Pelvic Girdle Pain and Diastasis Rectus Abdominis: How Physiotherapy and Osteopathy Can Support You During and After Pregnancy

Pregnancy and the postnatal period place significant physical and emotional demands on the body. While many aches and pains are considered “normal”, persistent discomfort, reduced function, or a feeling that your body doesn’t quite feel right should never be ignored.

Two of the most common pregnancy-related musculoskeletal conditions we assess and treat in clinic are Pelvic Girdle Pain (PGP) and Diastasis Rectus Abdominis (DRA). With the right support, education, and treatment approach, recovery is not only possible – it can be empowering.

What Is Pelvic Girdle Pain (PGP)?

Pelvic Girdle Pain refers to pain arising from the joints and soft tissues of the pelvis, often during pregnancy or in the months following childbirth. It can affect one or both sides of the pelvis and may be felt in the lower back, hips, buttocks, groin, or thighs.

Common symptoms include:

• Pain when walking or standing on one leg

• Discomfort when turning in bed or getting in and out of the car

• A feeling of heaviness or instability in the pelvis

• Reduced tolerance for sitting, standing, or walking

PGP is very common, affecting around 1 in 5 women during pregnancy, and for some, symptoms can persist beyond delivery if not properly addressed PGP 2021 updated.

Why Does Pelvic Girdle Pain Happen?

PGP is multifactorial, meaning there is rarely a single cause. Contributing factors may include:

• Changes in posture and movement as pregnancy progresses

• Hormonal influences on joint and ligament stiffness

• Altered muscle recruitment and load transfer

• Fatigue, stress, and psychosocial factors

Modern physiotherapy and osteopathy move beyond a purely biomechanical model. Instead, we use a holistic, biopsychosocial approach, recognising the interaction between physical changes, nervous system sensitivity, emotional wellbeing, and lifestyle demands.

How Is Pelvic Girdle Pain Assessed?

A thorough assessment is essential. This includes:

• Understanding your symptoms, activity levels, work demands, and support network

• Screening for obstetric and medical factors

• Observing movement, posture, gait, and functional tasks

• Assessing strength, muscle coordination, and joint mobility

Reassurance and education are key parts of the assessment. Many women feel anxious about movement during pregnancy – we help you understand what is safe, helpful, and beneficial.

Treatment for Pelvic Girdle Pain

Treatment is always individualised and may include:

• Targeted strengthening and movement retraining

• Breathing strategies to support load management

• Gentle manual therapy where appropriate

• Advice on daily activities, sleep positions, and pacing

• Mindfulness, relaxation, and nervous system regulation

• Guidance on safe and effective exercise during pregnancy

The goal is not just pain relief, but restoring confidence in movement and function.

Caesarean Section Recovery: What to Expect

Women who have had a C-section often experience more abdominal discomfort in the early postnatal period. While the incision does not cut through muscle, the abdominal fascia and connective tissues take time to heal.

Key points to know:

• Most women can begin gentle rehabilitation between 4–6 weeks, depending on recovery

• Full tissue strength takes months, not weeks, to return

• Fatigue, pain levels, anaemia, and wound healing all influence readiness to exercise

A graded, structured return to movement helps prevent long-term weakness and supports overall recovery PGP 2021 updated.

What Is Diastasis Rectus Abdominis (DRA)?

DRA refers to a widening of the connective tissue between the abdominal muscles. This is a normal adaptation in pregnancy, but for some women, the separation does not fully resolve after birth.

• Up to 100% of women have some degree of separation in late pregnancy

• Around 1 in 4 women still experience DRA one year postnatally

Symptoms may include:

• A visible abdominal gap or doming

• Ongoing “pregnant” appearance

• Lower back or pelvic pain

• Reduced core strength or confidence with movement

Assessing and Treating DRA

Assessment focuses on:

• Abdominal wall function (not just gap size)

• Breathing patterns and pressure control

• Functional tasks such as lifting and transfers

Treatment may involve:

• Early postnatal re-education of core muscles

• Progressive strengthening and load management

• Functional rehabilitation tailored to your goals

• Education around posture, exercise, and daily activities

Importantly, DRA is treatable, even months or years after delivery, with the right guidance.

How Osteopathy and Physiotherapy Can Help

At our clinic, we support women through every stage of pregnancy and postnatal recovery. Whether you are experiencing pelvic pain, abdominal weakness, or simply feel that your body hasn’t fully recovered, a personalised treatment plan can make a meaningful difference.

You do not need to “just live with it”. Help is available, and recovery is possible.

If you’d like support with Pelvic Girdle Pain, postnatal recovery, or abdominal rehabilitation, please get in touch with our team to book an appointment.