Pelvic girdle instability

Causes and treatment options

In the case of pelvic girdle instability, the ligaments that hold the pelvis together in the area of the pubic symphysis have become loose. The main causes are physical stress, hormonal changes during pregnancy, and previous pregnancies or births. Pelvic girdle instability is characterized, among other symptoms, by pelvic pain, low back pain, SI joint irritation, and restricted mobility.

Pregnant women are most affected by pelvic girdle instability combined with pelvic pain. Five to nine per cent of all pregnant women will develop pelvic girdle instability during pregnancy or the birth of their child.

Structure of the pelvic girdle

The pelvis consists of three bone components that form a ring. The pelvic girdle is located at the bottom of the back, connecting the trunk with the legs. The three bone parts of the pelvic girdle are connected by joints. These are reinforced by capsules and elastic ligaments. If the ligaments are overstretched, the pelvic girdle is loosened. The results are not only pelvic pain and restricted mobility but also lateral misalignment of the spine with trapped nerves or SI joint irritation.

Pregnancy-related pelvic girdle instability

During pregnancy, pelvic girdle relaxation, also known as symphysis relaxation or pelvic weakness, can occur together with pelvic pain. Due hormonal changes and the physical strain caused by the unborn child, the pelvic ligaments are stretched during pregnancy. The instability is mainly characterized by pelvic pain and impaired mobility. It may occur at the beginning of the pregnancy, and last a long time after the birth.

Pregnancy hormones influence all elastic ligaments, therefore also the pelvic ligaments. The ligaments become more elastic and more supple. This happens in preparation for the birthing process. The relaxation of the pelvis widens the birth canal through which the unborn child has to pass during birth. This hormonal ligament relaxation usually occurs around the 20th week of pregnancy. In some cases, the ligaments can be stretched beyond the usual degree much earlier. This leads to an instability of the pelvic girdle, which may affect the course of the birth.

Mechanical pelvic girdle instability

During birth, ligaments can be completely overstretched, and even tear. This may happen when the birth is too fast, during forceps or breech delivery, or when the child is very big. These complications will make another birth more difficult.

Sports-related pelvic girdle instability

Pelvic girdle instability can also occur during an accident or a sports injury. A football tackle can overstretch the ligaments as much as overexertion during a long session of running or walking. A fall for cyclists or horseback riders can cause a pelvic injury with subsequent instability.

Symptoms of pelvic girdle instability

Pelvic girdle instability is mainly characterized by pelvic pain and restricted mobility. Pelvic pain commonly occurs when getting up, using stairs, bending down, lifting heavy objects, and during exercise.

The pain can go as far as the groin or the inside of the thigh –

and, in women, to the vagina. Pelvic relaxation can also cause SI joint irritation with pain in the sacroiliac joints. Another consequence of pelvic girdle instability can also be an insecure gait. Those affected cannot turn when lying down, and cannot stand on one leg.

How to diagnose pelvic girdle instability

The doctor can diagnose pelvic girdle instability based on the typical symptoms mentioned. And a CT (computed tomography) can confirm the diagnosis. Usually, further examinations are carried out to exclude other disorders.

Treatment of pelvic girdle instability

The treatment goal is rapid pain reduction as well as strengthening and relief of the ligaments. Medication and massages of the pelvis will alleviate the pain. Physiotherapy will strengthen the ligaments and the surrounding muscles. Heat and infrared treatments can effectively support therapy. These measures, in particular the administration of painkillers, are taken in consultation with the treating doctor or midwife.

If pelvic girdle instability is recognized early and treated in time, there should be no reason to expect any related complications during birth. Pelvic weakness and pain, however, can persist over weeks and months. The treatment should therefore be continued after birth.

Reducing acute pelvic pain and preventing pelvic girdle instability

A pelvic orthosis such as SacroLoc can effectively support the treatment of pelvic pain and will prevent future problems. It helps reduce pain by stabilizing the pelvis and relieving the stretched ligaments, in particular in the area of the SI joint.

Two flexible, nubbed pads massage typically painful trigger points during movement, and stimulate circulation. This helps to relieve tension and counteract cramps.

Using the SacroLoc pelvic orthosis is simple. Its anatomically contoured shape offers a high degree of wearing comfort. A practical abdominal fastening with integrated finger loops makes it easy to put on the orthosis. The orthosis is tightened around the pelvis using two straps, and the stabilizing force can be adjusted as required. The closure and the edges have a flat design so they don’t cut in during wearing, and will hardly be noticed under clothes.