Jessica Florio

My Version of Pregnancy Self-Care Was Physical Therapy for My Pelvic Pain

When I first imagined pregnancy self-care, I thought of things like prenatal massages, yoga classes, and a relaxing babymoon on a beach somewhere far away. But when month four rolled around, my version of taking care of myself during pregnancy became chiropractic adjustments, physical therapy, and modified bed rest. Personal wellness pivoted from being fun and easy to medically necessary.

I remember how excited I was to reach the second trimester, especially as a big fitness lover. It was almost like magic: no more nausea, no more sore breasts, and a big jump in my energy levels. I was feeling good, pregnancy was running smoothly, and I couldn’t wait to take my little bump to dance class and shake my booty! 


Then something strange happened. Whenever I exerted myself too much—be it walking a few blocks in my home of New York City or going all out in boxing class, I experienced pelvic, back, and hip pain. It ranged from slightly annoying to absolutely excruciating. As I was already at the doctor frequently to check in on my thyroid levels (I was diagnosed with Graves’ Disease in 2016, which causes hyperthyroidism), it was easy to ask about these new symptoms right away. 

“You’re just having round ligament pain,” the doctor said at first. Based on my previous internet searches, this seemed to track. So I bought a belly band and cut back on the rigorous exercise. I thought that I would be back to normal within a few weeks as my body adjusted. 

But the pain continued to get worse. My gut told me that something wasn’t right. At the next OB/GYN appointment, I brought up my concerns again, sharing that I went on a Googling spree and discovered a different condition that I was pretty sure I had.

My hunch said I had Symphysis Pubis Disorder (SPD). Transparently, I had never heard of it before, and it seemed a little scary. I am so glad I pressed the doctor this time, as I was referred to an orthopedist to check out where the pain was coming from. The orthopedist quickly agreed with my self-diagnosis: it was SPD. [Editor's note: in general, it's best not to self-diagnose. That said, you can always bring questions and concerns to your healthcare provider for a professional opinion.]

SPD is a pregnancy condition wherein the body releases too much of a hormone called relaxin, and this can cause your pelvic joints to destabilize. Usually, relaxin starts to surge closer to the end of the third trimester, as it helps prepare the pelvis to open up for delivery. For some people though, it can start as early as 10 weeks, leaving those experiencing this in debilitating pain. And while thankfully SPD doesn’t harm your baby, it’s still pretty difficult to deal with.

All of my fun second-trimester plans went out the window. No workouts, no traveling, no long walks, no stairs—nada! My main focus was now healing my body and resting as much as possible.

All of my fun second-trimester plans went out the window. No workouts, no traveling, no long walks, no stairs—nada! My main focus was now healing my body and resting as much as possible.

The first step was to start physical therapy right away, but every nearby pelvic floor physical therapist that took my insurance was booked for weeks. I could journey a bit farther away, but that didn’t really make sense considering my condition. Other practices were ready to take me the next day, but the out-of-network copays were too expensive. I remember crying in frustration to my husband that I would “never” be able to get the help that I needed. 

Of course, I did eventually get the help. I persevered—continuing to research and call places near my home subway line. After a few more days of trying, I found a great wellness practice that had reasonable rates and a warm, caring, environment. Not only was I able to go there for physical therapy, but also chiropractic work, and medical massages.

I looked forward to my twice-weekly visits and the sense of family that I grew to have there. I may not have been getting in any prenatal spa or yoga days, but it was exactly the kind of self-care that I needed. 

I looked forward to my twice-weekly visits and the sense of family that I grew to have there. I may not have been getting in any prenatal spa or yoga days, but it was exactly the kind of self-care that I needed. 

Physical therapy consisted of a few parts. We usually started off with some gentle stretches and bodywork on my pain points. The stretches needed to be gentle and supervised as too much stretching can aggravate SPD even more for some patients, like me. The bodywork would include manual manipulation on my back, legs, and pubic bone. (Yes, I basically had my vagina massaged!)

Next, we worked on core strengthening and body alignment. A big part of this was learning how to engage my core and lift my pelvic floor, as well as use the breathing techniques that go with the movements. I also had to re-learn how to walk! My therapist and I would practice walking around the center with the correct alignment of my entire body.

Even though it was best for my body, the new way of walking always felt unnatural like I was about to topple forward. Learning all of this while pregnant wasn't easy, but the knowledge has taken me through the postpartum period recovery period and beyond. To this day I still work hard to implement the core engagement exercises into my current fitness routines.

The best part of it all was the connection I made to my physical therapist. We were quickly able to talk and laugh like old friends. She would celebrate my wins (walking up stairs with no pain!), and also chastise me gently for wearing high heels to my baby shower. Her passion for helping pregnant and postpartum women spilled over into her healing touch.

After a few weeks of dedicated medical self-care, my SPD got better, and only continued to do so over time. The combination of twice-weekly physical therapy, bi-weekly chiropractic adjustments, and customized at-home exercises was key. The pain never went away completely, but as long as I didn’t push myself too far—like walking or moving too vigorously or sitting in an unsupportive seat for too long—I was able to go about my days as usual. Towards the end of my third trimester, I was able to walk longer distances and lift light weights during gentle exercise. I continued my PT regimen right up until my due date.

But self-care is not always relaxing and fun. It can mean fiercely advocating for yourself and hours of research to get the care that you need.

What I learned from this time is that self-care during pregnancy can look many different ways. Yes, I did eventually get prenatal massages and took a short babymoon to the beaches of Long Island (once I was cleared to do so). I also found solace in long, lukewarm baths and helping to plan my baby shower.

But self-care is not always relaxing and fun. It can mean fiercely advocating for yourself and hours of research to get the care that you need. It can mean moments of feeling hopeless and needing to find strength in yourself to keep going. Trust your gut when it comes to taking care of yourself. You can and will get through it if you keep going, and your body will thank you for it.

1 Source
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  1. Kanakaris NK, Roberts CS, Giannoudis PV. Pregnancy-related pelvic girdle pain: an updateBMC Medicine. 2011;9(1):15. doi:10.1186/1741-7015-9-15