Pelvic girdle pain in pregnancy: physio in Manchester
Ease the pain at the front or back of your pelvis, keep moving through pregnancy and feel ready for birth, with gentle care in positions that suit your bump.
Pelvic girdle pain physio in Manchester city centre
Reviewed by Nick Chatziviltsos, PgDip, HCPC-registered physiotherapist (PH114351), November 2026
At a glance
Who gets it: About 1 in 5 pregnant women, more often later in pregnancy.
Main symptom: Pain over the pubic bone or low at the back of the pelvis, worse walking, on stairs, turning in bed or parting your legs.
Is my baby safe? Yes. PGP is painful for you, but it doesn't harm your baby.
What helps most: Early advice, tailored exercise, gentle hands-on treatment and small changes to how you move.
Sessions: Often 3 to 6 in pregnancy, spaced to suit you, with a review after birth.
Get urgent help: Bleeding, waters breaking, fewer baby movements, a severe headache or vision changes, a swollen calf or a fever: call your midwife or maternity unit now.
If walking, stairs or turning over in bed has started to hurt low down in your pelvis, you're not alone. Pelvic girdle pain (PGP) affects about 1 in 5 pregnant women. It used to be called symphysis pubis dysfunction, or SPD.
It's common, but it isn't something you just have to put up with. The NHS says early diagnosis helps keep pain to a minimum. PGP doesn't harm your baby, and most women with it can have a vaginal birth.
At our clinic inside F45 NQ on Piccadilly, we help you understand what's going on, ease the pain and keep you moving. Every treatment is adapted for pregnancy, with you comfortable on your side or sitting.
🛠️ How we treat pelvic girdle pain
Every PGP plan at Athos Physio follows the same three steps. What changes is how far along you are and what your days involve.
Step 1. Find what's driving your pelvic pain
In your first 60-minute session, we work out three things:
Where it's coming from: the joint at the front of your pelvis, the SI joints at the back, or both. We also check whether your lower back or hip is involved.
What's aggravating it: long walks, stairs, a toddler on one hip, a standing job or turning in bed.
What's keeping it sore: muscles guarding the pelvis, weakness from doing less, poor sleep, or worry about the birth.
We use a 3D anatomy model to show you the joints of your pelvis and why they're sore. Seeing it helps the plan make sense.
Step 2. Ease the pain and change the load
Hands-on treatment in comfortable positions. Gentle joint mobilisation and soft tissue work for your back, hips and buttocks. You lie on your side with pillows, or sit supported. IASTM is used only on your back, hips and legs, never over your bump.
Change the movements that hurt. Getting into the car with your knees together, sitting down to dress, and taking stairs one at a time.
Find the exercises that help. Gentle glute, inner thigh and deep tummy muscle work often eases pain quickly. We test which ones work for you.
Pelvic floor exercises. We teach and coach these. We don't do internal pelvic floor assessments. If you need one, we'll refer you to a women's health (pelvic health) physio, your GP or your midwife.
Support if you need it. We'll advise whether a pelvic support belt or crutches could help for a while.
Step 3. Stay strong through pregnancy and beyond
Strength you can keep doing, such as sit-to-stands, side-lying hip lifts, supported squats and wall push-ups.
Rehab on the gym floor. Being inside F45 NQ means we can practise lifting, carrying and getting up from the floor, with your bump in mind.
Birth preparation. Positions that keep your legs within a comfortable range, and what to put in your birth plan.
After birth. A check-in to rebuild strength, so you can lift, carry and return to exercise.
A flare-up plan. What to do on a bad day, and which exercises to drop back to.
You'll get a custom rehab and strengthening plan, so you can do your exercises at home.
Pelvic pain making every step hard? Your first 60-minute session finds the cause and starts treatment the same day. Book your assessment →
🔍 What is pelvic girdle pain?
Your pelvis is a ring of bone with three joints. The pubic symphysis sits at the front, where the two halves meet. The two sacroiliac (SI) joints sit at the back, either side of the base of your spine.
PGP is pain in or around these joints. The NHS describes it as symptoms caused by stiff joints, or joints moving unevenly, at the front or back of the pelvis. It can start at any time in pregnancy.
It isn't your pelvis coming apart, and it isn't dangerous to your baby. It's a sensitive, overloaded set of joints that responds well to the right help.
Types of pelvic and back pain in pregnancy
PGP at the front (once called SPD): over the pubic bone, sometimes into the groin or inner thighs; worse parting your legs, on stairs or standing on one leg.
PGP at the back: low at the back of the pelvis, one or both sides, into the buttock; worse walking, turning in bed or getting out of a car.
PGP front and back: both areas together; often more limiting, so early help matters most.
Pregnancy back pain: across the lower back, above the pelvis; worse bending, lifting, or sitting or standing for long. See back pain in pregnancy.
PGP after birth: front or back of the pelvis; pain that hasn't eased in the weeks after birth.
⚠️ PGP symptoms
Most women with PGP have a mix of these:
Pain over the front of the pubic bone, roughly level with your hips
Pain across one or both sides of the low back or back of the pelvis
Pain in the perineum, the area between your vagina and bottom, or spreading into your thighs
Pain walking, climbing stairs or standing on one leg
Pain turning over in bed, getting in and out of the car or getting dressed
Clicking or grinding in the pelvis
Pain parting your legs, including during sex
Symptoms vary a lot. Some women have a mild ache, while others find walking very hard. The POGP says these symptoms shouldn't be dismissed as normal pregnancy aches.
Is it PGP, back pain or something else?
Pain across the lower back, worse bending or sitting: more often pregnancy back pain. See back pain in pregnancy.
Pain below the knee with tingling or numbness: points to an irritated nerve, such as sciatica. We check this.
Pain at the front of the hip or groin, worse bending deeply: can be the hip itself. We check this too.
Back pain in the second or third trimester that comes and goes, or tightenings: can be early labour. Call your midwife or maternity unit.
Pain under your ribs, a fever or pain when you pee: may be an infection. Call your GP or midwife urgently.
Any pelvic pain with bleeding: always call your midwife or maternity unit.
🔍 What causes PGP?
The exact cause isn't known. It's usually a mix of joints moving unevenly, changes in how your muscles work and the extra load of your growing baby. Hormones and your baby's position can play a part.
Things that make PGP more likely
Back or pelvic pain before pregnancy, or PGP in a previous pregnancy
An earlier injury to your pelvis
A physically demanding job
Carrying more weight
Expecting twins or more
Very flexible joints (hypermobility)
The POGP says smoking, age, height and breastfeeding aren't linked to PGP.
Myths about PGP
Your pelvis is out of line. It isn't. The joints are sore and sensitive, not out of place. Strength and comfortable movement are what help.
You'll need a caesarean. Usually not. The RCOG says most women with PGP can have a vaginal birth, and a caesarean isn't normally needed for PGP.
Nothing helps until the baby arrives. Treatment can help at any stage of pregnancy. The earlier you start, the better.
Rest is best. Long periods of rest tend to make it worse. Staying active within comfort helps.
🧪 How we assess pelvic girdle pain in pregnancy
Your first session lasts 60 minutes. Every test is gentle and safe in pregnancy, and we stop anything that hurts. You'll sit, stand, lie on your side or lie propped up, never flat on your back for long.
Your story (10 to 15 minutes). How far along you are, where it hurts, what makes it worse, your work, any older children, and how your pregnancy is going.
Safety screen. We check for the warning signs listed on this page and ask about your maternity care.
Everyday movements. How you walk, stand on one leg, get up from a chair and turn over.
Active straight leg raise (ASLR). Lying propped up, you lift one straight leg a little. We note how hard it feels, and whether a light squeeze around your pelvis makes it easier.
P4 test (posterior pelvic pain provocation). Lying propped up with a wedge under one hip, we press gently along your bent thigh. It shows whether the back of your pelvis is the sore spot. It takes under a minute.
Other pelvic, hip and back checks. Gentle pressure over the pubic bone and the ligament at the back of the pelvis, Patrick's (FABER) test, hip movement and a lower back check.
Your plan. In plain English: what's going on, what to change this week and how many sessions we expect.
The European guidelines say P4 and ASLR are the best-established tests for PGP. They also say a diagnosis should rest on several tests, not one. You'll leave with treatment started, the first two or three exercises of your custom rehab plan and a plan through to birth.
🛠️ Pelvic girdle pain treatment at Athos Physio
Your plan follows your pregnancy. We adjust it as your bump grows and carry on after your baby arrives.
First trimester (weeks 1 to 12). Settle early pain and build good habits. Advice on daily movements; gentle mobilisation and soft tissue work, sitting or side-lying; glute, inner thigh and deep tummy exercises; pelvic floor coaching.
Second trimester (weeks 13 to 27). Keep you active and strong. Side-lying hands-on treatment; sit-to-stands, side-lying hip lifts, supported squats, wall push-ups; a walking or swimming plan; a belt or crutches if needed.
Third trimester (week 28 to birth). Comfort, sleep and birth preparation. Side-lying or seated treatment; pacing your day; positions for sleep and labour; finding your comfortable range for birth.
After birth (from about 6 weeks, or after your 6 to 8 week GP check). Rebuild strength and get back to activity. Pelvic and trunk strength; lifting and carrying your baby; a return to the gym or running; referral for an internal pelvic floor assessment if you need one.
Safe treatment positions in pregnancy
From the second trimester, you lie on your side with pillows between your knees and under your bump, or sit leaning forwards onto a support.
In later pregnancy, we avoid you lying flat on your back for more than a few minutes. The NHS advises this, as it can make you feel dizzy.
Once your bump shows, we don't ask you to lie on your front.
IASTM is never used over your tummy. Hands-on work stays gentle and within comfort.
We don't use dry needling or machines. Your treatment is hands-on care and exercise.
Your home programme
Usually 3 to 5 exercises, taking about 10 to 15 minutes a day, reviewed each session. Many women need 3 to 6 sessions in pregnancy, then 1 to 3 after birth.
What helps pelvic girdle pain in pregnancy?
The main UK guidance comes from NICE's antenatal care guideline, the NHS and the RCOG. The European guidelines on pelvic girdle pain, summarised for the POGP, add more detail. Research in pregnancy is limited, so we treat recommendations with care.
What's supported: NICE says to consider referral to physiotherapy for exercise advice and, if helpful, a soft (non-rigid) pelvic belt; individualised exercise during pregnancy, rather than one set programme for everyone; physio that eases pain and improves muscle function, with exercises for the pelvic floor, tummy, back and hips; crutches or a support belt for a while, if you need them; after birth, clear information and reassurance, plus exercises for control and stability.
Less certain: belts on their own. NICE says consider one, but the European guidelines found too little evidence to rely on belts alone. We use them alongside exercise; acupuncture. The RCOG lists it as an option, but a high-quality trial found it worked no better than a sham. We don't offer it; long-term rest. Not supported, and it often makes things harder.
That's why your plan centres on exercise and practical changes, with hands-on treatment to ease pain along the way.
⏱️ How long does pelvic girdle pain last?
The NHS says PGP tends not to get completely better until your baby is born. The RCOG says it usually improves after birth, but about 1 in 10 women have ongoing pain. Pain in all three joints tends to take longer.
During pregnancy: pain can usually be eased so you stay mobile. It may not fully go until after birth.
First weeks after birth: many women feel much better within days to weeks.
6 to 12 weeks after birth: rehab rebuilds strength. Most women are back to normal daily life.
Still sore 3 months after birth: book an assessment. We'll write to your GP if you need further tests.
Painkillers after birth can hide PGP. The POGP advises taking care with activity until you've stopped them. That's when it's worth checking in with us.
✅ Living with PGP
Around the house and at work
Get into the car by sitting first, then swing both legs in with your knees together.
Sit down to get dressed, especially for knickers, trousers and socks.
Take stairs one at a time, leading with the less painful leg going up.
Stand with your weight even on both feet, in flat, supportive shoes.
Split shopping between two bags, or use a rucksack. Avoid heavy lifting.
Try not to carry a toddler on one hip. Sit down and let them climb onto your lap.
At work, ask for a pregnancy risk assessment, a good chair and regular breaks from sitting or standing.
Sleep
Lie on your side with a pillow between your knees and ankles, and one under your bump.
Roll over with your knees together, as if your legs are tied.
Silky pyjamas or sheets can make turning easier.
Sit on the edge of the bed for a moment before you stand.
Exercise
The NHS says exercise is safe for you and your baby. It suggests 150 minutes of moderate activity a week, plus two strength sessions, if you can.
Shorter, flatter walks are often easier than long ones.
Water takes weight off your joints. If breaststroke legs hurt, use a float and gentle front crawl kicks.
Avoid wide-legged moves such as lunges, sumo squats and side steps if they bring on pain.
Avoid sports with a risk of falling or a bump to your tummy.
A mild ache that settles by the next morning is usually fine. Sharp pain is a sign to ease off.
Labour and birth
Tell your midwife about your PGP, and add it to your birth plan. Upright positions, kneeling, all fours or lying on your side are often more comfortable than lying on your back.
Before labour, measure how far your knees can part without pain. Share this pain-free range with your midwife, especially if you have an epidural. Water can take weight off your joints, so ask your midwife about a water birth.
Related conditions
Back pain in pregnancy: an ache across the lower back as your bump grows
SI joint pain: pain low at the back of the pelvis, in or out of pregnancy
Diastasis recti: a gap between your tummy muscles after birth
Pregnancy and postnatal physio: everything we help with, during pregnancy and after birth
❓ Pelvic girdle pain FAQs
🚨 Physio, midwife, GP or A&E?
Most PGP is safe to manage with a physio alongside your usual maternity care. Some symptoms need your midwife or a doctor instead, and a few need help straight away. This list follows NHS guidance.
Book a physio (no GP referral needed): pelvic pain that changes with walking, stairs or turning in bed (book a physio; no GP referral needed; mention it to your midwife too).
Tell your midwife or GP: pelvic pain that makes it hard to walk, use stairs or get out of a car (tell your midwife or GP, and book a physio assessment); pain that's affecting your sleep, mood or work (tell your midwife or GP, as you may need extra support; physio can help too).
Call your midwife or maternity unit now, or your GP urgently or 111: back pain in your second or third trimester that comes and goes, or regular tightenings (call your midwife or maternity unit; it may be early labour); a temperature of 38C or above, shivering, pain when you pee or pain under your ribs (call your midwife or GP urgently, or NHS 111); any bleeding from your vagina (call your midwife or maternity unit; before 20 weeks, your GP or early pregnancy unit); your waters break, or fluid leaks from your vagina (call your midwife or maternity unit); your baby is moving less, or the pattern has changed (call your midwife or maternity unit now; don't wait until the next day); a severe headache, problems with your vision, or sudden swelling of your face, hands or feet (call your midwife or maternity unit now; these can be signs of pre-eclampsia); a painful, swollen, warm calf (get checked today: call your midwife, GP or NHS 111; it may be a blood clot).
Call 999 or go to A&E: chest pain or difficulty breathing; numbness around your genitals or bottom, loss of feeling in your legs, or trouble controlling your bladder or bowel (call 999 or go to A&E now).
If you're unsure about your pelvic pain, ring us on 07475 433300 and we'll tell you honestly whether to see us or someone else first. For anything about your baby, always call your maternity unit first.
Not sure whether you need a physio or your midwife? Book a free 15-minute call and we'll tell you honestly. Book a free call →
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They describe the same problem. SPD (symphysis pubis dysfunction) is the older name. PGP is now used because pain can come from the front or back of the pelvis.
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No. PGP can be very painful for you, but it doesn't harm your baby.
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Usually yes. Most women with PGP can have a vaginal birth, and a caesarean isn't normally needed for PGP. Tell your midwife and note your pain-free range in your birth plan.
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Yes. We use gentle hands-on treatment and exercise, with you lying on your side or sitting. We don't use dry needling or machines, and nothing goes over your bump.
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A soft belt can help some women for a while. NICE says it's worth considering, but the evidence for belts alone is limited. We use them alongside exercise.
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On your side, with a pillow between your knees and ankles and one under your bump. Roll over with your knees together.
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Yes, within comfort. Walking, swimming and gentle strength work usually help. Avoid wide-legged moves and anything that brings on sharp pain.
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For most women it improves soon after birth. About 1 in 10 have ongoing pain, which physio can help with.
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It can come back, but it's often less severe if you keep up your exercises and get help early.
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We teach and coach pelvic floor exercises. We don't do internal pelvic floor assessments. If you need one, we'll refer you to a women's health physio, your GP or your midwife.
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No. You can book directly with us. Do tell your midwife you're seeing a physio. If you're claiming on insurance, check with your insurer first.
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Your first 60-minute assessment and treatment is £95. Follow-up sessions are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. See our price list for all fees.
📍 Book pelvic girdle pain physio in Manchester city centre
Athos Physio is inside F45 NQ, 77 Piccadilly, Manchester M1 2BU, a two-minute walk from Piccadilly station and Piccadilly Gardens. We're open 7am to 8pm, Monday to Friday, so you can come in before or after work.
Your first appointment is a 60-minute assessment and treatment (£95). Follow-ups are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. We work with Bupa, WPA, Vitality and Aviva, and you can see all our fees on the price list.
Can't get into town? We also offer home physio visits and online physiotherapy. Not sure physio is right for you? Book a free 15-minute call and we'll talk it through.
Call or WhatsApp 07475 433300, or book online.
Other services: Physiotherapy and active rehab · Sports massage · Pregnancy and postnatal physio · Home visits · Online physio
Written by Nick Chatziviltsos, physiotherapist and founder of Athos Physio, BSc (Hons) Physiotherapy, HCPC registered. Last reviewed: November 2026.
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