Written by Michael Rizk, Co-Founder & Senior Physiotherapist, iMove Physiotherapy
TL;DR: Hip and pelvic pain during pregnancy is extremely common, affecting around one in five pregnant women, and it’s driven by the hormone relaxin loosening pelvic ligaments to prepare for birth. Keeping your hips mobile and your glutes strong is one of the most effective ways to manage it, and most cases settle well with the right guidance from a women’s health physio.
If your hips or pelvis have started aching as your pregnancy progresses, you’re not imagining it and you’re far from alone. As your baby grows, your pelvis widens and the hormone relaxin loosens the ligaments holding it together, which reduces stability right when your body is carrying more load than ever. The good news is that targeted hip mobility and strengthening work can make a real difference to how you feel day to day, from getting in and out of bed to walking the dog around Rozelle or Clovelly.
Why hip and pelvic pain shows up during pregnancy
What most people call pelvic girdle pain is discomfort felt anywhere between the top of the pelvic bone and the gluteal folds, and it’s one of the most common pregnancy-related complaints we see in clinic. It can start as early as the first trimester, though it often becomes more noticeable later as your baby grows and your centre of gravity shifts.
The underlying cause is largely hormonal. Relaxin loosens the ligaments around your pelvis to help your body accommodate birth, but that same loosening reduces the natural stability your pelvis normally has. Your body compensates by asking nearby muscles, particularly the glutes, to work harder to hold things steady. Overworked muscles get tight and tender fairly quickly, and tightness in the gluteus medius specifically can refer pain right down the back of the thigh, which is often mistaken for sciatica.
Why your glutes matter more than you’d expect
Your glutes carry a lot of the load your pelvis can no longer manage on its own during pregnancy. Keeping them strong and mobile helps them cope with that extra responsibility rather than becoming a source of pain themselves.
Squats are a simple, effective place to start. A wall-supported squat keeps your quads, hamstrings and glutes engaged without putting excessive strain through your lower back, and it’s something you can keep doing right through your later trimesters as walking and daily activities become more physically demanding. Pairing strength work with regular glute release, using a foam roller across the glutes, helps stop that overworked tension from turning into knots and ongoing pain.
Keeping your hips mobile day to day
Mobility matters just as much as strength here. Stiff hips make it harder for your pelvis to move the way it needs to as your body adapts, which can add to that feeling of instability. Gentle hip circles, supported lunges, and simply varying your position rather than sitting or standing for long stretches all help keep the joints moving well.
If you’re finding certain movements consistently aggravate the pain, whether that’s rolling over in bed, climbing stairs, or standing on one leg to get dressed, that’s worth mentioning to your physio specifically. Pain with a particular movement pattern usually points to what needs the most attention in your individual program, rather than being something to simply push through.
When to see a women’s health physio
Most hip and pelvic pain in pregnancy responds well to the right combination of mobility work, targeted strengthening, and some hands-on treatment where needed. According to the Royal College of Obstetricians and Gynaecologists, pelvic girdle pain is treatable at any stage of pregnancy, and starting treatment earlier tends to lead to better outcomes than waiting for it to resolve on its own.
A women’s health physio can properly assess how your specific pelvis and surrounding muscles are functioning, rather than relying on general advice that may not fit your situation. They can also guide you on supports like a pelvic belt if needed, and build a program that adapts as your pregnancy progresses rather than staying static.
Key Takeaways
- Pelvic girdle pain affects around one in five pregnant women and can start as early as the first trimester.
- Relaxin loosens pelvic ligaments to prepare for birth, which reduces stability and puts extra demand on surrounding muscles.
- Strengthening your glutes, through exercises like wall-supported squats, helps them cope with that extra load.
- Foam rolling and regular glute release help prevent overworked muscles from becoming a separate source of pain.
- Hip mobility work, alongside strength, helps your pelvis move the way it needs to as your body changes.
- Treatment is safe and effective at any stage of pregnancy, and earlier assessment tends to lead to better outcomes.
If hip and pelvic pain in pregnancy is affecting your day to day, our women’s health physios can help you manage it properly at any stage of your pregnancy. Book an appointment online with one of our Sydney clinics.
Frequently Asked Questions
Is hip and pelvic pain in pregnancy normal, or should I be worried?
It’s very common, affecting around one in five pregnant women, and is rarely a sign of anything serious. That said, it’s still worth having it properly assessed by a women’s health physio so you get the right guidance for your specific situation rather than just managing through it.
When during pregnancy does hip and pelvic pain usually start?
It can begin as early as the first trimester, though many women notice it becoming more prominent in the second and third trimesters as the baby grows and load through the pelvis increases.
Is it safe to exercise if I have pelvic girdle pain?
Yes, in most cases targeted exercise is part of the treatment rather than something to avoid. The key is choosing the right exercises for your stage of pregnancy and symptoms, which is where a women’s health physio can help tailor a program specifically for you.
Will pelvic girdle pain go away after I give birth?
For most women, symptoms improve significantly within weeks of delivery as hormone levels return to normal and pelvic stability improves. Some women continue to experience symptoms for longer, which is worth following up with a women’s health physio.
Can pelvic girdle pain affect how I give birth?
Most women with pelvic girdle pain are still able to have a vaginal birth. It’s worth discussing your symptoms with your midwife or obstetrician as part of your birth planning so your care team is aware.
What’s the difference between pelvic girdle pain and general pregnancy back pain?
Pelvic girdle pain is felt specifically around the pelvis, hips, groin, or the back of the thighs, and tends to worsen with movements like walking, climbing stairs, or turning over in bed. General pregnancy back pain is usually felt higher up and relates more to postural changes. A physio assessment can help clarify which you’re dealing with.
