Exercise such as walking can help reduce pelvic girdle pain during pregnancy.
The study, published in the British Journal of Sports Medicine, finds that high-impact sports such as jogging, ball games and aerobics up to five times a week may be most helpful.
The exact causes of pregnancy-related pelvic girdle pain are unclear. Women with a high body mass index (BMI) are known to be affected more, but the effect of other modifiable factors, such as exercise, have not been well studied.
Regular exercise has been proven to increase cardiovascular fitness, muscular strength and flexibility, and to prevent obesity. Aerobic exercise leads to endorphin production, which may reduce sensitivity to pain and produce feelings of relaxation. Pre-pregnancy exercise has been shown to reduce lower back pain, but exercise during pregnancy also reduces the risk of complications.
Up to 1 year after giving birth, 2-3% continue to suffer
Pelvic girdle pain includes pain in the rear of the pelvis and at the joint where the pubic bones meet at the front (the symphysis pubis). It is relatively common during pregnancy, and 2-3% of women may continue to experience it up to a year after the birth.
Fast facts about exercise in pregnancy
- Guidelines in the US recommend at least 150 minutes a week of exercise for healthy pregnant women
- Brisk walking is beneficial
- Women who exercised vigorously before pregnancy can normally continue but should consult with doctors.
Researchers hypothesized that exercise could be a modifiable factor for pelvic girdle pain in pregnancy.
Since women with pelvic girdle pain would be less likely to exercise while pregnant, the study focused on the frequency of exercise before pregnancy.
Participants in the study were 39,000 women who were expecting their first child between 2000 and 2009. They formed part of the Norwegian Mother and Child Cohort Study, which has been tracking the health and well-being of a cross section of Norwegian women, recruited between 1999 and 2008, and their children. Average age was 38, but it ranged from 14-46.
During a routine ultrasound scan in week 17 of pregnancy, the women were asked about the type and frequency of exercise taken during the 3 months before conception. In week 30, data was collected about the frequency and intensity of pelvic girdle pain.
The frequency of exercise was scored from 0-3 (from never to at least three times a week) and covered 13 types of exercise: brisk walking; jogging or orienteering; cycling; training in fitness centers; swimming; low-impact, high-impact or prenatal aerobics; dancing; cross country skiing; ball games; and horse riding.
Activity three times a week reduced pain
More than half (56.5%) of the women had exercised at least three times a week before pregnancy, and 90% were still exercising in the 17th week; 7% had not exercised.
Pelvic girdle pain was reported by 10% of women overall but by 12.5% of those who had not exercised.
Women who had exercised three to five times weekly had a 14% lower risk of developing pelvic girdle pain in pregnancy; high-impact exercises such as running, jogging, orienteering, ballgames, netball games and high-impact aerobics were associated with lower risk of pain. The risk of pelvic girdle pain did not continue to decrease with higher levels of exercise.
Additionally, those who reported pelvic girdle pain were more likely to smoke, be overweight, young (under 25) and to have a history of depression and lower back pain.
Limitations of the study include the fact that participants self-reported their pre-pregnancy exercise levels in week 17, so estimations may not have been precise. Also, the study did not ask about activities such as strolling, gardening and household chores, which are a form of physical activity.
Nevertheless, the researchers conclude:
"Acknowledging the limitations of our study, these results emphasize the importance of promoting regular exercise among women of childbearing age."
Regular exercise before pregnancy, particularly high-impact exercise, does appear to reduce the risk of pelvic girdle pain during pregnancy. The results stress the need for regular exercise among women to reduce the risk of disability, depression and discomfort during and after pregnancy.
In June this year, Medical News Today reported that diet and exercise can affect pregnancy.