What Is Round Ligament Pain

Are you experiencing sharp pain in your lower abdomen or genital area during your pregnancy journey? If so, you might be having the mysterious discomfort known as round ligament pain.

Unravel the secrets behind this common yet unique experience with confidence.

Read on to learn about how it causes pain during pregnancy and ways to cope with round ligament pain (RLP).

What is a round ligament?

The round ligament is a round band of rope consisting of fibro-muscular connective tissue, smooth muscle fibres, etc. that connects muscles, bones and organs. It is one of the true ligaments that supports and keeps your uterus stable, preventing excessive movement of the uterus when you move around. Round ligament pain is commonly experienced during pregnancy in the second trimester or the end of the first trimester.

Anatomy and location of the round ligament

There are two ends of the round ligaments on each side of the uterus. One end is connected to the cornua of the uterus. It travels across the pelvis and passes through the deep inguinal ring. It traverses through a canal and ends up in the labia majora (outer genital area).

The size of the round ligament is about 10 to 12 cm long covered by a folded peritoneum and contains the upper margin of the broad ligaments on either side of the uterus, fanning out to the pelvic fan wall.¹

Additionally, the round ligaments guide and maintain the position of the uterus within the pelvis which is important to ensure the proper alignment of the birth canal during childbirth and contribute to the overall protection of the developing fetus.

Round ligament pain is a discomfort a woman feels in her groin area or lower abdominal area during pregnancy.

Causes of round ligament pain

Rapid uterine growth - During pregnancy, the uterus stretches to accommodate the developing foetus. As a result of this, there is a sudden, sharp pain called round ligament pain (RLP) felt in the groin area.²

Sudden movements like coughing, or changing positions can trigger it. The pain might increase because of elevated pressure on the ligaments as the uterus grows and becomes heavier.

Hormonal changes - Hormonal changes during pregnancy can contribute to round ligament pain. Hormones like relaxin and oestrogen are released during pregnancy which causes the ligaments in the pelvic area to relax.³ This increased flexibility of the uterus can also lead to stretching and pulling of the round ligament.

While this type of pain is considered normal, it is essential to be aware of persistent or severe discomfort and consult a healthcare provider if required.

Physical activity - Sudden activities like coughing or sneezing, and changing positions can aggravate round ligament pain.

Symptoms of round ligament pain

Sharp, stabbing pain in the groin or lower abdominal area. The pain might radiate upward or downward.

Increases with physical activities such as prolonged standing, walking, rolling over bed, laughing, sneezing, etc.

Diagnosis and when to seek medical attention

Diagnosis can be made from the symptoms and there are no specific tests for round ligament pain during pregnancy. RLP is temporary and resolves on its own.

Warning signs to watch for:

• Excessive pain followed by pain while performing daily chores
• Vaginal bleeding during urination
• Fever and malaise
• Pain in the groin or the pelvic area is not always a round ligament pain. It could be due to many factors like hernia, kidney disease, etc.
• Round ligament stretch or hematoma is a result of the uterus rising in the abdomen

Coping and preventing round ligament pain

• Rest along with limiting physical activities can help alleviate the pain
• Stretching can help during round ligament pain. Gently place your hands and knees on the floor and lower your head towards the floor keeping your bottom in mid-air⁴
• Contracting your core muscles during coughing or sneezing helps reduce the intensity of the pain
• Avoid ballistic exercises and Stress Reduction
• Warm compression
• Lying with knees bent and keeping a pillow under your knees
• You can wear a maternal belt. But if it increases your symptoms, it is advised to consult your gynae
• Maintaining a correct posture and strengthening your core muscles is extremely important during pregnancy. Consulting a physiotherapist for further evaluation and guidance is recommended
• Staying hydrated and maintaining a healthy diet plate can alleviate your pain and help you for a smooth childbirth

Summary

In conclusion, round ligament pain is common during pregnancy and resolves on its own. It is certainly an uncomfortable experience that many women encounter during pregnancy. This discomfort results from the rapid growth of the uterus and the changes in the hormonal level of relaxin and estrogen which soften and stretch the round ligaments.

Round ligament pain is normal but it is not mandatory that every people assigned female at birth will feel the pain. RLP can vary in intensity and may be triggered by sudden movements or quick changes in position.

This type of pain can be a concerning issue sometimes, so it is important to consult a healthcare professional and keep health parameters within normal limits.

Round ligament pain can be managed through stretching, maintaining good posture, and finding positions that alleviate discomfort.

Bhashwati Deb Barma

Bachelor of Physiotherapy,M.S., Ramaiah Medical College, India

Bhashwati is a Physiotherapist with a firm grasp of Paediatric physiotherapy and is currently working with special children in the community.

She has 6 years of experience working in hospitals and non-profit organizations set up. As a writer by passion, she is putting up her practical and academic knowledge into her articles.

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