Pelvic Girdle Pain (PGP)

Pelvic Girdle Pain (PGP) is a specific form of low back pain that can occur separately or in combination with lower back pain.

Causes:

Whilst PGP is common, the aetiology and pathogenesis (“the underlying causes”) of PGP are unclear - possible causes can be hormonal and biomechanical aspects, stress on structures such as ligaments and inadequate muscle control. 

To understand why so many causes could affect the pelvis, let’s start by understanding the pelvis. It is important to transfer load from the trunk (the body) to the legs and therefore needs to be optimally stabilised. Stability is gained by form closure which is the surfaces of the joints fitting together and by force closure that is created by the muscles, ligaments and fascia. 

Factors that reduce this stability in pregnancy include increased ligament laxity, decreased efficiency of muscle activation due to altered proprioception and motor control and a less efficient angle of abdominal pull. 

Treatment: 

The good news for PGP is treatment with a women’s health physiotherapist can provide significant relief. Treatment techniques used may include:

• Assessment of body biomechanics to target rehab programs

• Soft tissue massage

• Exercise rehabilitation using RTUS (real time ultrasound) for biofeedback

• Functional exercise prescription and clinical pilates

• Postural advice

• Taping, belts or compression garments

• Lifestyle advice

• Activity modification

• Hot/cold therapy

Activity Modification
(**The Good Stuff **)

1. Use a lady-like approach when getting in + out of the car

How: Simply swing both legs together to reduce hip abduction/parting of the legs. Alternatively use a plastic bag under your bottom to create the perfect swivel surface 

2. Sit down when getting dressed

How: Drag a dining chair into the bedroom or sit on the bed. Instantaneously you’ve cut down the time standing on one leg that was aggravating your pain

3. Change your squat technique

How: If wider stances are meaning squats have become painful, time to modify. Reduce your stance for narrow squats. Still too painful? Try a small ball between the knees to squeeze

4. Roll to 4-point kneeling in bed

How: From side lying in bed, squeeze knees into pillow and move to 4-point kneeling (onto hands and knees). Then squeeze into the pillow again as you roll to the other side. You have just reduced the hip abduction or parting of the legs that was pain provoking!!