‘I’m a Pelvic Floor Therapist, and This Is the Sneaky Mistake That’s Making Your Pelvic Girdle Pain Worse’

You might not realize it, but every time you walk, climb the stairs, or even roll over in bed, you’re using your pelvic joints, muscles, and bones. And honestly, when everything in your pelvis works well, there’s really no reason to give it a second thought. You move through your day freely and pain-free. End of story.

But if there’s a problem with your pelvic girdle (the ring of bones around your body at the base of your spine), oh boy, will you feel it. A twinge of pain can strike when you least expect it—like getting when you’re putting clothes on or getting into the tub—and even the simplest movements can become really uncomfortable.

Pelvic girdle pain (PGP) happens when you have discomfort in the front (around the pubic bone) or the back (around the sacroiliac joints) of the pelvic region, says Marcy Crouch, PT, DPT, a pelvic floor physical therapist and co-host of the ‌No Mama Left Behind‌ podcast. “The pain can range from a mild ache to a severe, sharp pain that can interfere with daily activities,” Crouch says. You might also get a clicking or grinding in the pelvic area.

Pelvic girdle pain is pretty common in pregnancy (affecting one in five pregnant people, per the Royal College of Obstetricians and Gynecologists (RCOG)), but it can also affect nonpregnant people, too. And certain habits can make it worse. One surprising trigger is something you may do multiple times a day (and can’t avoid): Getting in and out of the car.

Yep, if you wince every time you sit in the driver’s seat, it’s no coincidence. Read on to learn why getting in and out of the car worsens pelvic girdle pain and what you can do about it (no, you don’t need to stop driving).

What causes pelvic girdle pain?

Pregnancy is the primary reason for pelvic girdle pain. It makes sense: There’s a lot going on in your pelvic area during this time. “During pregnancy, your posture, and therefore how you move and use your muscles, changes as baby gets bigger,” Crouch says. As your baby bump grows, the stress and pressure on your pelvis does, too. “This can sometimes cause previously trouble-free joints to become irritated due to unusual rubbing and your muscles straining to provide support in unfamiliar ways,” she says.

Pregnancy hormones play a role in pelvic girdle pain, too. “Another thing that happens during pregnancy is that your body produces relaxin, a hormone that loosens ligaments and joints to prepare for childbirth,” Crouch says. “While this is necessary, it can also make your pelvic joints less stable and more prone to pain.”

Though pelvic girdle pain is more likely to happen during pregnancy, it can affect you even if you’re not expecting. Other possible causes of pelvic girdle pain include the following, per Crouch:

• Previous or new pelvic or hip injuries
• Uneven weight distribution (like carrying heavy bags on one side)
• Weak pelvic floor, hip, or core muscles

How getting in and out of a car makes pelvic girdle pain worse

If your pelvic girdle is weak or unstable, anything that strains the pelvic bones and joints will cause or worsen pain. Getting in and out of a car is one of these things. Here’s why: getting in and out of the car “often involves asymmetrical movements that put more stress on the pelvic joints,” Crouch says. By “asymmetrical,” we mean standing on one leg.

When you get in or out of a car, you must shift your weight to one side. Problem is, “stepping one leg in or out at a time can cause uneven pressure,” she says, which can lead to pain and discomfort. That’s also why other asymmetrical activities/movements can cause pain. These include the following, per RCOG:

• Walking on uneven surfaces/rough ground or for long distances
• Standing on one leg, like climbing the stairs, dressing, or getting in or out of the bath

How to get in and out of the car with less pelvic girdle pain

Luckily, with a few simple tweaks, you can put less strain on your pelvis when getting in and out of a car. To reduce pain, try these tips, per Crouch:

• Sit first: Sit down on the car seat with your legs outside, then swing your legs in together. Do the opposite when getting out.
• Keep your knees together: Squeeze your knees together as you swing both legs in or out of the car to avoid putting uneven pressure on your pelvis.
• Use a plastic bag: Place a plastic bag on the seat to help you swivel more easily.
• Support yourself: When getting in our out, use your hands to support yourself on the door frame, steering wheel, or seat for added stability.

Other ways to manage pelvic girdle pain

“Pelvic girdle pain can be a real pain in the, well, pelvis. But with the right strategies and support, you can manage it effectively,” Crouch says. This usually “involves a mix of lifestyle adjustments, exercises, and sometimes professional help from a pelvic floor physical therapist” (more on this later).

Try the following strategies to help keep your pelvic girdle pain in check, per Crouch:

• Implement gentle exercise: “Gentle activity like walking, swimming, or prenatal yoga can help keep your muscles strong without putting too much strain on your pelvis,” Crouch says. Still, every person’s body is unique. “One exercise that might help someone could make another person's symptoms worse,” she says. Always listen to your body. If something hurts, stop doing it. Better yet, “talk to a pelvic floor therapist who can provide you with appropriate exercises to better support your pelvic joints,” Crouch says.
• Take breaks: “If you have pain with things you have to do (like walking, standing, sitting, etc.), make sure you take breaks from the activity once you start feeling irritation,” Crouch says. “Doing things in intervals can be a lifesaver here.”
• Avoid asymmetrical movements/exercises: “It is important to try to avoid any activities that cause you more pain,” Crouch says. Case in point: asymmetrical movements. That means unilateral exercises like lunges are not the best idea when dealing with pelvic pain.
• Pay attention to your posture. “Avoid standing with most of your weight on one leg or crossing your legs while sitting,” Crouch says.
• Use supportive gear: “Consider using a sacroiliac belt [like this one from Serola Biomechanics] to help stabilize your pelvis,” Crouch says. By wearing an SI belt, you can support your sacroiliac joint (in the back of the pelvis), so it works in a normal range of motion.
• Apply heat/ice: “Use heat packs or ice packs (whichever feels best) to soothe sore areas,” Crouch says.

Additional tips to reduce pelvic girdle pain include the following, per RCOG:

• Sit to get dressed and undressed
• Put equal weight on each leg when you stand
• Lie on the less painful side while sleeping
• Keep your knees together when turning over in bed
• Avoid lifting anything heavy, for example heavy shopping
• Avoid stooping, bending, or twisting to lift or carry a toddler or baby on one hip
• Avoid sitting on the floor, sitting twisted, or sitting or standing for long periods

When to see a physical therapist

If you’ve tried all the tips, and you still have persistent pelvic girdle pain, you don’t have to grin and bear it. Go get help from a pelvic floor physical therapist. They’re specially trained to diagnose and treat pelvic problems. “Don’t hesitate to reach out to a pelvic floor physical therapist,” Crouch says. “We are your go-to for getting that pain under control and getting you back to feeling your best.”

You should also check in with a physical therapist if you have the following symptoms, according to Crouch:

• If your pain is severe or affecting your daily activities
• If the pain doesn’t improve with home remedies or gets worse
• If you have difficulty walking or moving around
• If you’re dealing with pelvic girdle pain after giving birth

Resources like PelvicRehab.com and the Academy of Pelvic Health Physical Therapy can help you find a qualified pelvic health specialist near you.

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