Round Ligament Pain 101
A common issue during pregnancy is Round Ligament Pain.
A sharp, sometimes stabbing pain in the lower half of the belly off to the side or groin area.
It can come and go depending on activity or be a dull nagging sensation.
If you've had it you know what I'm talking about.
But is it really the ligaments fault?
Let's dive into why you may be experiencing this pain.
Anatomy & physiology.
The round ligament is a thick, tubular ligament that attaches the uterus to the pelvis. There is one on each side of the uterus. Their role is to keep the uterus stable (mainly from tipping backward or twisting) during pregnancy as it expands and becomes an abdominal organ. They are meant to stretch with movement, but not take on the entire load of the uterus.
When do they typically cause pain?
When a round ligament is stretched to it's max and then quickly pulled even more it responds with pain. It's a way of your body saying, "too much!"
This can happen if you stand up quickly, step to catch yourself from falling, twist, sneeze, coughetc.
But why?
ONE
Even though the role of the round ligaments is to keep the uterus in good positioning, it's not meant to support the extra weight. That's the role of your muscles!
When your muscles - specifically the 4 deep core muscles - are weak they are unable to provide the support needed to withstand the forces placed on your body during pregnancy.
The result, the ligaments have to do more work. This places more stress on the fibers as they stretch. And when stressed they can't withstand more force placed on them without warning. Thus...pain
TWO
Other tissues and joints around the ligament can inhibit stretch.
During pregnancy an area that can become tight is the deep back or more specifically the Psoas muscles. These muscles can become shortened and tight during pregnancy due to a weakening core, posture imbalances, and habitual sitting.
When a muscle is tight it becomes dehydrated, shortens and can pull on neighboring tissue.
Or when a joint is not in alignment it will cause the tissues attached to stretch or shorten.
This can be the case with the round ligament.
It follows a similar path as the Psoas. So as your Psoas picks up the slack from a weaker core, causing shortening it pulls on the round ligament. And it attaches the pelvis which moves and shifts during pregnancy and when done so in an uncontrolled manner. Pain.
What can you do?
The first thing to do is make sure it really is round ligament pain. So rule out any other pathology it could be.
Then get yourself to a pelvic floor PT who specializes in prenatal care.
By doing this you will learn safe exercises to improve your core functioning, spine mobility and hip flexibility.
In addition there are some excellent manual techniques to ease the tension and reduce pain.
In the mean time, there are simple things you can do to ease some pain.
Take a warm bath - add Epsom salts (for magnesium) and lavender or chamomile essential oils for extra soothing and relaxation
Heating pad - use for 10-15 minutes at a time and always follow the directions
Lie down on your left side with a pillow between your legs and draw your knees to your chest
Slow down!
Be mindful of your posture - try to keep a long, neutral spine with your ribs and pelvis stacked
Use core breathing to brace your uterus with effortful movements and activity
Gently stretch the tight front hips and waist
If you're having round ligament pain try out these tips and reach out for help. You don't need to suffer through the pain by yourself.