping on your side

rather than your back has been shown to

reduce the risk of stillbirth

some research has shown that sleeping on

your left side reduces the risk the most

so you might choose to do this

if you wake up on your back don't panic

just shift onto your side again before

you go back to sleep

lying on your side all night can get

uncomfortable a great tip is to pad out

your mattress using a spare duvet or

mattress topper now most women find some

extra pillows or a fancy pregnancy

pillow great for getting comfy in bed

you can try using them between your legs

and keep them in when you want to turn

over because squeezing into them may

feel more comfortable a small cushion or

towel under your Bump might help too and

if you tend to roll over onto your back

in your sleep a rolled up blanket or

pillow behind you will stop you doing

that

as your Bump grows you might feel it

pulling you forward giving a bit more of

a curve in your lower back when you're

standing or when you're walking

this isn't going to do any damage but if

you are getting pain it's worth playing

around with this posture to see if it

helps one stretch you can try is

softening your knees and tucking your

bum under like this you might feel your

tummy tightening or your Bump lifting

but don't worry this is just your tummy

muscles working and it's good to keep

them strong if you can

learning to pace yourself as you

progress through pregnancy can be a

really useful strategy in managing aches

and pains

this means trying to find the balance

between overdoing it and not doing

enough and let's be honest this is not

easy

if you are struggling it might be useful

to try and plan ahead and think about

how your balancing work family your

social life

try and figure out what your priorities

are

you'll probably find that some things

can wait and there will be other

activities that you can adapt to or jobs

that someone else can help with

might be things like shopping or general

work around the house that really make

the difference to your day and for

example you might consider swapping to

an online shop or maybe being a bit more

relaxed about the weekly house clean

try and accept offers of help if they're

there and if you get the balance wrong

and things flare up Don't panic because

the pain will settle back down again it

can be a steep learning curve especially

if you're very active but with a bit of

perseverance it can make things feel

much more manageable

so you might remember how we said that

stress anxiety and depression can have a

negative influence in your pain

try to find ways to look after your

mental well-being throughout your

pregnancy and ask your health

professional for advice if you're not

coping

things like relaxation breathing

exercises mindfulness or even yoga have

been shown to help reduce anxiety and

pregnancy

your Fitness routine may even be a part

of how you relieve stress

there are different things you can try

to ease your pelvic pain that are safe

to do in pregnancy

lots of people find heat relieving and

you can use a hot water bottle wheat bag

or heat pack as long as you don't

directly apply heat to your Bump

some women prefer cold especially on a

warm day and you can try a cold pack or

frozen peas wrapped in a damp towel

massage may give you some relief

if you've got a willing friend or a

partner who wants to help you out get

them to have a go you can get them to

use a firm pressure on your low back or

your pelvis using the heel of their hand

this generally feels more comfortable

than using fingers which can feel a bit

Pokey to be honest

tell them what feels good and tell them

what pressure feels most comfortable for

you

might find a pregnancy support belt

helpful if you've got a really physical

job or if you're on your feet a lot

throughout the day

if your pain is stopping you from doing

day-to-day activities then you may need

to consider taking some painkillers

in most cases taking some paracetamol is

perfectly safe but you could talk to

your GP about this if you're concerned

definitely talk to your GP if

paracetamol taken regularly isn't

working and that you feel that you might

need some stronger painkillers

the size is another important part of

trying to manage your pain in pregnancy

keeping active can feel like a real

challenge when you're in pain

but it's important to do what you can

and to try and aim for 150 minutes of

moderate activity each week there's lots

more about this in our video on exercise

and pregnancy and make sure you also

check out our video on pelvic floor

exercises as it's so important for you

to do those two

for now let's look at some simple

exercises you can try at any stage of

pregnancy

if you do have any concerns or have any

complications with your pregnancy check

with your Healthcare professional before

getting started

and don't forget to stick to the general

advice about exercise in pregnancy

stay hydrated don't know the heat listen

to your body and if you need a rest or

feel light-headed at all take it slow

and stop and have a break

for these exercises you need to get on

the floor on a mat or carpet if this is

a struggle then you might manage them on

your bed instead Becky is going to

demonstrate the exercises for us and

I'll talk you through what to do

on your hands and knees make a box shape

like this with your knees under your

hips and wrists under your shoulders now

start moving your back breathe in as you

look ahead and let your back Hollow then

breathe out as you look down chin to

chest and round your back up we'd

encourage you to start with really small

movements and gradually get bigger as

you feel more confident now remember

keep breathing As you move it's normal

to feel a bit of stretching if it's too

intense go back to smaller movements for

a bit

this exercise is great to do anytime you

feel your back needs a stretch or it's a

warm-up exercise if it feels good you

can do it as often as you like if you're

hoping to have an active labor then this

is a really good position to use and

practicing it in pregnancy might make it

feel more manageable in labor

next we're going to get your muscles

working try to maintain a flat back

throughout this next exercise

take a breath in and relax your tummy

muscles towards the floor as you slowly

breathe out draw your tummy muscles in

and tighten your pelvic floor as if you

were stopping wind from escaping you'll

feel a tightening and lifting around

your Bump as you take your next breath

in slowly relax your tummy muscles and

pelvic floor back to the starting

position you can practice repeating this

exercise about 10 times

if you manage that okay you can move on

to the next exercise which gets your

muscles working by challenging your

balance take a breath in and relax your

tummy muscles keeping your back flat

again this time as you breathe out

slowly tighten your tummy and pelvic

floor like with the previous exercise

and raise one arm ahead of you for the

duration of the out breath breathe in

and return to the starting position if

that felt okay try the other arm and

repeat or turn arms around 10 times

if you feel confident and you want to

make this a little more challenging you

can practice lifting alternate legs

instead of arms

if you manage this easily then try

lifting one arm with the opposite leg

not everyone finds this manageable so

just have a go doing what you can and

remember even a little movement is

better than nothing

10 is a guide and if you practice this

regularly you'll probably find you can

increase and do more on a good day

take it nice and slow here if you feel

your muscles tiring or you're getting

sore stop for a rest then try again

sitting back on your heels with knees

wide is a great rest position if you

need it after working a bit harder or

anytime you want a nice stretch let your

tummy relax and take a few nice deep

breaths

next up we're going to demonstrate some

exercises you can do on a gym ball or a

pregnancy ball

loads of women find the ball really

helps them with their pelvic girdle pain

so think about getting one if you can

you need to make sure that you get a

ball that's the right height for you so

your hips should be slightly higher than

your knees you if you're buying one

online look for a size guide to help you

choose the right one if you haven't got

a ball and you could do some of these

exercises sitting on a chair start

gently rocking your pelvis forwards and

back

again start small if you need to and

gradually increase the movement don't

forget to keep breathing here remember

you might feel some stretching or some

discomfort but you're not going to do

any damage

then try rocking from side to side

next up Circle your hips all the way

around one way and then the other small

movements to start with and increasing

as and when you feel able to

so now we're going to get your muscles

working again by challenging your

balance

sit up on the ball take a breath in and

relax your tummy as you breathe out draw

your tummy muscles in and tighten your

pelvic floor as if you were stopping

wind from escaping raise one arm up for

the duration of the out breath now as

you breathe in again return to that

starting position you can repeat this

with alternate arms and aim for about 10

or more repeats depending on how it

feels

if you feel confident and you want to

make it a little bit more challenging

you can practice raising alternate heels

instead of arms

you might even manage to lift one arm

and the opposite heel together

most women find that they cope better

with their pelvic girdle pain once they

understand a bit more about it and get

to grips with all of the strategies

we've discussed in this video

if you're still struggling to cope then

it's important to talk your GP or other

health professional about pain relief

and you can ask them to refer you to us

in pelvic Health Physiotherapy

thanks for taking the time to watch our

video we hope it's helped you to

understand a bit more about your pain

and pregnancy and how to manage it