3 Tests to know if you have Pelvic Girdle Pain (PGP)

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Last Updated on November 18, 2023 by theosteomum

Pelvic Girdle Pain – is it affecting you during pregnancy?

If it is, I have to say- I truly, truly feel for you.

I experienced what I would call a mild form of PGP in my second pregnancy.

At around the 8-month mark, I developed a right sided sacroiliac pain that would respond reasonably well to treatment… for a few hours. What I really needed was rest. But, with a 17-month-old to look after and a husband working long hours, that wasn’t going to happen.

I also didn’t know a whole lot about pregnancy- related pain back then. Sure, I’d done one semester of Obstetrics and Gynaecology at University about 12 years before but didn’t really know much more than the next manual therapist about what to do to help manage the day-to-day strain of PGP.

And yes, I’d also treated my fair share of pregnant women by then. However, I’ve since learned so much more that I’m sure I can help women achieve much better outcomes now.

My experience of Pelvic Girdle Pain:

I’ll never forget the time I thought I’d take my toddler for what I knew would be our last outing together for a while, about a week before my second baby was born. For those who don’t know, we live in Melbourne, Australia, and so I decided to take her to the Melbourne Zoo.

Our Zoo has a series of paths that lead off one central walkway. You enter each path, walk in a large loop past a variety of animals, and end up almost back where you began.

My daughter specifically wanted to see the orangutans, which are about ¾ of the way along one pathway. So, I obligingly hobbled and waddled along, pushing the pram. We saw the orangutans, and I set off on what I thought would be the short walk to complete this path and finish off our outing.

The sign that brought tears to my eyes:

I could’ve cried when I saw the sign that read, “path closed”, directing us back the way we’d come. Knowing that I had to walk all that way back again, in progressively worsening pain, delivered a blow that I can still feel to this day. My initial relief of reaching the car was very quickly overshadowed by the fact that I had to lift both the toddler and the pram into it.

And this is only a ‘mild’ case. I know there are women out there who are/were a whole lot worse off than I was.

So, if you’re pregnant and experiencing some sort of pain that you’re not quite sure how to define, read on to see if what you’re experiencing could be classified as “pelvic girdle pain” or PGP.

What is pelvic girdle pain (PGP)?

Pelvic girdle pain is the broad term for many different forms of pain. Other names include:

PGP
Symphysis pubis dysfunction
SPD
$%^&* (insert your choice of expletive here)

Basically, it is an all-encompassing term for pain anywhere between the sacroiliac joints, into the butt muscles, down the back of the thighs, and/or through the bony parts at the front of your pelvis, i.e. around the pubic bone.

Just to clarify, the sacroiliac joints are under the two ‘dimples’ on either side of the bottom of your spine.

How is pelvic girdle pain different to lower back pain?

There is a very distinct anatomical difference between the spine and the pelvis.

If you have pain only in the area in or around your spine (usually the 5 vertebrae of the lower back), then you have lower back pain.

If your pain is in or around your pelvis, or going into the back of your legs, then you may have PGP.

Lower back pain can in fact coexist with PGP, but the two can also be separate.

Why is it important to know the difference?

It is important to know which one(s) of these you are suffering, because the management for each is quite different.

If you’re unlucky enough to be experiencing both lower back pain and PGP, then you’ll need to find a personal balance between the two management strategies.

How do I know if I have pelvic girdle pain or lower back pain?

There are a few simple tests you can apply to figure out whether the pain you’re experiencing can in fact be called PGP.

We’ve already discovered that if your pain is only located in your spinal area, then it’s not technically called PGP. We’ll have another post about pregnancy-related lower back pain and its management very soon!

So- what are the tests for pelvic girdle pain (PGP)?

Tests known as “Orthopaedic tests” are used in the diagnosis of PGP. Some are more complicated than others, and some require another person to perform some sort of manoeuvre on you.

Technically, for you to give yourself the label of having PGP, the following two statements need to be true:

your pain must be in the pelvic area we discussed earlier, AND
at least 2 of these tests should be positive

3 tests for Pelvic Girdle Pain:

The three tests that I’m going to outline here though are super easy to perform. So, you can do them by yourself, and still get an idea whether your pain truly can be labelled PGP.

I’ve included some videos so you can be completely sure you’re performing the tests accurately.

1. Modified Trendelenburg–

Stand in front of a mirror. If you’re by yourself, it’s a good idea to have something nearby to hold on to for balance.

Lift one leg up so that it’s bent to 90 degrees at the hip and knee- to get an image of what this looks like, try channelling the Karate Kid doing his “Stork Stance” just before he delivers his final kick.

It’s also a good idea to have a look at the level of your hips when you do this (which is why you’re in front of a mirror). If you notice that one hip drops down a lot when that leg is raised off the ground, that’s a good sign that you could do with some strengthening through the gluteal muscles of the leg that you’re standing on.

2. Hip drop–

Stand with your feet about shoulder width apart. Keeping both feet on the ground, bend one knee just a little. Then straighten this knee and repeat on the other side.

3. Active Straight Leg Raise (ASLR)–

Lay on your back (just for a minute to perform this test- if you’re past the 20-week mark of your pregnancy, you shouldn’t stay there for much longer than this). Keeping your legs out straight, lift one foot up about 20cms (roughly 8 inches). Then lower that leg down and repeat on the other side.

All of these tests are positive if they reproduce or intensify your pain anywhere in or around your pelvis.

So, you did the tests- now what?

How did you go?

Did any of them increase your symptoms, or provoke pain elsewhere in your pelvis?

By definition, if these tests didn’t cause an increase in your pain, then what you’re experiencing most likely can’t be labelled as PGP.

Odds are that if you’re truly experiencing PGP, then at least one of these tests will increase your pain.

Whilst it may seem like a drag to have this information, knowledge is power, and now you can find some targeted strategies to help you manage your symptoms.

I’ve written this post to help you find some self-management tools for PGP and hopefully enjoy the rest of your pregnancy as much as possible.

Don’t have time to read the whole post?

One of the easiest and quickest to implement strategies you can use is a pelvic belt, such as this one. These belts provide proven reinforcement for the joints in the pelvis that are causing much of your pain.

Will my pelvic girdle pain get better after birth?

The good news is, in the majority of cases, PGP will settle either immediately or shortly after giving birth.

As with many areas of health, though, this is not always the case.

I’ve written an entire blog post dedicated to improving your chances of resolving your pelvic girdle pain. You can read it here.

Pelvic girdle pain- wrapping up:

Despite the fact that you’re having some pain around your back or pelvis during pregnancy, it may not actually be pelvic girdle pain. These 3 quick and easy tests to know if what you’re experiencing actually can be labelled “pelvic girdle pain”. Knowing these and getting an accurate diagnosis of your condition can help make sure you’re choosing the correct management strategies.

I love hearing your stories around how this information has helped make your pregnancy more comfortable. Leave me a comment below or share this with your pregnant friends to help make their journey easier too!