Why do my hips hurt in pregnancy - and what to do about it

Pregnancy aches and pains are no joke, but hip and pelvis pain can make your life a misery. We chat to physiotherapist and mum Ceridwen Way about why pregnancy is a literal pain in the butt - and what to do about it.

When you’re growing a human, your body makes many adaptations to compensate for the new life you’re creating. You’ll recognise the hallmark changes - pigmentation on your face, tender boobs, increased heart rate and postural changes to adjust to your changing centre of gravity. But you might not realise that your connective tissue is softening too, in readiness for childbirth. This laxity might be the cause of your pelvic pain, says Ceridwen, Principal Physiotherapist and Director of Burleigh & Broadbeach Physiotherapy Centre.

“As your ligaments soften in pregnancy, the pubic symphysis [the joint between your pelvic bones] can separate to allow for your baby’s head to descend through the pelvic cavity,” she says. “This separation can contribute to pelvic pain.

“During pregnancy, your posture alters, changing where load is carried in your spine. This can cause pain in itself. As the curve in your lower back becomes more pronounced with your growing belly, your body will compensate with increased thoracic kyphosis.” That’s the mid back region. 

“As their boobs get bigger and heavier later in pregnancy, women also tend to slump more,” says Ceridwen. 

Coupled with general fatigue and nausea, your posture takes a beating. “If you’re tired all the time or feeling unwell, you just don’t have the same energy to hold yourself well,” says Ceridwen. The result? A pain in the low back (and hips, and pelvis).

Pregnancy and tendon pain

“Because weight gain is often rapid in pregnancy, increased load is placed on your tendons and ligaments,” says Ceridwen, “which can also contribute to glute med tendinopathy.” So that dull hip ache you’re feeling is actually a literal pain in the butt. “Lying on your side all the time in the second and third trimesters can also result in pain,” she says.

Symptoms to look for

If your pelvic pain is longer lasting than a day or two, and affecting your sleep or ability to go about your day, consider seeing a physiotherapist for guidance and support. Ceridwen notes these common symptoms of pelvic pain in pregnant women:

• Pain in the middle of your pelvis, where the two pelvic bones meet (your pubic symphysis - PS).
• Pain in the adductor (inner thigh), which is working harder than ever to hold your PS together.
• Pain in your hips and back. (Interestingly, Ceridwen notes that some women with a history of back pain actually feel better in pregnancy because the ligament laxity gives them improved mobility.)
• Difficulty or pain standing on one leg - such as walking up stairs and getting in and out of your car.
• Sciatica or pins and needles in one leg.

 

How to treat pelvic pain in pregnancy

First up, Ceridwen has words of reassurance - “if your pelvic pain is presenting for the first time during your pregnancy, rest assured that it will most likely resolve as soon as you have your baby,” she says. “And there is no correlation between low back pain and childbirth, so don’t be worried about your ability to give birth.”

 

Next, dealing with the pain. Ceridwen suggests aids such as pregnancy belts, lumbar supports or braces and SRC shorts, which all help to offload your ligaments and muscles from working so hard. “Finding the support that fits you properly is key,” she says. “It also depends on your job - if you sit a lot, some of these devices are not practical.” So work with your physio on the best solution for you.

 

Proving that movement is medicine, Ceridwen also recommends exercise - working out in the pool is excellent as it’s not weight bearing, she says, while pregnancy yoga or pilates with a qualified practitioner are great options.

 

Simple moves at home include Cat/Cow to ease your spine through full range of motion along with pelvic tilts standing supported with your back against the wall.

 

At work, check your posture regularly to ensure you’re not slumping on your desk or leaning on the centre console of your car during your commute. When standing, ensure your weight is evenly distributed between both feet rather than popping one hip to the side.

 

Can you have a physio adjustment during pregnancy?

 

If all else fails and you’re seeking pain relief and postural support, consult a pregnancy physio. Ceridwen says it is safe to have treatment at any point during pregnancy with a qualified practitioner. Your physio will make modifications for your condition, such as using mobilisations for your joints or “manipulation through the thoracic spine with small amplitude”, says Ceridwen, which can provide muscle relaxation and ease your pain.

 

“We modify all treatments for pregnant women,” she says, “such as treating clients in a side lying position or on their stomach on a pregnancy table. Cushions make lying down more comfy and treatment techniques are more gentle.

 

“When you’re pregnant, you’re more sensitive overall,” she says. “This is the time to be treated gently and nurtured.”

 

Overcoming pelvic pain at all stages of pregnancy

Ceridwen shares her top tips for combatting pelvic and low back pain during pregnancy:

 

Pre-natal - “Get strong,” she says. “Build a strong back, glutes and abs and build your cardiovascular fitness.” Pregnancy is no time to start a hard-core fitness regime - take your time to build a strong foundation before you start trying to conceive.

 

During pregnancy - Pregnancy pilates, yoga or the hydrotherapy pool are all great options. “In later pregnancy, keep both feet planted on the ground during exercise and avoid twisting through your pelvis,” she recommends.

 

Post-natal - “Work on building hip strength,” says Ceridwen, in addition to building your abs. “Try bridging with external rotation such as with your feet pointed slightly outwards and a Theraband around your ankles.”