If you are or have been pregnant, you probably have felt “round ligament pain”.

A sharp sensation in your groin, when you move positions or sneeze. And you’ve likely been told this is normal. However, more current literature is pointing out that this actually may be more an indication that your round ligament is restricted, or tight.

Before we expand on this further, lets first discuss the anatomy of the round ligament.

The Round Ligament starts towards the top and side of the uterus, and travels down through our deep inguinal ring, through the transverse inguinal ring, into the labia majora, and then finally terminating into the mons pubis. As well, there is the round ligament artery called: The Sampson Artery. This artery arises from where the ovarian and uterine artery come together.

This is wild — the ligament around our uterus literally turns into the muscles around the opening of our vagina! And as well, a lot of anatomist are starting to argue that the Round Ligament is more of a muscle, than a ligament. Because it starts off having ligamentous fibers, but half way through turns into involuntary muscle. This has huge implications on how it expands, grows, and functions to support pregnancy and the postpartum recovery.

Now lets start addressing some of the issues that can be associated with a “tight” round ligament —

Fertility Issues — There are multiple reasons that tightness through this ligament contribute to someone’s fertility. If there are restrictions around the Sampson Artery, then that will limit the blood supply to our ovaries and fallopian tube. This will make it be able to contract less fully to help push the egg towards the sperm, and vise versa: decreased assistance in letting the sperm travel towards the egg.
Vulvar varicosities — This ligament can be highly vascularized and physically turns into the muscles that are around the opening of the vagina. If there are restrictions/tightness throughout the ligament, this can reflect itself with blood supply being trapped in the vulvar area. This can look and feel like varicose veins. Therefore, manual treatment of the round ligament can greatly improve these symptoms, and help the pregnant person people able to stand and move more throughout the day.
Endometriosis — There are more and more studies indicating that up to 30% of women with endometriosis will have lesions into the round ligament. That will certainly contribute to pelvic pain, pain during menstruation, and fertility issues. Knowing this, treating this ligament should be considered a primary treatment approach for these individuals.
Breech or Transverse Fetal Position — If the ligament is too tight and pulling the uterus closer to the pelvis (down). It is harder for the baby to get its head to face this direction. We have worked with countless of women to help “flip” babies, and it entails creating space in the bottom of the uterus. This is done by mobilizing the round ligament, and it can work wonders!

These are only some of the major issues that we see related to restrictions in the round ligament, but as you can see, it can really make a difference in an individual’s quality of life.

If you suspect that you are suffering from round ligament pain or restrictions, a simple exercise you can try is a gentle inversion daily. If this is comfortable on your body, you hold this pose for 30 seconds. If this feels too extreme, you can do it off of a 6 inch step or come into a basic child’s pose. This will help relax the round ligaments, and allow gravity decrease tension on the uterus.

We hope that this was an enlightening blog post for you, and if you want more instruction or think you could benefit from manual therapy to address your round ligament involvement, please reach out to Method Physical Therapy today.