What is pelvic girdle pain?
During pregnancy the ligaments of the pelvis soften, the abdominal wall stretches, and the centre of gravity moves forward. The muscles that normally hold the pelvic ring steady, the pelvic floor, deep abdominals, glutes and back muscles, have to work differently, and in many women they cannot keep up. The result is pain at the back of the pelvis, at the pubic bone, or both, that flares with any activity that loads one leg more than the other.
Pelvic girdle pain is not a sign of damage and the pelvis is not “out of alignment”. It is a control problem in a temporarily less stable system, which is why targeted exercise works and why symptoms settle for most women after birth, provided the muscles are retrained. For those whose pain continues postpartum, a specific stabilising program has been shown to reduce pain and disability a year later.
Common signs and symptoms
- Pain at one or both sacroiliac joints, the buttocks or the back of the thigh
- Pain, clicking or grinding at the pubic bone
- Pain turning in bed, getting out of a car, climbing stairs or standing on one leg to dress
- Difficulty walking long distances or a waddling gait
- Pain that is worse at the end of the day or after activity
- Pelvic floor symptoms, such as leaks or heaviness, alongside the pain
What causes it?
- Hormonal softening of the pelvic ligaments during pregnancy
- Altered control of the pelvic floor, deep abdominal and gluteal muscles
- A shifting centre of gravity and changed posture as the baby grows
- A previous history of back or pelvic pain, or a physically demanding job
- Asymmetric loading: carrying a toddler on one hip, standing on one leg, poor sleep positions
- Childbirth itself, particularly a long labour or difficult delivery
How pelvic floor physiotherapy helps
Physiotherapy for pelvic girdle pain is hands-on and practical. It calms the irritated joints, restores control in the muscles that stabilise the pelvis, and teaches you the movement strategies that let you get through pregnancy and the first months of parenthood with less pain.
A treatment plan typically includes:
- An assessment of the sacroiliac joints, pubic symphysis, hips, pelvic floor and deep core, using recognised clinical tests
- Manual therapy to ease joint and muscle irritation
- Specific stabilising exercises for the deep abdominals, pelvic floor, glutes and back, progressed over weeks
- Movement strategies for turning in bed, stairs, getting out of the car, lifting and carrying
- Advice on support belts, sleep positions and pacing when they help
- A postpartum program for pain that continues after birth, coordinated with your midwife or doctor
What the research says
The studies below are peer-reviewed and linked to their permanent records so you can read them yourself.
The European guidelines define pelvic girdle pain, describe the clinical tests used to diagnose it, and recommend individualised exercise and education, with manual therapy where appropriate, as the treatment of choice.
Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 2008. View study
Women with pelvic girdle pain after pregnancy who followed a 20-week program of specific stabilising exercises had significantly less pain and disability, and better quality of life, at one year than women who received standard physiotherapy without the specific exercises.
Stuge B, Lærum E, Kirkesola G, Vøllestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine, 2004. View study
Exercise programs during pregnancy reduced low-back and pelvic pain and related disability, and physiotherapist-led programs were among the interventions supported by this Cochrane review.
Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews, 2015. View study
Treatment at Corelife Wellness in Oakville
Corelife Wellness is a dedicated pelvic health clinic at 3075 Hospital Gate, Unit 312, Oakville, next to Oakville Trafalgar Memorial Hospital. Care starts with a free 15-minute consultation by phone, video or in person, followed by a full assessment with our Registered Physiotherapist. Every pelvis is unique, so your plan is built from that exam rather than a template. No referral is needed, and physiotherapy is often eligible under extended health benefits.
How assessment and treatment work, and how to book, are on our main page: Pelvic floor physiotherapy in Oakville.
Helpful reading from our team
When to see a doctor first
Pelvic floor physiotherapy is safe and you do not need a referral, but some symptoms need a medical assessment before or alongside treatment:
- Pelvic pain in pregnancy with bleeding, fluid loss, contractions or reduced baby movements (contact your care provider urgently)
- Pain with fever, or burning when passing urine
- Numbness in the saddle area, leg weakness, or new bladder or bowel control problems
- Pain after a fall or accident
