What Is Pregnancy Pelvic Girdle Pain (SPD/PGP)?
If you feel a sharp, burning, or achey pain around the pubic bone, inner thighs, hips, or low back—especially when walking, turning in bed, getting in/out of the car, or putting on pants—you’re not alone. This is often pelvic girdle pain (PGP), sometimes called symphysis pubis dysfunction (SPD).
During pregnancy, hormones (hello, relaxin) and changing posture can make the joints at the front and back of the pelvis more sensitive. The pubic symphysis (front) and sacroiliac joints (back) are designed to be sturdy and slightly mobile. When they get irritated by repeated asymmetric loading—like standing on one leg to put on pants, long strides, deep twisting, or uneven stairs—they can get inflamed and grumpy.
Good news: PGP is very treatable. You don’t need to “get stronger at all costs.” You need calmer mechanics, smart support, and repeatable movement rules that give the pelvis a chance to settle.
The Golden Rules (Read This First)
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Move your legs together like a team.
- Getting in/out of bed or the car? Knees together, thighs moving as a unit.
- Rolling in bed? Squeeze a pillow between knees, roll like a log.
- Pants/socks? Sitting only—no single-leg balancing.
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Shorten your stride.
- Walk like you’re on slightly shorter steps. Think “gliding,” not “bounding.”
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Avoid big, split-stance stretches.
- Skip deep lunges, pigeon, big figure-4, high step-ups for now.
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Support from the outside.
- Pelvic belt or belly band during chores/walks.
- Wear stable shoes; avoid soft, unsupportive slides.
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Breathe first, then move.
- On exhale, gently gather the lower belly (below the navel) and imagine the sit bones drawing a millimeter closer—then move.
- On inhale, allow everything to soften and lengthen.
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2/10 rule during exercise.
- Pain up to 2/10 that doesn’t linger afterward is okay.
- If pain climbs or lasts > 2–3 hours post-activity, reduce range/reps next time.
Positions That Soothe (Use These All Day)
- Side-lying with pillow between knees/ankles. Add a small towel under your bump for extra comfort.
- Hands-and-knees (tabletop) for 1–2 minutes with slow breathing—great “reset.”
- Supported high seat posture (hips slightly higher than knees) with a small towel behind the low back.
- Supported forward lean onto a counter or high stack of pillows, knees soft and evenly loaded.
Quick check: If your jaw/face is tense, your pelvic floor and hips will often co-tense. Soften your jaw and tongue tip; let the exhale lengthen.
Your 15-Minute Daily Relief Routine (5–6 days/week)
This routine is pregnancy-safe for most and built for symmetry, calm, and support. Keep the breath smooth; stop any move that clearly aggravates pain.
1) Breath & Reset (3 minutes)
- Side-lying 360° rib breathing (pillow between knees/ankles).
- Inhale through your nose: feel ribs expand 360° and pelvic floor soften.
- Exhale softly through the mouth: imagine zipping the lower belly and the sit bones gently gathering.
- 6–8 slow breaths, rest, repeat.
2) Pelvic Mobility (3 minutes)
- Cat–Cow (small range) x 6–8 slow reps. Keep ranges tiny and pain-free.
- Hip Circles (hands-and-knees) x 5 each direction—very small, controlled.
- Rock Back (wide knees, supported) x 4–6 breaths—only to the point that feels good.
3) Gentle Support & Activation (6 minutes)
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Adductor Pillow Squeeze (seated):
- Place a small pillow between knees. Exhale → 5-second gentle squeeze, inhale → release.
- 6–8 reps. Tip: 4/10 effort is plenty.
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Bridge on Incline (upper back on pillows/sofa):
- Heels under knees, feet hip-width and even.
- Exhale → lift hips 1–2 inches; inhale → lower.
- 8–10 reps. If it twinges, reduce range or skip today.
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Clamshell (side-lying, tiny range):
- Hips stacked, pillow between ankles. Exhale → lift top knee 1 inch; inhale → lower.
- 8–10 reps per side. Keep the pelvis still; no rolling back.
4) Functional Finishers (3 minutes)
- Sit-to-Stand (chair, symmetrical stance):
- Feet even. Exhale to stand, inhale to sit with control.
- 6–8 reps.
- Counter Hip-Hinge (hands on counter):
- Tiny bow at the hips with even weight. Exhale on the way up.
- 6 reps.
After the routine: Walk around your space for 1–2 minutes with short strides. Notice if turning and steps feel smoother.
Micro-Habits That Change Everything
- Bed logistics: Slide to the edge on your back, pillow between knees; roll to side; drop both knees together; push to sit using arms. Reverse to lie down.
- Car hacks: Back up to the seat, sit first, then swivel both legs in together. To exit, swivel both legs out, plant feet, exhale and stand.
- Stairs: One step at a time, handrail for support. If one side hurts more, lead with the comfortable leg going up, the symptomatic leg going down.
- Dressing: Sit for pants/socks. No single-leg balancing.
- Chores: Break tasks into short bouts; use a pelvic belt for longer sessions.
What to Avoid (For Now)
- Long single-leg stances (balancing to dress, big step-ups).
- Deep asymmetrical stretches (pigeon, deep lunges, big figure-4).
- High-impact (jumping/running) and wide sumo stances that pull the pubic joint apart.
- Heavy lifting without breath prep. If you must lift, exhale/gather, keep load close, use both legs evenly.
Optional Tools That Help
- Pelvic support belt: Wear during chores/walks; remove for lying rest and most floor exercises.
- Heat or warm shower before mobility.
- Ice (wrapped) to the painful pubic area for 5–8 minutes after activity if it calms symptoms.
- Footwear: Stable, supportive shoes to reduce wobble.
A Sample Day Using the Rules
- Morning (3–5 min): Breath & Reset + 1 set Adductor Pillow Squeezes.
- Mid-day breaks: 2 minutes hands-and-knees mobility.
- Chores/walk: Belt on, short strides, take breaks every 10–15 minutes.
- Evening (10–12 min): Full 15-minute routine.
- Bedtime: Pillow between knees/ankles, log roll to turn.
How This Plan Helps the Pelvic Floor (Not Just the Joints)
PGP often makes the pelvic floor guard. Guarding equals tension; tension can amplify pain. Your breath-led approach tells the nervous system to down-shift, letting the floor lengthen on inhale and recoil gently on exhale. The adductor/pillow work provides midline support to the pubic joint, the small-range clams/bridges re-introduce balanced glute/hip support, and the hinge/sit-to-stand restore real-world strength without pulling the pelvis apart.
You’re not trying to “hold your pelvis together.” You’re teaching it to share load evenly again.
Troubleshooting & Tweaks
- Pain after bridges? Lift half as high, or switch to glute set + exhale (no lift) for a week.
- Clams flare symptoms? Shrink range to ¼ inch or swap for side-lying hip abduction (toe forward, 6 slow reps).
- Walking still rough? Use the belt, shorten strides further, and add 2 minutes hands-and-knees before/after walks.
- Turning in bed is the worst? Add a silky pillowcase under your hips to reduce friction and move in two smaller rolls instead of one big turn.
Birth & Beyond: What This Means for Labor
The same rules that calm SPD/PGP in pregnancy help at birth: shorter strides, supported positions, and exhale-based effort. Hands-and-knees or side-lying with a pillow between the knees often feel better than flat on the back. If you had a strong pain response during pregnancy, share what positions felt best with your birth team—they can help you replicate them.
Quick Reference Card (Screenshot This)
- Legs together for turning, car, bed.
- Short strides, stable shoes.
- No big stretches; small, symmetrical mobility.
- Exhale to gather, then move.
- 15 minutes/day relief routine.
- Belt for chores, breaks every 10–15 minutes.
- Pillow between knees for sleeping.
Bottom Line
SPD/PGP is common, frustrating—and fixable. Calm the irritation with movement rules, reinforce the pelvis with gentle, symmetrical activation, and keep breath in the driver’s seat. Give it consistent attention for 2–3 weeks and you’ll likely notice smoother turns, easier steps, and a steadier pelvis as you move toward birth.