Round Ligament Pain During Pregnancy

Round ligament pain is one of the most common causes of abdominal and pelvic pain during pregnancy. It often feels like a sharp, pulling, or aching pain in the lower abdomen or groin and is usually triggered by sudden movements such as standing up, rolling over in bed, coughing, sneezing, or walking.

Although round ligament pain is considered a normal part of pregnancy, it should not prevent you from enjoying your pregnancy or staying active. Pelvic floor physical therapy can help reduce discomfort by improving the way your muscles support your growing baby, reducing strain on the ligaments, and teaching movement strategies that make everyday activities more comfortable.

At Evolve Physical Therapy in Holly Springs, we specialize in helping pregnant women stay active, comfortable, and confident throughout pregnancy.

What Is Round Ligament Pain?

The round ligaments are two strong bands of connective tissue that help support your uterus. As your baby grows, these ligaments stretch to accommodate your expanding uterus.

During pregnancy, hormonal changes—particularly increased relaxin—allow these ligaments to become more flexible. Combined with your growing baby and changing posture, this increased flexibility can cause the ligaments to become irritated or strained, resulting in pain.

Round ligament pain most commonly begins during the second trimester, although some women notice symptoms earlier or later in pregnancy.

What Does Round Ligament Pain Feel Like?

Every woman experiences pregnancy differently, but common symptoms include:

• Sharp pain in the lower abdomen
• Pulling sensation in the groin
• Pain on one or both sides of the pelvis
• Discomfort when rolling over in bed
• Pain when standing up quickly
• Pain after coughing or sneezing
• Aching after long walks
• Pain while changing positions
• Temporary pain during exercise
• Mild soreness after a busy day

Many women notice that the pain comes on suddenly, lasts only a few seconds, and then resolves. Others experience a dull ache that lingers throughout the day.

What Causes Round Ligament Pain?

Several factors contribute to round ligament pain during pregnancy.

Your Growing Uterus

As your baby grows, your uterus becomes significantly heavier. This places increasing tension on the ligaments that support it.

Hormonal Changes

Pregnancy hormones cause ligaments throughout your body to become more flexible. While this flexibility is important for childbirth, it also decreases stability around the pelvis.

Changes in Posture

As your center of gravity shifts forward, your back, hips, abdominal muscles, and pelvic floor must work harder to support your body.

Muscle Weakness

Weakness or poor coordination of the deep abdominal muscles, glutes, hips, and pelvic floor can increase stress on the ligaments.

Sudden Movements

Quick movements often stretch the ligaments before the surrounding muscles have time to stabilize your pelvis.

Is Round Ligament Pain Normal?

Yes.

Round ligament pain is extremely common and usually does not indicate a problem with your pregnancy.

However, "common" does not mean you have to simply live with it.

Many women find that physical therapy significantly reduces their symptoms and allows them to continue exercising, sleeping, working, and caring for their families more comfortably.

When Should You Call Your OB Provider?

Although round ligament pain is generally harmless, you should contact your healthcare provider immediately if you experience:

• Vaginal bleeding
• Fever or chills
• Severe abdominal pain that does not improve
• Pain accompanied by contractions
• Leaking fluid
• Decreased fetal movement (when appropriate for your stage of pregnancy)
• Burning with urination
• Persistent pain that continues to worsen

These symptoms may indicate another medical condition that requires prompt evaluation.

Can Pelvic Floor Physical Therapy Help Round Ligament Pain?

Absolutely.

Physical therapy cannot stop your ligaments from stretching—which is a normal part of pregnancy—but it can dramatically reduce the stress placed on them.

Rather than focusing only on the painful area, we evaluate how your entire body moves.

Many women develop movement compensations during pregnancy without realizing it. Improving how your hips, pelvis, abdominal muscles, breathing mechanics, and pelvic floor work together often decreases the strain placed on the round ligaments.

Treatment is individualized based on your symptoms and stage of pregnancy.

How Physical Therapy Helps

At Evolve Physical Therapy, your treatment plan may include:

Manual Therapy

Gentle hands-on techniques can reduce muscle tension and improve mobility around the pelvis, hips, abdomen, and lower back.

Pelvic Stability Exercises

Targeted exercises improve the muscles responsible for supporting your pelvis during daily movement.

Core Coordination

Rather than performing aggressive abdominal exercises, we teach your deep core muscles how to support your body safely throughout pregnancy.

Breathing Strategies

Your diaphragm, abdominal muscles, and pelvic floor work together. Optimizing your breathing often decreases pressure through the pelvis.

Movement Education

Small adjustments to everyday activities can make a big difference.

We teach strategies for:

• Getting out of bed
• Rolling over comfortably
• Standing up with less pain
• Lifting toddlers safely
• Walking longer distances
• Climbing stairs
• Exercising during pregnancy

Can You Exercise With Round Ligament Pain?

In most cases, yes.

Remaining active during pregnancy is beneficial for both mother and baby.

However, pain is your body's way of asking for modification.

A physical therapist can help determine:

• Which exercises are appropriate
• Which movements should be modified
• How to continue strength training safely
• How to stay active without increasing symptoms

Our goal is to help you keep doing the activities you enjoy whenever possible.

Will a Belly Band Help?

A pregnancy support belt or belly band may reduce symptoms for some women by decreasing strain on the ligaments and improving pelvic support during walking or exercise.

However, a support belt should not replace strengthening, movement training, and individualized treatment.

Many women achieve the best results by combining physical therapy with temporary external support when appropriate.

What Happens During Your First Visit?

Your first appointment is a full one-on-one evaluation with a Doctor of Physical Therapy.

We'll discuss:

• Your pregnancy history
• Your symptoms
• Activities that increase your pain
• Exercise goals
• Previous pregnancies (if applicable)

We'll then evaluate:

• Posture
• Walking mechanics
• Hip mobility
• Pelvic stability
• Core coordination
• Breathing mechanics
• Functional movements such as squatting, lifting, and getting out of bed

Based on your evaluation, you'll receive a personalized treatment plan along with exercises and practical strategies you can begin using immediately.

Frequently Asked Questions

Does round ligament pain hurt the baby?

No. Round ligament pain affects the tissues supporting the uterus and does not harm your baby.

Can round ligament pain happen on both sides?

Yes. Some women feel pain on only one side, while others experience symptoms on both sides depending on movement and baby position.

Is walking good for round ligament pain?

Walking is generally safe, but if it consistently increases your symptoms, your walking mechanics, footwear, or pelvic stability may need to be addressed.

Can physical therapy completely eliminate round ligament pain?

Every pregnancy is different. While we cannot stop the natural stretching of the ligaments, many women experience significant improvements in comfort, mobility, and daily function with physical therapy.

When does round ligament pain go away?

For most women, symptoms improve after delivery as the uterus returns to its normal size and the ligaments gradually recover.

Why Choose Evolve Physical Therapy?

At Evolve Physical Therapy, pregnancy care isn't just one service we offer—it's one of our specialties.

Every visit is a private, one-on-one session with a Doctor of Physical Therapy who understands the unique changes that occur throughout pregnancy. We combine evidence-informed treatment with personalized care to help you stay active, reduce pain, and prepare confidently for birth and postpartum recovery.

Whether you're hoping to continue lifting weights, keep running, enjoy walks with your family, or simply roll over in bed without pain, we're here to help you move through pregnancy with greater comfort and confidence.

Schedule Your Pregnancy Physical Therapy Evaluation

You don't have to accept pain as "just part of being pregnant."

If round ligament pain is interfering with your sleep, exercise, work, or daily life, our team is here to help.

Evolve Physical Therapy proudly serves patients from Holly Springs, Fuquay-Varina, Apex, Cary, Raleigh, and the surrounding Wake County communities. Contact us today to schedule your one-on-one pregnancy physical therapy evaluation and take the first step toward a more comfortable pregnancy.