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Last Updated on November 18, 2023 by theosteomum
Round ligament pain in pregnancy is something that many women have heard of.
Unfortunately though, many people don’t fully understand this pregnancy symptom. Often they just know it hurts!
Many pregnant women I see in my clinic also assume that they just have to accept it.
They just don’t quite know that there’s a variety of round ligament pain stretches and other management strategies that could be quite helpful for them.
I can remember experiencing quite a sharp pain back in my first pregnancy, and wondering what it was.
Like many newly-pregnant ladies, I was initially worried that it may be a sign that there was something wrong with my little jelly bean.
Luckily for me, my Osteopathic training meant that I knew that round ligament pain in pregnancy was a relatively common occurrence.
I also knew my anatomy well enough to understand that the sharp pain on the side of the abdomen I was experiencing corresponded to the round ligament, so I was able to rest assured that all was well.
Round ligament pain is just one of the possible causes of Pelvic Girdle Pain (PGP) in pregnancy.
If you’d like to learn more about PGP, I’ve written some epic posts here and here.
The purpose of this article is to explain:
- Anatomy of the round ligaments
- What round ligament pain in pregnancy feels like (so you can determine if it’s actually what you’re experiencing)
- What symptoms are not likely to be due to the round ligaments stretching?
- Where you’re most likely to feel it at all stages of pregnancy
- Common triggers for round ligament pain
- What complications can occur with the round ligaments?
- Round ligament pain stretches, and other management strategies
What and where are the round ligaments?
There are two round ligaments- one on either side of your uterus.
The round ligaments are a little different to most ligaments of the body. This is because, unlike other ligaments, the contain the same type of muscle fibres that are found in organs such as your heart and lungs. As a result, they are able to contract and relax when placed under load.
The round look a little like a band of rope. Each one is usually around 10-12cm (3.9-4.7 inches) long.
An interesting little fact is that the round ligaments develop from the same tissues that form the testicles in males. So way back when you were a little embryo yourself, the round ligaments had to decide which type of tissue they would eventually form in to. Pretty cool hey?
The role of the round ligaments is to support the weight of the uterus within your belly.
The round ligaments are located on the upper, outer part of your uterus on either side, just near where your Fallopian tubes join on to the uterus.
From this point, they run downwards through the pelvis, eventually attaching onto your labia majora. These are the outer “lips” of what’s commonly called the vagina. In this way, they help connect the uterus to the groin.
If you’re a visual learner like me, check out this diagram for a little better understanding of this.
*** I must clarify that this image does make it look a little like the round ligaments are attached to the ovaries, and this is not the case.
During pregnancy, the round ligaments can be stretched and lengthened, which can sometimes cause pain.
What does round ligament pain in pregnancy feel like?
In its non-pregnant state, your uterus is usually about the size of your fist, if not a little smaller.
As your pregnancy progresses, the uterus gradually gets bigger and heavier. This puts more weight on the round ligaments, meaning they get stretched and loaded more. Sometimes, this can cause pain.
Round ligament pain in pregnancy can feel:
- Sharp
- Pulling
- Spasm-like, or
- Crampy
This might occur as a sudden pain that comes on almost out of nowhere, and then eases almost as quickly.
Other times it can last a little longer (usually not more than a couple of minutes), and you may need to stop and rest briefly for it to ease.
At times, it can feel quite severe and really stop you in your tracks.
Usually, though, round ligament pain in pregnancy is fairly short lived.
What symptoms are not likely to be due to the round ligaments stretching?
Round ligament pain in pregnancy is not normally accompanied by symptoms such as:
- fever
- chills
- pain when passing urine, or
- difficulty walking
- progressively worsening pain
If you are experiencing any of the above symptoms, you need to seek medical attention.
Speak to your Ob Gyn, Midwife or other Medical practitioner.
Where you’re most likely to feel round ligament pain at all stages of pregnancy:
Round ligament pain in pregnancy is usually located over the site(s) of the round ligament(s).
This changes, depending on how far along you are.
If you’re in your first trimester of pregnancy, the uterus is usually still nestled deep down in your pelvis.
So, pain from the round ligaments during the first twelve weeks of pregnancy is usually quite low down, close to your pubic bone, on either side of the centre.
As you move into the second and third trimesters of pregnancy, your uterus will continue to grow.
As a result, the round ligaments will be a little higher up in your belly.
The same principle applies, however- the ligaments are outside of the centre of your belly and run down to your vaginal area.
Many women’s uterus’ have a tendency to turn to the right.
As a result, round ligament pain in pregnancy is slightly more common on the right side than on the left.
Common triggers for round ligament pain:
There are a few common times when women will experience this often-painful condition.
Most commonly, pain occurs when the ligaments stretch or are put under some sort of load.
These include:
- Rolling over in bed
- During exercise
- Whilst lifting
- Whilst coughing or sneezing, or other sudden active movements
- During prolonged standing
Do these sound like the types of movements that trigger your pain?
What complications can occur with the round ligaments?
There are two main issues that can arise from the round ligaments.
Usually, only 1 is a problem during pregnancy.
1. Endometriosis-
Endometriosis is a condition where tissues that are normally located inside the uterus extend into surrounding tissues.
All of the pelvic ligaments, including the round ligaments, can be affected by this.
This can lead to painful periods, painful sex, chronic pelvic pain, and infertility.
If you believe you may be suffering from endometriosis and have not already done so, please seek medical attention for help with this condition.
2. Round ligament varices (RLV)-
This occurs where the veins that drain blood from the round ligaments become twisted and inflamed.
During pregnancy, there is an overall increased volume of fluids circulating throughout your body. Add to this the fact that the uterus is getting heavier by the day, and it’s easy to see how blood can pool in these veins.
Usually, these present as swellings on both sides of the pubic region.
You will need to have an ultrasound performed to accurately diagnose these.
Please seek medical attention if this appears to be affecting you.
Round ligament pain stretches, and other management strategies:
There are two ways to help round ligament pain during pregnancy:
- Prevention, and
- Treatment
Prevention of round ligament stretch pain in pregnancy:
As sudden or unexpected movements can cause round ligament pain in pregnancy, it’s best to try to avoid situations where these are more likely if you’re really suffering with this condition.
You could do this by:
- walking on smooth footpaths instead of off-road surfaces where possible
- avoiding playing sports such as tennis where you need to constantly change direction
- making slower movements and using both legs to push yourself when rolling over in bed
- avoiding prolonged standing or heavy lifting
Of course, this is not always possible.
As your belly grows larger and it gets harder and harder to see where you’re putting your feet, it’s almost inevitable that you’ll miss a small pothole or forget about that bottom step.
So, at some point, you may need to also consider treating this condition!
Treatment of round ligament stretch pain in pregnancy:
There are a number of different approaches to treating round ligament pain in pregnancy. These include:
- Stretching your hips and lower back in all of their directions of movement. Stretch your buttock muscles, the muscles at the front of your thigh, the muscles on the inside of your thigh and your hip flexor muscles.
- Seeking treatment from a suitably qualified Osteopath/PT/manual therapist. These practitioners may be able to determine and treat any specific factors placing additional strain on your round ligaments.
- Wearing a supportive belly band, such as this one can help minimise the load on the round ligaments. I’ve recommended this particular belly band for this type of pain, as opposed to a belt such as the Serola, as it’s much more comfortable to wear for longer periods of time. Belts can be very helpful in more severe cases of pelvic girdle pain, however. If you’d like to learn more about them, you can read this post.
- Taking a warm bath or applying a warm (not hot) compress around your pubic area for 10-15 minutes at a time. It is important that this is only warm, as applying heat directly to this area could cause harm to your baby.
- Resting when necessary- as if you needed another excuse for a nap!
Wrapping up- round ligament pain in pregnancy.
Round ligament pain in pregnancy can be a very real, painful condition.
The good news is, it doesn’t usually last more than a few seconds to minutes at a time, and there are some practical tips you can implement to try to make sure it happens as little as possible throughout your pregnancy.
If you’re suffering from round ligament pain in pregnancy, why not give the prevention and treatment tips outlined above a go, and leave me a comment to let me know how it’s going for you!
