Pelvic Stretches for Pregnancy: Third Trimester Support From a Pelvic Floor Therapist
The third trimester is full of rapid changes & growth. As we prepare our homes and finalize all the details for baby’s arrival it's possible you are beginning to feel a bit of heaviness, fatigue, tension, or achy.
If you have spent any time on google, apps, or asking around- the common consensus is “this is normal” or “welcome to motherhood”- this is not the case! Although this is very common in the last trimester , there are movements and stretches we can do to decrease or eliminate.
Pregnancy does not need to be a time of discomfort, it can actually be enjoyable and comfortable. There is great evidence on the benefits of gentle movement and stretching during pregnancy.
What’s Actually Happening to Your Pelvis in the Third Trimester
In the third trimester your pelvis and surrounding supportive structures are changing rapidly to support the weight of growing baby in the uterus.
Ligaments are softening to prepare for birth with the help of hormone changes in late pregnancy. With the increased weight of the baby and more give of these typically very supportive structures the pelvic floor is managing more pressure and weight, especially as baby descends lower into the pelvis in the weeks before birth.
The incorrect default common recommendation is that “you are just too tense” or “your pelvic floor must need more strength” (just do kegels - it will fix all the things. Spoiler alert this not the answer). Your pelvic floor is complex, functioning constantly under different requirements to get you through the day, support the baby, stabilizing to keep you upright and without toppling over, keeping you continent of urine and bowels. It deserves more attention than some isolated squeeze and release kegels.
Stretching and light movement is far more functional and beneficial. Stretches help improve your range of comfortable movement, creating more space, and flexibility for baby to get into optimal position prior to birth.
Why Stretching Can Help and When It Can Make Things Worse
Stretching can help:
When you can feel tension and stiffness is your hips, inner thighs, back, or pelvic floor muscles
If uou notice you are more stiff and tight. You can’t move as much as typical
Signal to the brain that you are safe and tell the nervous system to calm and rest
Research shows that stretching, paired with the right stabilizing exercises improve mobility and reduce pain throughout pregnancy.
Stretching can make things worse if:
You are pushing the stretch through pain and forcing yourself into positions beyond what is comfortable
Pain is coming from instability
Stretching causes more of an uneven pull, especially at the pubic bone
If you are experiencing discomfort that will not go away, or worsens with movement. We recommend getting a pelvic floor assessment to find the deeper reason contributing to this pain as most stretches are going to increase the discomfort.
How to Stretch Safely
At Bloom Pelvic Therapy we encourage daily comfortable stretch and movement, prioritizing:
Moving in a pain-free range for stretching- should feel comfortable, not pulling or painful
Moving gently into, during and after the stretch- don't be afraid to lean into or out of the movement, or to soften where it's not serving you on this day. You can hold the stretch for 30 seconds if that feels comfortable.
Breathing well! It is so important. Inhale, let your ribs expand 360 degrees, try bringing the air as deep in your abdomen as you can. The visual of bringing air all the way to the baby or your pelvic floor is often helpful. On gentle exhalation ribs and stomach will go back into their resting position.
Oftentimes in painful stretching we hold our breath while grinning & baring the stretch hoping for a positive outcome. This is not productive and secondarily can send warning signals to the brain and nervous system- the complete opposite of what we want to achieve in stretching.
Not forcing it! Moving with good form and intention is really important. Use props to support you, check your body for alignment when stretching. Don’t try to move into the deepest stretch or perfect, small adjustments and connection matter far more!
The Best Pelvic Stretches for Third Trimester Comfort and Support
There are some of our favorite third trimester safe and pelvic stretches.
Supported child’s pose- this helps to open the hips and lengthen the muscles of the pelvic floor. Additionally, research shows this stretch paired with diaphragmatic breathing does exponentially well signaling to the brain and nervous system that it’s time to relax & to let go of any stress or tension.
To get into the position: kneel on the floor and sit back to rest your butt on your heels. Move both of your knees outward far enough to allow room for the belly to fit. Lean forward on to your elbows and forearms. You can stretch your arms out fully in front of you if this is comfortable.
Try draping your arms over the seat of a chair or sofa to allow room for the belly to comfortably relax. This is one of our favorites with arms draped over a birth ball, gently shifting your hips side to side. A child's pose over the birth ball translates really well into all stages of labor as well!
If you find you are still trying to hold your position or you are not able to let go of your glutes try to put pillows under your knees and gently sit back for improved comfort.
Inhale let the belly soften to the ground ribs expand all around, sink into your hips, reaching your tailbone long behind you. As you exhale belly and ribs return.
For a stretch to the sides of your trunk try keeping your arms extended, walking hands over to the left, breath into the area between your lower right ribs and hip. Stay here as long as it feels good, then slowly walk hands over to the right, breathing into the left side of your body.
Cat Cow- great one for low back pain, improving general spinal mobility and pelvic tilts. A traditional cat cow is on all fours with your knees about hip width apart on the floor and hands planted on the ground shoulder width apart supporting the upper body with extended arms.
Inhale let your belly and back relax completely, inhale as you gently look up, keep tailbone lifted, lifting your hips upward. Exhale and curl up like a scared cat, tucking the chin and tailbone. Think about moving each segment of your back slowly and controlled. Move through this movement a couple of times.
Try about 10 repetitions of cat cow
Adductor Rock Back- this is great for those tight and sore inner thighs as well assisting in decreasing tension in the pelvic floor.
Start by kneeling on your hands and knees, extending one leg out to the side with toes facing forward.
As you inhale gently move hips backwards towards your heel, keeping a straight back. Try moving just far enough to feel a stretch, and then begin to exhale slowly moving out of it. Try the same again and see if you can move a bit deeper comfortably, you can also hold the position for a gentle sustained stretch. Try about 10 times, and then switch the straighten leg to the other side.
Side lying open book stretch- feels so good to release tension in the mid back while laying on your side. Place a pillow between your knees to keep the hips, knees and ankles in a line.
Start by laying on your side, knees bent slightly, pillow between your knees and ankle. Place your arms straight out in front of you stacked on top of each other. This is your resting position. From there exhale as you move the top hand slowly overhead until it's in line with your top shoulder and feels like a good stretch. Inhale to lower the arm back to resting position. You can hold at the top or move gently. Switch sides and try the same with the opposite arm reaching upward.
How to Modify Stretches for Pelvic Girdle Pain, SI Joint Pain, & Pubic Symphysis Pain:
For people with pelvic girdle pain, public symphysis dysfunction or sacroiliac joint pain stretching can flare symptoms.
Sharp pain in the back of the pelvis or tailbone, that is often one sided and moves into the glutes may be Sacroiliac Joint Pain.
Avoid single leg loading and low intense twists.
Instead- stretch symmetrically
Try activate glutes to keep stability at back of pelvis before stretching
Breathtaking sharp pain right at the front of the public bone, often occurs with going up stairs, putting on pants, getting into the car, or turning in bed. Pubic Sympthysis Dysfunction most often happens when there is an uneven pull between muscles paired with relaxed supportive structures.
Avoid deep lunges
Any move with wide movements to one side. Instead keep knees in line with hips
Try exercises or stretches gently keeping a pillow between knees
Pelvic Girdle Pain is pain anywhere in the pelvic bones, often felt in the front pubic area, lower back, or hips.
Avoid sustained deep stretches
Modify with shorter stretch duration
Stability belt such as Serola belt or Baby Belly Band
When Stretching Isn't The Answer and What To Do Instead
If your pain is coming from instability or movements that are no longer effective for your changing body stretching is not going to resolve the pain.
Pelvic Floor Therapy can help assess the cause and mechanism of the pain you are dealing with. At Bloom Pelvic Therapy we address the root case to get you comfortable and enjoying the entire pregnancy.
If stretching is not effective you may benefit from pelvic therapy to address:
Improve pelvic stability through gluteal activation, engaging the deep core appropriately, and strengthening the lower extremities
Manual therapy or soft tissue work to the pelvic floor, and surrounding muscles to decrease tension holding patterns, decrease any tender spots, and support overall muscle relaxation in preparation for labor and delivery
External Supports such as a SI belt, pregnancy support belt, or kinesio taping to provide external support essential often increases comfort, especially in the later stages of the third trimester
Addressing and changing habits such as rolling in bed, moving from sitting to standing, getting in and out of the car, putting on leggings or socks, climbing stairs, or lifting babies makes a world of difference in managing pain and can help immediately.
Signs it’s time to see a Pelvic Floor Therapist:
Pain that increases with walking, stairs, rolling in bed, or standing on uneven surfaces
Clicking sound or sharp pain in pubic bone
Pain moving into the gluts or inner thigh
Feeling like your pelvis is wobby
Sitting or standing is uncomfortable for any duration of time
Pressure, heaviness, bulging in perineum or vagina
Tailbone or low back pain that is not improving
Inability to relax pelvic floor or tense muscles
Discomfort in pregnancy is common- but does not need to be your experience. The right stretches paired with stabilizing exercises will help you feel comfortable and supported in the 3rd trimester into birth.