Pelvic Girdle Pain During Pregnancy: Physio That Actually Helps

Pelvic girdle pain pregnancy is one of the most common reasons women contact our clinic in Amsterdam. In fact, around one in five pregnant women develops it. However, many are told to simply rest and wait. As a result, the pain often gets worse, not better. The good news is that targeted physiotherapy actually works. Above all, the right exercises, manual therapy, and timely use of a pelvic belt can dramatically reduce symptoms. In this guide, we explain what pelvic girdle pain is, why it happens, and how to treat it safely during and after pregnancy.

What is pelvic girdle pain pregnancy?

Pelvic girdle pain (PGP) is pain located between the top of your hip bones and the gluteal fold. It can radiate into the buttocks, groin, or upper thighs. Importantly, it is different from general back pain in pregnancy. Back pain sits higher and is usually muscular. In contrast, PGP is a joint-related problem of the pelvis itself.

Women often describe a sharp, catching pain when they roll over in bed. Similarly, climbing stairs, getting out of a car, or standing on one leg can trigger it. For some, walking longer than ten minutes becomes painful. Therefore, daily life shrinks fast if no one helps you manage it.

PGP versus pubic symphysis dysfunction

Pubic symphysis dysfunction (SPD) is actually a subtype of PGP. The pain sits at the front, right over the pubic bone. Spreading the legs, for example getting out of bed or a car, often feels like a stab. On the other hand, classic PGP is felt more at the back, near the sacroiliac joints.

PGP versus SIJ pain

Sacroiliac joint (SIJ) pain is also part of the PGP spectrum. It is felt as a deep, one-sided ache just below the dimples of the lower back. Furthermore, it often worsens with single-leg load, such as stepping up a curb. Many women have both SIJ and pubic pain at the same time during pregnancy.

Why pelvic girdle pain happens during pregnancy

Three things usually combine to cause PGP. First, the hormone relaxin softens the ligaments around the pelvis. Second, your centre of gravity shifts forward as the baby grows. Third, the deep stabilising muscles around the hips and pelvis start to fire unevenly. Consequently, the pelvic joints lose their normal control and become irritated.

Relaxin: helpful, but not the villain

Relaxin prepares your body for birth. However, it is not the sole cause of pain. Many women have high relaxin levels and no symptoms at all. In other words, hormones set the stage, but load and muscle control decide who gets pain.

Load redistribution

As your bump grows, your lumbar curve increases. Meanwhile, your pelvis tilts forward. This change shifts load onto the front of the pubic joint and the SI joints at the back. Without good muscle support, those joints take the full hit.

Asymmetric muscle activation

Often one side of the gluteus medius switches off slightly. At the same time, the opposite hip flexor becomes tight. As a result, you walk and stand with a subtle tilt. Over weeks, that tilt overloads one SI joint. This is why most PGP starts on one side before becoming bilateral.

Activities that typically provoke pelvic girdle pain

Knowing your triggers is the first step to managing the pain. Most women with PGP report problems with the following.

• Rolling over in bed at night.
• Getting in and out of a car.
• Climbing or descending stairs.
• Standing on one leg while dressing.
• Walking more than 10 to 15 minutes.
• Pushing a shopping trolley or buggy.
• Carrying a toddler on one hip.

If two or more of these sound familiar, you likely have PGP rather than simple muscular back pain. Therefore, a proper assessment is worth booking sooner rather than later.

What actually helps: evidence-based physiotherapy

Here is the most important message of this article. Rest alone does not fix pelvic girdle pain pregnancy. In fact, prolonged rest often makes it worse, because the stabilising muscles weaken further. Instead, modern guidelines recommend an active approach with targeted exercise, manual therapy, and education.

Targeted exercises, not generic prenatal yoga

Specific exercises retrain the deep hip and pelvic stabilisers. For example, side-lying clams with a small range, supported bridges, and standing hip hitches work well. Moreover, transversus abdominis activation paired with breathing reduces SI joint strain. A trained physiotherapist will tailor the dose to your trimester and symptoms.

Manual therapy

Gentle mobilisations of the SI joints and lumbar spine reduce pain quickly. In addition, soft tissue work on the gluteus medius, piriformis, and adductors releases the muscles that have been compensating. These techniques are safe at every stage of pregnancy when performed by someone with prenatal experience.

Pelvic belt: timing matters

A pelvic belt can offer huge relief, but only if used correctly. Wear it during provoking activities such as long walks, grocery shopping, or work shifts on your feet. However, do not wear it all day, because that lets your muscles switch off. As a rule, use it as a tool, not a permanent solution. Your physio will show you the exact placement; too high is the most common mistake.

What to avoid with pelvic girdle pain pregnancy

Some popular pregnancy exercises actually worsen PGP. Therefore, knowing what to skip is just as important as knowing what to do.

• Deep squats in the second and third trimester if pubic pain is present.
• Wide-leg stretches and butterfly stretches that open the pubic joint.
• Single-leg loading such as lunges early in rehab.
• Frog-style stretches often promoted on social media.
• Long walks without a belt when symptoms are flaring.
• Breaststroke kicks when swimming; choose freestyle legs instead.

In short, anything that forces the pelvis open or asks one side to work alone should wait. Once symptoms settle, we gradually reintroduce these movements with proper control.

Is acupuncture safe during pregnancy?

Yes, when performed by a trained practitioner, acupuncture is safe during pregnancy. It can be a useful add-on for PGP, especially for the muscular component. Furthermore, evidence supports its use for pregnancy-related nausea, anxiety, and sleep problems.

Points to avoid in pregnancy

Certain points are traditionally contraindicated during pregnancy. These include LI4 (Hegu), SP6 (Sanyinjiao), BL60, BL67, and lower abdominal points. A qualified practitioner knows exactly which points to skip. Therefore, always tell your acupuncturist you are pregnant, even if your bump is not visible yet.

Where acupuncture helps most

For PGP, local points around the gluteal muscles and lower back reduce muscle tension. In addition, acupuncture has solid evidence for morning sickness, pregnancy insomnia, and anxiety. Many of our patients combine weekly acupuncture with physiotherapy and report faster recovery than either alone.

Related complaints we often see alongside PGP

Pelvic girdle pain rarely travels alone. Often the same muscle imbalances cause referred symptoms elsewhere. For example, one-sided hip pain frequently appears in the same patients. Likewise, lower back pain may persist after the pelvic pain settles. Addressing all three together gives the best long-term result.

Postnatal continuation: do not stop at delivery

Many women assume PGP will disappear the moment the baby arrives. Sometimes it does. However, in about 20 percent of cases the pain continues for months after birth. The reason is simple. The muscle imbalances and joint control problems do not reset automatically. Therefore, postnatal physiotherapy is essential if symptoms remain at six weeks postpartum.

We typically restart with gentle core and pelvic floor reactivation. Next, we progress to single-leg control, then to lifting and carrying patterns suited to early motherhood. Within six to twelve weeks, most women return to walking, cycling, and light training without pain. Even better, addressing it now reduces the risk of recurrence in a future pregnancy.

When to seek help

Do not wait until you cannot walk to your front door. Early intervention is faster and more effective. As a guideline, contact a physio if you have pain rolling in bed, climbing stairs, or walking more than ten minutes. Furthermore, get checked if you feel a sharp catch in the pubic area or one-sided pain near the SI joint.

Our team in Amsterdam works with pregnant and postnatal women every week. We combine physiotherapy, acupuncture, and clear self-management plans. Above all, we give you back the confidence to move during a period when your body changes faster than ever. To book an assessment, visit our contact page or call us directly.

Key takeaways

• Pelvic girdle pain pregnancy is a joint problem, not just back pain.
• Rest alone does not fix it; targeted exercise and manual therapy do.
• A pelvic belt helps when used selectively, not all day.
• Avoid deep squats, wide-leg stretches, and early single-leg loading.
• Acupuncture is safe with a trained practitioner and helps multiple pregnancy symptoms.
• Continue rehab postnatally if pain persists past six weeks.

With the right plan, pelvic girdle pain pregnancy is highly treatable. You do not need to white-knuckle through your second and third trimester. Get assessed, learn what your body needs, and stay active safely. Your future self, and your baby, will thank you for it.

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