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Pregnancy-related pelvic girdle pain exercises
Pelvic girdle pain in pregnancy is pain around the joints of the pelvis: at the front over the pubic bone, or at the back over one or both dimples at the base of the spine, sometimes spreading into the buttock or the back of the thigh. It affects around one in five pregnancies. It comes from a change in the way load is shared across the pelvis, not from the joints being damaged, separating or unstable.
Several things contribute. The growing baby shifts your centre of gravity forwards, hormonal changes make the supporting tissues a little more giving, and the muscles around the hip and trunk are being asked to control a moving load they have not met before. It is more likely if you had it in a previous pregnancy, or have a history of low back pain.
The triggers are unmistakable once you know them: walking, stairs, turning over in bed, standing on one leg to dress, getting in and out of a car, and pushing a trolley. It is often worse at the end of the day and after a long walk, and it can disturb sleep. It can be genuinely painful and wearing.
It does not harm the baby, it does not mean anything is coming apart, and it usually settles in the weeks after birth. Staying as active as comfort allows leads to a better outcome than resting, and pacing - several shorter walks rather than one long one - usually helps more than stopping. This programme reduces pain with positioning and gentle activation, strengthens the hip, buttock and deep trunk muscles that support the pelvis, and gives practical ways to manage daily tasks.
Who this programme is for
Pregnant women with pain around the pubic bone or the back of the pelvis that is worse with weight-bearing on one leg. If you have severe pain, a fever, vaginal bleeding, reduced baby movements, or signs of labour, contact your maternity team rather than starting exercises.
Get checked by a clinician first if
- Regular tightening or cramping, a gush or trickle of fluid, or any vaginal bleeding - contact your maternity unit
- Reduced or absent baby movements
- Severe headache, vision changes, or sudden swelling of the face and hands - could indicate pre-eclampsia, seek urgent review
- Fever, pain passing urine, or feeling generally unwell with the pelvic pain
- Sudden severe pubic pain with a grinding sensation and inability to walk or lift the leg
- The pain followed a significant accident, fall or direct blow and you have not been checked over
- You feel unwell with the pain - a fever, night sweats, or losing weight without trying
- The area is hot, very swollen and red, especially if you also feel feverish
- Pain that is severe, steadily getting worse, or keeps you awake every night and does not ease with a change of position
The staged programme
Stage 1
Settle the pain
Start here. Use gentle pelvic tilting and breathing to ease muscle guarding, keep the legs closer together when moving and turning, and take stairs one at a time. Little and often movement beats long rests or long walks.
Stage 2
Build support
As pain allows, strengthen the buttock, hip and deep trunk muscles that support the pelvis, most days, keeping within a comfortable range and avoiding wide-legged positions that provoke the pain.
Stage 3
Manage daily life
Combine trunk and hip control with practical strategies - sitting to dress, keeping knees together getting out of the car, a pillow between the knees in bed, and pacing activity across the day.
How long recovery takes
Symptoms usually stay manageable through pregnancy with the right exercises and daily strategies, and most cases improve markedly within days to weeks of giving birth. A minority have pain that persists past the early postnatal months and benefits from ongoing pelvic health physiotherapy.
Knowing when to progress
Let pain guide you: keep exercises and daily movements within a range that does not sharply provoke the pelvis, and favour symmetrical positions - both feet planted, legs not too far apart. If a support belt reduces pain when walking, it is fine to use. Progress the strengthening as your tolerance allows.
Common questions
Is my pelvis unstable or damaged?
No. The term instability is misleading - the joints are not slipping or being harmed. The load-sharing across the pelvis has changed and the muscles need help to support it. Thinking of it this way tends to reduce fear and improve movement.
Should I stop walking and exercising?
Stay as active as comfort allows. Long walks may need to be broken into shorter ones, but general rest makes stiffness and deconditioning worse. Swimming, stationary cycling and the exercises here are usually well tolerated.
Will it affect my labour and birth?
Most women with pelvic girdle pain have a normal vaginal birth. It helps to note before labour how far you can comfortably part your legs, so positions can be chosen that stay within that range. Discuss it with your midwife.
Does a support belt help?
A pelvic support belt worn low, around the hips, reduces pain for many women during walking and standing. Use it for activity rather than all day, alongside the strengthening programme.
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