Pregnant women may complain of lower abdominal, pelvic, groin, hip, or pubic pain. A common cause of this may very well be the stretch sensation of the round ligament which can provoke pain in these areas. The round ligaments are two of the suspensory ligaments of the uterus (there’s one on each side). It originates at the lateral wall of the uterus on either side, passes through the inguinal canal, and inserts into the mons and pubic symphysis. As the baby and uterus grows and lengthens so must the suspensory ligaments. The round ligament is initially about 2 inches in length and can stretch to about 4 times its length by the end of pregnancy. Round ligament pain commonly starts in the second trimester and can worsen in the third trimester of pregnancy.
The good news is that physical therapy can assess and treat for this problem at any time during pregnancy and resolve the pain. Our expert therapists evaluate the round ligaments for tenderness or adverse tension and we assess the pelvis and hips for misalignment which may perpetuate or be a causative factor. We find many patients have a pubis symphysis misalignment concurrently. This is checked carefully via manual assessment shown in the image. Here you can see an obvious misalignment. Because we approach patient care comprehensively, the entire spine, pelvic girdle, lower quadrants, rib cage, movements patterns, and breathing are also assessed. The round ligaments and surrounding abdominal-pelvic soft tissues are treated with gentle manual therapies to ease tension and pain. In this image we are performing gentle manual therapies to help resolve pain and tension. The alignment of the pelvis (including pubic symphysis and sacrum), and hips are also corrected via painfree advanced manual therapies. There is no reason why patients have to suffer through this pain during pregnancy as there is fast effective treatment available at our clinic. Patients are also given prescriptive stretches and home exercises to help keep the lower quadrant more flexible, maintain mobility, and enhance pelvic stability. Pregnancy pelvic support garments are also prescribed that may ease pressure off of the pubic region and lessen the tension on the round ligaments. Overall, round ligament pain is easily treated.