Executive Summary

Introduction

The Pregnancy-Related Pelvic Girdle Pain (PrPGP) Masterclass, taught by Dr Angela James and Elise Fraser provides a complete overview of PrPGP. This executive summary provides clinically relevant, actionable information that may be useful to health professionals.

Part 1 - Myth Busting & Tips

PrPGP affects 44% of Australian women and is influenced by both physical and psychosocial factors. The pelvis remains stable during pregnancy, and postural changes are normal. Pain isn’t caused by alignment or detected through specific joint tests. Belts and manual therapy alone aren’t enough, self-management is key. Effective care focuses on reducing fear, encouraging movement, and supporting function over symmetry.

Use pain education to challenge fear-based beliefs and encourage active self-management.
Emphasise functional goals over achieving perfect pelvic symmetry.
Reassure patients that posture changes are normal and not harmful.
Modify positioning using simple tools (e.g a wedge) rather than relying on specialised equipment.

Part 2 - Physical Assessment of the Pregnant Pelvis

Effective assessment of PrPGP begins with a detailed history, including pain behaviour, functional impact, beliefs, sleep, stress, and potential red flags. Screen for disordered eating, especially in athletic populations. Observe movement and posture, assess functional tasks, and use provocation tests in clusters for SIJ pain. Respect privacy when palpating sensitive areas, and always test within the patient’s tolerance. Build strong referral networks for pelvic floor or medical concerns.

Use function-based assessments such as sit-to-stand and single-leg tasks
Screen for RED-S and disordered eating where appropriate.
Use pain provocation tests as a cluster rather than in isolation.
Refer on when symptoms are atypical, unchanging, or beyond your scope

Masterclass Preview

Enjoy this free preview of Angela & Elise breaking down some common myths.

Part 3 - Interpreting Assessment Findings

Pain in pregnancy often stems from a combination of contributing factors. Understanding the concepts of form and force closure helps interpret aggravating factors. Reduced form closure relates to pain in weight-bearing or stretching positions, while increased force closure is often aggravated by bracing or stabilisation tasks. Use assessment findings to guide treatment and embed education into the patient’s personal experience. This approach makes your explanations more meaningful and can support better engagement in care.

Link aggravating factors to either form or force closure issues.
Avoid prescribing more stabilisation exercises for increased force closure

Part 4 - Treatment of PrPGP

Treatment for PrPGP should combine evidence, clinical judgement, and patient expectations. Exercise therapy and physical activity are distinct and should be tailored to the individual. SIJ belts may help with reduced force closure, while relaxation and manual therapy may ease increased force closure. Taping can be useful, but comfort and patient language are key. Sleep screening is essential, as poor sleep can amplify pain. Education and reassurance support confidence and function.