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Pregnancy week 18 | Managing PGP (pelvic girdle pain)

Hi everyone,

Lower back pain, PGP, SPD, sciatica.... whatever it's called, I've been in a lot of pain recently and it's not going to go away by itself!

First all, let's get the disclaimer out there that I am not a doctor and if you are struggling too, I would highly suggest seeking professional advice from your midwife, GP or physiotherapist. Maybe reading this post you can find comfort in knowing you're not the only one and perhaps even find a helpful tip in this post to manage the issue.

What is this pain??

Pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD) is a collection of uncomfortable symptoms caused by a stiffness of your pelvic joints or the joints moving unevenly at either the back or front of your pelvis. It was previously referred to as SPD and now referred to as PGP, don't ask me why. The discomfort can be in the lower back and/or on the pubic bone. Though midwives and doctors, and the NHS website, say 'it's not harmful to your baby', it can be life changing as it can be painful during walking, standing, lifting, sitting and sleeping. Basically everything daily life revolves around.

To top things off, the hormone Relaxin is coursing through your body during pregnancy which softens all your ligaments as your body prepares for birthing, making your pelvic area and lower back more prone to being unstable.

The back story

I have struggled with lower back pain and sciatica for around 10 years, before I fell pregnant with Alexiia who is now nearly 5 years old. It's been a personal project of mine to further understand how to avoid it, what aggravates it, what's beneficial and what's not.

So when lower back pain reared its ugly head again a few weeks ago, I felt like I was at a loss because I've been neglecting my trusty core and pelvic floor exercises ever since being around 5 weeks pregnant (my previous blog post might explain why). As the weeks have gone by and baby has grown, my lower back has increasingly arched and my core seems to have fallen asleep. I notice my pelvis has found it's way to an anterior tilt and I've not been taking good care of my posture the past few weeks. Time to make some changes.

Let's take note that many women struggle with this, in different degrees, and though midwives and doctors say it's normal during pregnancy, the level of pain and discomfort shouldn't be over looked. It can really take over a women's life, to the point where she's on crutches or in a wheelchair. No thanks!

Core exercises are not to be confused with 'ab workouts'.

Courtesy of experiencing back pain, the whole point of working my core has always been to provide stability for my back and build internal strength. Not only that but I found it enabled me to explore Yoga postures that I previously found challenging/uncomfortable and that my waistline was trimmer. Win win.

Core and pelvic floor exercises, paired with good posture whilst seated or standing makes a HUGE difference when it comes to back pain. I wanted to get to a point where I wasn't just putting up with it and actively doing something about it.

Regarding pregnancy, I'm carrying a lot lower than I did in comparison to Alexiia. I'm experiencing ligament pain, lower back pain, pain running down my left leg and the past few days, my pubic bone feels sore. I remember feeling like this a lot later in my first pregnancy, not at 18 weeks.

When I mentioned all this to my midwife, I think she thought I would be doing crazy stomach crunches and overdoing the whole pelvic floor thing. I don't want a six pack, I just want to stop walking like I've sh*t myself. I did try to explain what I think might help me and what I did in my first pregnancy but she said not to change anything workout wise.

I hobbled home thinking I can't put up with this pain anymore, I have a physical job and a life to lead. This has only got worse and clearly not getting any better so I grabbed some coffee (decafe) and started writing a plan.

What's causing it?

Though there's not one specific thing I can identify what's causing it and making it worse, I have noticed a few things that absolutely kill my back:

  1. Standing in the kitchen, cooking and cleaning for any more than 30 minutes.

  2. Running up and down the stairs cleaning and tidying the house.

  3. Certain Yoga postures, such as standing on one leg for long periods etc.

  4. Rushing around.

  5. Sleeping on my back.

  6. Plyos and weights.

  7. Sitting incorrectly.

  8. Poor posture.

  9. Stress.

The answer is quite simple then; we live off of microwavable meals, my house can turn into a tip and I'll just have to stop work and exercising for the rest of the pregnancy. Not exactly realistic.

Making simple lifestyle changes

Having got to the point where I'm sometimes holding furniture to get from A to B in the house and waddling like I'm 8 months pregnant to triplets, this just won't do. I decided to make a few adjustments to my lifestyle and see if it would make a difference.

Here's what I did:

  1. Clean the kitchen and cook at separate times. So what if the kitchen is a tip for a while if it saves my back?

  2. No more running up and down the stairs tidying and cleaning. Anything that needs to go upstairs gets put in a pile and taken when I actually next need to go upstairs.

  3. My Yoga practice and what I demonstrate in my classes has had to be modified even more. I'll do a separate post on Yoga for PGP pain as it will take too long for to explain here.

  4. No more rushing around if I can help it. Certain things take more time, I either have to be more organised or late arriving to places. Oh well.

  5. Altering sleep positions. I sleep on my side with a pillow in between my legs and no more sleeping on my back.

  6. Bye Plyos and decreasing weights. Hello resistance workouts for my body + mind. I'll admit I did struggle on the inside letting go of my usual workouts but this isn't forever and I have to adapt as the pregnancy continues. The most important thing is exercising for my mental health, keeping physically mobile and my back stable. There are still other exercises I can do that don't impact my back and joints, and to be honest stripping it back to basics has been good.

  7. Sitting properly at my desk with my feet resting on a cushion and knees hips distance. I'm one of those people that cannot sit still and change position about seven times in ten minutes. Plus, I sit either crossed legged, or with my knees up to my chest, or one of my legs folded. A physios nightmare.

  8. Posture awareness is at an all time high. When I'm standing, I'm busy lengthening my spine towards my heels and drawing my pelvic floor muscles up a little. I didn't realize how much I was tilting my pelvis this pregnancy and arching my back. No wonder my back was screaming in pain.

  9. Quick body massage. When I was pregnant with Alexiia, I had much more time to moisturise my body and found it relaxing. Life is very different having LO to look after, there's just a lot more to juggling and even more coming my way. I don't have much time to think clearly and can finish a whole can of dry shampoo in a week but I'm trying to prioritize moisturizing head-to-toe every other day. Though I know that it would make Gwyneth Paltrow role her eyes at my feeble attempt for some sort of healthy routine but I am trying and it really does help. I notice such a huge difference when I do. I feel a lot more alert with a boost in circulation and any knots I get to focus on ironing out for a bit.

So there you go, a few lifestyle changes have gone a long way and - oh, I forgot to mention: Ask for help!

I hate asking for help and even though I'm sure Mr H and my friends are sick of me moaning about my darn back but asking them to help me lift my Yoga equipment in or out the car or walking a little slower, also makes a big difference.

Lastly, no two women's bodies are the same. Did you know there are four different pelvic types, we are a little more complex than we think! If you've tried making lifestyle changes and feel like something isn't right, seek professional help right away.

Helpful links:

NHS PGP leaflet - After I saw my midwife and spoke to her about PGP I didn't want to give up and I found this NHS leaflet really helpful. If you're scratching your head, wondering how or if you are doing pelvic floor exercises correctly, get in touch with a physiotherapist, personal trainer or Yoga teacher that specializes in PGP/lower back care that can help guide you. They'll work with you closely, giving you tips and exercises you can safely continue to do at home.

Don't forget to comment or send me a message on IG @namasyoga if you have any questions or other tips that I didn't mention, that way we can all help and support each other.

See you next week

N x


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