If you are having vaginal or pelvic pressure to the point where it hurts to walk or a cramping sensation late in your pregnancy, it is most likely due to your expanding uterus. Pelvic pain during pregnancy can range from annoying pressure all the way up to “it feels as though a horse kicked me squarely in my crotch” to the fun sounding, “It feels like lightning struck my princess.
Pelvic discomfort is usually accompanied by lower back and groin pain. It can even cause clicking sounds- Oh the wonders of pregnancy!
Pelvic pain during pregnancy is typically more active at night, raising hell from the moment you lay down. It will have you turning over in bed because your hips start to burn from the pressure of laying on them, or waking you up screaming from lighting-like pain in your groin.
In the last trimester, you may also experience that sharp, lightning-like pain. This is caused by the pressure of your baby getting closer to and then moving into the birth canal.
So if you’re approaching 36 weeks or 37 weeks and it hurts to walk from severe pelvic pain, you’re not alone. While the pain and pressure at this stage of pregnancy is a typical occurrence, that doesn’t mean that it’s any less uncomfortable.
Although this is good news because it means you are getting closer to meeting your baby, the bad news is that this pain and pressure can last for weeks before you actually go into labor.
What Causes Pelvic Pain in Pregnancy?
Here’s a quick anatomy lesson of your pelvis to understand why it’s happening:
There are the two big bony pieces that connect at the base of your lumbar spine, called the sacrum.
The front of your pelvis is your pubis. There are 2 symmetrical parts to your pelvic, the right and left side, which are held together at a joint called the pubic symphysis.
The joint is made up of fibrous tissue and cartilage and held together by an intricate web of muscles and ligaments.
During pregnancy, that gap between either side of your pelvic bones nearly doubles in width. The pubic symphysis is one of the main joints that the relaxin hormone relaxes, which causes the pelvis and the pelvic ring to become incredibly hyper-mobile.
On its own, this is a good thing: the baby will need that extra wiggle room to pass through, but this may be at the expense of your body.
Symphysis Pubis Dysfunction
Symphysis pubis dysfunction or SPD is a condition caused by excessive movement of the pubic symphysis. It is extremely painful and may be associated with the misalignment of your pelvis.
It’s often referred to as “lightning crotch” because that is exactly what it feels like.
The major cause of SPD is failure or lack of support of the pelvic floor. This is why pregnant people typically experience this towards the end of their pregnancy- think 36 or 37 weeks.
The Pelvic Floor’s Involvement
Your pelvic floor is like a giant trampoline that holds up your pelvic parts. It’s made up of ligaments that are like plastic fruit bags, meaning that they stretch and deform. After all the misshaping, they do not have the elasticity to snap back like muscles do.
When you have your first child, that “trampoline” is tight. By the end of the pregnancy, it starts to stretch out, much like what a trampoline looks like after a heavy snow.
Why Does it Happen Early With the Second Pregnancy?
Post-pregnancy, that “trampoline” slowly begins to return to its previous shape, but never quite regains its pre-pregnancy elasticity and strength.
So, with a second pregnancy, you’ll put a little more weight on it this time, it dips a little lower, and the pelvic pain comes out even earlier. I hear all the time, “I didn’t get this until the end of my first and now I’m only at 5 months and I already feel it!”
Related Post: 9 Totally Normal Symptoms During the Last Month of Pregnancy
How a Pregnancy Trained Chiropractor Would Diagnose and Treat a Pubic Injury
SPD symptoms are becoming more widely recognized by clinical care providers. While the condition is common, it is far from normal and if left unchecked, can cause long-term problems.
Imaging is one way to diagnose and assess SPD, but x-rays are contraindicated in pregnancy. Therefore, your practitioner will need to rely on your symptoms and a thorough exam.
Often times, women have uneven legs without even realizing it until now. The unevenness of your legs can cause the sacroiliac (SI) joint that is between the sacrum and ilium bones of the pelvis to rotate towards the back.
This causes stress and mild shearing or pulling apart with straining the front pubic joint.
I suggest you have an International Chiropractic Pediatric Association (ICPA) certified chiropractor evaluate your leg lengths.
Related Post: How a Chiropractor Can Help During Pregnancy
Here is what you can and should expect from your pregnancy trained chiropractor:
- A full evaluation of your lower back, pelvis, and pubis for restrictions, meaning bones that are not moving properly and muscles that aren’t functioning correctly or have areas of spasm.
- A personalized treatment plan that includes gentle manipulation/mobilization of the pelvis, sacrum, and lower back.
- Muscle work on the affected muscles of the hips, lower back, and pubis, and gentle mobilization of the pubic joint.
- Recommendations for modifications to improve your Activities of Daily Living and/or bracing instructions.
- An acute treatment plan that transitions you into active care, as tolerated. This will likely include demonstrating exercises for the pelvis and core for you to perform at home or in the office. This will not only help stabilize your back, but also set you up for greater success after you deliver with that chubby baby and loading bulky strollers and car seats into your car.
Other treatment options they might recommend include physical therapy, hydrotherapy (exercise in water) and acupuncture.
If you are still having pelvic pain and discomfort after birth, it would be helpful to consult with a pelvic floor physical therapist. They will address muscles inside the pelvic ring as well as give you exercises to strengthen and balance your pelvic floor.
Chiropractors cannot address internal structures in many states.
What Does Pubic Symphysis Dysfunction Feel Like?
PSD starts with just a little pressure in your groin and can escalate quickly all the way to “Lightning Crotch,” or stabbing pains “Downtown.” Groin issues are typically caused by issues of supporting weight – however small – that are unresolved from a prior pregnancy.
The pain and pressure around 37 weeks can make it hurt to walk, stand, or even sit.
The mechanism of injury and strain for a pregnant patient is very similar to that of a shin splint. This means that, under stress, the ligaments in the groin tug on the bone, creating inflammation and edema.
Related Post: The Ultimate Third Trimester Checklist
What Makes It Worse?
PSD typically shows up to wreck your groin with your second baby because your pelvic floor is made of ligaments and like plastic fruit bags – they stretch but do not stretch back. This changes where your second and subsequent baby’s position is, putting more stress on the groin.
What Can Make It Go Away?
You can definitely heal pelvic pain, but it may not be as quick as you think.
There are certain pregnancy exercises for pelvic pain that you can do to reduce the discomfort. However, exercising in your third trimester can sometimes be tough.
Try some of these strategies to heal pelvic pain at 37 weeks and resolve it once and for all:
- While seated, use a playground ball between your knees and squeeze gently to release and stretch your groin.
- Do stretches that open up your pelvis like lunges and squats.
- Gentle trigger point work.
- Ice to your nether-regions using a small ice pack for 5 minutes.
If these exercises and stretches don’t help your pelvic pain, try some strategies to compensate for the discomfort until it fully heals like:
- Sleep with a pregnancy pillow between your legs.
- Pregnancy belt to support the weight of your growing belly and take the weight off your pelvis.
- Use a small bench under your desk to put your feet up or while preparing food.
- Sit to put on your pants and don’t try to do it standing.
Pelvic pain during pregnancy can certainly bring on a lot of stress and discomfort. This can be especially upsetting if it’s your second or subsequent pregnancy and you have small children to take care of.
But if you’re experiencing pain and pressure in your pelvis in the third trimester, have faith that it will resolve. With some of the above mentioned strategies, you can heal pelvic pain and feel better before giving birth.
About the Author
Dr. Brandie Nemchenko is the founder and CEO of Experience Chiropractic and Bloom @ Experience Chiropractic, a tailored approach to prenatal chiropractic. Through webinars, training for medical professionals, and her book, What You Don’t Expect What You’re Expecting, newly released in its second edition, Dr. Nemchenko is committed to helping pregnant women across the country be open about their pain and take action to treat it.
