PGP help sheet

by | Nov 8, 2018 | pregnancy

PGP (Pelvic Girdle Pain) which was previously called SPD is a debilitating condition, worsened by the hormonal and mechanical changes of pregnancy. In a past blog I have written about pelvic pain and dysfunction and how Osteopathy works so well to help.

In this post I have put together an advice sheet on what to do alongside and after your treatment, and to support ongoing treatment with us, in terms of reducing pain and getting the body back to normal more quickly and effectively. This will also help longer term.


1. Use frozen peas!!!!

Yes it really does work! Most of the pain experienced, especially at the pubic bone and sacroiliac joints (at the back of the pelvis), is inflammatory in nature. This means it responds really well to cold. Pop a handful of frozen peas in a freezy bag, tie in a knot, then use as your ice pack. 10 minutes at a time on all sore spots. This can also work really well on both of the hips before you go to bed, as many people experience their PGP pain on the outside of the hip as they sleep. By using frozen peas before bed, this can help to give you more sleep.

2. Pillow between the knees

Boring, but it does work. If you are sleeping on your side, make sure your hip bones are stacked on top of each other to prevent further imbalance. A pillow under the bump too can be fantastic to help keep the bump in a good place and not being dragged downwards.

3. Avoid crossing legs

Try to avoid crossing one leg over the other for prolonged periods of time, it can be easier on your pelvic muscles to try to keep your pelvis in a neutral position. Thereby, sit with equal weight through both sit bones. Try to avoid twisting repetitively whilst you are in this position too.

4. Maybe ditch the stilettos (and flip flops)..

High heels can push your weight even further forwards. If you are pregnant then you will be weight bearing more in this position anyway due to your bump. Try to wear good comfy shoes whenever a lot of walking is required. By supporting your arches you will be able to help reduce any dysfunctional loading through the pelvis, particularly on those of you who have had babies before, the ligament on the sole of the foot which supports your arch, can often increase in laxity, therefore forcing the muscles to work too hard.

5. Get strong!

Stronger glutes and core muscles (and of course pelvic floor muscles) are imperative in keeping out of pain more long term. This can be done whilst pregnant and after. Pilates works wonders. Ask us for some basic exercises to help you individually. Although best to avoid single leg exercises for now unless you are with a specialist trainer. It is important to continue to exercise if you can, as it makes such a difference to your fitness for birth, mental health, and general pain levels.

6. Don’t overstretch

So there are loads of little muscles and ligaments around your pelvis, both front and back, which are likely quite strained with SPD/PGP. If you open your legs too wide to get out of the car, do a box splits position or similar type stretch in a yoga class, or always sit with your knees together, and hips turned inwards (and feet/lower legs out), then definitely worth avoiding if possible. The issue is usuall;y when it comes to going to full range stretch, therefore when doing yoga, or other exercises, try to not over stretch. Using a newspaper to swivel on in the car can be really helpful to avoid this. The full stretch positions can take the muscles further than they want to go, so if they are inflamed they can get really sore. Swimming is amazing, but you may prefer back crawl or front crawl now as breaststroke can cause overstretching at the pubic symphysis area.

7. Avoid hip carrying other children

Try to carry your elder children centrally, like a monkey carry if possible. If you hitch your hip to carry a child, toddler or baby in this way, then you can cause a further disruption to the balance of the muscles around the hips and pelvis, and put more strain on the ligaments, causing muscles to spasm, and further exacerbate a pelvic issue. Central carrying is a great habit to get into from a very early age.

8. Try to relax

It is much easier said than done, but most of the latest research on PGP tends to tie it in with times of stress. PGP is far more common in those going through serious life stresses, overworking, or moving house. The stress hormones will act as a sensitiser, and therefore can increase perception of pain significantly. Cortisol will affect how every cell in your body functions. Normal day to day stresses are OK, but when it can be too much, or for prolonged periods of time, then our bodies try to find another route out of it. Often in pregnancy, this can be through the highly sensitised pelvis. So finding exercise that you enjoy is really important, finding ways to manage your stress, walking, nature, meditation, pilates, yoga. Whatever you can find to help improve mood and allow you to relax is really important. Walking is really beneficial, but make sure you do it after you have ate, so that your body is not too fatigued. Good brisk walking can be great. This can be difficult if you are in lots of pain, but even 5 minute chunks can be really useful. Keeping moving is fab where you can.


I hope all of this information is helpful. Osteopathy is fab for realigning and rebalancing the pelvis, and calming down pain and inflammation and muscle spasm brought on by pelvic pain and SPD. SPD is predominantly a mechanical issue, whereby the load through the pelvis has been disrupted. Lots of women can be pain free after treatment, but do need to take care of themselves for the rest of their pregnancy to prevent the pain from returning. This advice sheet will help you to remember the important bits.

Please contact us if you have any questions: