Why Your Pelvic Pain Might Be Pelvic Girdle Pain

Pelvic girdle pain is pain that is felt in or near the pelvis and is usually caused by instability or inflammation of the pelvic girdle structure. Your pelvic girdle can actually be the source of many types of pelvic pain, as it is made up of three different bones in the pelvis: the ilium, ischium, and pubis. 

These bones fuse together in the front (anterior) of your pelvis, connected by the pubic symphysis. In the back, the left and right ilia bones fuse together with the sacrum. All this can sound a little confusing without a visual guide, so if you need a video explanation, view this reel!

The pelvic girdle’s purpose is to help support our body’s locomotor system (the skeleton, ligaments, tendons, muscles—all of that fun stuff.) A lot of these structures directly attach to the pelvic girdle, and all work together to provide movement and posture!

The pelvic girdle also supports your upper body weight, and transfers that weight to the lower body to provide stability. Lastly, the pelvic girdle helps protect your pelvic organs.

As you can see, the pelvic girdle has a lot of jobs and connects to a lot of parts within the body. Therefore, there are plenty of reasons why the pelvic girdle could cause pain. 

This pain can be felt in many areas too, such as in your lower back, hips, thighs, or the front or back of your pelvis. Inflammation or instability in the pelvic girdle may even cause pain during movements like walking, getting out of bed, or moving between sitting and standing positions.

We’ll talk about what could be the cause of your pain next!

We mentioned before that pelvic girdle pain is often the result of inflammation or instability in your pelvic girdle—but what exactly causes this?

The most common cause of instability or strain on the pelvic girdle is pregnancy, although it isn’t necessarily the only cause. Some factors such as injury, arthritis, muscle imbalances, hypermobility, and pelvic floor dysfunction can lead to pelvic girdle pain in both non-pregnant and pregnant individuals.

For those who are pregnant, pelvic girdle pain is pretty common. As the baby grows, the extra weight causes stress on the lower body and changes the way you walk, sit, and stand—which can put a lot of pressure on your pelvic girdle. 

The hormones associated with pregnancy (such as relaxin) also cause a lot of your ligaments and muscles to loosen up. This relaxation of your ligaments and other structures directly affects how your pelvic girdle moves. These changes in how your joints and other structures move is known as hypermobility.

Hypermobility can occur in non-pregnant individuals too. If you’ve ever had back or pelvic pain, or injuries to either of these areas, those joints may have more motion than they should. In some instances, these joints may be sitting in an uneven position, which can cause your muscles to pull and move differently. This hypermobility can directly affect the joints that make up the pelvic girdle.

Lastly we have pelvic floor dysfunction which, as mentioned before, can play a role in pelvic girdle pain. The pelvic floor is a sling of 26 muscles found in your pelvis. These muscles work alongside your pelvic girdle to provide stability and movement!

These muscles help lift or hold your pelvic organs too, so they are very interconnected with the pelvic girdle.

When these muscles are too tight, weak, or uncoordinated, they fail to provide the support needed, and can cause pain in many areas of the pelvic girdle. Problems with the pelvic floor often cause urinary, bowel, and sexual dysfunctions as well, such as incontinence, constipation, painful sex, and more.

You don’t have to just endure pelvic girdle pain! Even during pregnancy or postpartum, this pain can be better managed with safe and effective treatments like physical therapy. Physical therapy can significantly improve your symptoms and alleviate your pain, which we’ll discuss below.

So we’ve uncovered what may be causing your pain, now what can we do to treat it? 

Treatment for pelvic girdle pain can vary based on your individual needs and causes of your pain. Rest assured that I always use a thorough evaluation to determine the root cause of your pelvic girdle pain and any other factors that may affect your pelvic health. This can include your medical history, lifestyle choices, past injuries or surgeries, and more!

Your evaluation may include an examination, which is only done with your consent. This examination allows me to better understand your overall pelvic health and pelvic floor condition, which can determine the types of treatment you may need. Once your evaluation is finished, I’ll create a plan of care that is curated to your unique needs! 

The treatments used for pelvic girdle pain can vary from person to person, but your care plan may include some of the following goals and treatment methods:

Posture & Alignment

The pelvic girdle supports your upper body weight and movements, but if your posture is poor or your body is misaligned, this can put more pressure and strain on the hips and pelvic girdle. This strain, especially when left untreated in the long-term, can create pain in the hips, lower back, and other areas.

In these situations, I may incorporate treatments like spinal manipulation or joint mobilization into your care plan to reduce this straining, improve your range of motion, and reduce pain. I will also observe your posture while sitting, standing, or walking, and make adjustments or corrections as needed to prevent any areas of the body from overcompensating.

Strengthening and Mobility

Many areas of the body such as your hips, lower back, and abdominals are interconnected with your pelvis. These areas need to be strong and flexible in order to work together with your pelvic girdle! When these areas are strong, balanced, and mobile, your upper body and movements are better supported. 

When you have muscle imbalances or weakness in these areas, your pelvic girdle and joints may begin to overcompensate, causing pain in a variety of areas. Therefore, I’ll look to strengthen these areas and improve their mobility! To do this, I’ll create a curated exercise plan for your needs, which may include things like stretching or yoga to improve flexibility.

Pelvic Floor Training

We mentioned before that pelvic floor dysfunction can contribute to pelvic pain, as the pelvic floor is located within the pelvic girdle and helps support the body alongside other structures. When your pelvic floor muscles aren’t functioning as they should, your pelvic pain can be worsened significantly and other symptoms like constipation or incontinence may appear, too. 

Additionally, pain or instability in the pelvic girdle can actually cause pelvic floor dysfunction. This is because the pelvic floor may overcompensate for this instability, or build up tension from long-term pelvic girdle pain.

Due to the interconnectedness of these two structures, your treatment plan will aim to make sure your pelvic floor is healthy and functioning as it should. This can include treatments, exercises, and techniques that will restore coordination, improve muscle strength, and relieve tension in your pelvic floor.

Behavioral Modifications

Behavioral modifications are an important part of physical therapy, as they are usually lifestyle changes that you’ll incorporate into your daily life. These changes will support better pelvic girdle health and help prevent a relapse of your symptoms. 

This can include things like correcting poor posture, changing your form during lifting or other activities, and even adjusting the restroom habits you may have. I can also recommend a variety of tools, products, resources, and more to support your pelvic girdle pain management!

Alongside these modifications, I’ll want to discuss at-home strategies and exercises as a part of your care plan, which are essential for long-term results and preventative care.

As you can see, pelvic floor physical therapy can be a very effective form of treatment for pelvic girdle pain, no matter if your cause of pain is pregnancy, muscle imbalance, or hypermobility. Additionally, those who are pregnant or postpartum can benefit immensely from seeing a pelvic floor therapist for reasons other than treating pelvic girdle pain, too!

I accept all patients, no matter your age or gender identity. Every patient will receive a unique and comprehensive treatment plan, so you can be confident that your care plan will include techniques that are the best fit for your needs. If you’d like to get started on relieving your pelvic girdle pain, make an appointment with me!

For additional questions, please consider a discovery call.