So lately it seems like every other pregnant person I talk to here on these internets is having the same problem I am - namely, pelvic girdle pain, or symphysis pubis dysfunction. Their hips ache, they are having trouble walking, pain radiates down their thighs, their pubic joint aches (mine actually cracks), etc. and so on. That link above has some more detailed examples of symptoms.
Basically, it blows, and it can significantly reduce your mobility and quality of life. OH FRIENDS, DO I FEEL YOUR PAIN.
So I know I've talked about mine before, and some of what I do for it, but it's in a few different blog posts and I wanted to have just one that had everything in it. It's easier to find, and it's easier than sending eleventeen tweets to anyone on Twitter who asks about it, you know? Plus I can go in to more detail. Blog posts are also a lot less ephemeral than Twitter.
Disclaimer: I am not a medical professional. All I can share is things I personally do for this condition and that I find helpful, which I have found through years of doing physical therapy and experimentation. I cannot guarantee you will find them helpful. If any of these things causes bad things, such as an increase in your pain, contractions of any sort, or injury, please, please don't do them. Please listen to your body.
Things I find helpful
- Lay on your side with a pillow between your legs. Because I have a history of lower back problems, this is something I've been doing for years anyway. I have a specific pillow that is my leg pillow for when I sleep. However, I find as my pregnancy progresses, that pillow is a little too thin to do much good when my pelvis is really bad. I like using it when I'm actually sleeping, because it's a standard sized pillow and fits between my legs from hips to ankles, but it's not sufficient to really start relieving any pain I'm having.
So my advice is this: lay on your side, knees slightly bent, keeping your hips as straight and aligned as possible. And experiment with pillows. Don't be afraid to put a fat, firm pillow between your legs. My personal favorite right now is the Snoogle Mini, and that sucker is firm and like eight inches thick. Experiment with placement, as well. I find that the Snoogle helps most when it's between my thighs and pretty close to my pelvis (bonus: I can put the rest of it under my belly and boobs which feels nice). When I get it in the right place, I can feel my lower back, pelvis, and hip joints slowly stretch out and work themselves back more or less in to place. It's sometimes disconcerting and almost achy, but not painful. If it's painful, stop. I usually lay with the Snoogle for about an hour total before I go to sleep, half an hour on each side, then when I'm ready to go to sleep I switch to my usual leg pillow. Do what works for you. - Leg rocks. So if you're like me, rolling over in bed can easily turn in to a five minute ordeal. Often I have a few minutes where I just have to stop, breathe, and lay on my back before I can continue to my other side. I know they say OMG DON'T LAY ON YOUR BACK DURING PREGNANCY, but for most people, for a few minutes, it's fine (after all, you probably do it at EVERY OB OR MIDWIFE APPOINTMENT). When you're in this position, you can do what my last physical therapist called "rocking the baby", which now that I'm pregnant is entirely too relevant to my life.
Here's how you do it. While laying on your back, bend your knees, keeping your legs together. Gently rock just your legs from side to side. Imagine that there is a baby balanced on your knees, and you are rocking it to sleep. Don't rock your legs faster or farther than you would if there were a baby up there. It's important to keep your spine flat on your bed - don't let your hips lift up as your move your legs. What this does is gently rotates your hip joints which can alleviate pain and help work them back in to place. This can also be helpful if you have sciatica - try doing it before you get out of bed in the morning for a few minutes, or any time the sciatica flares up.
- Pelvic tilts. Now we start getting in to the nitty-gritty. One of the most helpful things you can do to help stabilize your pelvis is to strengthen your abdominal muscles (belly!), your glutes (YOUR ASS), and your PC muscles (the ones Kegels are targeted at). These muscles are what surround your pelvis and lower back, and you can use them to not only stabilize these areas, but to some extent, correct and compensate for loose joints and ligaments (aka WHAT'S HAPPENING TO YOU NOW YAY THANKS PREGNANCY).
Here is an excellent primer on how to do these, both while laying on your back, or while standing against a wall. Personally, I prefer the standing version right now, although last time I was in PT for my back, I did the laying version, and I can attest that both work. This gives a gentle stretch to your lower back, as well as works on strengthening your abdominal muscles. The trick to these, which is not in the tutorial, is that you want to tighten your abdominals (and to some extent, your PC muscles and glutes) to gently press your lower spine either in to the bed or the wall. You don't need a very large movement - the tutorial has a gif that illustrates just how little you need to move.
Right now, I do five of these per day, and I hold each for five seconds. Again, not a medical professional, but that is a decent starting point to try. When I was doing this for my back in PT, I worked up to two to three sets of ten per day, holding each for at least ten seconds. Please, please, listen to your body and don't rush them. It honestly does not take much, I have found, to provide relief.
- Kegels. I know they tell those of us with vaginas to do these anyway, but here's why: as I outlined above, the PC muscles that you exercise with these help support your pelvis and lower back. These muscles can be used to compensate for the bullshit your pelvis is pulling.
Here is a good tutorial on how to do these, including how to identify which muscles you actually want. What I would add is what my last PT told me. You can do two variations on these - and basically do them whenever you think of them. Variation one is "quick" Kegels: contract the muscles, hold for one second, release for one second, and repeat, ten to twenty times in a row. Variation two is closer to what's in the tutorial: contract, hold for ten seconds, release. Repeat in sets of ten to twenty. - Lateral pelvic shift correction. Because of my existing back problems, the non-technical term for this is that I tend to stand and sit crooked. If you look at my spine, often it seems to be running on a diagonal. My right hip tends to jut out past my right shoulder, which brings my left hip more under my neck than my left shoulder. This also leads to further lower back and pelvic pain and instability. To check to see if the same thing is happening to you, stand up and look in a mirror. Are your hips both directly below their matching shoulders? If so, then you don't have this. If one hip looks higher than the other (you can check by putting a hand on each hip bone), then maybe you do (this is often the most noticeable symptom for me - my right hip looks about three inches higher than the left when it's bad - and it can be pretty bad right now). A physical therapist can also diagnose this (which is how I know I have it).
This YouTube video describes how to do these. For those that can't do the video, what you are doing is using the wall as a straight surface to align your spine and hips. Since it's my right hip that juts out, I place my left side against the wall - if your left hip jutted out, you would place your right side against the wall. Bend your elbow on the wall side, keeping it tucked in close to your body. Place your wall shoulder and elbow against the wall. Your outside leg should be straight but leaning, about a foot or two away from the wall. Your inside leg moves to be next to your outside leg. Gently use your abdominal, PC, and glute muscles to shift your inside hip so that it is pressed against the wall, in line with your shoulder. Go SLOWLY. You can also place a hand on your outside hip to help press. Once your inside hip is aligned, hold for 2-5 seconds using your abs, glutes, and PC muscles, then take your inside leg, step against the wall, and stand up straight. Currently, I do a set of five of these per day, holding each for five seconds.
- Posture. So in the last few items, I've been talking about the three major muscle groups that stabilize your hips and lower spine - your abdominal muscles, your glutes (aka the muscles in your ass), and your PC muscles (the ones you do Kegels with). But you don't just use them during the PT exercises I've outlined above. You use them when you're sitting, standing or walking as well.
What you want to do is tighten each of these muscle groups in order to help maintain good posture - upright back, not crooked, not slumping or slouching, hips aligned, keep your legs close together, etc. You don't need to tighten them MUCH - I found that my pain increased if I tightened too much. And you will have to experiment to see how much each group has to be kept tight. If you're not used to doing it, you might not be able to do it all the time, and that's fine. But keep practicing. It gets easier with the exercises and with practice. If you can keep your posture as good as possible while sitting, standing, and walking, it really does help relieve the pain. Also, I understand that if your pelvis is really bad, you might not be able to stand up straight at first - I usually can't right when I get out of bed. Do the best you can, and improve when possible.
- Keep moving. Yeah, I know, probably the last thing you want to do when it fucking hurts to move. But, if you stay in one position too long, that gives your joints a chance to lock up in that position, making any changes that much more painful. So if you've been laying for a while, sit up for a bit. If you've been sitting for a while, get up and walk around for a few minutes. If you've been standing for a while, gently sway back and forth (just like if you were trying to soothe a baby) or for you ballroom dancers out there, practice what your instructor calls "Cuban motion" (video), that you use in rhythm/Latin dances. Don't lock your knees. If you have a bad back, they say switch positions every fifteen minutes, and that's a great ideal. Me, I'm fucking tired, so often it's like every hour I change. But change positions.
I find right now with walking, especially if I'm up and walking after laying down, the first step is the most painful. My joints are locked, my muscles are complaining, it's awful. The next half dozen aren't so grand either. But after that, I start to feel my joints shifting back in to place and my stride becomes much easier and less painful. Give your body the chance to do that - and again, remember your posture. Fix it when you can.
- Stop fucking moving. Yeah I know I just told you to move. But you're only going to have so much moving in a day. Your body currently has limits on what it can do, which, especially if you've never really had limits like this before, can be difficult and intensely frustrating (but let's not kid ourselves: I've had limits on body movement for years and I still get intensely pissed about it. Your feels, whatever they are, are okay). Please trust that when I tell you that respecting those limits is a way better idea than fighting them, because I have learned the hard way, many, many times. To give you an idea, right now, one of my limits is with stairs. If we count going either up or down a flight of stairs (so 10-15 steps, yeah?) as one trip, I get four trips per day. That's it. If I go beyond that, I pay, oh my sweet dark lord, do I pay, often the same evening.
There's also only so much walking, standing, and sitting I can do in a day. So, if I know like today, I have an OB appointment (requires 2 stair trips to get out of my house, requires getting in and out of the car, requires sitting in the car, sitting in the waiting room, sitting in the exam room, requires some walking), then I know that I probably won't be able to stand long enough to make dinner that night, so I either throw something in the slow cooker or plan on delivery or plan on an easy dinner that The Man is capable of cooking on his own.
If you can, build in days where you don't have to do anything. I realize this is easier for me because I do not work full-time and therefore do not have to leave the house every day. But, if you have three, four, five days in a row where you have to be up and get shit done, try to give yourself at least one day where you DON'T. Sleep late, take a super long warm shower, don't do any damn laundry, nothing. Again, I know it's not always practical, but try to give yourself as much of a break as possible. And please feel zero shame about asking your partner, spouse, best friend, neighbor, old enough kids, whoever, to help get shit done. You have limits. It blows. But you have them. Even if you can go, say, do a load of dishes, then lay down or sit with your feet up for fifteen minutes after (and drink a glass of water) before you have to do the next thing, it helps. I now have a chair in my apartment's kitchen for exactly this purpose.
- Heat, cold, pressure. I am a huge fan of hot showers, and just letting the hot water beat on my lower back to start the day. It loosens shit up (I know, I know) and eases some of the achiness that can set in overnight.
I am also a huge fan of icing the joints that have just gotten a huge workout after I'm done. Sometimes, a cold pack on your hip joint or pubic joint or lower back can work wonders to soothe it after you've asked a lot of it. Some people prefer either heat or cold - whichever works for you and provides the most relief.
Finally, a little massage helps too. I really like to have The Man provide some pretty strong pressure to either side of my spine, just above my pelvis, at the end of the night when I'm laying in bed. You might like to have your hips rubbed. Whatever - try it out. If a spot is achy and sore, try a little massage. It doesn't have to be fancy.
Also, if you are in a lot of pain and can access and afford it, a good physical therapist can provide so much help. They can provide additional exercises, make sure you're doing them correctly, and help figure out exactly what's wrong to fix it. I absolutely credit the PTs I have worked with in the past with the fact that I largely live my life pain-free, even with the severe disk herniations I have lived through.
If any of these aren't clear, please let me know and I'm happy to provide more details. And again, not a medical professional, listen to your body, etc. All I can tell you is things I personally do that help. And sympathize with your pain, because OH MY GOD DID I MENTION THAT I FEEL YOUR PAIN.
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