The pelvis is formed by 2 innominate bones that connect in the front, forming the pubic symphysis, and join the spine in the back, making up the sacroiliac (SI) joints .  In addition to muscles that attach to the pelvis, There are strong ligaments that hold the bony halves together, therefore making the pelvis very stable. The pelvis is a pretty central part of our body, as it connects our trunk to our lower extremities, and a lot of forces and pressure are transmitted through the pelvis with everyday activities. 

During pregnancy, the hormone relaxin softens the ligaments to accommodate the growing uterus and prepare the body for delivery. Pain or discomfort is usually felt in the pelvis and the knees, since this is where most of the weight and stress are directed. You may feel the onset of pelvic girdle pain early on in your pregnancy when the hormone levels change more drastically and you start to feel the physical effects on your body, generally around 12 weeks. It can also appear or worsen close to the third trimester, as the weight of the baby grows and puts more strain on your pelvis. 

Pubic symphysis pain will be centrally localized and can be felt as a sharp pain in the vagina or tenderness with pressure to the pubic bone. It will feel the worst with walking, going up and down stairs, getting dressed (standing on one leg), and rolling/ getting out of bed. Sacroiliac joint pain is generally felt more on one side more than the other and also be experienced as a sharp pain in the lower back/ buttock area. You can even experience pain and soreness in the back of the thigh if severe. Walking, prolonged standing and sitting, and climbing stairs can also exacerbate this pain. 

How is pelvic girdle pain treated?

Physical therapy will target the areas where the pain is concentrated. The muscles around the affected joints will become very tight and guarded, restricting movement of the hips, trunk, and legs. Massage and targeted stretching and exercises to the pelvic region can be helpful to reduce pain and improve muscle function. It is important to modify your current prenatal exercise program. Avoid exercises that increase asymmetry of the pelvis, such as with certain standing and balance yoga poses and high impact activities. Maternity belts and garments can provide temporary support for the joints. You will also learn strategies to move and transition in ways to avoid further strain on the pelvis.