Pelvic Girdle Pain (SPD) Physiotherapy in Clapham

Pelvic girdle pain (PGP) is pain in the joints of the pelvis, at the front where the pubic bones meet, at the back where the pelvis joins the spine (the sacroiliac joints), or both. When the pain is mainly at the front, it’s often called symphysis pubis dysfunction (SPD).

According to the NHS, PGP affects around 1 in 5 pregnant women to some degree. It isn’t harmful to your baby, but it can be painful and make it hard to get around.

You may feel pain:

• Over the pubic bone at the front of your pelvis
• Across one or both sides of your lower back or buttocks
• In your groin, inner thighs or the area between your vagina and anus (perineum)

It’s often worse when walking, climbing stairs, standing on one leg, turning over in bed, getting in or out of the car, or moving your legs apart. Some women also feel or hear clicking or grinding in the pelvis.

PGP happens when the pelvic joints become stiff or move unevenly, putting strain on the joints and the muscles around them. The NHS lists several things that make it more likely, including:

• A history of lower back or pelvic girdle pain
• A previous injury to your pelvis
• PGP in a previous pregnancy
• A physically demanding job
• Being overweight

The NHS recommends physiotherapy for PGP, to relieve pain, improve muscle function and improve the position and stability of the pelvic joints. The earlier it’s treated, the better. Depending on your assessment, treatment may include:

• Hands-on treatment to the pelvic joints and surrounding muscles
• Exercises to strengthen your tummy, back, hips and pelvic floor
• Advice on moving, sleeping and daily activities with less pain
• Advice on support belts or crutches, if needed
• A home programme to manage your symptoms between sessions

Small changes to how you move can make a big difference. The NHS suggests:

• Staying active within your pain limits, and resting when you need to
• Wearing flat, supportive shoes
• Sitting down to get dressed and undressed
• Sleeping with a pillow between your legs, and keeping your knees together when turning over
• Getting in and out of the car with your knees together
• Taking stairs one step at a time, and avoiding heavy lifting

Most women with PGP can have a vaginal birth. It helps to plan ahead with your midwife and birth partner, and to write the positions you find most comfortable in your birth plan.

Olivia can help you find comfortable labour positions and work out how far you can comfortably move your legs apart, so your birth team can avoid straining your pelvis. Our Pregnancy MOT covers birth preparation in more detail.

PGP usually improves after your baby is born, but for some women the pain continues. If it does, postnatal physiotherapy can help you recover and get back to exercise.

Pelvic girdle pain isn’t only linked to pregnancy. It can also follow a fall or injury, sport, or problems with the hips or lower back. Read more about pelvic and sacroiliac joint pain.

Your first appointment lasts 60 minutes and takes place in a private, judgement-free room at our Clapham clinic. Olivia will:

• Talk through your symptoms, what makes them better or worse, your pregnancy or birth history and your goals
• Assess your posture, pelvis, back and hips, and how you move
• With your consent, assess your pelvic floor. It’s always optional and fully explained beforehand
• Explain what she has found and agree a treatment plan with you

Treatment is adapted for each stage of pregnancy, so you can be seen at any point.