Pelvic pain is a common symptom experienced during pregnancy as the body undergoes many different changes and increased weight in the uterus. The pelvis is a complex structure that supports much of this growing weight throughout pregnancy.

As the pelvis endures this pressure, along with all the other bodily changes pregnancy causes (which we’ll talk about more later), it is likely to create pain and discomfort in some way.

However, pelvic pain can present itself in different forms that may vary from person to person. The two main types of pelvic pain experienced during pregnancy include:

• Pubic symphysis dysfunction: Pain felt in or near the pubic symphysis joint, which is located towards the front of the pelvis. It connects the left and right pelvic bones, and becomes more flexible during pregnancy.
• Pelvic girdle pain (PGP): Describes pain in or near the entire pelvic region, as the “pelvic girdle” consists of the hip bones, sacrum, and coccyx (tailbone).

While these two terms are often used to describe pain felt in the pelvis during pregnancy, other causes or types of pain can include UTIs, pelvic floor dysfunction, round ligament pain, or uterine fibroids.

Pelvic pain may seem like a straightforward term, but the symptoms related to it can be more complex.

You may feel the pain in the entire pelvic region, more towards the front or back of the pelvis, in the perineum, hips, or sacroiliac joints, or even during certain movements.

Things like walking, climbing stairs, turning over, or getting out of a vehicle may be painful or difficult.

Some individuals may even feel clicking or popping noises from the pelvis, and feel pain in other areas like the abdominals, knees, lower back, genitals, or thighs.

These areas may seem unrelated, but the pelvis is actually an important connection point of the body that absorbs much of the impact and pressure from the upper body.

When its job is made more difficult by pregnancy, the result can be pain in a variety of locations.

Additionally, pregnancy can cause other symptoms related to the pelvis, such as constipation, urinary troubles, or painful sex—which are symptoms of pelvic floor dysfunction. The pelvic floor plays a significant role during pregnancy, so it is likely to contribute to your pelvic pain if dysfunction is present.

While you can’t necessarily prevent pregnancy-related pelvic pain completely, you can improve your outcomes by engaging in pelvic floor therapy before or during pregnancy.

Not to mention, all of these different symptoms of pelvic pain and discomfort can be difficult to distinguish from one another during pregnancy.

Working with a professional gives you one less thing to worry about, and can significantly improve your quality of life during pregnancy.

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The body undergoes many changes during pregnancy, both hormonal and physical, that may contribute to pelvic pain.

All of these aspects put more pressure and strain on the pelvic bones, muscles, ligaments, and other structures. Here are some examples of pregnancy-related changes that can contribute to pain in the pelvis:

• The increased weight from a baby changes your center of gravity, affecting your movements and posture.
• Hormonal changes cause your ligaments to relax and expand.
• Many of your muscles throughout the hips, buttocks, abdomen, back, and pelvic floor will change and may become weak, tight, or inflexible.
• Your spinal curves and pelvic tilt change significantly.
• Your uterus may shift and rest on your abdominal muscles.
• The lower body experiences more pressure as the uterus and placenta grow.

All of these changes put more and more pressure on the pelvis. Additionally, your pelvic pain may be worse during pregnancy if…

• You have had multiple pregnancies.
• You are carrying more than one baby (twins, triplets, etc.).
• You have a syndrome that causes hypermobility.
• You have experienced a pelvic injury previously.

You may be thinking, “Surely my pelvic pain will just go away once I give birth.” Unfortunately, that is not usually the case. Your body cannot simply bounce back so easily after pregnancy. It will need time to rest and will require extra care to restore function and comfort.

In order to give your body the restorative care it deserves—as well as relieve postpartum symptoms of pelvic pain, incontinence, and more—it is recommended to work closely with a pelvic floor physical therapist during postpartum.

Pelvic floor physical therapy is a great way to manage pregnancy-related pelvic pain.

A pelvic floor physical therapist will be able to perform treatments that are completely safe during pregnancy, as well as suggest strategies for reducing pain and pressure throughout the remainder of your pregnancy journey and even into postpartum.

This can include treatments such as the following:

Strengthening and Stretching

If the muscles in your hips, pelvis, core, pelvic floor, and lower back are weak, inflexible, or not properly coordinated, they cannot perform their jobs properly; such as adequately supporting your growing belly.

Therefore, your physical therapist will lead you through gentle stretches, yoga, activities, and exercises to help build strength and flexibility in these areas.

They may also guide you through special movements or activities to improve coordination of these muscles, so that they can all work in harmony to support your body properly.

Pelvic Floor Training

The pelvic floor plays a major role during pregnancy and even childbirth. It supports your body’s weight and movements, maintains stability, and allows for a variety of functions like using the restroom or enjoying sex.

The pelvic floor consists of 26 different muscles throughout the pelvis, and it interconnects with other muscles of the body like the abdominals, hips, lower back, and more. It is a very important muscle group, and therefore will need specialized care and treatment.

The pelvic floor experiences a lot of pressure and strain during pregnancy, which makes pelvic floor dysfunction likely and common. This dysfunction causes symptoms like pelvic pain, incontinence, constipation, painful sex, and more.

To counteract this, your physical therapist will lead you through a variety of treatments to better coordinate these muscles, improve your control and awareness of them, and restore their strength and mobility.

Improving Posture and Movements

As mentioned before, your center of gravity and spinal curves will shift dramatically during pregnancy. This can significantly affect your posture and the way you move, such as when bending over, getting up from sitting, lifting items, and more.

To ensure you don’t create additional strain and pressure on the pelvis, hips, or lower back, your physical therapist will be sure to correct any imbalances in your posture and help you modify movements to better suit your needs.

Education and More

One important aspect of physical therapy treatment, for pregnancy and any other condition you can think of, is education. Pregnancy-related pelvic pain can be frustrating, and may disrupt your day-to-day activities.

Understanding why that pain is happening and what you can do to minimize it can not only reduce your symptoms, but also your stress or anxiety.

Your Hive physical therapist can provide a wealth of information about your body, the changes it is experiencing, and why those changes cause pain in different places.

Pregnancy needs can vary from person to person. Each person’s daily life, symptoms, and pregnancy journey will vary.

That’s why your physical therapist will be sure to listen closely to your needs and concerns, and help create strategies to better manage your symptoms. This can include things such as:

• Identifying activities that may be exacerbating your pain, and either modifying them or suggesting you avoid them for the time being.
• Suggesting tools to help relieve pain, such as pregnancy pillows, belly belts, and more.
• Creating a curated exercise routine that will help keep you active without overdoing it.
• Suggesting safe or more comfortable positions for sexual activity.

The pelvic floor therapists at Hive Therapy and Wellness are dedicated to providing holistic, individualized care for their patients. They understand that pregnancy and pelvic pain can look different for each person.

While receiving treatment at Hive, you can feel confident that your provider will hear your needs and curate a plan of care that is unique to you.

While receiving treatment for pregnancy-related pelvic pain, you can expect your physical therapist to utilize a variety of methods, such as the following:

• Neuromuscular re-education 
• Manual therapy
• Exercise prescription
• Cupping 
• Behavioral modification
• Therapeutic activities
• Spinal manipulation
• Therapeutic modalities 
• Biofeedback