Pelvic Girdle Pain: What Helps, What to Avoid and When to Get Help

Pelvic girdle pain is one of the most common complaints in pregnancy and a frequent hangover afterwards, and it is far more treatable than most people are told. This guide covers what causes it, the daily changes that reduce it fastest, gentle exercises that help and the movements worth avoiding. Written for UK readers in pregnancy or the months after birth.

TL;DR

• Pain around the pubic bone, lower back or the joints at the back of the pelvis, often worse on stairs or turning in bed.
• It is common, treatable and not a sign of damage.
• Physiotherapy is the main treatment and referral is usually available through your midwife or GP.
• Keeping your knees together for movements that separate them helps immediately.
• Glute and deep core strength reduces the load through the pelvis.
• It usually improves substantially after birth, though not always immediately.

What pelvic girdle pain actually is

Your pelvis is three bones joined at three fairly stiff joints: the pubic symphysis at the front and the two sacroiliac joints at the back. Pelvic girdle pain is pain arising from those joints and the surrounding structures.

In pregnancy the usual contributors are hormonal softening of ligaments, a rapidly changing centre of mass, and the load of a growing uterus, which together change how force moves through those joints. It is sometimes still called SPD, or symphysis pubis dysfunction, though pelvic girdle pain is the term now generally used because the problem is rarely limited to the front joint.

The important framing: the joints are not unstable in the sense of coming apart, and the pain is not evidence of damage. The NHS covers it in its guidance on pelvic pain in pregnancy.

What it feels like

• Pain over the pubic bone, sometimes described as grinding or clicking.
• Pain in one or both buttocks or at the back of the pelvis.
• Pain that spreads into the thighs.
• Worse on stairs, getting in and out of a car, turning over in bed, standing on one leg to dress.
• Worse at the end of a long day or after a lot of walking.

That list of aggravating movements has a pattern: they all involve the legs moving separately. That pattern is what most of the practical advice below is built on.

Daily changes that help fastest

• Keep your knees together where you can. Swing both legs together getting in and out of a car and out of bed. Sit down to put trousers on.
• Take stairs one at a time, leading with the less painful leg going up.
• Sleep with a pillow between your knees to stop the top leg dropping across.
• Shorten your stride rather than walking further with a limp.
• Sit down for tasks you would normally stand for, including ironing and food prep.
• Break up standing. Prolonged standing is one of the biggest aggravators.
• Avoid carrying a toddler on one hip. It loads one side of the pelvis heavily.

These usually make more difference in the first week than any exercise does, because they remove the repeated provocations.

Gentle exercises that help

The aim is to improve how well the muscles around the pelvis control load, particularly the glutes and the deep abdominals. Work within a pain-free range, and stop anything that makes symptoms worse afterwards.

• Pelvic floor contractions. They form part of the support system for the pelvis. Ten slow holds, three times a day.
• Ball squeeze. Lying with knees bent, squeeze a soft ball between the knees gently and hold for five seconds. Ten repetitions. This works the inner thighs without separating the legs.
• Glute bridge, small range. Lift the hips only as far as is comfortable. Eight to ten repetitions.
• Side-lying clam with a light loop. Only if it does not provoke symptoms, and keep the range small.
• Connection breathing. Exhale as you lift the pelvic floor, ten breaths.

The ball squeeze in particular suits pelvic girdle pain because it strengthens without the leg separation that tends to hurt. A small ball and a light loop cover the list, and our Postnatal Recovery Kit includes both plus a latex-free band, cotton strap and printed pelvic floor guide for £14.99.

Shop the Postnatal Recovery Kit

What to avoid

• Wide-legged movements. Deep squats, wide lunges, breaststroke leg kick and wide yoga stances.
• Standing on one leg to dress, or single-leg exercises while symptomatic.
• Heavy lifting and long walks that leave you sore the next day.
• Pushing through pain. Discomfort that settles quickly is different from pain that worsens over the following day.
• Crossing your legs when sitting for long periods.

When to get help

Sooner than most people do. Pelvic girdle pain responds well to physiotherapy, and you do not need to wait until after birth. Ask your midwife or GP for a referral to a women's health physiotherapist, who can assess the movement pattern, prescribe exercises and fit a support belt if one is likely to help.

The Pelvic, Obstetric and Gynaecological Physiotherapy network lists specialists, and the Chartered Society of Physiotherapy covers private options. Seek advice promptly if pain is severe, if you cannot weight bear, or if it is stopping you sleeping.

FAQs

What causes pelvic girdle pain?

It comes from the joints of the pelvis and the muscles around them, usually where hormonal softening of ligaments, a changing centre of mass and increasing load combine in pregnancy. It can also follow a fall, an awkward lift or a birth. It reflects how load is being managed rather than damage to the joints.

Does pelvic girdle pain go away after birth?

For most people it improves substantially in the weeks after birth as hormones and load return towards normal. A minority have symptoms that persist for months, and those respond well to physiotherapy rather than to waiting. If it is still there at three months, get it assessed.

Can I exercise with pelvic girdle pain?

Yes, within a pain-free range and avoiding wide-legged movements. Swimming can help, but avoid breaststroke leg kick. Ball squeezes, small-range glute bridges and pelvic floor work are usually well tolerated. Judge exercises by how you feel the next day, not just during.

Is a support belt useful for pelvic girdle pain?

It helps some people, particularly for walking and standing. Fit and positioning matter a lot, and a belt is best fitted by a physiotherapist rather than bought speculatively. It is a support to make activity comfortable, not a treatment on its own.

Is pelvic girdle pain the same as SPD?

SPD, or symphysis pubis dysfunction, is an older term for pain focused on the pubic joint at the front. Pelvic girdle pain is now the preferred term because symptoms usually involve the sacroiliac joints at the back as well. You will still see both used.

Can you get pelvic girdle pain without being pregnant?

Yes. It can follow a fall, a heavy or awkward lift, or occur alongside other conditions affecting the pelvis and lower back. The assessment and management approach is broadly similar, and physiotherapy is still the mainstay.

Conclusion

Change the daily movements that provoke it, keep your knees together where you can, build the glutes and deep core gently, and get referred sooner than feels necessary. Most people improve a great deal with those four things.

For the gentle strengthening, the Postnatal Recovery Kit covers the ball and loop work at £14.99, and our hip mobility routine is a sensible next step once symptoms settle.