Groin Pain in Pregnancy and What To Do About It

Published: 08th April 2010
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Groin pain or pubic pain in pregnancy is extremely common and once you have it, it can be difficult to manage and treat. It is especially difficult to manage if you have it when you are due to give birth. The medical term for it is Symphysis Pubis Dysfunction.

What is Symphysis Pubis Dysfunction in Pregnancy?

The pelvis is made up of 3 large bones - the sacrum (the flat bit of your pelvis at the back), and the two ossa coxae (hip bones). These bones are connected by tough ligamentous tissue that allow for some very minor flexibility. The ligament which connects the bones at the front is called the Symphysis Pubis.

No-one really knows what causes SPD, but the most likely probable cause is due to the pregnancy hormones. During pregnancy the hormones relaxin and progesterone soften up the pelvic ligaments allowing a lot more flexibility so that the pelvis can open accordingly as the pregnancy progresses.

Although this laxity is necessary it does mean that the pelvis of a pregnant woman becomes unstable and is less able to provide postural support for the increasing load.

The discomfort felt in the symphysis pubis is due to the pelvis not functioning as it should and most likely results from strain referred by one or both of the sacroiliac joints.

Other contributing factors to SPD could be:

History of pelvic trauma

Misaligned pelvis

Sensitivity to pregnancy hormones / overproduction of pregnancy hormones

Previous multiple pregnancies or large babies

How do you know if you have SPD?

Do you have pain and tenderness in the pubic area? If no then it could be Round Ligament Pain

If yes it could also be associated with pain through the hips, buttock and lower abdomen.

Does walking, getting in and out of a car, climbing stairs or any other one legged activity make the pain worse?

Are you shuffling/waddling to avoid the pain?

If all of the above are sounding very familiar then it's probable that you have SPD.

What Can You Do About It?

1) Avoid all positions and activities that aggravate SPD. These are all one legged activities such as climbing the stairs and getting in and out of the car.

Try going up and down stairs on your bum.

To get in and out of the car, sit down in the seat sideways on facing out of the door. Then swing both legs in together to avoid splitting the legs and pulling on the ligament.

Keep the knees together when turning in bed

Avoid twisting the upper body - turn your whole body to face the direction you want to look

Avoid straddle positions (definitely NO lunging!)

Avoid breaststroke

Take weight off the pelvis wherever possible by sitting down to get dressed, prepare food, brush your teeth etc...

Treatment

There is no way of tightening up the affected ligaments but you can improve pelvic support through strength work.

Kegels and TA work should be a daily part of your Pregnancy Fitness program anyway but if you are suffering with SPD, make sure you are doing these 3 times daily.

A pelvic girdle can often help with the pain and you should be able to get one from your osteopath or physiotherapist - but make sure it is fitted properly.

Try and keep mobile, doing nothing will make it worse. While the pelvic ligaments are overly mobile, they still need daily movement to keep them supple. Depending on how severe the pain is, you may still be able to do some gentle pregnancy exercise like hip bridges, pelvic tilts to increase the stability of your pelvis and back or swimming which will take the load off of the Symphysis Pubis ligament.

If you do choose to go swimming do not attempt to get in and out of the pool using the stairs or with one leg up and the other down - most pools have a wheelchair ramp which you can use easily.

Minimise leg movement and torsion of your body - Swim using your arms only - it's a great upper body workout - or you can just float. The buoyancy of the water will provide immediate pain relief.

Drugs

If the pain is severe then you may want to visit your GP to discuss if there are any anti-inflammatory drugs you can take to reduce pain. You can also take paracetamol during pregnancy but you should speak with your GP before taking ANY medication as what may be safe for one person is not necessarily safe for you.


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Nisha is a leading expert on Pregnancy Fitness and the author of The 9 Month Club Pregnancy Fitness Coaching System. For a FREE comprehensive guide to safe and effective pregnancy health and fitness get the complete set of 20 videos " 20 Rules to Safe and Effective Pregnancy Health and Fitness" for FREE from The 9 Month Club - The Home of Pregnancy Fitness at http://www.12daysoffitness.com


Video Source: Youtube


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