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What is meant by postpartum hip problems?
Postpartum hip problems refer to pain or stiffness in the hip, back, or lower back that arises during pregnancy or within the first months after childbirth. It may involve weakened muscles, hypermobility, or inflammation in structures around the hip and pelvis.
How the hip is affected during pregnancy and after childbirth
Hormonal changes
During pregnancy, the body releases the hormone relaxin, which is necessary to make the pelvic joints and soft tissues more flexible in preparation for childbirth. In some cases, however, this can cause instability that persists postpartum.
Changes in posture and load
As pregnancy progresses, the body’s balance shifts and certain body parts must compensate to support the growing belly. The hip and gluteal muscles must work differently for several months, which can lead to overuse.
Muscle weakness after pregnancy
The muscles of the core, glutes, and pelvic floor weaken during pregnancy and may struggle to regain full function. This reduces hip stability, which can persist if the musculature remains weak postpartum.
Hip problems after a cesarean section
What is less known is that some hip issues can also arise after a C-section. This is often due to compensatory movements in the hip that cause pain, for example due to:
- scar tissue and muscle involvement around the incision area
- altered movement patterns after surgery to protect the incision
- delayed activation of abdominal muscles and deep stabilizers
Common causes of hip pain after pregnancy and childbirth
Pelvic joint dysfunction (SI joint problems)
The sacroiliac joint (SI joint) can become hypermobile or overloaded, causing pain in the hip, glutes, and lower back.
Inflammation in tendon attachments (trochanteric bursitis)
The tendons on the outside of the hip may become irritated, causing tenderness when pressed and pain when walking or lying on the side.
Entrapment in the gluteal muscles
The gluteal muscles help support hip rotation and stability. Tight or overactive muscles can compress nerve structures and cause radiating pain in the hip and gluteal area.
Muscle strength imbalance
It is common to have weak gluteal muscles and tight hip flexors, which can force the hip into an incorrect movement pattern.
Scar tissue and effects after a C-section
After a C-section, tension around the incision may affect how the body stabilizes the hip. This can lead to increased load on one side and cause pain.
Symptoms of postpartum hip problems
- Pain on the outside or front of the hip
- Pain in the glutes or lower back
- Stiffness, especially after rest
- Pain when climbing stairs or carrying heavy items
- Increased fatigue or weakness in the hip
- Pain radiating down the leg
When should you seek medical care?
You should contact healthcare if:
- the pain does not decrease or disappear within a few weeks
- you have difficulty walking or putting weight on the hip
- the pain interferes with daily activities or caring for your baby
- you experience numbness, leg weakness, or worsening pain
- you develop fever, redness, or marked local tenderness
Examinations and diagnosis
A doctor or physiotherapist can perform a clinical examination, assessing posture, pain intensity, muscle strength, and movement. When the pain is long-lasting or difficult to localize, a MRI scan of the hip joint and pelvis can be helpful. MRI can reveal inflammation in tendon attachments, signs of overuse in muscles and bones, as well as possible impingements or irritations in the hip’s soft tissues or the SI joint.
Treatment and self-care
Hip problems are often treated with physiotherapy, but manual techniques and pain-relieving medications may also be part of the treatment plan. Physiotherapists commonly create a structured plan with strengthening and mobility exercises focusing on the gluteal muscles, hip flexors, core muscles, and the hip’s deep stabilizers.
Can I prevent postpartum hip problems?
Stabilizing exercises
It is possible to prevent hip problems by training stability early and gradually strengthening the glutes and core. It is important to tailor exercises to your delivery type and focus equally on balance, mobility, and strength.
Load management and ergonomics
Being mindful of relieving the hip helps reduce the risk of uneven loading. Vary baby-carrying positions, avoid standing with weight on one hip for long periods, and use support while breastfeeding to help maintain good posture.