Exercise generally works best once your pelvis has been realigned by an experienced manual therapist and when you feel little pain. If you have a lot of pain, it generally does not matter how much exercise you do, your pain will inhibit your muscles from working properly and you may put in a great deal of effort for little or no reward. It is best to start with manual therapy to sort out the joint function, and then discuss with your manual therapist which type of exercise is most likely to be beneficial for you. See our 'PGP is treatable' and 'What to expect from treatment' pages for more information.
Each woman’s experience of PGP differs slightly, so different exercises will suit different women. There is no one single exercise or exercise programme that will suit all women. The ultimate goal is for you to recover enough to be able to enjoy whichever sport/exercise you practised before you became pregnant and developed PGP. Our members have reported getting back to all of the following after receiving the correct treatment: marathon running, skiing, sailing, dancing, horse-riding, trampolining, hiking, jogging, kick boxing and ballet.
As a general rule, you should allow your pain to act as a guide to how much exercise you can do. It can help to keep as active as possible, within the limits of your pain.
Before you start any exercise, we suggest that you talk to your manual therapist who should be able to give you a bespoke exercise plan as part of the course of treatment, and will update the exercises you need to do at each appointment. Often there are only a couple of strengthening and/or stretching exercises for you to focus on after each session – if your pain is reducing, you will be able to move normally which is the best sort of exercise and means that you are effectively exercising every time you do anything. If you follow the specific exercises you are given and they are regularly updated and progressed, you will stand the best chance of making a full recovery.
Until you have recovered it may be best for you to avoid sports that involve a lot of asymmetric movement, for example, some aerobic exercises which require you to abduct your legs beyond the pain-free gap. Swimming breaststroke, some gym machines and yoga movements also do this.
Once your pelvis is well aligned and you are largely pain-free you might like to try the following to ease back into exercise:
- Walking: a graded walking programme can be beneficial, gradually building up the distances to be walked.
- Pilates: Pilates is a gentle, low-impact form of exercise. It can help to maintain and improve the condition of both abdominal and pelvic floor muscles, which in turn stabilises the joints of the pelvis. Many women who have PGP have found that Pilates can help to stop their pelvis moving out of alignment and therefore keep ‘the niggles’ at bay. For more information and class locations, see www.pilates.co.uk.
- Swimming: when your manual therapist suggests you are ready to return to exercising in water it can be helpful to follow a graded programme similar to walking, as the resistance of the water and the buoyancy can often mask how difficult the exercise is, so it is easy to overdo it. Front or back crawl are often less of a strain on the pelvic joints; breaststroke can be quite a strong stress across the pelvic joints, so take care when you go back to this style of swimming. Many women find hydrotherapy and aquanatal exercise helpful, click here for more information about which exercises can be helpful and what to avoid with PGP.
Here are some suggestions to consider whilst exercising which can help you to avoid stressing the pelvic joints as you recover:
- Make sure your instructor knows that you have PGP so that they can tailor the activity to your ability.
- Try not to lift or push anything too heavy.
- Try not to over-exert yourself.
- Be careful of any large movement that causes one side of the pelvis to move against the other, for example, standing on one leg. This results in a vertical or up and down stress across the symphysis pubis and sacroiliac joints.
- Any large movement that causes each side of the pelvis to move in opposite directions is unwise, for example, moving the legs far apart. This results in a ‘gapping’ movement of the symphysis pubis joint.
There is no need to panic if you do overdo it! You won't be back to square one but if you find your symptoms are worse after doing a particular exercise, it will be worth seeking further 'hands on' treatment and advice from your manual therapist about modifying the exercises you are doing.