For many, postpartum recovery brings a long list of changes—healing from delivery, caring for a newborn, disrupted sleep, breastfeeding or feeding, carrying a baby, and gradually returning to normal activities.
But what about the pelvic pain or low back pain that doesn't seem to be going away?
If you're experiencing pain around your pelvis, hips, sacroiliac (SI) joints, pubic area, or lower back after pregnancy, you may be dealing with postpartum pelvic girdle pain (PGP).
Research has found an interesting connection between pregnancy-related changes in the pelvic ligaments and pelvic girdle pain that persists after delivery. One study found that asymmetrical laxity of the sacroiliac joints during pregnancy was associated with a greater likelihood of moderate-to-severe pelvic pain continuing into the postpartum period.
So, what does that mean for you—and where might chiropractic care fit into postpartum recovery?
What Is Pelvic Girdle Pain?
Pelvic girdle pain refers to pain involving the pelvic region, which may include the area around the sacroiliac joints, the pubic symphysis, buttocks, hips, or lower back.
You might notice pain when:
Walking
Going up or down stairs
Getting in and out of bed
Rolling over in bed
Standing on one leg
Getting in or out of a car
Lifting or carrying your baby
Putting on pants or shoes
Sitting for extended periods
Returning to exercise
Postpartum pelvic girdle pain can affect much more than your comfort. It can make everyday activities—and caring for a newborn—more difficult.
What Does Pregnancy Have to Do With Ligament Relaxation?
During pregnancy, your body undergoes significant hormonal and biomechanical changes.
Hormonal changes contribute to increased laxity of connective tissues around the pelvis. This is part of the body's preparation for childbirth. However, pelvic pain is not simply a matter of having “too much relaxin.” Research suggests that the relationship between hormones, ligament laxity, pelvic movement, muscle function, and pain is more complicated. One particularly interesting finding involves asymmetry.
A study of pregnant women found that overall SI joint laxity wasn't significantly different between women with and without pregnancy-related pelvic pain. However, the difference in laxity between the left and right sides was greater among women with moderate-to-severe pelvic pain.
A subsequent study found that among women experiencing moderate-to-severe pelvic pain during pregnancy, asymmetrical SI joint laxity was associated with approximately three times the risk of moderate-to-severe pelvic pain persisting postpartum compared with symmetrical laxity.
That's an important distinction.
It isn't simply about the pelvis becoming more mobile during pregnancy. How the pelvis is moving and loading from side to side may also matter.
Why Can Pelvic Pain Continue After Delivery?
Giving birth doesn't immediately return your body to its pre-pregnancy state.
After delivery, you're suddenly doing a lot of new physical activities:
Carrying your newborn
Feeding your baby
Getting up and down repeatedly
Bending over a crib
Lifting a car seat
Carrying diaper bags
Holding your baby on one hip
Spending time sitting during feedings
Sleeping in unfamiliar positions
Your center of gravity, activity level, sleep, muscle function, and movement patterns are all changing at the same time.
Current clinical guidance recognizes postpartum pelvic girdle pain as a multifactorial condition. Previous pain, symptom severity, physical workload, sleep, recovery, and other factors can influence how symptoms persist or improve.
“Does Postpartum Pelvic Pain Mean My Pelvis Is Out of Alignment?”
Not necessarily.
This is an important conversation to have with your chiropractor.
Pelvic pain doesn't automatically mean that one side of your pelvis is literally “out of place.” Pelvic girdle pain can involve multiple factors, including joint and ligament behavior, muscle function, movement patterns, and sensitivity of the surrounding tissues.
How Can Chiropractic Care Help With Postpartum Pelvic Pain?
Chiropractic care may be one component of a conservative approach to postpartum low back or pelvic girdle pain.
A chiropractor can evaluate your spine, pelvis, movement patterns, and surrounding musculature and discuss whether hands-on care is appropriate for your particular situation.
Depending on your needs, care may include:
Gentle spinal or pelvic mobilization
Appropriate manual therapy
Soft-tissue techniques
Mobility exercises
Strengthening exercises
Movement and body-mechanics recommendations
Home-care strategies
Referral or coordination with another healthcare professional when appropriate
Instead, treatment can focus on helping you move more comfortably, improve function, and gradually return to the activities that matter to you.
What About Exercise and Pelvic Health Physical Therapy?
Chiropractic care doesn't have to be an either/or decision.
Postpartum recovery may benefit from a team approach. Depending on your symptoms, a pelvic health physical therapist, primary care provider, OB/GYN, or other healthcare professional may also be an important part of your care.
Clinical guidelines for postpartum pelvic girdle pain emphasize assessment, rehabilitation, exercise, self-management, and appropriate referral or shared care.
Your individual treatment plan should depend on your symptoms, goals, health history, and response to care.
“How Do I Know If I Should Get Help?”
Consider talking with a healthcare professional if postpartum pelvic or back pain is:
Persisting instead of improving
Interfering with walking or stairs
Making it difficult to care for your baby
Affecting your sleep
Preventing you from exercising or returning to normal activities
Getting progressively worse
Limiting your ability to work or perform everyday tasks
You don't have to wait until your pain becomes severe before asking questions.
Your Body Went Through Something Big. Recovery Takes Time.
Pregnancy and childbirth can place substantial demands on the pelvis, spine, muscles, and connective tissues.
If you're still experiencing pelvic, hip, or low back pain after having your baby, you're not necessarily “just sore from being a new mom.”
We work with people throughout pregnancy and postpartum recovery to understand what's contributing to their symptoms and develop an individualized plan of care.
If postpartum pelvic girdle pain, SI joint discomfort, or low back pain is making everyday life harder, contact the office to schedule an evaluation and find out whether chiropractic care may be appropriate for you.