Have you been diagnosed with round ligament pain and are unsure what to do?
Well I have good news for you!
In this post you are going to learn:
- What the round ligament is and where its located,
- What round ligament stretching is, and
- What to do if you have pain.
Let’s get started.
Although I am a doctor, I am not your doctor. This information is for informational purposes only and should not substitute the advice from your healthcare professional. All kinds of exercise and dietary changes are potentially dangerous, and those who do not seek counsel from the appropriate health care authority assume the liability of any injury which may occur. Please read my full Disclaimer for more information. Also, this post may contain affiliate links: meaning I may receive a commission if you use them.
Ok, moving on.
What is the Round Ligament?
The round ligaments are two cord-like structures that attach the left and ride side of the uterus to the labia majora.
They aren’t “ligaments” per se, rather they are fibro-muscular connective tissues.
They are called the round ligaments because they create a circular shape from your uterus down to the pelvis.
Where Is The Location of The Round Ligament?
The round ligaments are located on both sides of the uterus in front of and below the fallopian tube.
These ligaments help to keep the uterus in the pelvis along with other supporting ligaments like the uterosacral ligament.
From the uterus, the round ligaments travel down the inguinal ring alongside the inguinal canal and attach it to the labia majora.
What causes round ligament pain?
Round ligament pain / stretching occurs when the round ligaments are placed on tension by your growing uterus.
A normal uterus is about 3-4 inches in length, and about 2.5 inches wide.
When you become pregnant, your uterus has to grow to the size of a grapefruit, and ultimately a watermelon to accommodate your growing baby.
As you could imagine, all the structures holding the uterus in place are stretching and also accommodating the increase in size.
When does round ligament pain start?
Round ligament pain will often start as pain during pregnancy in the second trimester as this is when the uterus begins to grow at a much faster rate.
At this point, your uterus no longer fits in the pelvis and is starting to expand upwards.
It is not typical to feel round ligament pain in the first trimester as the uterus is still quite small, so if you are experiencing significant hip and/or groin pain please speak with your OBGYN.
What does round ligament stretching feel like?
Round ligament pain or stretching typically feels like a sharp, stabbing, pulling pain that is worse with any sort of sudden movements or vigorous physical activity.
Resting usually makes the pain better.
Can round ligament pain be a constant dull ache?
Yes, some women describe round ligament pain as a constant dull ache in their pelvis.
With that said, round ligament pain is a diagnosis of exclusion. This means that if I cannot find another source of your pelvic pain in the second trimester, then your pelvic pain is likely caused by round ligament stretching.
Where do you feel round ligament pain?
Sometimes you may feel pain in your right and / or your left hip and it can radiate down to the groin region.
The pain can also radiate higher up towards your mid back.
Can round ligament pain last all day?
The pain caused by stretching of the round ligament is usually a brief, waxing, and waning pain that gets worse with certain movements.
However, in some circumstances it can feel like a constant dull pain.
This is especially true if you are active throughout the day.
How painful can round ligament pain be?
Round ligament pain can be quite painful. Everyone is unique and will experience round ligament pain differently.
Some women won’t experience any pain. Others might call it 10/10 intense pain.
If yours is very painful – you are not alone!
Often times, women come to labor and delivery for a triage evaluation because of it.
The good news is, we are able to rule out preterm labor (which is the worst case scenario.)
Is Round ligament pain a good sign?
Round ligament pain is not necessarily a good or bad sign.
It simply means that these ligaments are stretching due to the growing uterus. As I mentioned above, not every woman will experience round ligament stretching to the same degree.
That’s the beauty of life :).
Does Round ligament pain mean the baby is growing?
Yes, round ligament pain occurs as your uterus grows. Your uterus is growing because your baby is growing :).
One cool tip
What Can I Do For round ligament pain relief?
The good news is, round ligament pain is usually mild and self-limited.
This means that no treatment is necessary for the vast majority of the time.
With that said, there are a few things you can do to try and get pain relief. These include:
Stay well hydrated
Hydration is always something that can benefit most pregnancy related pains and discomfort.
I can’t stress this enough.
Staying well hydrated will improve your body’s circulation, which can help bring oxygen and nutrients to your tissues while removing waste products.
If your urine is a dark yellow – you must drink more water!
Another way to try and increase blood flow around your body is to perform some gentle stretches.
By getting into these positions, you are contracting and activating certain muscle groups, while relaxing others,
With that said, don’t overdo it. Always listen to your body and don’t stretch too far or into painful positions.
Here are some you can try.
This stretch targets the obliques and the latissimus dorsi muscle.
Hip flexor stretch
This stretch targets the anterior thigh and hip compartments.
This stretch targets the inner thighs and the hip joints.
Kneeling adductor stretch
This stretch targets the inner thighs.
Hip 90/90 stretches
This stretch targets the outer thighs and the posterior hips.
Try using a support belt
The next thing you can try to do is use a maternity belt.
These belts can help support the weight of your gravid uterus and ease some of the pressure off your hips and low back.
But make sure you experiment and see if it works for you.
If anything, a maternity support belt can make walking more comfortable.
This affordable maternity belt is “Amazon’s choice” and has a lot of good reviews.
Avoid excessive anterior tilt
The last thing you can do is avoid excessive anterior pelvic tilting during your pregnancy.
This is a lower-body postural misalignment that happens when your pelvis rolls forward due to muscle tightness and restrictions.
In this situation, the change in your pelvis could theoretically change the position of your uterus, potentially aggravating the round ligaments further.
In general, anterior pelvic tilt occurs when your abdominal muscles weaken while your lower back muscles and hip flexors get tight.
Medicate as needed
The very last thing you can try is a low dose over the counter analgesic like acetaminophen (tylenol).
You can take 2 tablets (650 mg) every 6 hours as needed to take the edge off, or 100 mg (the extra strength tablet) every 8 hours.
Do not take any non-steroidal anti-inflammatory medications such as Ibuprofen throughout your pregnancy.
Other Related Questions
Why is round ligament pain on the right side?
Round ligament pain is often seen on the right side, however, we do not know for certain why it affects this side more than the left.
With that said, some women will experience the pain on both sides.
When should I be worried about round ligament pain?
You should be worried about round ligament pain if:
- the pain is severe and does not improve with rest
- the pain does not get better as your pregnancy progresses and continues into the 3rd trimester
The good news is- both of these situations are rare.
If your pain is definitely caused by round ligament stretching, then it should be mild and improve with rest and time.
Is walking good for round ligament pain?
Walking can be good for round ligament pain, but it can also exacerbate the pain.
Everyone is unique and you will have to experiment with what works best for you. You might be able to walk for a certain amount of time before the pain starts to kick in.
Never continue doing an activity that worsens any pregnancy related pain.
I talk a lot more about Walking During Pregnancy here.
Is round ligament pain worse at night?
If you have spent the entire day walking around or engaging in activity, you may experience worsened pain at night time.
That’s because round ligament pain is thought to be purely a musculoskeletal irritation.
As such, these pains get worse with excessive movement, and improve with rest.
Final Words On Round Ligament Pain
Round ligament pain is a common condition that affects many women in the second trimester.
While it can be annoying, it isn’t dangerous.
Just be sure to speak with your healthcare provider to make sure your pain isn’t related to some other cause.
Now I want to hear from you.
What have you tried to get pain relief from round ligament stretching?
Comment below and let me know!
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Brittany N Robles, MD, MPH, CPT
Brittany N Robles is a full-time OBGYN, a NASM certified personal trainer, and health & fitness expert. She holds a Masters of Public Health degree in maternal health with a special interest in exercise and nutrition. She is also the co-author of The White Coat Trainer. Learn more about her here.
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