Pelvic Pain: Why & Relief Tips!

[00:01:08] Gina: Welcome to the MamasteFit Podcast. In this episode, we’re going to break down all of the things with pelvic girdle pain. What causes it? What are some solutions to find relief from it during pregnancy? Cause you don’t need to wait till birth to finally have relief. You can absolutely have relief from pelvic pain during your pregnancy.

[00:01:25] Gina: But before we dive into all of the answers that you have been seeking on how to have a pain free pregnancy, I want to share that my book, Training for Two, is now available for pre order. In Training for Two we have an entire section dedicated to finding pain relief during pregnancy because again, it is not a requirement of pregnancy. The book includes explanations of why you have pelvic pain, some solutions to it such as different exercises that you can do there are both strength training exercises and also mobility exercises, because you can absolutely find relief to have a comfortable and pain free pregnancy. Head to the notes below to grab the link to pre order our book. The book comes out September 10th of this year. So 2024, and we would love your support with your pre orders.

[00:02:07] Gina: So the first thing that we’re going to discuss in this episode is what is pelvic girdle pain? Because we’ll get a lot of folks that’ll message us to say, “Hey, I’m feeling this. What is this?” And they don’t know that this is what we would classify as pelvic girdle pain. So first, let’s just start with what is, what does it feel like?

[00:02:23] Gina: So Roxanne had more of the front pelvic pain, which is known as pubic symphysis dysfunction, or SPD, while I had more of the SI joint pain or that back, like some folks will describe it as like sciatic pain or piriformis pain or low back pain. So there’s a lot of sensations that can be associated with pelvic girdle pain. So let’s start with what is pubic symphysis dysfunction or SPD, which is that front pelvic pain. What did that feel like for you, Roxanne?

[00:02:49] Roxanne: So symphysis pubis dysfunction, SPD, some people call it pubic symphysis dysfunction, all the same thing. It’s the bone in the front of your pelvis is, it feels almost like grindy for me, and like a deep, deep ache. It would give like sharp pains every once in a while when I would do some single leg movements, but sometimes it just felt like a deep like aching kind of pain. Um similar to like a nerve pain. Some people describe nerve pain as that way, where it just was like constantly there and then would increase in the amount of pain in certain movements.

[00:03:26] Roxanne: And I really only found relief from that pain by doing certain movements pretty consistently. If I took, like, a couple days off, then it would come right back. And then it was always, usually, the most uncomfortable laying in bed, moving in bed.

[00:03:42] Gina: So for me, I’ve had more of the SI joint pain. During my first pregnancy was probably the worst. And that was also the pregnancy where I was told by a provider that, “It’s just one of those things, it’ll just go away when you give birth,” and I was like, “I’m like, 20 some weeks pregnant!” That’s a long, and I went to 41 weeks. I’m like, that is a long time to like, not be able to walk. Like, I’m in significant pain right now. Fortunately, I found a chiropractor that like, adjusted me and gave me some movements to do that I finally found relief. But like, I could have gone through that whole pregnancy thinking that this was just supposed to be this way instead of finding relief, which is ridiculous.

[00:04:23] Roxanne: And some people do.

[00:04:24] Gina: And some people do. And so for me, I had more of the SI joint pain, and it kind of will vary like which side, if it’s more right sided or left sided. But typically the culprits of it are the same, but it’s just like this deep pain a little bit towards one side of my pelvis, like in my lower back area.

[00:04:42] Gina: And usually it’s a little bit more exaggerated with like the single leg pivoting type movements, and it was usually worse when I was like rolling around in bed. But sometimes when I’m like walking, I’ll have like kind of a sharp pain that’s like makes it kind of hard to like walk. And so during my first pregnancy, it was definitely the worst before we had all the answers.

[00:05:01] Gina: And then subsequent pregnancies, I still had like flare ups every once in a while, similar to you, typically times of inactivity, when I was not doing quite as much exercise because I was feeling less motivated and then I would have like so much more pelvic pain.

[00:05:16] Gina: So let’s discuss the causes of pelvic pain. And so you can either have pelvic pain to the front of your pelvis, in this pubic symphysis joint, which is this middle joint in the center of your pubic bone, or that bony structure across the front of your pelvis or, and/or, cause you could have both, you may have pain more to the backside of your pelvis where the SI joints are.

[00:05:39] Gina: So the sacroiliac joints are on each side of your sacrum, which is this triangular bone on the back of your pelvis. And so you might have more discomfort towards one side or maybe the other. It could kind of alternate between sides. And again, you can have it both in the front and in the back. Typically you have it towards one side, but some of the unlucky few can have it in both both sides. I apologize. I’m sorry.

[00:06:06] Gina: So there’s two main causes to pelvic pain and the first reason is not because you have so much relaxin that your joints are moving more because elevated levels of relaxin don’t necessarily correspond to increased occurrence of pelvic girdle pain. However, relaxin does make your joints move a little bit more. And so kind of the culprits of pelvic girdle pain are kind of exaggerated during pregnancy. And so it really relates to what is your general pelvic positioning? Like how do you normally position your pelvis? Because it is a mobile bone. It does move. It’s not as much as like your hip or like your shoulder joint, but there is some movement capability to your pelvis.

[00:06:47] Gina: And so during pregnancy, that movement capability increases because human babies have big heads and we want them to be able to pass through our pelvises. And so we have more laxity or movement within our pelvic joints and pretty much the joints throughout our body. And so one of the reasons for pelvic pain is your pelvic position or how do you generally position your pelvis?

[00:07:10] Gina: And again during pregnancy we have more movement. And so these positions tend to get exaggerated. Commonly, for most of us, we’re going to favor position where our left hip comes a little bit more forward and our right hip comes a little bit more backwards. And now this is known as like the left AIC position. This is a common stance position because we like to favor weight in our right side. The organs are denser on this side. Our diaphragm is larger on this side. So we can stabilize better by putting weight into our right leg. And so this is going to bring that pelvic half backwards into more of a posterior and internally rotated position while it brings the left half forward in an anterior or externally rotated position.

[00:07:53] Gina: So essentially, if you’re watching the YouTube video, where your right pelvis or your right hip sits more back and your left hip sits a little bit more forward. If you were doing like the butterfly pose, your left knee would be a lot lower than your right knee because the right leg tends to have a harder time finding more external rotation.

[00:08:11] Gina: And so this position inherently by itself is not a problem, but if we get stuck in this position, and we can’t shift to the opposite, where the right hip comes forward and left hip comes back, it could impact how our pelvis can stabilize, or how our pelvic joints can form close on themselves, where they align and kind of compress onto themselves. Cause they’re kind of like a lock and key. Like they’re supposed to fit together. But if I can’t bring my right hip forward and bring my left hip back when I like put weight into my left leg, I may have some pelvic pain because the joints are not quite aligned very well.

[00:08:48] Gina: And so when it comes to correcting pelvic balance, we want to think about what muscles kind of pull our pelvic bones into these different positions. And so on the right side, the hamstring and the adductor, so the muscle on the backside of your leg and the inner thigh are helping to pull that pelvis half backwards, while the glute and the quad on the left side are pulling that pelvis forward. And so if we think about, okay, these are the muscles that are pulling my pelvis into these positions, we want to think about releasing tension in those muscles so that we can move the pelvis into a different position. So things like the adductor rock back on the right side can be super helpful. I think that’s something that you found to be really beneficial for you, especially for your pubic symphysis pain.

[00:09:34] Roxanne: Yes. I really enjoyed the adductor. So anything that involved releasing the adductor on my one side that is tighter would help with my symphysis pubis pain, because that tight adductor was almost pulling my pubic bone like out of place, for lack of a better word, and that would increase the amount of pain. But when I would like do some like foam rolling on that inner thigh or doing some mobility on that side and then strengthening on the opposite side, then I would find like this balance between and it would decrease the amount of pain that I was experiencing.

[00:10:06] Gina: So the opposite side of the mobility or the stretching, because that’s usually what folks will ask us. “I’m having pubic pain. I’m having SI joint pain. What stretch should I do?” It’s always like I want to stretch. The opposite of the mobility exercises to release the uneven tension is the strengthening.

[00:10:24] Gina: So muscles only have the ability to pull our bones and our structures into different positions. They don’t have the ability to push. So, when the muscles are tight or they’re contracting, they’re pulling that pelvic half into a certain position. And so the common muscles that are a little unbalanced with this pelvic position is right quad and right glute are a little bit weaker, particularly the glute mead, or the side glute, tend to be a little bit weaker on the right side, while the left side hamstring and inner thigh tend to be a little bit weaker compared to the right.

[00:10:58] Gina: And so we want to focus on strengthening your ability to abduct, or to bring the leg out or to stand on one leg on the right side while strengthening the quad. And so this could be like the Bulgarian split squat or like a, like B-Stance squat favoring the right leg, can be exercises that really help to strengthen the right side. Or even like lunges can be a great option.

[00:11:22] Gina: For the left side, the hamstring and adductor, so inner thigh and back of the leg musculature are a little bit weaker. And so Copenhagen planks. Crowd favorite for adductor strengthening. Not everybody likes them. Not everybody likes Bulgarian split squats either, though. Like the two least favorite exercises are like the most helpful.

[00:11:39] Roxanne: They’re so beneficial, but yes, definitely the least liked, especially when Gina throws in a little jumping Bulgarian split squat.

[00:11:45] Gina: I don’t do that for the pelvic pain folks though! Um, and then with the hamstring, really any sort of hinge like exercises. So staggered stance Romanian deadlifts, single leg deadlifts, just deadlifts, any sort of thing that you’re going to feel more in your hamstring is going to really help you pull that pelvis backwards so that we can have a little bit more stability on that left side.

[00:12:05] Gina: So as a quick refresher for the right side, we want to think about strengthening the glute muscle, so your booty on the right side and your quad, so the front side of your thigh, while releasing the inner thigh and the hamstring on the right side. For the left side commonly, we want to focus on strengthening the hamstring, which is the back of the thigh, and that inner thigh or adductor muscle, while releasing the glute, quad, and usually like hip flexor area. So those are, that’s kind of like what we want to focus on to balance the pelvic position.

[00:12:41] Gina: And we don’t need to do everything equal on both sides. Which is usually really hard. That’s like a really hard thing to grasp for a lot of folks. But we want to understand what muscles are too tight and which ones are too weak, and then address those when it comes to pelvic girdle pain.

[00:12:58] Gina: Let’s take a break from this week’s episode to talk about our podcast sponsor, Needed. Did you know that your protein requirements increase during pregnancy? And a really easy way to meet those increased demands is by adding in a collagen supplement. And Needed’s collagen is one of my favorites, or is my favorite, and the only one that I use during my pregnancy currently, and is an option that I definitely recommend for you.

[00:13:20] Roxanne: So we really like Needed Collagen Protein because one, it mixes in really nicely, it doesn’t clump up like a lot of other collagens we’ve tried. It doesn’t add any flavor to anything that I add it to, so it doesn’t make my coffee like a little brothy flavored. And they’re really intentional with their testing to make sure there’s not like, extra things in their collagen that’s not supposed to be there, such as heavy metals. They were given the Clean Label Project Award, which means that not just Needed has tested and made sure that there’s nothing extra in their collagen, but also this Clean Label Project has also tested it to make sure that there’s nothing extra in there that potentially could be toxic and maybe not great for us

[00:13:57] Gina: So we really love Needed, and we only recommend brands that we truly trust and use ourselves. And you can check them out at thisisneeded.com and use code MAMASTEPOD to get 20 off.

[00:14:06] Gina: However, not everybody can do single leg movements with pelvic girdle pain, even though it’s beneficial to focus on one side versus the other. Like it can be really painful to try to do a Bulgarian split squat on one leg, or to do a Copenhagen plank when you have pubic symphysis pain.

[00:14:22] Gina: So the things that we want to think about is can we put more effort into one side with more of these bilateral stances, which means both legs are working together. And so if I was doing a squat, for example, and I was trying to target this, like, uneven balance, when I was doing a squat, I would put a resistance band attached to like a squat rack or a sturdy structure around the inside of my left leg so that I’m resisting a pull outwards of my leg, which is going to increase inner thigh activation. So I’m helping to strengthen my inner thigh. While, for the right leg, I would put the band on the outside of my right leg to help strengthen the glute because now I’m resisting my knee coming in. So I have to abduct, or bring my knee out, to keep it aligned. So sometimes adding a resistance band with uneven tension can be one way to have like unilateral strengthening with an even stance. If the Copenhagen plank is too much, squeeze a ball between your knees. That’s still strengthening the inner thighs. Maybe do it in like a side lying hip abduction position where you’re squeezing the ball instead. And if this is like a lot of movements that you’re like, “I am not visualizing what you are putting down,” we’re going to link the exercises down in show notes for you because it is kind of hard to know exactly what we’re talking about.

[00:15:37] Gina: But the key is to know that you can still exercise and do strengthening movements even with pelvic gribble pain, where one sided movements are uncomfortable, with some modifications.

[00:15:48] Roxanne: So some of the movements that I really like to do once I had pubic symphysis pain was, I couldn’t really do lunges anymore, so I would just either not do walking lunges because that didn’t serve me anymore, I would either hold on to rings or I would hold on to the squat rack, so that gave me some stability while still being able to do the lunge movement. And then once the movement of like actually stepping out or stepping back into the lunge started to hurt, then I just kind of did a like stationary lunge, almost like a split squat at that point, but I was still getting the benefits of a lunge. So I was still getting that one legged movement, without having a lot of pain.

[00:16:29] Roxanne: Another movement that I really liked to implement was like a staggered stance. So it’s like I was putting more weight into one leg and I would put a ball between my thighs. So my legs were still even, but I was putting more effort into the other leg while this leg was almost like a kickstand and, well, the other leg was this kickstand. So it was still working one leg. So it was still getting the benefits of like doing the unilateral movements, but my pelvis was still in a neutral stance. So I wasn’t worrying about like kind of twerking in these movements while still being able to focus on the muscles that needed to be strengthened.

[00:17:03] Roxanne: So those are my two like really best movements that I kind of implemented. And then with lateral band walks, I had to stop doing like just traditional lateral band walks pretty early on in my first pregnancy. It was like 23 weeks when I started having pain in my pubic bone. So we had to kind of like play around with the lateral band walks. Because they’re such a beneficial movement for hitting all of those areas that you need, but I had to kind of play around with like the position of my pelvis. So like thinking about not really going into that, like anterior tilt, thinking about being a little bit more posterior kind of helped decrease the amount of pain as I was having. And then more recently I’ve learned with the lateral band walk you can almost do like an internal and an external rotation as you’re walking. It takes a lot longer to do them.

[00:17:50] Gina: It’s a lot of coordination.

[00:17:51] Roxanne: It’s a lot of coordination, but I had like zero signs of like my pubic bone having any sort of like kind of weird feeling or even pelvic floor wise, like my pelvic floor felt great while doing that type of lateral band walk, whereas sometimes I feel a little like iffy when I do the regular one.

[00:18:09] Roxanne: So I really am liking those three things kind of for my symphysis pubis pain.

[00:18:15] Gina: So that’s the beauty of, like, our programming and the way that we work with clients, is we work with in person prenatal clients, in person postpartum clients, like, exclusively. And so we’ve been able to figure out all these little modifications to help someone continue to do movement because we don’t want to just be like, “Well, when you feel better, come back,” because when they do the strength training exercises is when they’re going to feel better, but rather find a modification that feels good in their body. Because we don’t necessarily want to train in pain either. There’s going to be some sort of modification that works.

[00:18:48] Gina: And I always get really frustrated when I see like, “Pubic symphysis exercises to do” and it’s all like spreading the legs apart. It’s like clamshells and I’m like, “That is going to be super painful for somebody with pubic symphysis pain.” So a modification that we found to be like really helpful to still strengthening the outer glute musculature that involved no spreading of the legs was to do hip thrusts, where you put a band around the thighs and then you, you, I mean, you spread the feet out a little bit so that you have that tension in the band that you’re like resisting, and then you keep that the whole time. So there’s no, so there’s no like spreading as you like do the hip thrust. And so that seems to be like really obtainable for folks that do have that pubic symphysis pain if they’re trying to do an exercise specific to strengthening this muscular imbalance, that doesn’t involve like spreading their legs apart as long, and then finding a variation that feels accessible to them.

[00:19:44] Gina: And so usually my, like, way to approach modifying movements if you are having pelvic girdle pain is to, one, the first thing is going to be to decrease the overall movement. So walking lunges, that’s a lot of stability demand. Like you’re moving from foot to foot to foot. So you’re alternating your feet. Well, the first modification will be to just do one foot at a time. So I’m only stepping forward with my left foot and I bring my right foot forward. Then left foot, right foot. So that’s going to decrease the stability demand because you’re just focusing on one side doing work.

[00:20:14] Gina: When that becomes too much, then we can just do reverse lunges. Same thing, you can either alternate, which will be more of a stability demand, or I can just do one leg. So I’m just gonna step back with my left, bring my left foot forward, step back with my left, bring my left foot forward, and then I’ll do my right side. So that’s gonna be less of a stability demand.

[00:20:31] Gina: Like you said, we can also add an external support like holding onto rings, holding onto a squat rack, holding onto a partner. Anything that’s gonna bring your upper body into it more is gonna decrease the effort level in your legs and decrease the stability demand in your legs. And then like Roxanne said, going from one foot moving in the reverse lunge to now you have no feet moving in a split squat. So we still have the uneven stance, and we’re able to have more stability than we did in the reverse lunge, where one foot was moving, but both feet are going to stay the same. And then you’re going to lower down and then stand back up.

[00:21:05] Gina: Something that I had found to be really helpful for my clients that have pelvic pain when they’re doing like split squat positions, because even that position will sometimes still be uncomfortable, is to also consider the pelvic position, which is what you discovered with the lateral band walks. And so we’ll add a resistance band around the thigh, so now we have the, it’ll, the band will be around the inside of the thigh, pulling outwards. So now the inner thigh is turning on a lot more.

[00:21:33] Gina: Adductors play a big role in pelvic stability and they attach to our pelvic floor, they attach to the pelvis. And so they play a big role in what is happening down there. And so by activating them a little bit more, we already have a little bit more stability within the pelvis. And then as we lower down in our split squat, we’re rotating the pelvis forward. So we’re thinking like a belly to thigh position. If you’re holding, if you have your arms, you’re like reaching forward with the outside arm to kind of rotate your torso and your hips. And that also helps with stability because internal hip rotation and internal pelvic rotation is how we stabilize when we stance. Um, so adding the external band, making the stance uneven but stationary, and then adding in the pelvic rotation seems to really help with managing pelvic pain so that we’re strengthening in a way that feels accessible. And again, we’ll link, we’ll link these exercises down on the notes below. Because it might be hard to like totally understand what we’re saying, but when you see the exercises, you’ll be like, “I, I get it. Like, I get it now.”

[00:22:38] Gina: So after the asymmetrical stance, if that is still painful, this is where we come into that squat stance. So feet are even, we have the one sided band. So, band’s just on the left leg. Band’s just on the right leg. So we have the uneven loading in a stationary stance. So that’s kind of like my general progression when it comes to single leg movements. And so hopefully somewhere along that path, we find an exercise that feels good for you and your body that we can strengthen so that we can then progress from, back to those mobile movements. Because again, pain is not a requirement. We’re going to find a variation that feels good for you within your body. In our pelvic stability program, we offer like three or four modifications for like every exercise, because someone who’s in like severe pubic symphysis pain is not going to be able to do the same exercises as somebody who’s already gone through our program because they have the strength to help them stabilize a little bit better. And so we offer those different modifications and we offer those different modifications for our in person gym clients and our online prenatal fitness clients. Because we’re all at kind of different places, and it’s important that we have the modification that allows us to feel good in our body.

[00:23:47] Gina: So the first thing, just as a refresh, that causes the pelvic pain is the pelvic position is kind of stuck. And so when we’re changing positions, when I’m shifting my weight from my right to my left, my pelvic position is not also changing with me, and so it’s making it really hard for my joint to form close, or like compress on itself to stabilize. And so we need to help the pelvis find the opposite position by releasing the muscles that are too tight and strengthening the muscles that are too weak, and it will be asymmetrical or different on each side. And so again, if the exercises that we explained so far of the podcast were a little confusing or you didn’t quite visualize it, we will be linking them all down in the notes below.

[00:24:32] Gina: Now, the second thing that could be contributing towards pelvic pain is there’s too much movement happening and there’s not enough muscular coordination to help stabilize with force closure. So this means that the muscles and the tissues and the structures that support that pelvic joint are not coordinating and strong enough to kind of force the pelvic joint to stabilize upon itself. And so we have form closure, which is the pelvic position, and force closure is like the things compressing it to stabilize.

[00:25:02] Gina: And this is going to relate to like your myofascial slings. So we have different lines of muscle and tissue throughout our body that are connected because our body is a kinetic chain. Movement in one place of my body is going to impact movement in other places, and lack of movement in places of my body will impact other places within my body as well. And so we have four major myofascial slings. We have the anterior oblique sling, which is the chest, crosses your belly, crosses your pubic symphysis into the opposite inner thigh. So it’s inner thigh, pubic symphysis, like obliques into your chest. We have our posterior oblique sling, which is on the back side. So it’s like your lat, it crosses above the SI joint into the opposite glute. So you can think like there’s two X’s on your body that help you kind of rotate and walk and do functional movement. So when I’m walking, like the opposing anterior and posterior oblique slings are kind of supporting one another so that I can extend my hip backwards as I rotate my upper body forward.

[00:26:03] Gina: And then we have the lateral sling, which helps with single leg stability. This is from your glute. It kind of wraps around to your inner thigh. This is going to help you essentially maintain hip stability when you’re standing just on one leg. And then we have the deep longitudinal sling, which runs essentially all down one side of your body. So from like the back of your neck, down like one side of your back, glute, hamstring, calf, all the way down to your ankle.

[00:26:25] Gina: So we have like two deep longitudinals essentially down your backside. Your lateral slings are like spirals around each leg, and then we have the two crosses on each side of our back. So all of those slings are essentially crossing from the upper body to the lower body, aiding in movement that’s happening at the pelvis. So the pelvis is a big junction of all the movement within our body.

[00:26:50] Gina: Sometimes the slings, like one part of the sling, is not as strong as the opposing part. Or they’re not kind of turning on at the same time. Or maybe the opposing sling is not quite as coordinated as the other. And so this is where we might have that one sided, like, SI joint pain, or one sided like discomfort somewhere within our body. And it could be related to the slings. One of my favorite exercises to do with the Crossover Symmetry to help support myofascial sling strengthening, especially for the SI joint area, is to help strengthen that posterior oblique sling with a rowing motion that helps to strengthen my lat, and a hip extension motion that helps to strengthen the opposing glutes. So like a lunge row or like a squat row are like my favorites for posterior oblique sling strengthening, which is my personal favorite, because I have, I tend to have more SI joint pain for me personally.

[00:27:41] Gina: If I was having more pubic symphysis pain, or I was trying to focus on more of the front side or like core strengthening, I would be doing more of the anterior oblique sling. So like paloff presses where I have the band in the center of my chest and I’m pressing straight out and I’m resisting rotation or the new exercise that I came up with that I haven’t named very well: the split squat march with rotation.

[00:28:02] Roxanne: Oh gosh.

[00:28:03] Gina: I’m not good at naming my exercises. I never know what to call them. Uh, where you’re in a split squat and you rotate away from the point of attachment. So you have oblique, but then it’s your inside leg that is standing. So you have inner thigh activation. So I have adductor to opposite oblique working, which is, it’s really good. That’s a really good one, but it’s, the name is not great. If you have a better name for this exercise, comment below and let us know your recommendation.

[00:28:33] Gina: But those are two exercises that I really love doing to help support pubic symphysis stability and SI joint stability during pregnancy and all other times of my life because I do these exercises all the time. And the Crossover Symmetry system is like one of my favorite ways to integrate it because it’s so versatile. It’s really easy to find some sort of attachment that works for your home. If you want to check out Crossover Symmetry, you can use our code MAMASTEFIT20 to get 20 percent off your own shoulder system, which is the resistance bands that attach. And they also have a Hip Core band, which is essentially like a glue band. That’s also one of our favorites. It’s a little bit more padded. So it doesn’t like scrunch up and roll like some of those latex bands do, and so they’re like super comfortable to use. So if you want to check them out, you can check them out at CrossOverSymmetry.Com and use code MAMASTEFIT20 to get 20 percent off.

[00:29:22] Gina: So with the myofascial slings, it’s a lot of strengthening exercises. And you can kind of see from like the pelvic balance movements and now the myofascial sling ones, it’s all like strengthening exercises because during pregnancy we have too much movement happening within our pelvic joints, which is causing a lot of that discomfort. Plus, the pelvic position is a little bit off, or the coordination of the muscles supporting the pelvic joints are not, are a little bit off as well, can cause some of that pain. But if you notice, the thing that contributes towards pelvic pain is not pregnancy. Like that that was not one of the causes. And so giving birth does not automatically equal pain relief, which a lot of folks are a little shocked when they give birth and they imagine that this pain is suddenly going to be gone and they still have pelvic pain for four plus months postpartum, which is pretty common because the culprit of the pelvic pain is not pregnancy. It is movement patterns, pelvic position, the things that are going to continue in the postpartum where we still have that same laxity for several months after we give birth. And so you may find that you do not have relief from pelvic pain just because you gave birth. And so the advice that you may have received to, “Well, when you give birth, that’ll go away is, is probably not true.”

[00:30:41] Gina: So what are some other things that we can do to help resolve pelvic pain? If you’re like, “I feel really overwhelmed. by trying to figure out all these exercises by myself.” What can we do to help resolve pelvic pain? One of the first things that you can do is you can get a belly band. Sometimes just a little bit of external support can be really helpful with pelvic pain. Like I have a belly band that I really like from Bao Bei. It’s their ProBump band. Huge fan of it. There’s so many great options out there. It’s just something that kind of gives you a little bit of support for your belly could sometimes help relieve pelvic pain as well. And so that can be like a really great, easy option. Cause sometimes we just want quick fixes. You just want something quick.

[00:31:21] Roxanne: Belly bands or even like, uh, they have pregnancy support leggings. So they have leggings that can do the same thing as a belly band, but you don’t have to wear an additional item on top of your clothes. So some people like they have leggings or the belly bands can be really great options that I even utilized during my pregnancies because I could not work out as much because I was working full time as a nurse during my first pregnancy. So belly bands were what got me through.

[00:31:46] Gina: Other things that you could do is you can work with professionals as well. Like, working with a professional is not exclusive to the postpartum phase. Some folks think they’re not allowed to work with the PT until after they give birth. You can absolutely work with a pelvic floor a physical therapist or just a physical therapist during your pregnancy as well. If you are in pain and that pain is impacting your ability to walk and move your body, you should 100 percent be able to work with a physical therapist. I am a firm believer in that.

[00:32:12] Gina: They may not do like internal work if you are seeing a pelvic floor a physical therapist, but not every PT session with a pelvic floor PT would involve internal work anyways. There’s so much that we can do externally as you can probably already tell from this episode, like we’ve already listed so many exercises that you could do to help resolve pelvic pain, but a pelvic floor PT can help you with that. Now, if you go to your PT and all they do is manual therapy on you, where they like, massage you, they do some dry needling, and you’re doing like the same exercises every single week, you need to find a new PT, because you’re not going to find relief from pelvic pain by having somebody else to do just a bunch of stuff to you. Now, some of that stuff is helpful, but we also need to progress so that you can stand up and move your body and not be in pain. So just be aware of like what type of therapy you’re receiving. If it’s all manual therapy and you’re only on the table and there doesn’t seem to be much progression, there are other options out there.

[00:33:09] Gina: Our in house PT, Hayley Cava, has a pelvic balance class that she does virtually, it’s a “pay as much as you want.” It’s a really great option if you’re wanting to work with a PT, maybe it’s not accessible to you, maybe you haven’t found one that’s working for you. Hayley Cava is a PT that I would absolutely trust with my own pregnancy and my own postpartum recovery. And so she’s someone that I feel very confident about recommending to you if you cannot find somebody in your area to support you. If you can find an in person PT that really vibes with 100 percent that would be the best option if you can’t, signing up for her pelvic balance series or doing a virtual session with her is like a really great option too, because she’s a really outside of the box thinker as well, because it’s not all like glute bridges and clamshells. There’s so much that we can do to help you feel comfortable throughout your pregnancy. Like again, pain is not a requirement.

[00:33:58] Roxanne: Another really great option that you can do is see a Webster Certified chiropractor during your pregnancy to help with like balancing of your pelvis. So this is something that I started doing during my pregnancy, probably right when I started feeling pelvic pain. I’ve, I think I Googled and tried to find like the nearest chiropractor as soon as I started having this pain, and it really seemed to help a lot.

[00:34:19] Roxanne: I will say with chiropractic care, it is just helping relieve the symptoms. You still need to do like movement to strengthen the muscles so that like you can still maintain that position, but it is a really great benefit and a really great option to kind of help with that pain so that you’re able to do that movement. Because with my first pregnancy, I definitely did not do the movements, but I saw a chiropractor and as my pregnancy progressed, I had to see them more and more often to be able to move about my day without pain.

[00:34:51] Gina: During my first pregnancy, that was how I finally found relief to then be able to do my strengthening exercises, was I saw a Webster Certified Chiropractor and I finally was able to find relief. And it was really refreshing to work with a provider who was actually like, “Yeah, no, you don’t have to be in pain. Like it’s not not something that’s mandatory during pregnancy,” and I was like, “What do you mean? I was told I had to deal with this for four months. Like, oh, okay.”

[00:35:16] Roxanne: And it’s also important to note that, like, they say that it will go away. Like, oh, the answer to all your problems is having a baby and your pelvic pain is going to be gone. This is only due to pregnancy. And yes, sometimes it can be due to, like, baby’s position, sometimes. Like, baby is just in there, just right in your pelvis, and no matter what you do, until baby moves off of that specific spot, that pain may not go away. Because. It just might be the actual position of your baby, placing pressure on your pelvis. But most of the time, even postpartum, yes, you had your baby, oh, magically your pelvis is fixed. No, every single baby that I’ve had, and I had some sort of pelvic, pelvic pain, I still had it postpartum. And I still have it today at nine months postpartum. I have to work on it every day. So just them saying like, “Oh, just wait till you’re not pregnant anymore. It’ll go away,” is false. False. False. False. False.

[00:36:20] Gina: Because pregnancy is not the cause of pelvic pain.

[00:36:23] Roxanne: Exactly.

[00:36:24] Gina: It’s the movement patterns and the pelvic position.

[00:36:26] Roxanne: But doing all of this work during your pregnancy will set you up for being able to like survive postpartum, because that pain won’t be there and then you’re like trying to recover with pubic pain is not great. Don’t recommend.

[00:36:41] Gina: So things that I have, because I have some flare ups every once in a while with SI joint pain, it’s not, I’m not a completely pain free pregnancy. I don’t think that’s possible. I don’t think that you have to be in chronic pain your entire pregnancy. Like there’s absolutely relief available for you in some capacity. Maybe it’s working with professional, maybe some sort of external support, maybe some exercises that you can do, but I will still have some flare ups every once in a while. Most recently, it was from my sleeping position was a little bit off, so I brought my pregnancy pillow. And what I did to find some like immediate relief was I did some hip shifted exercises where I focused on shifting more weight into my left leg and what that does is it stretches more of the left posterior pelvic floor, which sometimes it’s a little bit tight for me, plus it’s bringing that hip into more of that internal rotation, so it’s stretching the glute and the quad musculature for me that tends to be a little bit tight on that right side. Um, so that was really helping. And then I did a little bit of like myofascial release with like a yoga TuneUp ball, I guess it’s TuneUp Fitness ball. Um, it’s a little bit softer than a lacrosse ball, so just got it right up in there in that little like tailbone opening area and just kind of massaged out, and that seemed to really help bring me some immediate relief. And then the next day in the gym, I really focused on the Bulgarian split squats on the right side, Copenhagen planks on the left, and then incorporating the posterior oblique sling exercises to strengthen now that I did the mobility, I then focused on the strengthening so that I could help maintain a better position. And I haven’t had any pelvic pain since then.

[00:38:11] Gina: Uh, when I was postpartum, I randomly had pubic symphysis pain, like out of nowhere. And I was like, what is this? I don’t have this. I don’t have this. Um, and I did something similar where I did like a pelvic reset thing where I squeezed a ball between my thighs. And so I would do like 10 squeezes with my exhales. And then I did like a hip shift where I brought my left hip back and my right knee forward and I squeezed the ball, and I did that for 10 times and it felt better.

[00:38:38] Roxanne: Yeah.

[00:38:38] Gina: Instant relief. So sometimes it’s just helping the position a little bit with some quick movements can help you find some like really quick relief, but then coupling that with the strengthening exercise so that you can maintain a better position is super, super beneficial.

[00:38:54] Gina: So this was definitely one of our more technical episodes with explanation of why you have pelvic pain, exercise that you can do, why those exercises are beneficial. And so hopefully you weren’t like completely lost during it. We’re a little worried that it might be a little bit too technical. However, it’s hard to not be when it comes to pelvic pain, because there is such like such specific things that you have to do to find that relief. But relief is absolutely possible. It is not a mandatory part of pregnancy. Anybody tells you that you just need to wait till you give birth doesn’t understand the full story. They have tons of education on other topics. Pelvic pain is not one of them. And so know that there are solutions for you.

[00:39:35] Gina: If you want to work with a professional, pelvic floor physical therapy, working with a chiropractor, are both really great options during pregnancy. We can add on some external support with like a belly band. You can get like massage. Sometimes massage can be really beneficial to releasing some of that tension, but definitely adding in the strengthening exercises are going to be super beneficial.

[00:39:56] Gina: A really easy way to do it is with resistance bands. Crossover Symmetry is one of our favorites for that. Again, you can check them out with our code. So if you have any questions on pelvic pain, cause again, this is one of our more technical episodes. Feel free to DM us on Instagram, shoot us an email. We would definitely love to answer your questions.

[00:40:13] Gina: But if you want more support during your pregnancy to have a pain free pregnancy, check out our online prenatal fitness programs. Our online prenatal fitness programs are designed to help you stay strong throughout your pregnancy and pain free with the incorporation of all of these pelvic stability exercises to support pelvic balance, strengthening of the myofascial slings, and also core exercises to help you be able to maintain your position.

[00:40:36] Gina: Our programs also include birth preparation exercises with pelvic opening and pelvic floor release exercises, which could also help with relieving pelvic pain as well. You can check out all of our prenatal fitness programs on our website and mamastefit.com and use code STORY10 to get 10 percent off any of them.

[00:40:53] Gina: We have two different formats. We have our app based program, list of exercises, short demo videos, really great option for somebody that likes to work out at a gym sitting with a barbell. And then we have our on demand program, which I am currently refilming and adding in like double the amount of videos as we speak, uh, which is a video that you follow and work out with at the same time, which is also how our pelvic stability program is designed.

[00:41:16] Gina: So if you’re wanting pelvic stability specific work, like, “Hey, I can’t do the prenatal programs yet because I’m in so much pain,” the pelvic stability program could be a really great option for you. Most of our athletes that do the pelvic stability program usually find relief within like a week or two. I think most of them report back that they find relief before they finish the three week program. So we have a lot of hope for you to also have a pain free pregnancy.

[00:41:40] Roxanne: This podcast is sponsored by Needed, a nutrition company focused on the perinatal timeframe that both Gina and I utilize during our pregnancies, postpartum, still now, our husbands even use it, and that even our kids will take their immune support. We don’t recommend a lot of products except ones that we really trust and use ourselves, and we really trust Needed, and you can check them out using our code MAMASTEPOD percent off your first order.

[00:42:02] Gina: And this podcast is sponsored by Crossover Symmetry, which is one of our favorite pieces of equipment to utilize in our gym, for our clients, and for ourselves. They have their shoulder systems, which are resistance bands that attach with different types of attachment points, depending on what is available to you. Plus their Hip and Core Band, and they even have a bunch of training programs available too, so they have like, a shoulder warmup circuit. Like if you’re a swimmer, they got programs for you. And so there’s a really great resource as well. And you can check them out at crossoversymmetry.com and use our code MAMASTEFIT20 to get 20 percent off.