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Pelvic Girdle Pain & SI Joint Pain in Pregnancy

When Walking, Rolling or Standing Hurts

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Maybe walking was fine a few weeks ago, but now every step seems to remind you that your pelvis is pregnant too.

Perhaps pain appears around the back of one side of your pelvis near the sacroiliac joint—or SI joint. Maybe you feel pain across both sides of your lower back, through your buttocks, around your hips or directly at the pubic bone in the front.

Rolling over in bed becomes a carefully planned movement.

Getting out of the car hurts.

Stairs feel harder.

Standing on one leg to put your pants on suddenly seems impossible.

You may have been told:

“Your pelvis is unstable because of pregnancy.”

Or:

“It's just relaxin—you'll have to wait until the baby comes.”

But pregnancy-related pelvic girdle pain is more complicated than simply having a loose or unstable pelvis.

Current RCOG guidance emphasizes that the pelvis remains strong and adapts to pregnancy, and experiencing pelvic girdle pain does not necessarily mean that your pelvis is damaged or injured. Multiple factors can contribute to symptoms.

And importantly, you do not automatically have to live with significant pain until delivery.

At Peloraa

At Peloraa, our goal is to help you understand your pain without making you afraid of your body.

Understand your journey

What You Should Know About Pelvic Girdle Pain & SI Joint Pain in Pregnancy

Find clear, supportive answers to common questions about urinary incontinence, bladder leakage, symptoms, treatment, and pelvic health physiotherapy.

What Is Pregnancy-Related Pelvic Girdle Pain?

Pelvic girdle pain (PGP) is pain arising around the joints and structures of the pelvis during or after pregnancy.It may be felt:Around one or both sacroiliac joints at the back…

Pelvic girdle pain (PGP) is pain arising around the joints and structures of the pelvis during or after pregnancy.

It may be felt:

Around one or both sacroiliac joints at the back of the pelvis
Around the pubic symphysis at the front
Through the buttocks
Around the hips or groin
Into the thighs
Across the lower back

The sacroiliac joints (SIJs) are the joints where the sacrum at the base of your spine connects with the pelvic bones.

So when someone says they have SI joint pain during pregnancy, that can fall within the broader category of pregnancy-related pelvic girdle pain.

RCOG reports that PGP affects approximately 1 in 5 pregnant women and commonly affects walking, stairs and turning over in bed.

Pelvic Girdle Pain, SIJ Pain & Pubic Pain: What's the Difference?

Pain PatternWhere You May Feel ItCommon Aggravating ActivitiesSI Joint–Dominant PainOne or both sides of the lower back or upper buttock close to the sacrum.Walking, stairs,…

Pain Pattern

Where You May Feel It

Common Aggravating Activities

SI Joint–Dominant Pain

One or both sides of the lower back or upper buttock close to the sacrum.

Walking, stairs, prolonged standing, turning, getting in/out of the car or single-leg activities.

Pubic Symphysis Pain

Front of the pelvis around the pubic bone, groin or inner thighs.

Walking, stairs, rolling in bed, separating the legs or standing on one leg.

General Pelvic Girdle Pain

Front, back or both sides of the pelvis and sometimes hips or thighs.

Walking, prolonged positions, lifting, bed mobility and daily activities.

Pregnancy-Related Lower Back Pain

More centrally through the lumbar spine and surrounding muscles.

Sitting, standing, lifting, bending or prolonged activity.

Why Does Pelvic Girdle Pain Happen?

Pregnancy creates significant changes in how your body carries load.Your baby grows.Your abdominal wall changes.Your centre of gravity shifts.Your movement strategies…

Pregnancy creates significant changes in how your body carries load.

Your baby grows.

Your abdominal wall changes.

Your centre of gravity shifts.

Your movement strategies adapt.

Hormonal and tissue changes occur.

Your hips, spine and pelvic muscles are responding to a body that is changing quickly.

RCOG's newer information emphasizes that PGP is multifactorial and should not automatically be described as pelvic damage or instability.

This can be reassuring.

Pain does not necessarily mean your SI joint is “out of place.”

And treatment does not need to revolve around repeatedly trying to “put the pelvis back in.”

Why Does Rolling Over in Bed Hurt So Much?

Rolling in bed requires you to shift load across the pelvis while moving the trunk and legs.When the pelvic girdle is sensitive, this combination can become painful.The same…

Rolling in bed requires you to shift load across the pelvis while moving the trunk and legs.

When the pelvic girdle is sensitive, this combination can become painful.

The same reason explains why standing on one leg to get dressed, climbing stairs or getting out of a car can be particularly uncomfortable.

RCOG identifies walking, stairs, standing on one leg, moving the legs apart and rolling in bed as common aggravating activities.

Physiotherapy may help you find temporary movement strategies that reduce irritation while also gradually improving strength and movement tolerance.

Should I Stop Moving?

Usually, complete avoidance is not the goal.The updated RCOG patient guidance specifically notes that movement and exercise are not harmful and can reduce pregnancy-related pelvic…

Usually, complete avoidance is not the goal.

The updated RCOG patient guidance specifically notes that movement and exercise are not harmful and can reduce pregnancy-related pelvic girdle pain.

However, this does not mean pushing through significant pain.

Your physiotherapist may temporarily modify the amount or type of walking, lifting, stairs, exercise or single-leg activity you are doing while helping you build tolerance again.

The goal is:

Modify—not immobilize.

How Can Physiotherapy Help?

NICE recommends considering referral to physiotherapy for pregnancy-related pelvic girdle pain for exercise advice and/or a non-rigid lumbopelvic support belt.Depending on your…

NICE recommends considering referral to physiotherapy for pregnancy-related pelvic girdle pain for exercise advice and/or a non-rigid lumbopelvic support belt.

Depending on your assessment, physiotherapy may include:

Hip and pelvic strengthening
Abdominal and trunk exercises
Movement and activity modification
Mobility where appropriate
Strategies for rolling in bed or getting in/out of a car
Advice for lifting or caring for another child
Breathing and pressure management
Pelvic floor assessment when relevant
Support-belt recommendations
Hands-on treatment when appropriate

The goal is not simply to temporarily reduce pain during your appointment.

It is to make walking, sleeping, working and everyday movement easier.

What Does the Pelvic Floor Have to Do With SIJ or Pelvic Girdle Pain?

The pelvic floor is one part of a larger system that includes your abdominal muscles, hips, diaphragm, spine and pelvic girdle.When movement hurts, your body may begin protecting…

The pelvic floor is one part of a larger system that includes your abdominal muscles, hips, diaphragm, spine and pelvic girdle.

When movement hurts, your body may begin protecting the area by tightening muscles around the pelvis. Sometimes this includes the pelvic floor.

But pelvic girdle pain does not automatically mean the pelvic floor is weak, and it does not automatically mean you need Kegels.

Your pelvic floor may be strong.

It may be tense.

It may be functioning normally.

Or it may be one part of the movement pattern contributing to symptoms.

That is why Peloraa looks at the whole system rather than assuming one muscle is responsible.

How we support you

The Peloraa Way

The Peloraa Way: We Don't Tell You Your Pelvis Is Broken
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At Peloraa, our goal is to help you understand your pain without making you afraid of your body.

Pregnancy-related pelvic girdle and SIJ pain can be very uncomfortable, but pain does not automatically mean your pelvis is unstable, damaged or unable to support your pregnancy.

We begin by listening to where you hurt, what movements aggravate symptoms, when the pain began and how it is changing your daily life.

Maybe your goal is to walk your dog.

Sleep more comfortably.

Continue working.

Exercise.

Pick up your toddler.

Or simply turn over in bed without preparing yourself for pain.

Your physiotherapy assessment may include your back, hips, pelvis, movement, strength, abdominal system, breathing and pelvic floor when relevant.

From there, treatment is individualized around movement, strength, symptom management and confidence.

Listen. Understand. Support. Move. Strengthen. Restore Confidence.

That's the Peloraa Way.

Pelvic Girdle Pain Care Works Better as a Team
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Pregnancy-related pain should still be viewed within your overall pregnancy.

Peloraa works collaboratively with your midwife, obstetrician, family physician and maternity healthcare team.

If symptoms are unusual, severe, accompanied by neurological symptoms or do not fit a typical musculoskeletal pattern, we may recommend further medical assessment rather than assuming the SI joint is responsible.

RCOG also emphasizes early assessment and treatment because PGP can often be managed during pregnancy rather than simply waiting for delivery.

A little more clarity

Short FAQs About Rectal Pain

Royal College of Obstetricians and Gynaecologists (RCOG). Pelvic Girdle Pain and Pregnancy. Provides information regarding pregnancy-related pelvic girdle pain, SI and pubic symphysis involvement, symptoms and physiotherapy treatment.

RCOG. Pelvic Girdle Pain Patient Information, 2025 update. Emphasizes that the pelvis is strong, PGP is multifactorial and movement and exercise can be helpful rather than harmful.

National Institute for Health and Care Excellence (NICE). Antenatal Care (NG201). Recommends considering physiotherapy referral for pregnancy-related pelvic girdle pain for exercise advice and/or a non-rigid lumbopelvic belt.

This information is intended for general education and does not replace individualized pregnancy or medical assessment.

Not all lower-back, pelvic or hip pain during pregnancy comes from the SI joints or pelvic girdle. Other musculoskeletal, neurological, urinary, obstetric and medical conditions can produce similar symptoms.

Seek prompt medical or maternity assessment for severe or rapidly worsening pain, significant trauma, fever, vaginal bleeding, leaking fluid, regular contractions before term, new leg weakness or significant numbness, loss of bladder or bowel control, significant calf pain or swelling, inability to bear weight, decreased fetal movement or other symptoms that concern you.

Peloraa works collaboratively with your maternity healthcare team whenever further medical evaluation or pregnancy-related precautions are required.

Is SI joint pain common during pregnancy?

Pain around the SI joints can occur as part of pregnancy-related pelvic girdle pain, which affects about 1 in 5 pregnant women.

Does SIJ pain mean my pelvis is unstable?

Not necessarily. Current RCOG guidance emphasizes that the pelvis remains strong and that PGP does not mean there is necessarily injury or damage.

Can physiotherapy help pelvic girdle pain?

Yes. NICE recommends considering physiotherapy for exercise advice and/or a non-rigid pelvic support belt.

Should I stop exercising?

Usually not completely. Activity may need to be modified according to symptoms, but movement and appropriate exercise are generally encouraged.

Can I still have a vaginal birth with pelvic girdle pain?

Usually yes. RCOG states that most people with PGP can have a vaginal birth. Your labour team can help support comfortable positions.

Will pelvic girdle pain disappear after birth?

Many people improve after delivery, although some continue experiencing symptoms postpartum and may require continued rehabilitation.

References & Clinical Credits

Royal College of Obstetricians and Gynaecologists (RCOG). Pelvic Girdle Pain and Pregnancy. Provides information regarding pregnancy-related pelvic girdle pain, SI and pubic symphysis involvement, symptoms and physiotherapy treatment.

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RCOG. Pelvic Girdle Pain Patient Information, 2025 update. Emphasizes that the pelvis is strong, PGP is multifactorial and movement and exercise can be helpful rather than harmful.

‍

National Institute for Health and Care Excellence (NICE). Antenatal Care (NG201). Recommends considering physiotherapy referral for pregnancy-related pelvic girdle pain for exercise advice and/or a non-rigid lumbopelvic belt.

Medical Disclaimer

This information is intended for general education and does not replace individualized pregnancy or medical assessment.

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Peloraa works collaboratively with your maternity healthcare team whenever further medical evaluation or pregnancy-related precautions are required.

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