How pregnancy yoga can help to ease symptoms of Pelvic Girdle Pain
- Emily Zarza
- Sep 24
- 4 min read
Pelvic girdle pain (PGP) is a condition that affects 1 in 5 women during pregnancy, and, according to Dr Sinead Dufour, up to 70% of women in subsequent pregnancies. It can be experienced from mild discomfort all the way to debilitating pain. The NHS calls PGP a ‘collection of uncomfortable symptoms caused by stiffness of your pelvic joints or the joints moving unevenly at either the back or front of the pelvis.’ On their webpage regarding the condition, they also say that ‘it is not known exactly why pelvic pain affects some women, but it’s thought to be linked to a number of issues, including previous damage to the pelvis, pelvic joints moving unevenly, and the weight or position of the baby.’ Dr Sinead Dufour, an advocate for women’s pelvic health and an expert in PGP, acknowledges PGP’s somewhat vague definition as ‘pain felt from below the rib line to just under the gluteus muscles, any time during pregnancy or in the first year after birth.’
I was interested in learning more about pelvic girdle pain (PGP) and wanted to develop my understanding of it as it is such a common symptom of pregnancy. I wanted to find out more about how we, as yoga teachers, can help students to find the help they need, the most recent evidence-based information on what PGP is, and how yoga can help to ease the symptoms of it.
Current issues surrounding PGP
Previously PGP was thought to have been linked to the hormone relaxin, which, alongside other hormones in the body, soften the ligaments and tissue around the pelvis in order to accommodate the growing baby. Women were (and still are) told that PGP is a result of ‘instability’ in the pelvis, which was caused by too much relaxin creating movement in the joints, causing them to become inflamed. Stability bands and pelvic stability exercises are often recommended to women with PGP. Women are also often told that their symptoms will worsen over time.
However, more recent evidence championed by PGP expert Dr Sinead Dufour has shown the cause of PGP to be far more complex. There are many causes for inflammation in the body, including lack of sleep, diet, and stress levels. The pelvic region is susceptible to pain sensitivity through inflammation, and it is also an area that retains trauma, especially if a woman has had a traumatic first birth. There is evidence to suggest that PGP may be exacerbated by a ‘guarding and protection’ effect that increases the sensitivity in the area in order to draw attention to it.
How yoga can help students with PGP
Postural awareness and knowing your body
Often, women who experience PGP will find that it ‘manifests as a sharp pain when walking or when carrying weight unevenly on one leg.’ However, PGP presents itself differently in each individual so it is important to gain an understanding of what aggravates it, and how to move mindfully to avoid it. In pregnancy yoga, it is common to include postural awareness movements such as pelvic tilts and finding your centre of gravity which can give students an opportunity to explore their bodies and gain an understanding of what feels right or wrong for them. In yoga students with PGP, encouraging them to keep ‘the legs closer, taking more weight into the arms, using pelvic floor muscles for additional support’ can ‘be carried into everyday movements’ which will help them throughout their pregnancy, not just in yoga class.
Yoga asana as a general practice is about discovering your body’s natural asymmetry. Everybody has a slightly asymmetrical body, and will have a dominant side when doing everyday activities. Regular asymmetrical movements will aggravate PGP, which yoga can help to correct. Finally, pregnancy yoga is not just about the poses themselves, but also the mindful transition from one pose to another. Learning to move in this mindful way can help students with PGP to alleviate their symptoms by understanding how to shift from standing, to sitting, to lying down, in a way that does not cause their symptoms to flare up.
Reducing inflammation and sensitivity through lower cortisol levels
In Sinead Dufour’s essay Pregnancy-related Pelvic Girdle Pain: Irish Physiotherapists’ Perspectives, she emphasises the link between PGP and increased cortisol levels. A research project in Ireland in 2017 found that ‘targeting the stress system rather than the biomechanics of the pelvis, was effective in reducing PPGP and improving function over only two treatment systems.’ Part of the treatment involved ‘gentle restorative movement.’ Yoga can be a powerful way to switch on the parasympathetic nervous system, or the ‘rest and digest’ nervous system, which tells the body to reduce its production of cortisol. There is a ‘growing body of evidence on the effects of yoga practices on the modulation of inflammatory markers…and hormones such as cortisol.’ If increased cortisol levels and inflammatory markers in the body have been linked to PGP, and if yoga is strongly associated with the reduction of these, women can ease their PGP symptoms by simply attending pregnancy yoga classes.
Language and creating positivity
Yoga students with PGP may be coming to class having been told by well-meaning healthcare practitioners that their symptoms will worsen over time, that they are due to their ‘unstable’ pelvis, and that they will have to simply cope until after their pregnancy is over. As yoga teachers, we are not healthcare professionals, so our role in this instance is not to try to be one, but to refer students to local women’s health physiotherapists. However, we can still emphasise to students that their pelvis is strong and stable. We can also explain to students that the most recent evidence in the causes of PGP shows that it is far more complex than simply ‘too much relaxin’ and that there are in fact many factors that could contribute to it manifesting in women, which is why they should find a women’s health physio that specialises in it, to obtain a holistic and individualised care plan.
References
Pregnancy-related Pelvic Girdle Pain: Irish Physiotherapists’ Perspectives, 2019, Dr Sinead Dufour https://www.academia.edu/41727693/Pregnancy_related_Pelvic_Girdle_Pain_Irish_Physiotherapists_Perspectives
The role of yoga in inflammatory markers, 2022, Carolina Estevao, https://pmc.ncbi.nlm.nih.gov/articles/PMC6700894/
Yoga for Pregnancy and Birth, Uma Dinsmore-Tuli
Dr Sinead Dufour - Yoga for Pelvic Girdle Pain with Dr. Sinear Dufour on The Connected Yoga Teacher Podcast hosted by Shannon Crow.
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