Round Ligament Pain, Pubic Symphysis Pain, & Sacroiliac Joint Pain

Round Ligament Pain, Public Symphysis Pain, & Sacroiliac Joint Pain During Pregnancy and How Pelvic Floor Physical Therapy Can Help

Dr. Katie Ihlenfeldt, PT, DPT

Being pregnant comes with lots of bodily changes and symptoms. Some include nausea, headaches, fatigue, and when your little one starts growing there can be some bodily aches and pains that come along with it too. Most common pains during pregnancy can include round ligament pain, pubic symphysis pain, and sacroiliac joint pain. Good news is you don’t have to just “live with it” and a pelvic floor physical therapist can help!

Round Ligament Pain

Symptoms of round ligament pain:

Sharp or achy pain in the front of either side of the hip, lower abdomen, or groin area. Can be quick sharp pain that happens when you move or it can be achy pain that you can feel for hours.

What/where the round ligament:

The round ligament is a band of connective tissue that attaches from either side of your uterus to your labia. The purpose of the ligament is to support your uterus. When the uterus starts to grow with your baby, the round ligament has to stretch too, so quick movements can cause this stretched ligament to cause pain. Increased physical activity can also cause feelings of achiness due to the demand on the stretching ligaments. There are other muscles and joint movements that can contribute to this pain though too besides the ligament itself! Looking at the hip flexor mobility and strength, someone’s ability to maintain pelvic stability (including the pelvic floor function!), and mobility of the hip and low back can all contribute to this pain.

What can help?

Pelvic floor physical therapists look at the surrounding structures to see what else is contributing to your pain. Treatment may include soft tissue mobilization to the area, hip flexor stretching and strengthening, and core and pelvic stability exercises.

Pubic Symphysis Pain (also referred to as pelvic girdle pain)

Symptoms of pubic symphysis pain:

This pain can be felt right at the pubic bone, the hard/boney structure right above your vulva, or in the groin on either side. Pain is usually felt when getting out of a car, rolling in bed, walking, or when squatting down. The pain can feel sharp and sudden when you move or can be consistent achy pain you feel throughout the day/night.

What/where is the pubic symphysis:

The pubic symphysis is at the midline of your body, the hard bony structure right above your vulva that is between your right and left pubic bone. This pain can occur due to the combination of hormonal changes that lead to increased flexibility within your joints that help your pelvis grow to accommodate your growing baby and muscle demand around the joint. Unequally pulling of your muscles on this joint and increased mobility can contribute to why you are feeling this pain and this is where pelvic floor physical therapists can help!

What can help?

Generally keeping your knees together when rolling to get out of bed or when getting out of the car can be helpful in immediate relief of symptoms if pain is occurring during these movements. Sleeping with a pillow between your knees can also be helpful. It’s also important to look at why and what muscles could be causing this unequal pull and address these to reduce your symptoms as you progress throughout your pregnancy.

Sacroiliac Joint Pain

Symptoms of sacroiliac pain: Pain at either sacroiliac joint (around the low back/hip region) which can range in intensity from being sharp to dull and achy experiencing during walking, standing, or sitting. Some may feel this as a radiating pain that goes into the glute.

What/where is the sacroiliac joint?

You have two sacroiliac joints, on each side of your sacrum. These joints connect your hip bones to your sacrum, which is around your tailbone region. We can thank those pregnancy hormones for some increased laxity of the joint and surrounding muscle activity to why people begin to have pain here during pregnancy.

What can help?

Although we can’t do anything about the effect of the hormones on the joint, we can address the support muscles around it to help create more stability and support to reduce this pain. A pelvic floor physical therapy can evaluate what specific muscles need to be strengthened or stretched and give you specific exercises to help with stability to decrease pain and set you up for success postpartum.

What about support belts for these types of pain?

Support belts can be great for quick pain relief if you are experiencing a flare in pain, however the support belts are a kind of “band aid” for the issue. Just like a supportive device such as an ankle brace or elbow sleeve, these devices are supplying what we describe as passive support. Your muscles do not have to work as hard to provide stability and support when wearing an extra supportive device. Wearing these support belts for hours at a time can also lead to weakening of surrounding muscles because they do not have to work to do their supportive job, which can increase your pain whenever you are not wearing them. So although it can be helpful in times of increased pain for relief, its also important to address our supportive muscular system that will be able to help at all times and address the cause of pain at the source!

Need more help? Send us a message and we can discuss what you’re feeling and how to help!