Pelvic girdle pain (PGP) and symphysis pubis dysfunction (SPD) are conditions of the pelvic ring joints -- the sacroiliac joints and the symphysis pubis -- that become hypermobile and painful due to the hormonal changes of pregnancy (relaxin causing ligamentous laxity). While covered separately in the pregnancy article, PGP and SPD are common enough and distinct enough in their walking mechanics to warrant a focused discussion.
How PGP and SPD Limit Walking
The pelvis forms a ring: the two sacroiliac joints posteriorly and the symphysis pubis anteriorly. In PGP/SPD, increased laxity at these joints produces abnormal motion during the single-leg stance phase of walking (when body weight is entirely on one leg). The result:
- Symphysis pain: Sharp, stabbing groin and pubic pain during weight transfer from one leg to the other -- worst when stepping up (stairs), getting out of a car, or walking on uneven surfaces
- Sacroiliac pain: Posterior pelvic pain, often one-sided, that worsens with prolonged walking and single-leg activities
- Waddle gait: Women with severe PGP develop a wide-based, lateral trunk-swaying gait that reduces single-leg stance time, reducing the peak load on the hypermobile joints
Cane Use in Pelvic Girdle Pain
A cane in PGP is held ipsilateral or contralateral depending on the dominant pain location:
- For predominantly unilateral sacroiliac pain: cane contralateral to the painful SI joint reduces the loading asymmetry during single-leg stance
- For symphysis pubis pain (central): either hand may be used; the primary effect is reducing overall single-leg stance loading by sharing load through the upper limb
The key mechanism: during single-leg stance on the right leg (left leg swing phase), the right hip abductors must produce a moment equal to body weight times the distance from the hip to the midline. A cane on the left reduces this abductor demand -- and the corresponding pelvic joint loading -- during right single-leg stance.
Postpartum PGP
In most women, PGP resolves within weeks to months of delivery as relaxin levels normalise and ligamentous stiffness returns. A cane used during PGP is therefore typically a short-term aid. If PGP persists beyond 3-6 months postpartum, specialist pelvic physiotherapy and further assessment are warranted.
PGP and Cane Strategy
| PGP Location | Cane Side | Benefit Mechanism |
|---|---|---|
| Unilateral sacroiliac pain (right) | Contralateral (left hand) | Reduces right hip abductor demand and right pelvic joint loading |
| Symphysis pubis pain (central) | Either hand; dominant side preferred | Reduces single-leg stance loading overall |
| Bilateral sacroiliac pain | Two canes or forearm crutches | Bilateral load sharing; reduces peak pelvic ring loading |
Related: Walking Cane During Pregnancy. Explore DaiWalk walking canes.
